xCG: Explainable Cell Graphs for Survival Prediction in Non-Small Cell Lung Cancer

Understanding how deep learning models predict oncology patient risk can provide critical insights into disease progression, support clinical decision-making, and pave the way for trustworthy and data-driven precision medicine. Building on recent advances in the spatial modeling of the tumor microenvironment using graph neural networks, we present an explainable cell graph (xCG) approach for survival prediction. We validate our model on a public cohort of imaging mass cytometry (IMC) data for 416 cases of lung adenocarcinoma. We explain survival predictions in terms of known phenotypes on the cell level by computing risk attributions over cell graphs, for which we propose an efficient grid-based layer-wise relevance propagation (LRP) method. Our ablation studies highlight the importance of incorporating the cancer stage and model ensembling to improve the quality of risk estimates. Our xCG method, together with the IMC data, is made publicly available to support further research.

AI-based Anomaly Detection for Clinical-Grade Histopathological Diagnostics

While previous studies have demonstrated the potential of AI to diagnose diseases in imaging data, clinical implementation is still lagging behind. This is partly because AI models require training with large numbers of examples only available for common diseases. In clinical reality, however, only few diseases are common, whereas the majority of diseases are less frequent (long-tail distribution). Current AI models overlook or misclassify these diseases. We propose a deep anomaly detection approach that only requires training data from common diseases to detect also all less frequent diseases. We collected two large real-world datasets of gastrointestinal biopsies, which are prototypical of the problem. Herein, the ten most common findings account for approximately 90% of cases, whereas the remaining 10% contained 56 disease entities, including many cancers. 17 million histological images from 5,423 cases were used for training and evaluation. Without any specific training for the diseases, our best-performing model reliably detected a broad spectrum of infrequent ("anomalous") pathologies with 95.0% (stomach) and 91.0% (colon) AUROC and generalized across scanners and hospitals. By design, the proposed anomaly detection can be expected to detect any pathological alteration in the diagnostic tail of gastrointestinal biopsies, including rare primary or metastatic cancers. This study establishes the first effective clinical application of AI-based anomaly detection in histopathology that can flag anomalous cases, facilitate case prioritization, reduce missed diagnoses and enhance the general safety of AI models, thereby driving AI adoption and automation in routine diagnostics and beyond.

RudolfV: A Foundation Model by Pathologists for Pathologists

Histopathology plays a central role in clinical medicine and biomedical research. While artificial intelligence shows promising results on many pathological tasks, generalization and dealing with rare diseases, where training data is scarce, remains a challenge. Distilling knowledge from unlabeled data into a foundation model before learning from, potentially limited, labeled data provides a viable path to address these challenges. In this work, we extend the state of the art of foundation models for digital pathology whole slide images by semi-automated data curation and incorporating pathologist domain knowledge. Specifically, we combine computational and pathologist domain knowledge (1) to curate a diverse dataset of 103k slides corresponding to 750 million image patches covering data from different fixation, staining, and scanning protocols as well as data from different indications and labs across the EU and US, (2) for grouping semantically similar slides and tissue patches, and (3) to augment the input images during training. We evaluate the resulting model on a set of public and internal benchmarks and show that although our foundation model is trained with an order of magnitude less slides, it performs on par or better than competing models. We expect that scaling our approach to more data and larger models will further increase its performance and capacity to deal with increasingly complex real world tasks in diagnostics and biomedical research.

