Addressing Dataset Shift for Trustworthy Deep Learning Diagnostic Ultrasound Decision Support

Ultrasound (US) is the most widely used medical imaging modality due to its low cost, portability, real time imaging ability and use of non-ionizing radiation. However, unlike other imaging modalities such as CT or MRI, it is a heavily operator dependent, requiring trained expertise to leverage these benefits.Recently there has been an explosion of interest in AI across the medical community and many are turning to the growing trend of deep learning (DL) models to assist in diagnosis. However, due to possible differences in training and deployment, model performance suffers which can lead to misdiagnosis and operator hesitancy. This issue is known as dataset shift. Two aims to address dataset shift were proposed. The first was to quantify how US operator skill and hardware affects acquired images. The second was to use this skill quantification method to screen and match data to deep learning models to improve performance.A CAE Healthcare BLUE phantom with mock lesions was scanned by three operators using three different US systems (Siemens S3000, Clarius L15, and Ultrasonix SonixTouch) producing 39013 images. DL models were trained on a specific set to classify the presence of a simulated tumour and tested with data from differing sets. Principle Component Analysis (PCA) for dimension reduction was applied, then K-Means clustering was used to separate images generated by operator and hardware into clusters. This clustering algorithm was then used to screen incoming images during deployment to best match input to an appropriate DL model which is trained specifically to classify that type of operator or hardware. Results showed a noticeable difference when models were given data from differing datasets with the largest accuracy drop being 81.26% to 31.26%. Overall, operator differences more significantly affected DL model performance. Clustering models had much higher success separating hardware data compared to operator data. The proposed method reflects this result with a much higher accuracy across the hardware test set compared to the operator data.