Self-feedback Transformer: A Multi-label Diagnostic Model for Real-World Pancreatic Neuroendocrine Neoplasms Data

CAD is an emerging field, but most models are not equipped to handle missing and noisy data in real-world medical scenarios, particularly in the case of rare tumors like pancreatic neuroendocrine neoplasms (pNENs). Multi-label models meet the needs of real-world study, but current methods do not consider the issue of missing and noisy labels. This study introduces a multi-label model called Self-feedback Transformer (SFT) that utilizes a transformer to model the relationships between labels and images, and uses a ingenious self-feedback strategy to improve label utilization. We evaluated SFT on 11 clinical tasks using a real-world dataset of pNENs and achieved higher performance than other state-of-the-art multi-label models with mAUCs of 0.68 and 0.76 on internal and external datasets, respectively. Our model has four inference modes that utilize self-feedback and expert assistance to further increase mAUCs to 0.72 and 0.82 on internal and external datasets, respectively, while maintaining good performance even with input label noise ratios up to 40% in expert-assisted mode.