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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>An Xception-GRU Model for Visual Question Answering in the Medical Domain</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Shengyan Liu</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Xiaozhi Ou</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Jiao Che</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Xiaobing Zhou</string-name>
          <email>zhouxb@ynu.edu.cn</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Haiyan Ding</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>School of Information Science and Engineering, Yunnan University</institution>
          ,
          <addr-line>Kunming 650091</addr-line>
          ,
          <country country="CN">P.R.China</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>This paper introduces an Xception-GRU model for ImageCLEF 2019 Medical Domain Visual Question Answering (VQA-Med) Task. First, we enhance the images and remove extraneous words from the questions and convert the questions to vectors. Then, we employ pretrained Xception model to extract image features and use GRU model to encode the questions. To generate the output, we combine these two models with the attention mechanism. Our Xception-GRU model achieves the accuracy score of 0.21 and BLEU score of 0.393.</p>
      </abstract>
      <kwd-group>
        <kwd>VQA-Med</kwd>
        <kwd>Xception</kwd>
        <kwd>GRU</kwd>
        <kwd>Attention Mechanism</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>Introduction</title>
      <p>
        2019 Task [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ] [
        <xref ref-type="bibr" rid="ref7">7</xref>
        ]. The model takes an image and a question as an input and
outputs the answer to this question based on features combined both image and
question features with an attention mechanism.
      </p>
      <p>The rest of this paper is structured as follows. The next section will provide
a brief overview of the work involved. The dataset provided in the rang of the
VQA-Med challenge is described in Section 3. The deep learning networks that
we proposed for VQA in the medical domain is presented in Section 4. The
submitted runs is described in Section 5. Finally, Section 6 is the summary of
the paper.
2</p>
    </sec>
    <sec id="sec-2">
      <title>Related Work</title>
      <p>Because VQA involves the two domains of CV and NLP, a natural VQA
solution is to combine CNN and RNN, which have been very successful in CV
and NLP, respectively, to construct a combination model. The VQA model,
which is composed of deep CNN and LSTM network structure, is a relatively
good model in visual question answering. Among them, some of the superior
VQA models are introduced below.</p>
      <p>
        Deeper LSTM Q + norm I model [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]. This model is proposed by
Aishwarya Agrawal et al. In which, “I” refers to the extracted image features, and
“norm I” refers to L2 normalization of image semantic information vector (1024
dimension) extracted by CNN. CNN extracts image semantic information and
LSTM extracts text semantic information contained in the problem, and then
the two information are fused so that the model can learn the meaning of the
problem. Finally, the answer output is generated in a multi-layer MLP with
Softmax as the output layer.
      </p>
      <p>
        VIS+LSTM model [
        <xref ref-type="bibr" rid="ref11">11</xref>
        ]. This model is proposed by Mengye Ren et al. The
basic structure of the model is to extract image information with CNN at first,
and then connect LSTM to generate prediction results.
      </p>
      <p>
        Neural-Image-QA model [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ]. This model is proposed by Mateusz
Malinowski et al. Based on CNN and LSTM, a model with length-variable prediction
result is designed. In this model, visual question answering task is regarded as
an auxiliary sequence to sequence task combined with image information.
      </p>
      <p>
        mQA model [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ]. This model is proposed by Gao H et al. In their paper,
the understanding of visual question and answer task is that this model needs to
give an answer to the question of the free form of an image, and the answer can
be a sentence, a phrase or a word. The mQA model consists of four sub-modules,
the first module encodes natural statements into a dense word vector feature by
a LSTM network, i.e., extracts the information contained in the problem, called
the problem LSTM network; The second module extracts image features from a
deep CNN; The third module is another different LSTM network, which is used
to code the characteristic information of the current word and some previous
words in the answer, called the answer LSTM network; The last module fuses
the information generated by the previous three models to predict the next word
to be generated in the answer.
