Skin Lesion Classification Using CNNs With Patch-Based Attention and Diagnosis-Guided Loss Weighting.

This paper addresses two key problems of skin lesion classification. The first problem is the effective use of high-resolution images with pretrained standard architectures for image classification. The second problem is the high-class imbalance encountered in real-world multi-class datasets. To use high-resolution images, we propose a novel patch-based attention architecture that provides global context between small, high-resolution patches. We modify three pretrained architectures and study the performance of patch-based attention. To counter class imbalance problems, we compare oversampling, balanced batch sampling, and class-specific loss weighting. Additionally, we propose a novel diagnosis-guided loss weighting method that takes the method used for ground-truth annotation into account. Our patch-based attention mechanism outperforms previous methods and improves the mean sensitivity by [Formula: see text]. Class balancing significantly improves the mean sensitivity and we show that our diagnosis-guided loss weighting method improves the mean sensitivity by [Formula: see text] over normal loss balancing. The novel patch-based attention mechanism can be integrated into pretrained architectures and provides global context between local patches while outperforming other patch-based methods. Hence, pretrained architectures can be readily used with high-resolution images without downsampling. The new diagnosis-guided loss weighting method outperforms other methods and allows for effective training when facing class imbalance. The proposed methods improve automatic skin lesion classification. They can be extended to other clinical applications where high-resolution image data and class imbalance are relevant.