Simple black-box universal adversarial attacks on medical image classification based on deep neural networks

Universal adversarial attacks, which hinder most deep neural network (DNN) tasks using only a small single perturbation called a universal adversarial perturbation (UAP), is a realistic security threat to the practical application of a DNN. In particular, such attacks cause serious problems in medical imaging. Given that computer-based systems are generally operated under a black-box condition in which only queries on inputs are allowed and outputs are accessible, the impact of UAPs seems to be limited because well-used algorithms for generating UAPs are limited to a white-box condition in which adversaries can access the model weights and loss gradients. Nevertheless, we demonstrate that UAPs are easily generatable using a relatively small dataset under black-box conditions. In particular, we propose a method for generating UAPs using a simple hill-climbing search based only on DNN outputs and demonstrate the validity of the proposed method using representative DNN-based medical image classifications. Black-box UAPs can be used to conduct both non-targeted and targeted attacks. Overall, the black-box UAPs showed high attack success rates (40% to 90%), although some of them had relatively low success rates because the method only utilizes limited information to generate UAPs. The vulnerability of black-box UAPs was observed in several model architectures. The results indicate that adversaries can also generate UAPs through a simple procedure under the black-box condition to foil or control DNN-based medical image diagnoses, and that UAPs are a more realistic security threat.