The robustness of supervised deep learning-based medical image classification is significantly undermined by label noise. Although several methods have been proposed to enhance classification performance in the presence of noisy labels, they face some challenges: 1) a struggle with class-imbalanced datasets, leading to the frequent overlooking of minority classes as noisy samples; 2) a singular focus on maximizing performance using noisy datasets, without incorporating experts-in-the-loop for actively cleaning the noisy labels. To mitigate these challenges, we propose a two-phase approach that combines Learning with Noisy Labels (LNL) and active learning. This approach not only improves the robustness of medical image classification in the presence of noisy labels, but also iteratively improves the quality of the dataset by relabeling the important incorrect labels, under a limited annotation budget. Furthermore, we introduce a novel Variance of Gradients approach in LNL phase, which complements the loss-based sample selection by also sampling under-represented samples. Using two imbalanced noisy medical classification datasets, we demonstrate that that our proposed technique is superior to its predecessors at handling class imbalance by not misidentifying clean samples from minority classes as mostly noisy samples.

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