# Localization supervision of chest x-ray classifiers using label-specific eye-tracking annotation

arXiv: https://arxiv.org/abs/2207.09771 · HTML: https://mlsanity.com/paper/2207.09771/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 16 of its 30 references that are in the map.
- First posted on arXiv 20 Jul 2022.

## Builds on (most cited first, 16 of 16)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift](https://mlsanity.com/paper/1502.03167/) (2015)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [On the Convergence of Adam and Beyond](https://mlsanity.com/paper/1904.09237/) (2019)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning](https://mlsanity.com/paper/1711.05225/) (2017)
- [PadChest: A large chest x-ray image dataset with multi-label annotated reports](https://mlsanity.com/paper/1901.07441/) (2019)
- [VinDr-CXR: An open dataset of chest X-rays with radiologist's annotations](https://mlsanity.com/paper/2012.15029/) (2020)
- [Large Language Models are Few-Shot Clinical Information Extractors](https://mlsanity.com/paper/2205.12689/) (2022)
- [Attention Based Glaucoma Detection: A Large-scale Database and CNN Model](https://mlsanity.com/paper/1903.10831/) (2019)
- [Creation and Validation of a Chest X-Ray Dataset with Eye-tracking and Report Dictation for AI Development](https://mlsanity.com/paper/2009.07386/) (2020)
- [Thoracic Disease Identification and Localization with Limited Supervision](https://mlsanity.com/paper/1711.06373/) (2017)
- [Follow My Eye: Using Gaze to Supervise Computer-Aided Diagnosis](https://mlsanity.com/paper/2204.02976/) (2022)
- [REFLACX, a dataset of reports and eye-tracking data for localization of abnormalities in chest x-rays](https://mlsanity.com/paper/2109.14187/) (2021)

## Built on by (most cited first, 3 of 3)

- [PadChest-GR: A Bilingual Chest X-ray Dataset for Grounded Radiology Report Generation](https://mlsanity.com/paper/2411.05085/) (2024)
- [When Eye-Tracking Meets Machine Learning: A Systematic Review on Applications in Medical Image Analysis](https://mlsanity.com/paper/2403.07834/) (2024)
- [A Comparison of Object Detection and Phrase Grounding Models in Chest X-ray Abnormality Localization using Eye-tracking Data](https://mlsanity.com/paper/2503.01037/) (2025)

## Abstract (arXiv)

Convolutional neural networks (CNNs) have been successfully applied to chest x-ray (CXR) images. Moreover, annotated bounding boxes have been shown to improve the interpretability of a CNN in terms of localizing abnormalities. However, only a few relatively small CXR datasets containing bounding boxes are available, and collecting them is very costly. Opportunely, eye-tracking (ET) data can be collected in a non-intrusive way during the clinical workflow of a radiologist. We use ET data recorded from radiologists while dictating CXR reports to train CNNs. We extract snippets from the ET data by associating them with the dictation of keywords and use them to supervise the localization of specific abnormalities. We show that this method improves a model's interpretability without impacting its image-level classification.