Privacy-Aware Continual Self-Supervised Learning on Multi-Window Chest Computed Tomography for Domain-Shift Robustness.

We propose a novel continual self-supervised learning (CSSL) framework for simultaneously learning diverse features from multi-window-obtained chest computed tomography (CT) images and ensuring data privacy. Achieving a robust and highly generalizable model in medical image diagnosis is challenging, mainly because of issues, such as the scarcity of large-scale, accurately annotated datasets and domain shifts inherent to dynamic healthcare environments. Specifically, in chest CT, these domain shifts often arise from differences in window settings, which are optimized for distinct clinical purposes. Previous CSSL frameworks often mitigated domain shift by reusing past data, a typically impractical approach owing to privacy constraints. Our approach addresses these challenges by effectively capturing the relationship between previously learned knowledge and new information across different training stages through continual pretraining on unlabeled images. Specifically, by incorporating a latent replay-based mechanism into CSSL, our method mitigates catastrophic forgetting due to domain shifts during continual pretraining while ensuring data privacy. Additionally, we introduce a feature distillation technique that integrates Wasserstein distance-based knowledge distillation and batch-knowledge ensemble, enhancing the ability of the model to learn meaningful, domain-shift-robust representations. Finally, we validate our approach using chest CT images obtained across two different window settings, demonstrating superior performance compared with other approaches.