Data privacy mechanisms are essential for rapidly scaling medical training databases to capture the heterogeneity of patient data distributions toward robust and generalizable machine learning systems. In the current COVID-19 pandemic, a major focus of artificial intelligence (AI) is interpreting chest CT, which can be readily used in the assessment and management of the disease. This paper demonstrates the feasibility of a federated learning method for detecting COVID-19 related CT abnormalities with external validation on patients from a multinational study. We recruited 132 patients from seven multinational different centers, with three internal hospitals from Hong Kong for training and testing, and four external, independent datasets from Mainland China and Germany, for validating model generalizability. We also conducted case studies on longitudinal scans for automated estimation of lesion burden for hospitalized COVID-19 patients. We explore the federated learning algorithms to develop a privacy-preserving AI model for COVID-19 medical image diagnosis with good generalization capability on unseen multinational datasets. Federated learning could provide an effective mechanism during pandemics to rapidly develop clinically useful AI across institutions and countries overcoming the burden of central aggregation of large amounts of sensitive data.

The emerging paradigm of federated learning (FL) strives to enable collaborative training of deep models on the network edge without centrally aggregating raw data and hence improving data privacy. In most cases, the assumption of independent and identically distributed samples across local clients does not hold for federated learning setups. Under this setting, neural network training performance may vary significantly according to the data distribution and even hurt training convergence. Most of the previous work has focused on a difference in the distribution of labels or client shifts. Unlike those settings, we address an important problem of FL, e.g., different scanners/sensors in medical imaging, different scenery distribution in autonomous driving (highway vs. city), where local clients store examples with different distributions compared to other clients, which we denote as feature shift non-iid. In this work, we propose an effective method that uses local batch normalization to alleviate the feature shift before averaging models. The resulting scheme, called FedBN, outperforms both classical FedAvg, as well as the state-of-the-art for non-iid data (FedProx) on our extensive experiments. These empirical results are supported by a convergence analysis that shows in a simplified setting that FedBN has a faster convergence rate than FedAvg. Code is available at https://github.com/med-air/FedBN.Recent studies have attempted to address the problem of FL on non-iid data. Most variants of FedAvg primarily tackle the issues of stability, client drift and heterogeneous label distribution over clients (

Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing.

Multiple medical institutions collaboratively training a model using federated learning (FL) has become a promising solution for maximizing the potential of data-driven models, yet the non-independent and identically distributed (non-iid) data in medical images is still an outstanding challenge in real-world practice. The feature heterogeneity caused by diverse scanners or protocols introduces a drift in the learning process, in both local (client) and global (server) optimizations, which harms the convergence as well as model performance. Many previous works have attempted to address the non-iid issue by tackling the drift locally or globally, but how to jointly solve the two essentially coupled drifts is still unclear. In this work, we concentrate on handling both local and global drifts and introduce a new harmonizing framework called HarmoFL. First, we propose to mitigate the local update drift by normalizing amplitudes of images transformed into the frequency domain to mimic a unified imaging setting, in order to generate a harmonized feature space across local clients. Second, based on harmonized features, we design a client weight perturbation guiding each local model to reach a flat optimum, where a neighborhood area of the local optimal solution has a uniformly low loss. Without any extra communication cost, the perturbation assists the global model to optimize towards a converged optimal solution by aggregating several local flat optima. We have theoretically analyzed the proposed method and empirically conducted extensive experiments on three medical image classification and segmentation tasks, showing that HarmoFL outperforms a set of recent state-of-the-art methods with promising convergence behavior. Code is available at: https://github.com/med-air/HarmoFL

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