Accuracy Is Not Enough: An Efficiency- and Statistics-Aware Benchmark of ResNet50 and Vision Transformer for Explainable Multi-Class Gastrointestinal Diseases Classification

Automated gastrointestinal (GI) endoscopy classification requires models that generalize across diverse modalities and class distributions, often far from natural-image pretraining. We propose MultiAttenGastro, a plug-and-play attention framework with parallel 1-D channel, 2-D spatial, and 3-D contextual heads, and present the first systematic cross-dataset evaluation across eight CNN and transformer backbones on five public GI datasets (80 backbone--dataset runs). We find that attention effectiveness is not universal but tracks the representational gap between ImageNet features and the target distribution: MultiAttenGastro improves 6 of 8 backbones on Kvasir-Capsule (14-class WCE, large gap; best macro F1 98.33%), is uniformly negative on the small-gap Kvasir-v2 benchmark (0/8), and shows mixed outcomes on datasets with intermediate gap. Five-seed ablation on the strongest case (Kvasir-Capsule, ConvNeXt-Tiny) shows this improvement is directionally consistent, but not statistically decisive (paired $t$: $p=0.47$; Wilcoxon: $p=0.63$), and that individual attention heads are not uniformly beneficial in isolation only their combination yields a positive mean effect. Centered Kernel Alignment (CKA) analysis links this pattern to representational redundancy: low inter-head CKA under large domain gaps coincides with the framework's only consistent gains, while high redundancy under small gaps coincides with its losses. We report these results, including the non-significant margins, as evidence for when and why multi-dimensional attention helps GI endoscopy classification, rather than as a claim that MultiAttenGastro is a strictly superior architectural choice.

Gastrointestinal diseases impose a growing global health burden, and endoscopy is a primary tool for early diagnosis. However, routine endoscopic image interpretation still suffers from missed lesions and limited efficiency. Although AI-assisted diagnosis has shown promise, existing models often lack generalizability, adaptability, robustness, and scalability because of limited medical data, domain shift, and heterogeneous annotations. To address these challenges, we develop RATNet, a foundation model for gastrointestinal endoscopy imaging based on analogical reasoning. RATNet acquires and transfers knowledge from heterogeneous expert annotations across five gastrointestinal endoscopy datasets through a cyclic pre-training strategy. Its architecture consists of an encoder, a relevance-knowledge acquisition and transfer (RAT) module, a projector, and a multi-task head, and supports fine-tuning, linear probing, and zero-shot transfer. Evaluations show that RATNet outperforms existing foundation models, including GastroNet and GastroVision, across six scenarios: diagnosis of common gastrointestinal diseases, few-shot learning for rare diseases, zero-shot transfer to new medical sites, robustness under long-tailed disease distributions, adaptation to novel diseases, and privacy-preserving deployment via federated learning. Its advantage comes from an analogical reasoning mechanism that matches image-derived posterior knowledge to a learned prior knowledge base and transfers relative knowledge to guide diagnosis, improving generalization and resistance to bias. RATNet is open and cost-effective, supports automatic integration of heterogeneous annotations without manual label unification, and reduces data acquisition costs, making it a practical foundation for intelligent gastrointestinal diagnosis, especially in resource-limited settings.

We developed a multi-label gastrointestinal video analysis pipeline based on a ResNet-50 frame classifier followed by anatomy-guided temporal event decoding. The system predicts 17 labels, including 5 anatomy classes and 12 pathology classes, from frames resized to 336x336. A major challenge was severe class imbalance, particularly for rare pathology labels. To address this, we used clipped class-wise positive weighting in the training loss, which improved rare-class learning while maintaining stable optimization. At the temporal stage, we found that direct frame-to-event conversion produced fragmented mismatches with the official ground truth. The final submission therefore combined GT-style framewise event composition, anatomy vote smoothing, and anatomy-based pathology gating with a conservative hysteresis decoder. This design improved the final temporal mAP from 0.3801 to 0.4303 on the challenge test set.