# Big Self-Supervised Models Advance Medical Image Classification

arXiv: https://arxiv.org/abs/2101.05224 · HTML: https://mlsanity.com/paper/2101.05224/

## Key facts

- Cited by 320 papers in the map (data through 14 Oct 2026).
- Builds on 41 of its 55 references that are in the map.
- First posted on arXiv 13 Jan 2021.

## Builds on (most cited first, 30 of 41)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [Momentum Contrast for Unsupervised Visual Representation Learning](https://mlsanity.com/paper/1911.05722/) (2019)
- [Improved Baselines with Momentum Contrastive Learning](https://mlsanity.com/paper/2003.04297/) (2020)
- [Unsupervised Feature Learning via Non-Parametric Instance-level Discrimination](https://mlsanity.com/paper/1805.01978/) (2018)
- [Unsupervised Representation Learning by Predicting Image Rotations](https://mlsanity.com/paper/1803.07728/) (2018)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Unsupervised Learning of Visual Representations by Solving Jigsaw Puzzles](https://mlsanity.com/paper/1603.09246/) (2016)
- [Big Self-Supervised Models are Strong Semi-Supervised Learners](https://mlsanity.com/paper/2006.10029/) (2020)
- [Contrastive Multiview Coding](https://mlsanity.com/paper/1906.05849/) (2019)
- [Learning deep representations by mutual information estimation and maximization](https://mlsanity.com/paper/1808.06670/) (2018)
- [Colorful Image Colorization](https://mlsanity.com/paper/1603.08511/) (2016)
- [Unsupervised Visual Representation Learning by Context Prediction](https://mlsanity.com/paper/1505.05192/) (2015)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [Self-Supervised Learning of Pretext-Invariant Representations](https://mlsanity.com/paper/1912.01991/) (2019)
- [Big Transfer (BiT): General Visual Representation Learning](https://mlsanity.com/paper/1912.11370/) (2019)
- [Learning Representations by Maximizing Mutual Information Across Views](https://mlsanity.com/paper/1906.00910/) (2019)
- [Data-Efficient Image Recognition with Contrastive Predictive Coding](https://mlsanity.com/paper/1905.09272/) (2019)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [Exploring the Limits of Weakly Supervised Pretraining](https://mlsanity.com/paper/1805.00932/) (2018)
- [Large Batch Training of Convolutional Networks](https://mlsanity.com/paper/1708.03888/) (2017)
- [Time-Contrastive Networks: Self-Supervised Learning from Video](https://mlsanity.com/paper/1704.06888/) (2017)
- [Transfusion: Understanding Transfer Learning for Medical Imaging](https://mlsanity.com/paper/1902.07208/) (2019)
- [What is being transferred in transfer learning?](https://mlsanity.com/paper/2008.11687/) (2020)
- [Contrastive learning of global and local features for medical image segmentation with limited annotations](https://mlsanity.com/paper/2006.10511/) (2020)
- [Med3D: Transfer Learning for 3D Medical Image Analysis](https://mlsanity.com/paper/1904.00625/) (2019)
- [Unsupervised Embedding Learning via Invariant and Spreading Instance Feature](https://mlsanity.com/paper/1904.03436/) (2019)
- [Not-so-supervised: a survey of semi-supervised, multi-instance, and transfer learning in medical image analysis](https://mlsanity.com/paper/1804.06353/) (2018)
- [Self supervised contrastive learning for digital histopathology](https://mlsanity.com/paper/2011.13971/) (2020)