      </p>
      <p>
        Most of the work discussed in this section cannot be directly applied to the
VQA-Med for two reasons. The first one is obvious, this task mainly focuses on
the medical domain, which gives this problem its unique set of challenges. As for
the other one, it is related to how the sentences of the answers are constructed in
VQA-Med, which is different from existing VQA datasets, such as DAtaset for
QUestion Answering on Realworld images (DAQUAR) [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ], Visual7W [
        <xref ref-type="bibr" rid="ref14">14</xref>
        ], Visual
Madlibs [
        <xref ref-type="bibr" rid="ref13">13</xref>
        ], COCO-QA [
        <xref ref-type="bibr" rid="ref11">11</xref>
        ], Freestyle Multilingual Image Question Answering
dataset (FM-IQA) [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ], Visual Question Answering (VQA) [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ], etc.
3
      </p>
    </sec>
    <sec id="sec-3">
      <title>Dataset Description</title>
      <p>
        This dataset of ImageCLEF 2019 VQA-Med [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ] differs from previous data
sets in that it divides the problems into four categories based on modality, plane,
organ system, and abnormality. The purpose is to generate a more focused set
of problems for the evaluation of the results. The dataset contains 12,792 QA
pairs, 3,200 medical images for training sets, and 2,000 QA pairs, 500 medical
images for validation sets, and 500 medical images with 500 questions for test
sets. Fig.1 shows an example of a medical image and the associated question
and answer from the training set of VQA-Med 2019 dataset. Table 1 lists the
statistics of VQA-Med 2019 dataset.
1. Modality, e.g. What kind of image is this? Was IV contrast given to the
patient?
2. Plane, e.g. What plane is the image acquired in? In what plane is this image
oriented?
      </p>
      <p>Although at present the research in the VQA field has made some
achievements, there’s still a challenging problem that the overall accuracy of the answer
by using existing models to realize the visual question and answer the problem
is not high. The existing VQA models are relatively simple in structure, the
content and form of answers are relatively simple, and more priori knowledge
is needed for slightly complex problems, so simple reasoning cannot make
correct answers. The reason is that, in addition to the image information of CNN,
the knowledge source of LSTM in the learning process is only focused on the
training question and answer pairs, with simple knowledge structure and lack
of information. After comparing the characteristics of each pre-training CNN
model, we propose the following model for our participation in VQA-Med 2019.</p>
      <p>
        We use Xception [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ] to extract image features and GRU to extract question
features. Since the number of image features is much larger than question
features, the question features should be repeated to make the number of the two
features equal, and then an attention mechanism [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ] is added before fusion.
      </p>
      <sec id="sec-3-1">
        <title>4.2 Image Representation</title>
        <p>In recent years, many CNN models have been proposed, such as AlexNet,
VGGNet, Inception, Xception, ResNet, etc. In this paper, we use Xception to
extract image features. Xception was proposed by Francois Chollet, author of
Keras, in 2017. It is another improvement of Inception-v3 proposed by Google
after Inception. The advantage of Xception is that it can improve the efficiency of
network, as well as in the case of a number of equal participation. On large data
sets, the effect is better than Inception-v3. This also provides another idea of
“lightweight”: increasing network efficiency and performance as much as possible
in the case of given hardware resources, which can also be understood as making
full use of hardware resources. The architecture of Xception is shown in Fig.3.</p>
        <p>First, the image goes through a convolution kernel of 1*1, the function of
1*1 convolution is to reduce dimension, and because each convolution kernel
convolves only with the corresponding channel, the network uses separate
convolution kernels. Finally, the features of each channel are joined together. The
benefit about this method is that we get features that are independent of each
other, without too much redundancy.
4.3</p>
      </sec>
      <sec id="sec-3-2">
        <title>Question Representation</title>
        <p>
          Gated Recurrent Unit(GRU) [
          <xref ref-type="bibr" rid="ref3">3</xref>
          ] was proposed by Cho van Merrienboer,
Bahdanau and Bengio in 2014. By introducing the concept of gate, the calculation
method of hidden state in the cyclic neural network is modified, which includes
reset gate, update gate, candidate hidden state and hidden state. GRU is one
gate less than LSTM. We can think of the GRU as an optimization or variation
of the LSTM. Resetting the gate helps capture short-term dependencies in the
time series. Update gates help capture long-term dependencies in time series,
but the experimental results are quite similar:
        </p>
        <p>When we train a GRU network, the input of the output layer is:
yti = W0h:
yto = (yti):
The output is:</p>
        <sec id="sec-3-2-1">
          <title>The loss function at a certain moment is: 1</title>
          <p>Et = 2 (yd yto)2:</p>
          <p>In this part, we use the GRU model to extract the features of questions after
preprocessing them.
