Thorax disease classification with attention guided convolutional neural network

•A novel attention guided convolutional neural network (AG-CNN) is proposed for thorax disease identification.•AG-CNN integrates the global and local information to improve the recognition performance.•We introduce a CNN training baseline, which produces competitive results to the state-of-the-art methods.•A new state-of-the-art is yielded by AG-CNN on the ChestX-ray14 dataset. This paper considers the task of thorax disease diagnosis on chest X-ray (CXR) images. Most existing methods generally learn a network with global images as input. However, thorax diseases usually happen in (small) localized areas which are disease specific. Thus training CNNs using global images may be affected by the (excessive) irrelevant noisy areas. Besides, due to the poor alignment of some CXR images, the existence of irregular borders hinders the network performance. For addressing the above problems, we propose to integrate the global and local cues into a three-branch attention guided convolution neural network (AG-CNN) to identify thorax diseases. An attention guided mask inference based cropping strategy is proposed to avoid noise and improve alignment in the global branch. AG-CNN also integrates the global cues to compensate the lost discriminative cues by the local branch. Specifically, we first learn a global CNN branch using global images. Then, guided by the attention heatmap generated from the global branch, we infer a mask to crop a discriminative region from the global image. The local region is used for training a local CNN branch. Lastly, we concatenate the last pooling layers of both the global and local branches for fine-tuning the fusion branch. Experiments on the ChestX-ray14 dataset demonstrate that after integrating the local cues with the global information, the average AUC scores are improved by AG-CNN.