Cited by 242Privacy-Preserving Technologies in DataArtificial Intelligence in Healthcare and EducationDomain Adaptation and Few-Shot Learning

The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index; 4 of the 9 sources its claims cite were checked for support.

Federated learning improves site performance in multicenter deep learning without data sharing

Open access

Abstract

Objective: To demonstrate enabling multi-institutional training without centralizing or sharing the underlying physical data via federated learning (FL). Materials and Methods: Deep learning models were trained at each participating institution using local clinical data, and an additional model was trained using FL across all of the institutions. Results: We found that the FL model exhibited superior performance and generalizability to the models trained at single institutions, with an overall performance level that was significantly better than that of any of the institutional models alone when evaluated on held-out test sets from each institution and an outside challenge dataset. Discussion: The power of FL was successfully demonstrated across 3 academic institutions while avoiding the privacy risk associated with the transfer and pooling of patient data. Conclusion: Federated learning is an effective methodology that merits further study to enable accelerated development of models across institutions, enabling greater generalizability in clinical use.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In a 3-institution study using real prostate MRI, federated learning produced a single model without sharing patient data. The FL model outperformed each institution’s private model on held-out institutional test sets and an external challenge dataset.

Key findings

  • The FL model achieved an overall private-test-set mean Dice of 0.895 ± 0.036, significantly better than each private model (P < .001); private model overall Dice values were 0.833 ± 0.131 (NCI), 0.854 ± 0.074 (SUNY), and 0.745 ± 0.178 (UCLA).
  • On the external PROSTATEx challenge dataset (n = 343), the FL model achieved 0.889 ± 0.036, significantly better than the private models: NCI 0.872 ± 0.062, SUNY 0.838 ± 0.043, UCLA 0.812 ± 0.136 (P < .001 for all comparisons).
  • Private models performed well on their own institutional test sets (Dice range 0.883–0.925) but had diminished performance on other institutions’ test sets (Dice range 0.575–0.887).

Methods

  • Retrospective multicenter study at UCLA, SUNY Upstate, and NCI: each institution collected 1 prostate MRI from 100 patients, with axial T2W images at 3T and expert whole-prostate segmentations; each private dataset was split into 80 training and 20 held-out test images. An external challenge dataset of 343 axial T2W prostate images from SPIE-AAPM-NCI PROSTATEx was also used.
  • The model was a 3D Anisotropic Hybrid Network trained with soft Dice loss and Adam; each private training set was split into 5 sets of 16 images to train 5 submodels combined into an ensemble. All models were trained for 300 epochs.
  • Federated learning used a cloud-based aggregation server; after each epoch, model weights and validation metrics were sent from each institution, combined by a weighted average based on validation mean Dice, and redistributed. Evaluation used Dice coefficient and 2-sided paired t-tests comparing private models to the FL model on the combined private test set and the challenge dataset.

Limitations

  • Stated: the authors did not address the potential for an inside actor to recover underlying patient data through a model inversion attack on shared weights; they suggest calibrated distortion to shared weights as a possible future enhancement.
  • Stated: the task (prostate segmentation on T2-weighted MRI) is relatively simple, and all private models achieved high performance on their own institutional datasets, so the study could not demonstrate that an FL-trained model would significantly outperform a single-site-trained model on that single site’s data.
  • Stated: because private datasets were similarly sized, the authors did not explore varying the federated aggregation methodology; adding more institutions may introduce challenges in imaging data quality heterogeneity, governance, intellectual property, and model generalizability, possibly requiring private fine-tuning. Evident from the text: only 3 academic institutions and one segmentation task were tested, and no formal privacy attack evaluation was performed.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1093/jamia/ocaa341

Cites

27 of 27 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Figure 1. Federated learning architecture overview.
Figure 1. Federated learning architecture overview.CC BY · PubMed Central

Verification

Claims the paper makes

8 Own interpretation · 4 Own method · 4 Own result · 3 Partly supported · 2 No basis given · 1 Sources not found · 1 No full text of the sources · accuracy not yet measured

Show all 10 claims

  • Probably not a substantial claim. 6
  • It may state two separate claims as one. 8
13 of 13
  • The paper relies on this without support.

    The practical risk of model inversion by an inside actor outside crafted malintent is low due to the weight averaging scheme.

    “we empirically believe that the practical risk of inversion outside of crafted malintent on the part of study designers to be low due to the weight averaging scheme in place.”
  • The paper relies on this without support.

    Medical imaging data in most cases is siloed within provider institutions, and assembling large-scale datasets traditionally requires transfer of data between silos.

    “However, medical imaging data in most cases is siloed within provider institutions, and, as a result, assembling large-scale datasets traditionally requires the transfer of data between these silos.”
  • The paper relies on this without support.

    Very few public large-scale pooled medical image datasets exist.

    “As a result, very few public large-scale pooled medical image datasets exist.”
  • The paper relies on this without support.

    Deep learning models are primarily interpolators, not extrapolators—they perform best when presented with inputs similar to training data.

    “This large volume is required because deep learning models are primarily interpolators, not extrapolators—that is, they perform best when presented with inputs that are similar to the data that those models were trained on.”
  • The paper relies on this without support.

    The task of prostate segmentation on T2-weighted MRI is relatively simple.

    “the task we used (prostate segmentation on T2-weighted MRI) is relatively simple”
5 of 5

Claims other papers make about this one

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Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

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Metadata

Authors
Sarma, K. V., Harmon, S., Sanford, T., Roth, H. R., Xu, Z., Tetreault, J., Xu, D., Flores, M. G., Raman, A. G., Kulkarni, R., Wood, B. J., Choyke, P. L., Priester, A. M., Marks, L. S., Raman, S. S., Enzmann, D., Turkbey, B., Speier, W., & Arnold, C. W.
Affiliations
  • University of California, Los Angeles (US)
  • National Institutes of Health (US)
  • SUNY Upstate Medical University (US)
  • Nvidia (United States) (US)
  • National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
Corresponding author
Arnold, Corey W
Venue
Journal of the American Medical Informatics Association
Published
2021-02-04
Volume
28
Issue
6
Pages
1259-1264
ISSN
  • 1067-5027 (ISSN-L)
  • 1527-974X
OpenAlex
W3128304793
Cited by
242
References
25
Citations by year
2026: 36 · 2025: 54 · 2024: 55 · 2023: 49 · 2022: 34 · 2021: 13
FWCI
8.11
Type
journal article
Language
en
Open access
Locations
  • Journal of the American Medical Informatics Association (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion, cc-by)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • NIH NCI (F30CA210329, R21CA220352, P50CA092131, ZIDBC011242, Z1ACL040015, HHSN261200800001E)
  • NIH NIGMS (GM08042)
  • NIH
  • AMA Foundation
  • NVIDIA Corporation Academic Hardware Grant
  • NIH Center for Interventional Oncology
  • Intramural Research Program of the NIH, and a cooperative research and development agreement (CRADA) between NIH and nVIDIA
Topics
  • Physical Sciences › Computer Science › Artificial Intelligence › Privacy-Preserving Technologies in Data
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Physical Sciences › Computer Science › Artificial Intelligence › Domain Adaptation and Few-Shot Learning
Keywords
federated learning, data privacy, data sharing, model generalization, clinical data
MeSH terms
Deep Learning, Humans, Privacy, Information Dissemination

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