Improved performance and robustness of multi-task representation learning with consistency loss between pretexts for intracranial hemorrhage identification in head CT
Abstract
With the recent development of deep learning, the classification and segmentation tasks of computer-aided diagnosis (CAD) using non-contrast head computed tomography (NCCT) for intracranial hemorrhage (ICH) has become popular in emergency medical care. However, a few challenges remain, such as the difficulty of training due to the heterogeneity of ICH, the requirement for high performance in both sensitivity and specificity, patient-level predictions demanding excessive costs, and vulnerability to real-world external data. In this study, we proposed a supervised multi-task aiding representation transfer learning network (SMART-Net) for ICH to overcome these challenges. The proposed framework consists of upstream and downstream components. In the upstream, a weight-shared encoder of the model is trained as a robust feature extractor that captures global features by performing slice-level multi-pretext tasks (classification, segmentation, and reconstruction). Adding a consistency loss to regularize discrepancies between classification and segmentation heads has significantly improved representation and transferability. In the downstream, the transfer learning was conducted with a pre-trained encoder and 3D operator (classifier or segmenter) for volume-level tasks. Excessive ablation studies were conducted and the SMART-Net was developed with optimal multi-pretext task combinations and a 3D operator. Experimental results based on four test sets (one internal and two external test sets that reflect a natural incidence of ICH, and one public test set with a relatively small amount of ICH cases) indicate that SMART-Net has better robustness and performance in terms of volume-level ICH classification and segmentation over previous methods. All code is available at https://github.com/babbu3682/SMART-Net.
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Studies that evaluate robustness to various data distributions through external validation inherently address the generalizability of the model.
“studies that evaluate the robustness to various data distributions through external validation inherently address the generalizability of the model19–22.”
From A scoping review of robustness concepts for machine learning in healthcare (2025) · cites this paper as [19]
Cites
Concurrent Spatial and Channel ‘Squeeze & Excitation’ in Fully Convolutional Networks
Roy, A. G., Navab, N., & Wachinger, C. (2018) · Lecture Notes in Computer Science · doi:10.1007/978-3-030-00928-1_48 · Cited by 869 · see citing works
A scoping review of transfer learning research on medical image analysis using ImageNet
Morid, M. A., Borjali, A., & Del Fiol, G. (2021) · Computers in Biology and Medicine · doi:10.1016/j.compbiomed.2020.104115 · Cited by 508 · see citing works
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A scoping review of robustness concepts for machine learning in healthcare
Balendran, A., Beji, C., Bouvier, F., Khalifa, O., Evgeniou, T., Ravaud, P., & Porcher, R. (2025) · npj Digital Medicine · doi:10.1038/s41746-024-01420-1 · Cited by 43 · see citing works
- Authors
- Kyung, S., Shin, K., Jeong, H., Kim, K. D., Park, J., Cho, K., Lee, J. H., Hong, G., & Kim, N.
- Affiliations
- Asan Medical Center (KR)
- Corresponding author
- Kim, Namkug
- ORCID
- Venue
- Medical Image Analysis
- Publisher
- Elsevier BV
- Published
- 2022-10
- Volume
- 81
- Pages
- 102489
- ISSN
- 1361-8415 (ISSN-L)
- OpenAlex
- W4281259597
- Cited by
- 32
- References
- 2
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 7 · 2023: 7 · 2022: 3
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Medical Image Analysis (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Health and Welfare (HI18C0022, HI18C2383)
- Korea Health Industry Development Institute
- Topics
- Health Sciences › Medicine › Neurology › Intracerebral and Subarachnoid Hemorrhage Research
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Medical Image Segmentation Techniques
- Life Sciences › Neuroscience › Neurology › Brain Tumor Detection and Classification
- Keywords
- intracranial hemorrhage, non-contrast head CT, multi-task learning, representation learning, consistency loss, transfer learning, 3D convolution
- MeSH terms
- Diagnosis, Computer-Assisted, Humans, Image Processing, Computer-Assisted, Sensitivity and Specificity, Tomography, X-Ray Computed, Intracranial Hemorrhages
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