Here Comes the Explanation: A Shapley Perspective on Multi-contrast Medical Image Segmentation

Deep learning has been successfully applied to medical image segmentation, enabling accurate identification of regions of interest such as organs and lesions. This approach works effectively across diverse datasets, including those with single-image contrast, multi-contrast, and multimodal imaging data. To improve human understanding of these black-box models, there is a growing need for Explainable AI (XAI) techniques for model transparency and accountability. Previous research has primarily focused on post hoc pixel-level explanations, using methods gradient-based and perturbation-based apporaches. These methods rely on gradients or perturbations to explain model predictions. However, these pixel-level explanations often struggle with the complexity inherent in multi-contrast magnetic resonance imaging (MRI) segmentation tasks, and the sparsely distributed explanations have limited clinical relevance. In this study, we propose using contrast-level Shapley values to explain state-of-the-art models trained on standard metrics used in brain tumor segmentation. Our results demonstrate that Shapley analysis provides valuable insights into different models' behavior used for tumor segmentation. We demonstrated a bias for U-Net towards over-weighing T1-contrast and FLAIR, while Swin-UNETR provided a cross-contrast understanding with balanced Shapley distribution.

Re-DiffiNet: Modeling discrepancies loss in tumor segmentation using diffusion models

Identification of tumor margins is essential for surgical decision-making for glioblastoma patients and provides reliable assistance for neurosurgeons. Despite improvements in deep learning architectures for tumor segmentation over the years, creating a fully autonomous system suitable for clinical floors remains a formidable challenge because the model predictions have not yet reached the desired level of accuracy and generalizability for clinical applications. Generative modeling techniques have seen significant improvements in recent times. Specifically, Generative Adversarial Networks (GANs) and Denoising-diffusion-based models (DDPMs) have been used to generate higher-quality images with fewer artifacts and finer attributes. In this work, we introduce a framework called Re-Diffinet for modeling the discrepancy between the outputs of a segmentation model like U-Net and the ground truth, using DDPMs. By explicitly modeling the discrepancy, the results show an average improvement of 0.55\% in the Dice score and 16.28\% in HD95 from cross-validation over 5-folds, compared to the state-of-the-art U-Net segmentation model.