Natural images allow universal adversarial attacks on medical image classification using deep neural networks with transfer learning

Transfer learning from natural images is used in deep neural networks (DNNs) for medical image classification to achieve a computer-aided clinical diagnosis. Although the adversarial vulnerability of DNNs hinders practical applications owing to the high stakes of diagnosis, adversarial attacks are expected to be limited because training datasets (medical images), which are often required for adversarial attacks, are generally unavailable in terms of security and privacy preservation. Nevertheless, in this study, we demonstrated that adversarial attacks are also possible using natural images for medical DNN models with transfer learning, even if such medical images are unavailable; in particular, we showed that universal adversarial perturbations (UAPs) can also be generated from natural images. UAPs from natural images are useful for both non-targeted and targeted attacks. The performance of UAPs from natural images was significantly higher than that of random controls. The use of transfer learning causes a security hole, which decreases the reliability and safety of computer-based disease diagnosis. Model training from random initialization reduced the performance of UAPs from natural images; however, it did not completely avoid vulnerability to UAPs. The vulnerability of UAPs to natural images is expected to become a significant security threat