Dual-Distribution Discrepancy for Anomaly Detection in Chest X-Rays

Chest X-ray (CXR) is the most typical radiological exam for diagnosis of various diseases. Due to the expensive and time-consuming annotations, detecting anomalies in CXRs in an unsupervised fashion is very promising. However, almost all of the existing methods consider anomaly detection as a One-Class Classification (OCC) problem. They model the distribution of only known normal images during training and identify the samples not conforming to normal profile as anomalies in the testing phase. A large number of unlabeled images containing anomalies are thus ignored in the training phase, although they are easy to obtain in clinical practice. In this paper, we propose a novel strategy, Dual-distribution Discrepancy for Anomaly Detection (DDAD), utilizing both known normal images and unlabeled images. The proposed method consists of two modules, denoted as A and B. During training, module A takes both known normal and unlabeled images as inputs, capturing anomalous features from unlabeled images in some way, while module B models the distribution of only known normal images. Subsequently, the inter-discrepancy between modules A and B, and intra-discrepancy inside module B are designed as anomaly scores to indicate anomalies. Experiments on three CXR datasets demonstrate that the proposed DDAD achieves consistent, significant gains and outperforms state-of-the-art methods. Code is available at https://github.com/caiyu6666/DDAD.