Recent advancements in medical vision-language pre-training (MedVLP) have significantly enhanced zero-shot medical vision tasks such as image classification by leveraging large-scale medical image-text pair pre-training. However, the performance of these tasks can be heavily influenced by the variability in textual prompts describing the categories, necessitating robustness in MedVLP models to diverse prompt styles. Yet, this sensitivity remains underexplored. In this work, we are the first to systematically assess the sensitivity of three widely-used MedVLP methods to a variety of prompts across 15 different diseases. To achieve this, we designed six unique prompt styles to mirror real clinical scenarios, which were subsequently ranked by interpretability. Our findings indicate that all MedVLP models evaluated show unstable performance across different prompt styles, suggesting a lack of robustness. Additionally, the models' performance varied with increasing prompt interpretability, revealing difficulties in comprehending complex medical concepts. This study underscores the need for further development in MedVLP methodologies to enhance their robustness to diverse zero-shot prompts.
This short technical report demonstrates a simple technique that yields state of the art results in medical image-text matching tasks. We analyze the use of OpenAI's CLIP, a general image-text matching model, and observe that CLIP's limited textual input size has negative impact on downstream performance in the medical domain where encoding longer textual contexts is often required. We thus train and release ClipMD, which is trained with a simple sliding window technique to encode textual captions. ClipMD was tested on two medical image-text datasets and compared with other image-text matching…
Maastricht University（马斯特里赫特大学）；Maastricht University Medical Centre+（马斯特里赫特大学医学中心+）
Artificial Intelligence has emerged as a useful aid in numerous clinical applications for diagnosis and treatment decisions. Deep neural networks have shown same or better performance than clinicians in many tasks owing to the rapid increase in the available data and computational power. In order to conform to the principles of trustworthy AI, it is essential that the AI system be transparent, robust, fair and ensure accountability. Current deep neural solutions are referred to as black-boxes due to a lack of understanding of the specifics concerning the decision making process. Therefore, the…
University of Kentucky（肯塔基大学）；Eastern Kentucky University（东肯塔基大学）
A key challenge in training neural networks for a given medical imaging task is often the difficulty of obtaining a sufficient number of manually labeled examples. In contrast, textual imaging reports, which are often readily available in medical records, contain rich but unstructured interpretations written by experts as part of standard clinical practice. We propose using these textual reports as a form of weak supervision to improve the image interpretation performance of a neural network without requiring additional manually labeled examples. We use an image-text matching task to train a f…
As AI-based medical devices are becoming more common in imaging fields like radiology and histology, interpretability of the underlying predictive models is crucial to expand their use in clinical practice. Existing heatmap-based interpretability methods such as GradCAM only highlight the location of predictive features but do not explain how they contribute to the prediction. In this paper, we propose a new interpretability method that can be used to understand the predictions of any black-box model on images, by showing how the input image would be modified in order to produce different pred…
University of Washington（华盛顿大学）；Tel Aviv University（特拉维夫大学）；Swedish Medical Group（瑞典医疗集团）；University of California, Irvine（加州大学欧文分校）；Allen Institute for AI（艾伦人工智能研究所）
Understanding the relationship between figures and text is key to scientific document understanding. Medical figures in particular are quite complex, often consisting of several subfigures (75% of figures in our dataset), with detailed text describing their content. Previous work studying figures in scientific papers focused on classifying figure content rather than understanding how images relate to the text. To address challenges in figure retrieval and figure-to-text alignment, we introduce MedICaT, a dataset of medical images in context. MedICaT consists of 217K images from 131K open acces…
Deep learning methods, in particular convolutional neural networks, have emerged as a powerful tool in medical image computing tasks. While these complex models provide excellent performance, their black-box nature may hinder real-world adoption in high-stakes decision-making. In this paper, we propose an interactive system to take advantage of state-of-the-art interpretability techniques to assist radiologists with breast cancer screening. Our system integrates a deep learning model into the radiologists' workflow and provides novel interactions to promote understanding of the model's decisio…
Technische Universität München（慕尼黑工业大学）；Johns Hopkins University（约翰斯·霍普金斯大学）
In this paper, we propose a novel interpretation method tailored to histological Whole Slide Image (WSI) processing. A Deep Neural Network (DNN), inspired by Bag-of-Features models is equipped with a Multiple Instance Learning (MIL) branch and trained with weak supervision for WSI classification. MIL avoids label ambiguity and enhances our model's expressive power without guiding its attention. We utilize a fine-grained logit heatmap of the models activations to interpret its decision-making process. The proposed method is quantitatively and qualitatively evaluated on two challenging histology…
