Vulnerability of deep neural networks for detecting COVID-19 cases from chest X-ray images to universal adversarial attacks

Under the epidemic of the novel coronavirus disease 2019 (COVID-19), chest X-ray computed tomography imaging is being used for effectively screening COVID-19 patients. The development of computer-aided systems based on deep neural networks (DNNs) has been advanced, to rapidly and accurately detect COVID-19 cases, because the need for expert radiologists, who are limited in number, forms a bottleneck for the screening. However, so far, the vulnerability of DNN-based systems has been poorly evaluated, although DNNs are vulnerable to a single perturbation, called universal adversarial perturbation (UAP), which can induce DNN failure in most classification tasks. Thus, we focus on representative DNN models for detecting COVID-19 cases from chest X-ray images and evaluate their vulnerability to UAPs generated using simple iterative algorithms. We consider nontargeted UAPs, which cause a task failure resulting in an input being assigned an incorrect label, and targeted UAPs, which cause the DNN to classify an input into a specific class. The results demonstrate that the models are vulnerable to nontargeted and targeted UAPs, even in case of small UAPs. In particular, 2% norm of the UPAs to the average norm of an image in the image dataset achieves >85% and >90% success rates for the nontargeted and targeted attacks, respectively. Due to the nontargeted UAPs, the DNN models judge most chest X-ray images as COVID-19 cases. The targeted UAPs make the DNN models classify most chest X-ray images into a given target class. The results indicate that careful consideration is required in practical applications of DNNs to COVID-19 diagnosis; in particular, they emphasize the need for strategies to address security concerns. As an example, we show that iterative fine-tuning of the DNN models using UAPs improves the robustness of the DNN models against UAPs.Comment: 17 pages, 5 figures, 3 table

Adversarial Attack Vulnerability of Medical Image Analysis Systems: Unexplored Factors

Adversarial attacks are considered a potentially serious security threat for machine learning systems. Medical image analysis (MedIA) systems have recently been argued to be vulnerable to adversarial attacks due to strong financial incentives and the associated technological infrastructure. In this paper, we study previously unexplored factors affecting adversarial attack vulnerability of deep learning MedIA systems in three medical domains: ophthalmology, radiology, and pathology. We focus on adversarial black-box settings, in which the attacker does not have full access to the target model and usually uses another model, commonly referred to as surrogate model, to craft adversarial examples. We consider this to be the most realistic scenario for MedIA systems. Firstly, we study the effect of weight initialization (ImageNet vs. random) on the transferability of adversarial attacks from the surrogate model to the target model. Secondly, we study the influence of differences in development data between target and surrogate models. We further study the interaction of weight initialization and data differences with differences in model architecture. All experiments were done with a perturbation degree tuned to ensure maximal transferability at minimal visual perceptibility of the attacks. Our experiments show that pre-training may dramatically increase the transferability of adversarial examples, even when the target and surrogate's architectures are different: the larger the performance gain using pre-training, the larger the transferability. Differences in the development data between target and surrogate models considerably decrease the performance of the attack; this decrease is further amplified by difference in the model architecture. We believe these factors should be considered when developing security-critical MedIA systems planned to be deployed in clinical practice.Comment: First three authors contributed equall

SEDA: Self-Ensembling ViT with Defensive Distillation and Adversarial Training for robust Chest X-rays Classification

Deep Learning methods have recently seen increased adoption in medical imaging applications. However, elevated vulnerabilities have been explored in recent Deep Learning solutions, which can hinder future adoption. Particularly, the vulnerability of Vision Transformer (ViT) to adversarial, privacy, and confidentiality attacks raise serious concerns about their reliability in medical settings. This work aims to enhance the robustness of self-ensembling ViTs for the tuberculosis chest x-ray classification task. We propose Self-Ensembling ViT with defensive Distillation and Adversarial training (SEDA). SEDA utilizes efficient CNN blocks to learn spatial features with various levels of abstraction from feature representations extracted from intermediate ViT blocks, that are largely unaffected by adversarial perturbations. Furthermore, SEDA leverages adversarial training in combination with defensive distillation for improved robustness against adversaries. Training using adversarial examples leads to better model generalizability and improves its ability to handle perturbations. Distillation using soft probabilities introduces uncertainty and variation into the output probabilities, making it more difficult for adversarial and privacy attacks. Extensive experiments performed with the proposed architecture and training paradigm on publicly available Tuberculosis x-ray dataset shows SOTA efficacy of SEDA compared to SEViT in terms of computational efficiency with 70x times lighter framework and enhanced robustness of +9%.Comment: Accepted at DART (Domain Adaptation and Representation Transfer) Workshop, MICCAI, 2023. Code: https://github.com/Razaimam45/SED