5</p>
        </sec>
      </sec>
    </sec>
    <sec id="sec-4">
      <title>Evaluation and Results</title>
      <p>Before running the evaluation metrics on the answers, the following
preprocessing are performed:
1. The capitals in each answer are converted to lowercases,
2. All punctuations are deleted and each answer is tokenized by single words.
The evaluation can be conducted based on the following metrics:
Accuracy (Strict) Accuracy is our most common evaluation indicator, and it
is easy to understand. For a given test dataset, the number of correct samples
in the test task is divided by the number of all samples. Generally speaking, the
higher the accuracy, the better the classifier.</p>
      <p>
        BLEU How to measure the similarity between the generated statement and
the reference statement is an important issue. In 2002, Kishore Papineni et al
proposed a classic measure standard BiLingual Evaluation Understudy (BLEU)
[
        <xref ref-type="bibr" rid="ref10">10</xref>
        ]. BLEU is an auxiliary method to evaluate the quality of Bilingual
translation. This method is simple, short, fast and easy to understand. Because the
effect is reasonable, it has been widely migrated to various assessment tasks
of natural language processing. It is used to determine how similar
machinetranslated sentences are to human-translated sentences. BLEU calculates the
ratio of similarity between two sentences by counting the frequency of words
appearing together, using the n-gram matching rule. BLEU evaluations are fast
and close to human ratings. So the performance of a VQA model can be judged
with the BLEU score. The higher the score, the better performance of a VQA
model.
      </p>
      <p>Three experiments are conducted to evaluate our model. The parameters are
set as follows, the size of dictionary is 1000, the length of sequences is 9, the
hidden size of GRU is 128, and the batch size of training is 256. We set the
epoch to 54.</p>
      <p>The experiments are described as follows.
1. In the first experiment, we run our proposed model (Xception-GRU) without
date enhancement.
2. In the second experiment, we use Bi-LSTM instead of GRU to extract text
features. Obviously, bidirectional LSTM is less effective than GRU.
3. In the last experiment, we run our proposed model (Xception-GRU) with
date enhancement, the rest of the architecture stays the same.</p>
      <sec id="sec-4-1">
        <title>The following table shows the results obtained on the test set:</title>
        <p>
          As shown in Table 2, our proposed Xception-GRU model without data
enhancement achieves good results in term of BLEU metric (0.393) and accuracy
(0.21). When we try Bi-LSTM model [
          <xref ref-type="bibr" rid="ref6">6</xref>
          ] to extract question features and
Xception to extract image features without data enhancement, the effect is reduced a
little. Then we remain Xception-GRU architecture, and introduce data
enhancement, the effect is reduced a lot. The reason is that due to the high performance
of Xception model and the depth of feature extraction, it is easy to overfit.
Therefore, Xception without image enhancement produces better results, while
with image enhancement produces worse results.
        </p>
        <p>In this regard, we still need to make some improvements on the mechanism
to prevent overfitting. However, since there are no medical imaging professionals
who can provide suggestions for the improvement of our process, the results may
differ from the actual situation.
6</p>
      </sec>
    </sec>
    <sec id="sec-5">
      <title>Conclusion</title>
      <p>In this paper, we present our contribution to the visual question answering
task in the field of medicine in view of the very meaningful but challenging
VQAMed Task of ImageCLEF 2019. Our Xception-GRU model achieves the
accuracy score of 0.21 and BLEU score of 0.393.</p>
      <p>
        Our future work will focus on making the answers more readable and
accurate. We consider that there is an essential semantic gap between the regional
visual features and the source of the problem text representation. Due to the
great success of the attention-based model in VQA task [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ], we want to work
on features, namely how to extract visual information more effectively and
apply the attention mechanism better. We will improve our visual model by using
attention feature enhancement techniques to further make regional semantic
representations more relevant to the problem. Our future work also includes training
on multiple data sets, improving model performance, etc.
      </p>
    </sec>
    <sec id="sec-6">
      <title>Acknowledgments</title>
      <p>This work was supported by the Natural Science Foundations of China under
Grants 61463050, the NSF of Yunnan Province under Grant 2015FB113.</p>
    </sec>
  </body>
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