Towards Multi-dimensional Explanation Alignment for Medical Classification
King Abdullah University of Science and Technology（阿卜杜拉国王科技大学）；HKUST(GZ)（香港科技大学（广州））；Tongji University（同济大学）；Ant Group（蚂蚁集团）；The University of Auckland（奥克兰大学）；RIKEN Center for Advanced Intelligence Project (AIP)（理化学研究所先进智能项目中心）
Peter Munk Cardiac Center（彼得·芒克心脏中心）；University of Toronto（多伦多大学）；Vector Institute（向量研究所）；University of Waterloo（滑铁卢大学）
Medical image segmentation is a difficult but important task for many clinical operations such as cardiac bi-ventricular volume estimation. More recently, there has been a shift to utilizing deep learning and fully convolutional neural networks (CNNs) to perform image segmentation that has yielded state-of-the-art results in many public benchmark datasets. Despite the progress of deep learning in medical image segmentation, standard CNNs are still not fully adopted in clinical settings as they lack robustness and interpretability. Shapes are generally more meaningful features than solely textu…
University of Amsterdam（阿姆斯特丹大学）；Georgia Institute of Technology（佐治亚理工学院）
Medical image captioning automatically generates a medical description to describe the content of a given medical image. A traditional medical image captioning model creates a medical description only based on a single medical image input. Hence, an abstract medical description or concept is hard to be generated based on the traditional approach. Such a method limits the effectiveness of medical image captioning. Multi-modal medical image captioning is one of the approaches utilized to address this problem. In multi-modal medical image captioning, textual input, e.g., expert-defined keywords, …
On the Risk of Misleading Reports: Diagnosing Textual Biases in Multimodal Clinical AI
MICS, CentraleSupélec - Université Paris-Saclay, France（MICS，中央圣艾尔布兰大学-巴黎萨克雷大学，法国）；Google DeepMind, London, UK（谷歌DeepMind，伦敦，英国）；CONICET, Universidad de Buenos Aires, Argentina（CONICET，布宜诺斯艾利斯大学，阿根廷）
Decision support tools that rely on supervised learning require large amounts of expert annotations. Using past radiological reports obtained from hospital archiving systems has many advantages as training data above manual single-class labels: they are expert annotations available in large quantities, covering a population-representative variety of pathologies, and they provide additional context to pathology diagnoses, such as anatomical location and severity. Learning to auto-generate such reports from images present many challenges such as the difficulty in representing and generating long…
MedicalPatchNet: A Patch-Based Self-Explainable AI Architecture for Chest X-ray Classification
Department of Diagnostic and Interventional Radiology of the University Hospital RWTH Aachen（鲁尔大学亚琛医院诊断与介入放射科）；Else Kroener Fresenius Center for Digital Health, Technical University Dresden（德累斯顿技术大学埃勒克罗纳弗雷斯内尔数字健康中心）；Department of Medicine III, University Hospital RWTH Aachen（鲁尔大学亚琛医院第三医学部）；Pathology & Data Analytics, Leeds Institute of Medical Research at St James’s, University of Leeds（利兹大学圣詹姆斯医院医学研究所以及病理学与数据科学）；Department of Medicine I, University Hospital Dresden（德累斯顿大学第一医学部）；Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg（海德堡大学国家肿瘤疾病中心（NCT）肿瘤医学部）
University of Porto（波尔图大学）；INESC TEC（葡萄牙系统与计算机工程研究所）
The use of Deep Learning in the medical field is hindered by the lack of interpretability. Case-based interpretability strategies can provide intuitive explanations for deep learning models' decisions, thus, enhancing trust. However, the resulting explanations threaten patient privacy, motivating the development of privacy-preserving methods compatible with the specifics of medical data. In this work, we analyze existing privacy-preserving methods and their respective capacity to anonymize medical data while preserving disease-related semantic features. We find that the PPRL-VGAN deep learning…
Deep learning (DL) methods where interpretability is intrinsically considered as part of the model are required to better understand the relationship of clinical and imaging-based attributes with DL outcomes, thus facilitating their use in the reasoning behind medical decisions. Latent space representations built with variational autoencoders (VAE) do not ensure individual control of data attributes. Attribute-based methods enforcing attribute disentanglement have been proposed in the literature for classical computer vision tasks in benchmark data. In this paper, we propose a VAE approach, th…
Manipal Institute of Technology（马尼帕尔理工学院）；Carnegie Mellon University（卡内基梅隆大学）；OpenMined；University of Pennsylvania（宾夕法尼亚大学）；IIT Jodhpur（印度理工学院焦特布尔分校）；University of California, San Diego（加州大学圣地亚哥分校）
Given the increase in the use of personal data for training Deep Neural Networks (DNNs) in tasks such as medical imaging and diagnosis, differentially private training of DNNs is surging in importance and there is a large body of work focusing on providing better privacy-utility trade-off. However, little attention is given to the interpretability of these models, and how the application of DP affects the quality of interpretations. We propose an extensive study into the effects of DP training on DNNs, especially on medical imaging applications, on the APTOS dataset.
