Novel loss functions for ensemble-based medical image classification

PLoS One. 2021 Dec 30;16(12):e0261307. doi: 10.1371/journal.pone.0261307. eCollection 2021.

Abstract

Medical images commonly exhibit multiple abnormalities. Predicting them requires multi-class classifiers whose training and desired reliable performance can be affected by a combination of factors, such as, dataset size, data source, distribution, and the loss function used to train deep neural networks. Currently, the cross-entropy loss remains the de-facto loss function for training deep learning classifiers. This loss function, however, asserts equal learning from all classes, leading to a bias toward the majority class. Although the choice of the loss function impacts model performance, to the best of our knowledge, we observed that no literature exists that performs a comprehensive analysis and selection of an appropriate loss function toward the classification task under study. In this work, we benchmark various state-of-the-art loss functions, critically analyze model performance, and propose improved loss functions for a multi-class classification task. We select a pediatric chest X-ray (CXR) dataset that includes images with no abnormality (normal), and those exhibiting manifestations consistent with bacterial and viral pneumonia. We construct prediction-level and model-level ensembles to improve classification performance. Our results show that compared to the individual models and the state-of-the-art literature, the weighted averaging of the predictions for top-3 and top-5 model-level ensembles delivered significantly superior classification performance (p < 0.05) in terms of MCC (0.9068, 95% confidence interval (0.8839, 0.9297)) metric. Finally, we performed localization studies to interpret model behavior and confirm that the individual models and ensembles learned task-specific features and highlighted disease-specific regions of interest. The code is available at https://github.com/sivaramakrishnan-rajaraman/multiloss_ensemble_models.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Algorithms*
  • Area Under Curve
  • Diagnostic Imaging*
  • Entropy
  • Humans
  • Image Processing, Computer-Assisted / classification*
  • Lung / diagnostic imaging
  • ROC Curve
  • Thorax / diagnostic imaging
  • X-Rays

Grants and funding

This study is supported by the Intramural Research Program (IRP) of the National Library of Medicine (NLM) and the National Institutes of Health (NIH). The funder provided support in the form of salaries for authors SR, GZ, and SA, but did not have any additional role in the study design, data collection, and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.