On the robustness of deep learning-based lung-nodule classification for CT images with respect to image noise

Chenyang Shen, Min Yu Tsai, Liyuan Chen, Shulong Li, Dan Nguyen, Jing Wang, Steve B. Jiang, Xun Jia

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Robustness is an important aspect when evaluating a method of medical image analysis. In this study, we investigated the robustness of a deep learning (DL)-based lung-nodule classification model for CT images with respect to noise perturbations. A deep neural network (DNN) was established to classify 3D CT images of lung nodules into malignant or benign groups. The established DNN was able to predict malignancy rate of lung nodules based on CT images, achieving the area under the curve of 0.91 for the testing dataset in a tenfold cross validation as compared to radiologists' prediction. We then evaluated its robustness against noise perturbations. We added to the input CT images noise signals generated randomly or via an optimization scheme using a realistic noise model based on a noise power spectrum for a given mAs level, and monitored the DNN's output. The results showed that the CT noise was able to affect the prediction results of the established DNN model. With random noise perturbations at 100 mAs, DNN's predictions for 11.2% of training data and 17.4% of testing data were successfully altered by at least once. The percentage increased to 23.4% and 34.3%, respectively, for optimization-based perturbations. We further evaluated robustness of models with different architectures, parameters, number of output labels, etc, and robustness concern was found in these models to different degrees. To improve model robustness, we empirically proposed an adaptive training scheme. It fine-tuned the DNN model by including perturbations in the training dataset that successfully altered the DNN's perturbations. The adaptive scheme was repeatedly performed to gradually improve DNN's robustness. The numbers of perturbations at 100 mAs affecting DNN's predictions were reduced to 10.8% for training and 21.1% for testing by the adaptive training scheme after two iterations. Our study illustrated that robustness may potentially be a concern for an exemplary DL-based lung-nodule classification model for CT images, indicating the needs for evaluating and ensuring model robustness when developing similar models. The proposed adaptive training scheme may be able to improve model robustness.

Original languageEnglish (US)
Article number245037
JournalPhysics in medicine and biology
Issue number24
StatePublished - Dec 21 2020
Externally publishedYes


  • deep learning
  • lung nodule classification
  • robustness

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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