Counterfactual Explanations for Medical Image Classification and Regression using Diffusion Autoencoder
Technical University of Munich（慕尼黑工业大学）；Klinikum rechts der Isar（右侧伊萨尔医院）；Institute for Artificial Intelligence and Computer Science in Medicine, Technical University of Munich（慕尼黑工业大学人工智能与医学计算机科学研究所）；Computer Aided Medical Procedures, Technical University of Munich（慕尼黑工业大学计算机辅助医疗程序研究所）；AI for Image-Guided Diagnosis and Therapy, Technical University of Munich（慕尼黑工业大学图像引导诊断与治疗人工智能研究所）
Learning Concept-Driven Logical Rules for Interpretable and Generalizable Medical Image Classification
School of Data Science, Fudan University（复旦大学数据科学学院）；Dept. of Computer Science and Engineering, The Chinese University of Hong Kong（香港中文大学计算机科学与工程系）；Dept. of Oncology, University of Cambridge（剑桥大学肿瘤学系）
Deep Learning has achieved state of the art performance in medical imaging. However, these methods for disease detection focus exclusively on improving the accuracy of classification or predictions without quantifying uncertainty in a decision. Knowing how much confidence there is in a computer-based medical diagnosis is essential for gaining clinicians trust in the technology and therefore improve treatment. Today, the 2019 Coronavirus (SARS-CoV-2) infections are a major healthcare challenge around the world. Detecting COVID-19 in X-ray images is crucial for diagnosis, assessment and treatmen…
Enhancing Multimodal Medical Image Classification using Cross-Graph Modal Contrastive Learning
Department of Systems Engineering, Stevens Institute of Technology, Hoboken, New Jersey, USA（系统工程系，史蒂文斯理工学院）；Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan（高雄长庚纪念医院核医学部）；Institute of Statistics, National University of Kaohsiung, Kaohsiung, Taiwan（国立高雄大学统计研究所）；Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China（深圳先进技术研究院，中国科学院）
Interpretability of deep learning (DL) systems is gaining attention in medical imaging to increase experts' trust in the obtained predictions and facilitate their integration in clinical settings. We propose a deep visualization method to generate interpretability of DL classification tasks in medical imaging by means of visual evidence augmentation. The proposed method iteratively unveils abnormalities based on the prediction of a classifier trained only with image-level labels. For each image, initial visual evidence of the prediction is extracted with a given visual attribution technique. T…
SMFusion: Semantic-Preserving Fusion of Multimodal Medical Images for Enhanced Clinical Diagnosis
College of Information and Intelligence, Hunan Agricultural University（湖南农业大学信息与智能学院）；College of Artificial Intelligence, Nankai University（南开大学人工智能学院）
Generative Text-Guided 3D Vision-Language Pretraining for Unified Medical Image Segmentation
University of Science and Technology of China（中国科学技术大学）；Institute of Artificial Intelligence, Hefei Comprehensive National Science Center（合肥综合性国家科学中心人工智能研究院）；Imperial College London（帝国理工学院）
GFSR-Net: Guided Focus via Segment-Wise Relevance Network for Interpretable Deep Learning in Medical Imaging
Institute of Physical Chemistry (IPC) and Abbe Center of Photonics (ACP), Friedrich Schiller University Jena（耶拿弗里德里希·席勒大学物理化学研究所与阿贝光子学中心）；Leibniz Institute of Photonic Technology（莱布尼茨光子技术研究所）
Concept Complement Bottleneck Model for Interpretable Medical Image Diagnosis
Hong Kong University of Science and Technology（香港科技大学）；Department of Computer Science and Engineering（计算机科学与工程系）；Department of Chemical and Biological Engineering（化学与生物工程系）；Division of Life Science（生命科学部）
NeRD: Neuro-Symbolic Rule Distillation for Efficient Ontology-Grounded Chain-of-Thought in Medical Image Diagnosis
