Towards Ultrasound-based Reliable Disease Diagnosis Using Causal Inference

Aligning the decision-making process of deep learning models with that of experienced sonographers is essential for ultrasound-based reliable disease diagnosis. Although existing methods have made significant progress in this aspect, their alignments are primarily associational rather than causal, leading to pseudo-correlations between features and diagnostic results. Such a biased diagnosis blindly models the sonographer's diagnostic skills and attention to specific patterns, which we argue hardly produces an AI diagnoser that is comparable to human experts. To address this issue, we propose a causality-based diagnostic framework to align the model's diagnostic behaviors with those of experts. Specifically, by delving into both conspicuous and inconspicuous confounders within the ultrasound images, the back-door and front-door adjustment causal learning modules are proposed to promote unbiased learning by mitigating potential pseudo-correlations. In addition, we integrate causal inference into a well-designed dual-branch model with feature interaction bridges for compatibility with multimodal ultrasound inputs. To fully evaluate our method, we conduct comparative studies on different diseases and ultrasound modalities. In particular, we publish a carefully constructed multimodal ultrasound dataset for breast lesion diagnosis and segmentation. Sufficient comparative and ablation studies on this dataset emphasize that our method outperforms state-of-the-art methods.