Artificially Generated Visual Scanpath Improves Multi-label Thoracic Disease Classification in Chest X-Ray Images

Abstract: Expert radiologists visually scan Chest X-Ray (CXR) images, sequentially fixating on anatomical structures to perform disease diagnosis. An automatic multi-label classifier of diseases in CXR images can benefit by incorporating aspects of the radiologists' approach. Recorded visual scanpaths of radiologists on CXR images can be used for the said purpose. But, such scanpaths are not available for most CXR images, which creates a gap even for modern deep learning based classifiers. This paper proposes to mitigate this gap by generating effective artificial visual scanpaths using a visual scanpath prediction model for CXR images. Further, a multi-class multi-label classifier framework is proposed that uses a generated scanpath and visual image features to classify diseases in CXR images. While the scanpath predictor is based on a recurrent neural network, the multi-label classifier involves a novel iterative sequential model with an attention module. We show that our scanpath predictor generates human-like visual scanpaths. We also demonstrate that the use of artificial visual scanpaths improves multi-class multi-label disease classification results on CXR images. The above observations are made from experiments involving around 0.2 million CXR images from 2 widely-used datasets considering the multi-label classification of 14 pathological findings. Code link: https://github.com/ashishverma03/SDC