Department of Data Science & AI, Faculty of Information Technology, Monash University（莫纳什大学信息技术学院数据科学与人工智能系）；AIM for Health Lab, Faculty of Information Technology, Monash University（莫纳什大学信息技术学院AIM健康实验室）；Faculty of Engineering, Monash University（莫纳什大学工程学院）；Faculty of Medicine, The Chinese University of Hong Kong（香港中文大学医学院）；School of Computing Technologies, RMIT University（皇家墨尔本理工大学计算技术学院）
Interpretable Medical Image Classification using Prototype Learning and Privileged Information
Experimental Radiology, University Hospital Ulm, Germany（实验放射学，乌尔姆大学医院，德国）；Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Germany（诊断与介入放射学系，乌尔姆大学医院，德国）；i2SouI - Innovative Imaging in Surgical Oncology Ulm, University Hospital Ulm, Germany（i2SouI - 精准影像学在手术肿瘤学中的创新应用，乌尔姆大学医院，德国）
SHAMSUL: Systematic Holistic Analysis to investigate Medical Significance Utilizing Local interpretability methods in deep learning for chest radiography pathology prediction
Stockholm University（斯德哥尔摩大学）；Skatturinn (Iceland Revenue and Customs)（冰岛税务总局（冰岛税收和海关局））
As interpretability has been pointed out as the obstacle to the adoption of Deep Neural Networks (DNNs), there is an increasing interest in solving a transparency issue to guarantee the impressive performance. In this paper, we demonstrate the efficiency of recent attribution techniques to explain the diagnostic decision by visualizing the significant factors in the input image. By utilizing the characteristics of objectness that DNNs have learned, fully decomposing the network prediction visualizes clear localization of target lesion. To verify our work, we conduct our experiments on Chest X-…
Ensuring Medical AI Safety: Interpretability-Driven Detection and Mitigation of Spurious Model Behavior and Associated Data
Fraunhofer Heinrich Hertz Institut（弗劳恩霍夫 Heinrich Hertz 研究所）；Technische Universität Berlin（柏林技术大学）；Berlin Institute for the Foundations of Learning and Data (BIFOLD)（柏林学习与数据基础研究所（BIFOLD））
Keen Eye（基恩眼公司）；LTCI, Télécom Paris, Institut Polytechnique de Paris（巴黎理工学院巴黎电信学院LTCI实验室）
Deep learning methods are widely used for medical applications to assist medical doctors in their daily routines. While performances reach expert's level, interpretability (highlight how and what a trained model learned and why it makes a specific decision) is the next important challenge that deep learning methods need to answer to be fully integrated in the medical field. In this paper, we address the question of interpretability in the context of whole slide images (WSI) classification. We formalize the design of WSI classification architectures and propose a piece-wise interpretability app…
Northeastern University（东北大学）；Brigham and Women’s Hospital（布莱根妇女医院）；University of Amsterdam（阿姆斯特丹大学）
Pretraining multimodal models on Electronic Health Records (EHRs) provides a means of learning representations that can transfer to downstream tasks with minimal supervision. Recent multimodal models induce soft local alignments between image regions and sentences. This is of particular interest in the medical domain, where alignments might highlight regions in an image relevant to specific phenomena described in free-text. While past work has suggested that attention "heatmaps" can be interpreted in this manner, there has been little evaluation of such alignments. We compare alignments from a…
STPNet: Scale-aware Text Prompt Network for Medical Image Segmentation
Xiamen University（厦门大学）；University of Washington（华盛顿大学）；UT Southwestern Medical Center（西南大学医学中心）；University of Hull（赫尔大学）；Institute of Automation, Chinese Academy of Sciences（中国科学院自动化研究所）
Language-guided Medical Image Segmentation with Target-informed Multi-level Contrastive Alignments
School of Computer Science, The University of Sydney（悉尼大学计算机科学学院）；Institute of Translational Medicine, Shanghai Jiao Tong University（上海交通大学转化医学研究院）；Zhongguancun Academy & Zhongguancun Institute of Artificial Intelligence, Beijing, China（北京中关村学院及中关村人工智能研究院）；Department of Molecular Imaging, Royal Prince Alfred Hospital（皇家珀斯阿尔弗雷德医院分子成像部）
