# Knowledge Distillation with Adaptive Asymmetric Label Sharpening for Semi-supervised Fracture Detection in Chest X-rays

arXiv: https://arxiv.org/abs/2012.15359 · HTML: https://mlsanity.com/paper/2012.15359/

## Key facts

- Cited by 9 papers in the map (data through 14 Oct 2026).
- First posted on arXiv 30 Dec 2020.

## Built on by (most cited first, 9 of 9)

- [Lesion Segmentation and RECIST Diameter Prediction via Click-driven Attention and Dual-path Connection](https://mlsanity.com/paper/2105.01828/) (2021)
- [Radiomics-Guided Global-Local Transformer for Weakly Supervised Pathology Localization in Chest X-Rays](https://mlsanity.com/paper/2207.04394/) (2022)
- [OXnet: Omni-supervised Thoracic Disease Detection from Chest X-rays](https://mlsanity.com/paper/2104.03218/) (2021)
- [ORF-Net: Deep Omni-supervised Rib Fracture Detection from Chest CT Scans](https://mlsanity.com/paper/2207.01842/) (2022)
- [Scalable Semi-supervised Landmark Localization for X-ray Images using Few-shot Deep Adaptive Graph](https://mlsanity.com/paper/2104.14629/) (2021)
- [Knowledge Distillation approach towards Melanoma Detection](https://mlsanity.com/paper/2210.08086/) (2022)
- [Hetero-Modal Learning and Expansive Consistency Constraints for Semi-Supervised Detection from Multi-Sequence Data](https://mlsanity.com/paper/2103.12972/) (2021)
- [Deep Omni-supervised Learning for Rib Fracture Detection from Chest Radiology Images](https://mlsanity.com/paper/2306.13301/) (2023)
- [Semi-supervised object detection based on single-stage detector for thighbone fracture localization](https://mlsanity.com/paper/2210.10998/) (2022)

## Abstract (arXiv)

Exploiting available medical records to train high performance computer-aided diagnosis (CAD) models via the semi-supervised learning (SSL) setting is emerging to tackle the prohibitively high labor costs involved in large-scale medical image annotations. Despite the extensive attentions received on SSL, previous methods failed to 1) account for the low disease prevalence in medical records and 2) utilize the image-level diagnosis indicated from the medical records. Both issues are unique to SSL for CAD models. In this work, we propose a new knowledge distillation method that effectively exploits large-scale image-level labels extracted from the medical records, augmented with limited expert annotated region-level labels, to train a rib and clavicle fracture CAD model for chest X-ray (CXR). Our method leverages the teacher-student model paradigm and features a novel adaptive asymmetric label sharpening (AALS) algorithm to address the label imbalance problem that specially exists in medical domain. Our approach is extensively evaluated on all CXR (N = 65,845) from the trauma registry of anonymous hospital over a period of 9 years (2008-2016), on the most common rib and clavicle fractures. The experiment results demonstrate that our method achieves the state-of-the-art fracture detection performance, i.e., an area under receiver operating characteristic curve (AUROC) of 0.9318 and a free-response receiver operating characteristic (FROC) score of 0.8914 on the rib fractures, significantly outperforming previous approaches by an AUROC gap of 1.63% and an FROC improvement by 3.74%. Consistent performance gains are also observed for clavicle fracture detection.