Beyond Conventional Transformers: The Medical X-ray Attention (MXA) Block for Improved Multi-Label Diagnosis Using Knowledge Distillation

Medical imaging, particularly X-ray analysis, often involves detecting multiple conditions simultaneously within a single scan, making multi-label classification crucial for real-world clinical applications. We present the Medical X-ray Attention (MXA) block, a novel attention mechanism tailored specifically to address the unique challenges of X-ray abnormality detection. The MXA block enhances traditional Multi-Head Self Attention (MHSA) by integrating a specialized module that efficiently captures both detailed local information and broader global context. To the best of our knowledge, this is the first work to propose a task-specific attention mechanism for diagnosing chest X-rays, as well as to attempt multi-label classification using an Efficient Vision Transformer (EfficientViT). By embedding the MXA block within the EfficientViT architecture and employing knowledge distillation, our proposed model significantly improves performance on the CheXpert dataset, a widely used benchmark for multi-label chest X-ray abnormality detection. Our approach achieves an area under the curve (AUC) of 0.85, an absolute improvement of 0.19 compared to our baseline model’s AUC of 0.66, corresponding to a substantial approximate 233% relative improvement over random guessing (AUC = 0.5).