GazeLT: Visual attention–guided long-tailed disease classification in chest radiographs

Moinak Bhattacharya1, Gagandeep Singh2, Shubham Jain3, Prateek Prasanna1
1: Department of Biomedical Informatics, Stony Brook University, NY, US, 11790, 2: Department of Radiology, Columbia University, NY, US, 10027, 3: Department of Computer Science, Stony Brook University, NY, US, 11790
Publication date: 2026/02/02
https://doi.org/10.59275/j.melba.2026-d8c8
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Abstract

In this work, we present GazeLT, a human visual attention integration-disintegration approach for long-tailed disease classification. A radiologist’s eye gaze has distinct patterns that capture both fine-grained and coarser level disease related information. While interpreting an image, a radiologist’s attention varies throughout the duration; it is critical to incorporate this into a deep learning framework to improve automated image interpretation. Another important aspect of visual attention is that apart from looking at major/obvious disease patterns, experts also look at minor/incidental findings (few of these constituting long-tailed classes) during the course of image interpretation. GazeLT harnesses the temporal aspect of the visual search process, via an integration and disintegration mechanism, to improve long- tailed disease classification. We show the efficacy of GazeLT on two publicly available datasets for long-tailed disease classification, namely the NIH-CXR-LT (n=89237) and the MIMIC-CXR-LT (n=111898) datasets. GazeLT outperforms the best long-tailed loss by 4.1% and the visual attention-based baseline by 21.7% in average accuracy metrics for these datasets. Our code is available at https://github.com/lordmoinak1/gazelt.

Keywords

Eye gaze · Long-tailed classification · Chest X-ray

Bibtex @article{melba:2026:020:bhattacharya, title = "GazeLT: Visual attention–guided long-tailed disease classification in chest radiographs", author = "Bhattacharya, Moinak and Singh, Gagandeep and Jain, Shubham and Prasanna, Prateek", journal = "Machine Learning for Biomedical Imaging", volume = "2026", issue = "February 2026 issue", year = "2026", pages = "411--430", issn = "2766-905X", doi = "https://doi.org/10.59275/j.melba.2026-d8c8", url = "https://melba-journal.org/2026:020" }
RISTY - JOUR AU - Bhattacharya, Moinak AU - Singh, Gagandeep AU - Jain, Shubham AU - Prasanna, Prateek PY - 2026 TI - GazeLT: Visual attention–guided long-tailed disease classification in chest radiographs T2 - Machine Learning for Biomedical Imaging VL - 2026 IS - February 2026 issue SP - 411 EP - 430 SN - 2766-905X DO - https://doi.org/10.59275/j.melba.2026-d8c8 UR - https://melba-journal.org/2026:020 ER -

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