Salient and small lesions (e.g., microaneurysms on fundus) both play significant roles in real-world disease diagnosis under medical image examinations. Although deep neural networks (DNNs) have achieved promising medical image classification performance, they often have limitations in capturing both salient and small lesion information, restricting performance improvement in imbalanced medical image classification. Recently, with the advent of DNN-based style transfer in medical image generation, the roles of clinical styles have attracted great interest, as they are crucial indicators of lesions. Motivated by this observation, we propose a novel Adaptive Dual-Axis Style-based Recalibration (ADSR) module, leveraging the potential of clinical styles to guide DNNs in effectively learning salient and small lesion information from a dual-axis perspective. ADSR first emphasizes salient lesion information via global style-based adaptation, then captures small lesion information with pixel-wise style-based fusion. We construct an ADSR-Net for imbalanced medical image classification by stacking multiple ADSR modules. Additionally, DNNs typically adopt cross-entropy loss for parameter optimization, which ignores the impacts of class-wise predicted probability distributions. To address this, we introduce a new Class-wise Statistics Loss (CWS) combined with CE to further boost imbalanced medical image classification results. Extensive experiments on five imbalanced medical image datasets demonstrate not only the superiority of ADSR-Net and CWS over state-of-the-art (SOTA) methods but also their improved confidence calibration results. For example, ADSR-Net with the proposed loss significantly outperforms CABNet50 by 21.39% and 27.82% in F1 and B-ACC while reducing 3.31% and 4.57% in ECE and BS on ISIC2018.

Spatial attention (SA) mechanism has been widely incorporated into deep neural networks (DNNs), significantly lifting the performance in computer vision tasks via long-range dependency modeling. However, it may perform poorly in medical image analysis. Unfortunately, the existing efforts are often unaware that long-range dependency modeling has limitations in highlighting subtle lesion regions. To overcome this limitation, we propose a practical yet lightweight architectural unit, pyramid pixel context adaption (PPCA) module, which exploits multiscale pixel context information to recalibrate pixel position in a pixel-independent manner dynamically. PPCA first applies a well-designed cross-channel pyramid pooling (CCPP) to aggregate multiscale pixel context information, then eliminates the inconsistency among them by the well-designed pixel normalization (PN), and finally estimates per pixel attention weight via a pixel context integration. By embedding PPCA into a DNN with negligible overhead, the PPCA network (PPCANet) is developed for medical image classification. In addition, we introduce supervised contrastive learning to enhance feature representation by exploiting the potential of label information via supervised contrastive loss (CL). The extensive experiments on six medical image datasets show that the PPCANet outperforms state-of-the-art (SOTA) attention-based networks and recent DNNs. We also provide visual analysis and ablation study to explain the behavior of PPCANet in the decision-making process.

Cataracts are the leading cause of visual impairment and blindness globally attracting abroad attention from society. Over the years researchers have developed many state-of-the-art convolutional neural networks (CNNs) to recognize cataract severity levels based on different ophthalmic images. However most current works focus on improving cataract recognition performance by designing complex CNNs often ignoring resource-constrained medical device limitations. To this problem this paper proposes a novel dual-mixed channel-independent convolution (DMIConv) method which takes advantage of the multiscale convolution kernels by combining a depthwise convolution with a depthwise dilated convolution sequentially. Moreover we build a lightweight dual-mixed channel-independent network (DMINet) to recognize cataracts. To verify the effectiveness and efficiency of DMINet we conduct extensive experiments on a clinical anterior segment optical coherence tomography (AS-OCT) dataset of nuclear cataract (NC) and a publicly available OCT dataset. The results show that our proposed DMINet keeps a better tradeoff between the model complexity and the classification performance than efficient CNNs e.g DMINet outperforms MixNet by 3.34% of accuracy by using 4.58 % fewer parameters