## Built on by (most cited first, 30 of 320)

- [ImageNet-21K Pretraining for the Masses](https://mlsanity.com/paper/2104.10972/) (2021)
- [Self-Supervised Pre-Training of Swin Transformers for 3D Medical Image Analysis](https://mlsanity.com/paper/2111.14791/) (2021)
- [Transformers in Medical Imaging: A Survey](https://mlsanity.com/paper/2201.09873/) (2022)
- [Benchmarking Self-Supervised Learning on Diverse Pathology Datasets](https://mlsanity.com/paper/2212.04690/) (2022)
- [Exploring scalable medical image encoders beyond text supervision](https://mlsanity.com/paper/2401.10815/) (2024)
- [Recent advances and clinical applications of deep learning in medical image analysis](https://mlsanity.com/paper/2105.13381/) (2021)
- [AUC Maximization in the Era of Big Data and AI: A Survey](https://mlsanity.com/paper/2203.15046/) (2022)
- [Efficient Multimodal Large Language Models: A Survey](https://mlsanity.com/paper/2405.10739/) (2024)
- [Extending the WILDS Benchmark for Unsupervised Adaptation](https://mlsanity.com/paper/2112.05090/) (2021)
- [Self-Supervised Pretraining Improves Self-Supervised Pretraining](https://mlsanity.com/paper/2103.12718/) (2021)
- [Self-supervised representation learning from 12-lead ECG data](https://mlsanity.com/paper/2103.12676/) (2021)
- [Self-supervised learning methods and applications in medical imaging analysis: A survey](https://mlsanity.com/paper/2109.08685/) (2021)
- [MedAgent-Pro: Towards Evidence-based Multi-modal Medical Diagnosis via Reasoning Agentic Workflow](https://mlsanity.com/paper/2503.18968/) (2025)
- [Masked Image Modeling Advances 3D Medical Image Analysis](https://mlsanity.com/paper/2204.11716/) (2022)
- [Best of Both Worlds: Multimodal Contrastive Learning with Tabular and Imaging Data](https://mlsanity.com/paper/2303.14080/) (2023)
- [Does Your Dermatology Classifier Know What It Doesn't Know? Detecting the Long-Tail of Unseen Conditions](https://mlsanity.com/paper/2104.03829/) (2021)
- [Large AI Models in Health Informatics: Applications, Challenges, and the Future](https://mlsanity.com/paper/2303.11568/) (2023)
- [Is it Time to Replace CNNs with Transformers for Medical Images?](https://mlsanity.com/paper/2108.09038/) (2021)
- [CheXtransfer: Performance and Parameter Efficiency of ImageNet Models for Chest X-Ray Interpretation](https://mlsanity.com/paper/2101.06871/) (2021)
- [Parameter-Efficient Fine-Tuning for Medical Image Analysis: The Missed Opportunity](https://mlsanity.com/paper/2305.08252/) (2023)
- [MedAug: Contrastive learning leveraging patient metadata improves representations for chest X-ray interpretation](https://mlsanity.com/paper/2102.10663/) (2021)
- [Towards a clinically accessible radiology foundation model: open-access and lightweight, with automated evaluation](https://mlsanity.com/paper/2403.08002/) (2024)
- [DiRA: Discriminative, Restorative, and Adversarial Learning for Self-supervised Medical Image Analysis](https://mlsanity.com/paper/2204.10437/) (2022)
- [Robust and Efficient Medical Imaging with Self-Supervision](https://mlsanity.com/paper/2205.09723/) (2022)
- [PCRLv2: A Unified Visual Information Preservation Framework for Self-supervised Pre-training in Medical Image Analysis](https://mlsanity.com/paper/2301.00772/) (2023)
- [Robust and Interpretable Medical Image Classifiers via Concept Bottleneck Models](https://mlsanity.com/paper/2310.03182/) (2023)
- [CLIP in Medical Imaging: A Survey](https://mlsanity.com/paper/2312.07353/) (2023)
- [Label-Efficient Self-Supervised Federated Learning for Tackling Data Heterogeneity in Medical Imaging](https://mlsanity.com/paper/2205.08576/) (2022)
- [Deep Multi-modal Fusion of Image and Non-image Data in Disease Diagnosis and Prognosis: A Review](https://mlsanity.com/paper/2203.15588/) (2022)
- [Joint Embedding vs Reconstruction: Provable Benefits of Latent Space Prediction for Self Supervised Learning](https://mlsanity.com/paper/2505.12477/) (2025)

## Abstract (arXiv)

Self-supervised pretraining followed by supervised fine-tuning has seen success in image recognition, especially when labeled examples are scarce, but has received limited attention in medical image analysis. This paper studies the effectiveness of self-supervised learning as a pretraining strategy for medical image classification. We conduct experiments on two distinct tasks: dermatology skin condition classification from digital camera images and multi-label chest X-ray classification, and demonstrate that self-supervised learning on ImageNet, followed by additional self-supervised learning on unlabeled domain-specific medical images significantly improves the accuracy of medical image classifiers. We introduce a novel Multi-Instance Contrastive Learning (MICLe) method that uses multiple images of the underlying pathology per patient case, when available, to construct more informative positive pairs for self-supervised learning. Combining our contributions, we achieve an improvement of 6.7% in top-1 accuracy and an improvement of 1.1% in mean AUC on dermatology and chest X-ray classification respectively, outperforming strong supervised baselines pretrained on ImageNet. In addition, we show that big self-supervised models are robust to distribution shift and can learn efficiently with a small number of labeled medical images.