Interpretation of Disease Evidence for Medical Images Using Adversarial Deformation Fields

The high complexity of deep learning models is associated with the difficulty of explaining what evidence they recognize as correlating with specific disease labels. This information is critical for building trust in models and finding their biases. Until now, automated deep learning visualization solutions have identified regions of images used by classifiers, but these solutions are too coarse, too noisy, or have a limited representation of the way images can change. We propose a novel method for formulating and presenting spatial explanations of disease evidence, called deformation field interpretation with generative adversarial networks (DeFI-GAN). An adversarially trained generator produces deformation fields that modify images of diseased patients to resemble images of healthy patients. We validate the method studying chronic obstructive pulmonary disease (COPD) evidence in chest x-rays (CXRs) and Alzheimer's disease (AD) evidence in brain MRIs. When extracting disease evidence in longitudinal data, we show compelling results against a baseline producing difference maps. DeFI-GAN also highlights disease biomarkers not found by previous methods and potential biases that may help in investigations of the dataset and of the adopted learning methods.

Adversarial regression training for visualizing the progression of chronic obstructive pulmonary disease with chest x-rays

Knowledge of what spatial elements of medical images deep learning methods use as evidence is important for model interpretability, trustiness, and validation. There is a lack of such techniques for models in regression tasks. We propose a method, called visualization for regression with a generative adversarial network (VR-GAN), for formulating adversarial training specifically for datasets containing regression target values characterizing disease severity. We use a conditional generative adversarial network where the generator attempts to learn to shift the output of a regressor through creating disease effect maps that are added to the original images. Meanwhile, the regressor is trained to predict the original regression value for the modified images. A model trained with this technique learns to provide visualization for how the image would appear at different stages of the disease. We analyze our method in a dataset of chest x-rays associated with pulmonary function tests, used for diagnosing chronic obstructive pulmonary disease (COPD). For validation, we compute the difference of two registered x-rays of the same patient at different time points and correlate it to the generated disease effect map. The proposed method outperforms a technique based on classification and provides realistic-looking images, making modifications to images following what radiologists usually observe for this disease. Implementation code is available at https://github.com/ricbl/vrgan.