This paper investigates federated multi-centre liver tumour classification from contrast-enhanced CT under realistic data heterogeneity and domain shift. To address the practical constraint that medical data are often siloed across institutions, we develop a FedProx-based federated learning pipeline that enables collaborative training without exchanging raw patient data. Using the LiTS dataset as the training domain, we construct a slice-level binary classification task based on voxel-level annotations, while rigorously assessing out-of-distribution generalisation on an external held-out dataset, 3D-IRCADb. We conduct comprehensive experiments across multiple backbone architectures, including ResNet-50, EfficientNet-B3, ViT-B/16, and MobileNetV3-Small, comparing FedProx and FedAvg under three heterogeneity intensities (IID, mild non-IID, and severe non-IID). Furthermore, we evaluate transfer learning strategies, ranging from frozen backbones to partial fine-tuning of the last stage, and perform ablations on the proximal coefficient μ and local epochs E to characterise optimisation behaviour. Our results show that FedProx is generally comparable to FedAvg, with slightly more stable behaviour in some heterogeneous settings. We also observe a clear validation-to-external gap, indicating that external-domain robustness remains challenging and requires cautious interpretation for deployment. ImageNet pretraining yields consistent gains, particularly for data-sparse clients, while partial fine-tuning enhances adaptation to CT-specific features. Finally, MobileNetV3-Small offers a favourable performance–efficiency trade-off by reducing communication payload and computation cost, supporting practical deployment on resource-constrained clinical edge devices.
Zhu et al. (Fri,) studied this question.