Deep learning in medical image analysis often requires an extensive amount of high-quality labeled data for training to achieve Human-level accuracy. We propose Gist-set Online Active Learning (GOAL), a novel solution for limited high-quality labeled data in medical imaging analysis. Our approach advances the existing active learning methods in three aspects. Firstly, we improve the classification performance with fewer manual annotations by presenting a sample selection strategy called gist set selection. Secondly, unlike traditional methods focusing only on random uncertain samples of low prediction confidence, we propose a new method in which only informative uncertain samples are selected for human annotation. Thirdly, we propose an application of online learning where high-confidence samples are automatically selected, iteratively assigned, and pseudo-labels are updated. We validated our approach on two private and one public dataset. The experimental results show that, by applying GOAL, we can reduce required labeled data up to 88% while maintaining the same F1 scores compared to the models trained on full datasets.

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