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    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Convolutional Neural Networks for Medical Clustering</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>David Lyndon</string-name>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Ashnil Kumar</string-name>
          <email>ashnil.kumar@sydney.edu.au</email>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Jinman Kim</string-name>
          <email>jinman.kim@sydney.edu.au</email>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Philip H. W. Leong</string-name>
          <email>philip.leong@sydney.edu.au</email>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Dagan Feng</string-name>
          <email>dagan.feng@sydney.edu.au</email>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Institute of Biomedical Engineering and Technology, University of Sydney</institution>
          ,
          <country country="AU">Australia</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>School of Electrical and Information Engineering, University of Sydney</institution>
          ,
          <country country="AU">Australia</country>
        </aff>
        <aff id="aff2">
          <label>2</label>
          <institution>School of Information Technologies, University of Sydney</institution>
          ,
          <country country="AU">Australia</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>A major challenge for Medical Image Retrieval (MIR) is the discovery of relationships between low-level image features (intensity, gradient, texture, etc.) and high-level semantics such as modality, anatomy or pathology. Convolutional Neural Networks (CNNs) have been shown to have an inherent ability to automatically extract hierarchical representations from raw data. Their successful application in a variety of generalised imaging tasks suggests great potential for MIR. However, a major hurdle to their deployment in the medical domain is the relative lack of robust training corpora when compared to general imaging benchmarks such as ImageNET and CIFAR. In this paper, we present the adaptation of CNNs to the medical clustering task at ImageCLEF 2015.</p>
      </abstract>
      <kwd-group>
        <kwd>Deep Learning</kwd>
        <kwd>Convolutional Neural Networks</kwd>
        <kwd>Medical Image Retrieval</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>-</title>
      <p>
        This paper documents the Biomedical Engineering and Technology (BMET)
team from the University of Sydney's submissions for the ImageCLEF 2015 [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]
Medical clustering task [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ].
      </p>
      <p>
        The objective of our experiments was to evaluate the e ectiveness of
Convolutional Neural Networks (CNNs) for this task. In particular, we propose a deep
learning framework that learns high-level representations of anatomical elements
contained in each image and uses these to cluster the images.
since 2012 [3{5]. CNNs share the common features of all deep learning
algorithms: stacked layers of neuronal subunits that learn hierarchical
representations (allowing the data to be understood at various levels of abstraction, in
isolation or combination [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ]), the ability to perform unsupervised pre-training
on unlabeled data and e cient parallelization on multiple core GPUs which can
result in improvements of up to 5000% over CPU-only implementations [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ].
      </p>
      <p>
        A more subtle implication of deep learning is that it can automatically extract
features from raw data [3{5]. Typically, a key factor in the success of typical
machine learning algorithms is extracting salient features from the raw data.
Taking image recognition as an example, a feature set such as edges or SIFT [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ]
would be extracted from the raw data and it is these new features per se or
in combination with the original raw data that would be fed into the machine
learning algorithm. While some aspects of the process can be automated or
implemented with well known algorithms, a major drawback is that it generally
requires expert domain knowledge to de ne which features should be used and
evaluate their success.
      </p>
      <p>
        Deep learning algorithms, however, are able to directly utilise raw data
instead of hand-crafted features. By feeding the data sequentially through many
successive layers of subunits, the higher levels of the system are able to
understand the data in terms of successively abstract representations [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ].
      </p>
      <p>
        Medical Image Retrieval (MIR) tasks, such as the tests devised for
ImageCLEF, require learning precisely these kinds of highly abstract representations,
i.e. image modality or the anatomical semantics of the image. However, to the
best of our knowledge it is not currently a well established method in this domain.
This is due to not only the inherent challenges of medical images[
        <xref ref-type="bibr" rid="ref7">7</xref>
        ], but also
because state-of-the-art deep learning results are typically obtained using huge
sets of labelled training data4 on tasks that are arguably less subtle. As a justi
cation for these claims, consider that the ImageNET general object recognition
task corpora consists of millions of robustly labelled images and was created with
the assistance of crowdsourcing via Amazon Mechanical Turk [9]. On the other
hand, medical imaging datasets require careful labelling by domain experts,
often specialists in a particular area [7, 10{12] and as a result are generally much
smaller.
      </p>
      <p>Large training sets are a current necessity of very deep systems because they
contain many millions of internal parameters that must be estimated from the
data. Too little data can result in the the higher-level neurons' activation being
the result of salient features of the training set and not re ecting the high-level
representations. If this 'over tting' occurs then the system's ability to generalise
on new data is severely impaired [13].</p>
      <p>In addition to the issues regarding the volume of data required, it must be
mentioned that while deep learning can automatically perform excellent feature
extraction, this comes at the signi cant cost of the larger number of
hyperparameters that must be evaluated in order to nd an optimal system [14]. For
4 Krizhevsky et. al. [8] used approximately 1.2 million labelled examples for their
breakthrough result in ImageNET in 2012.
example, compared to a commonly used machine learning algorithm such as the
Support Vector Machine (SVM) that has a basic hyperparameter search space
with dimensions of choice of kernel, regularization constant and kernel
hyperparameter, even the simplest implementation of a CNN requires fundamental
choices about the number and type of layers, lter size and number of lters
per layer, and the learning rate. More advanced implementations include
factors such as unit activation function and the use of dropout. While there are
guidelines for these choices in the literature [14], the di culty of even a small
parameter search is compounded by the increased computational requirements
of training the system.
