Automated identification of thoracic pathology from chest radiographs with enhanced training pipeline

Chest x-rays are the most common radiology studies for diagnosing lung and heart disease. Hence, a system for automated pre-reporting of pathologic findings on chest x-rays would greatly enhance radiologists’ productivity. To this end, we investigate a deep-learning framework with novel training schemes for classification of different thoracic pathology labels from chest x-rays. We use the currently largest publicly available annotated dataset ChestX-ray14 of 112,120 chest radiographs of 30,805 patients. Each image was annotated with either a 'NoFinding' class, or one or more of 14 thoracic pathology labels. Subjects can have multiple pathologies, resulting in a multi-class, multi-label problem. We encoded labels as binary vectors using k-hot encoding. We study the ResNet34 architecture, pre-trained on ImageNet, where two key modifications were incorporated into the training framework: (1) Stochastic gradient descent with momentum and with restarts using cosine annealing, (2) Variable image sizes for fine-tuning to prevent overfitting. Additionally, we use a heuristic algorithm to select a good learning rate. Learning with restarts was used to avoid local minima. Area Under receiver operating characteristics Curve (AUC) was used to quantitatively evaluate diagnostic quality. Our results are comparable to, or outperform the best results of current state-of-the-art methods with AUCs as follows: Atelectasis:0.81, Cardiomegaly:0.91, Consolidation:0.81, Edema:0.92, Effusion:0.89, Emphysema: 0.92, Fibrosis:0.81, Hernia:0.84, Infiltration:0.73, Mass:0.85, Nodule:0.76, Pleural Thickening:0.81, Pneumonia:0.77, Pneumothorax:0.89 and NoFinding:0.79. Our results suggest that, in addition to using sophisticated network architectures, a good learning rate, scheduler and a robust optimizer can boost performance.