# Curriculum Learning with Synthetic Data for Enhanced Pulmonary Nodule Detection in Chest Radiographs

arXiv: https://arxiv.org/abs/2510.07681 · HTML: https://mlsanity.com/paper/2510.07681/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 17 of its 36 references that are in the map.
- First posted on arXiv 9 Oct 2025.

## Builds on (most cited first, 17 of 17)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Microsoft COCO: Common Objects in Context](https://mlsanity.com/paper/1405.0312/) (2014)
- [Faster R-CNN: Towards Real-Time Object Detection with Region Proposal Networks](https://mlsanity.com/paper/1506.01497/) (2015)
- [End-to-End Object Detection with Transformers](https://mlsanity.com/paper/2005.12872/) (2020)
- [Feature Pyramid Networks for Object Detection](https://mlsanity.com/paper/1612.03144/) (2016)
- [Improved Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2102.09672/) (2021)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [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)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [A systematic study of the class imbalance problem in convolutional neural networks](https://mlsanity.com/paper/1710.05381/) (2017)
- [CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning](https://mlsanity.com/paper/1711.05225/) (2017)
- [On The Power of Curriculum Learning in Training Deep Networks](https://mlsanity.com/paper/1904.03626/) (2019)
- [VinDr-CXR: An open dataset of chest X-rays with radiologist's annotations](https://mlsanity.com/paper/2012.15029/) (2020)
- [Exploring large scale public medical image datasets](https://mlsanity.com/paper/1907.12720/) (2019)

## Abstract (arXiv)

This study evaluates whether integrating curriculum learning with diffusion-based synthetic augmentation can enhance the detection of difficult pulmonary nodules in chest radiographs, particularly those with low size, brightness, and contrast, which often challenge conventional AI models due to data imbalance and limited annotation. A Faster R-CNN with a Feature Pyramid Network (FPN) backbone was trained on a hybrid dataset comprising expert-labeled NODE21 (1,213 patients; 52.4 percent male; mean age 63.2 +/- 11.5 years), VinDr-CXR, CheXpert, and 11,206 DDPM-generated synthetic images. Difficulty scores based on size, brightness, and contrast guided curriculum learning. Performance was compared to a non-curriculum baseline using mean average precision (mAP), Dice score, and area under the curve (AUC). Statistical tests included bootstrapped confidence intervals, DeLong tests, and paired t-tests. The curriculum model achieved a mean AUC of 0.95 versus 0.89 for the baseline (p < 0.001), with improvements in sensitivity (70 percent vs. 48 percent) and accuracy (82 percent vs. 70 percent). Stratified analysis demonstrated consistent gains across all difficulty bins (Easy to Very Hard). Grad-CAM visualizations confirmed more anatomically focused attention under curriculum learning. These results suggest that curriculum-guided synthetic augmentation enhances model robustness and generalization for pulmonary nodule detection.