3</p>
    </sec>
    <sec id="sec-2">
      <title>Methods</title>
      <sec id="sec-2-1">
        <title>3.1 Image Preprocessing</title>
        <p>A requirement of our classi ers was uniformly sized input vectors, however, there
was some variation in the training data size. The sizes of the images were at least
1600px in one dimension and then between 1600 and 2348px in the other. In order
to use consistently sized images and not lose any crucial information, we created
a new square image with the dimensions of the largest dimension of the original
image, lling any empty space with black pixels.</p>
        <p>Even prior to training the CNN, we were aware that the computational
requirements were quite demanding and this would be exacerbated by using large
images. With that in mind, we resized the images to 256x256px to reduce
computational overhead. Good results have been reported in the literature for complex
tasks with 48x48px images [15] and Krizhevsky et. al. [8] achieved state-of-the
art general object recognition with 256x256px images (technically, the system
had an input of 224x224px, but these were subimages of the original 256x256px
images).</p>
        <p>After resizing the images were 256x256x3px, the third dimension describing
the three colour channels. The images supplied were in actual fact gray scale, i.e.
all colour channels were equal-valued, so we simply sliced the array preserving
only the 'red' channel.</p>
        <p>We chose to train a single run of four models using 100% of the training data
with no parameter optimization and use the ImageCLEF results as the test.
3.2</p>
      </sec>
      <sec id="sec-2-2">
        <title>Convolutional Neural Network</title>
        <p>The task requires multi-label classi cation across four anatomical classes, with
a null set indicating that the data is a true-negative image taken with the same
camera, but not of the human body. To facilitate this output from our
experiments we constructed 4x1 vs. All CNN models.</p>
        <p>The architecture for the CNN used for our experimentation was based on a
simpli ed version of Yann LeCun et. al.'s [16] LeNet-55. This basic CNN is
capable of correctly classifying the MNIST handwritten digit database with 1.7%
5 http://deeplearning.net/tutorial/lenet.html
test error. We modi ed the input to account for larger images and output a
di erent number of classi cations. The network consists of two convolutional
pooling layers, with one fully connected hidden layer. The features that are
output by the hidden layer are used for binary classi cation by a logistic regression
classi er. The architecture of the system is shown in Figure 1.
The speci cations of the convolutional-pooling layers are detailed in Table 1.
Other hyperparameters for the CNN are detailed in Table 2.</p>
        <p>As mentioned earlier the CNN requires a great deal of computational resource
to run. We initially began training the four models on a CPU-only solution and
despite it being a very powerful machine6, it took approximately 90 minutes to
train a model for a single epoch (albeit, training four models simultaneously).
Fortunately, we were given an opportunity to run these models on a system with
two Nvidia K20 GPUs. Even training the four models simultaneously (two per
GPU), it only took approximately 11 minutes to train a model for a single epoch
{ an 8-fold speedup. We planned to submit a single run, having trained each of
the four classi ers for 100 epochs. This process would have taken over a week on
a CPU-only system, instead it took less than a day on the GPU server.
4</p>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>Results</title>
      <p>The test results for our submission as supplied by ImageCLEF are displayed in
Table 4.</p>
    </sec>
    <sec id="sec-4">
      <title>Perspectives for Future Work</title>
      <p>We believe that that these results can be signi cantly improved upon by making
use of a variety of techniques. Primarily we would want to continue to explore
training the CNNs using GPUs, because as we have demonstrated, the
performance increase is non-trival and allows us to expand our hyperparamter and
architecture search. Recti ed Linear Units (ReLUs), as opposed the Tanh units
used in our network are also known to improve training performance [17, 18].</p>
      <p>Although this network is very capable of learning quality representations
of the MNIST dataset, it is both less deep and less dense than networks used
to achieve state-of-the-art results in more sophisticated tasks [8]. For instance,
Krizhevsky et. al. [8] used a network with 2 convolutional-max pooling layers, 3
convolutional layers and 3 fully connected layers, all of which were more
neurondense that ours, to achieve their result in ImageNET 2012. Improved training
performance will allow us to implement a larger and deeper network along these
lines.</p>
      <p>Larger and deeper networks introduce issues with over tting, but we believe
this can be controlled using well-tried techniques such as dropout [8, 13, 19], data
augmentation [8, 20] and unsupervised pretraining [21, 22].</p>
      <sec id="sec-4-1">
        <title>Acknowledgements</title>
        <p>This work was supported in part by a Microsoft Azure for Research grant, which
provided the cloud infrastructure to conduct our experiments.
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