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Unsupervised Hybrid framework for ANomaly Detection (HAND)- applied to Screening Mammogram.

Zhemin Zhang, Bhavika Patel, Bhavik Patel

IEEE Journal of Biomedical and Health Informatics

|November 28, 2025

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Out-of-distribution (OOD) detection in AI mammogram screening is improved by the novel HAND model. This method accurately identifies abnormal samples, enhancing AI generalization and ensuring reliable screening performance across diverse datasets.

Area of Science:

Artificial Intelligence
Medical Imaging Analysis
Machine Learning for Healthcare

Background:

Out-of-distribution (OOD) detection is crucial for AI generalization in mammogram screening.
Distribution shifts in external datasets can significantly degrade AI model performance.
Unsupervised generative learning is preferred for OOD detection due to limited prior knowledge of external data characteristics.

Purpose of the Study:

To develop a novel approach for detecting OOD samples in mammogram screening.
To improve the robustness and generalization of AI models used in mammography.
To provide an automated solution for quality control in external mammogram datasets.

Main Methods:

Developed a novel hybrid CNN-transformer backbone named HAND for OOD detection.

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Incorporated synthetic OOD samples and a latent space discriminator.

Applied gradient reversal to OOD reconstruction loss to enhance OOD differentiation.

Computed an anomaly score based on reconstruction and discriminator loss.

Main Results:

The HAND model demonstrated superior performance in OOD detection compared to encoder-based, GAN-based, and other hybrid CNN+transformer baselines.
The proposed method effectively distinguishes between in-distribution (ID) and OOD samples.
Achieved strong results on both internal (RSNA) and external (Mayo Clinic) mammogram datasets.

Conclusions:

The HAND pipeline offers an automated and efficient computational solution for domain-specific quality checks in external screening mammograms.
This approach yields actionable insights without direct exposure to private medical imaging data.
The HAND model enhances the reliability of AI in mammogram screening by effectively handling OOD data.