Vision-Language Model Based Multi-Expert Fusion for CT Image Classification

Deep learning models for COVID-19 detection from chest CT scans generally perform well when the training and test data originate from the same institution, but they often struggle when scans are drawn from multiple centres with differing scanners, imaging protocols, and patient populations. One key reason is that existing methods treat COVID-19 classification as the sole training objective, without accounting for the data source of each scan. As a result, the learned representations tend to be biased toward centres that contribute more training data. To address this, we propose a multi-task learning approach in which the model is trained to predict both the COVID-19 diagnosis and the originating data centre. The two tasks share an EfficientNet-B7 backbone, which encourages the feature extractor to learn representations that hold across all four participating centres. Since the training data is not evenly distributed across sources, we apply a logit-adjusted cross-entropy loss [1] to the source classification head to prevent underrepresented centres from being overlooked. Our pre-processing follows the SSFL framework with KDS [2], selecting eight representative slices per scan. Our method achieves an F1 score of 0.9098 and an AUC-ROC of 0.9647 on a validation set of 308 scans. The code is publicly available at https://github.com/Purdue-M2/-multisource-covid-ct.

The COVID-19 pandemic exposed critical limitations in diagnostic workflows: RT-PCR tests suffer from slow turnaround times and high false-negative rates, while CT-based screening offers faster complementary diagnosis but requires expert radiological interpretation. Deploying automated CT analysis across multiple hospital centres introduces further challenges, as differences in scanner hardware, acquisition protocols, and patient populations cause substantial domain shift that degrades single-model performance. To address these challenges, we present a heterogeneous ensemble of nine models spanning three inference paradigms: (1) a self-supervised DINOv2 Vision Transformer with slice-level sigmoid aggregation, (2) a RadImageNet-pretrained DenseNet-121 with slice-level sigmoid averaging, and (3) seven Gated Attention Multiple Instance Learning models using EfficientNet-B3, ConvNeXt-Tiny, and EfficientNetV2-S backbones with scan-level softmax classification. Ensemble diversity is further enhanced through random-seed variation and Stochastic Weight Averaging. We address severe overfitting, reducing the validation-to-training loss ratio from 35x to less than 3x, through a combination of Focal Loss, embedding-level Mixup, and domain-aware augmentation. Model outputs are fused via score-weighted probability averaging and calibrated with per-source threshold optimization. The final ensemble achieves an average macro F1 of 0.9280 across four hospital centres, outperforming the best single model (F1=0.8969) by +0.031, demonstrating that heterogeneous architectures combined with source-aware calibration are essential for robust multi-site medical image classification.

We propose a deep learning framework for COVID-19 detection and disease classification from chest CT scans that integrates both 2.5D and 3D representations to capture complementary slice-level and volumetric information. The 2.5D branch processes multi-view CT slices (axial, coronal, sagittal) using a DINOv3 vision transformer to extract robust visual features, while the 3D branch employs a ResNet-18 architecture to model volumetric context and is pretrained with Variance Risk Extrapolation (VREx) followed by supervised contrastive learning to improve cross-source robustness. Predictions from both branches are combined through logit-level ensemble inference. Experiments on the PHAROS-AIF-MIH benchmark demonstrate the effectiveness of the proposed approach: for binary COVID-19 detection, the ensemble achieves 94.48% accuracy and a 0.9426 Macro F1-score, outperforming both individual models, while for multi-class disease classification the 2.5D DINOv3 model achieves the best performance with 79.35% accuracy and a 0.7497 Macro F1-score. These results highlight the benefit of combining pretrained slice-based representations with volumetric modeling for robust multi-source medical imaging analysis. Code is available at https://github.com/HySonLab/PHAROS-AIF-MIH