Leveraging weak complementary labels to improve semantic segmentation of hepatocellular carcinoma and cholangiocarcinoma in H&E-stained slides

In this paper, we present a deep learning segmentation approach to classify and quantify the two most prevalent primary liver cancers - hepatocellular carcinoma and intrahepatic cholangiocarcinoma - from hematoxylin and eosin (H&E) stained whole slide images. While semantic segmentation of medical images typically requires costly pixel-level annotations by domain experts, there often exists additional information which is routinely obtained in clinical diagnostics but rarely utilized for model training. We propose to leverage such weak information from patient diagnoses by deriving complementary labels that indicate to which class a sample cannot belong to. To integrate these labels, we formulate a complementary loss for segmentation. Motivated by the medical application, we demonstrate for general segmentation tasks that including additional patches with solely weak complementary labels during model training can significantly improve the predictive performance and robustness of a model. On the task of diagnostic differentiation between hepatocellular carcinoma and intrahepatic cholangiocarcinoma, we achieve a balanced accuracy of 0.91 (CI 95%: 0.86 - 0.95) at case level for 165 hold-out patients. Furthermore, we also show that leveraging complementary labels improves the robustness of segmentation and increases performance at case level.

Balancing the composition of word embeddings across heterogenous data sets

Word embeddings capture semantic relationships based on contextual information and are the basis for a wide variety of natural language processing applications. Notably these relationships are solely learned from the data and subsequently the data composition impacts the semantic of embeddings which arguably can lead to biased word vectors. Given qualitatively different data subsets, we aim to align the influence of single subsets on the resulting word vectors, while retaining their quality. In this regard we propose a criteria to measure the shift towards a single data subset and develop approaches to meet both objectives. We find that a weighted average of the two subset embeddings balances the influence of those subsets while word similarity performance decreases. We further propose a promising optimization approach to balance influences and quality of word embeddings.

Explanations can be manipulated and geometry is to blame

Explanation methods aim to make neural networks more trustworthy and interpretable. In this paper, we demonstrate a property of explanation methods which is disconcerting for both of these purposes. Namely, we show that explanations can be manipulated arbitrarily by applying visually hardly perceptible perturbations to the input that keep the network's output approximately constant. We establish theoretically that this phenomenon can be related to certain geometrical properties of neural networks. This allows us to derive an upper bound on the susceptibility of explanations to manipulations. Based on this result, we propose effective mechanisms to enhance the robustness of explanations.

Software and application patterns for explanation methods

Deep neural networks successfully pervaded many applications domains and are increasingly used in critical decision processes. Understanding their workings is desirable or even required to further foster their potential as well as to access sensitive domains like medical applications or autonomous driving. One key to this broader usage of explaining frameworks is the accessibility and understanding of respective software. In this work we introduce software and application patterns for explanation techniques that aim to explain individual predictions of neural networks. We discuss how to code well-known algorithms efficiently within deep learning software frameworks and describe how to embed algorithms in downstream implementations. Building on this we show how explanation methods can be used in applications to understand predictions for miss-classified samples, to compare algorithms or networks, and to examine the focus of networks. Furthermore, we review available open-source packages and discuss challenges posed by complex and evolving neural network structures to explanation algorithm development and implementations.

iNNvestigate neural networks!

In recent years, deep neural networks have revolutionized many application domains of machine learning and are key components of many critical decision or predictive processes. Therefore, it is crucial that domain specialists can understand and analyze actions and pre- dictions, even of the most complex neural network architectures. Despite these arguments neural networks are often treated as black boxes. In the attempt to alleviate this short- coming many analysis methods were proposed, yet the lack of reference implementations often makes a systematic comparison between the methods a major effort. The presented library iNNvestigate addresses this by providing a common interface and out-of-the- box implementation for many analysis methods, including the reference implementation for PatternNet and PatternAttribution as well as for LRP-methods. To demonstrate the versatility of iNNvestigate, we provide an analysis of image classifications for variety of state-of-the-art neural network architectures.

Backprop Evolution

The back-propagation algorithm is the cornerstone of deep learning. Despite its importance, few variations of the algorithm have been attempted. This work presents an approach to discover new variations of the back-propagation equation. We use a domain specific lan- guage to describe update equations as a list of primitive functions. An evolution-based method is used to discover new propagation rules that maximize the generalization per- formance after a few epochs of training. We find several update equations that can train faster with short training times than standard back-propagation, and perform similar as standard back-propagation at convergence.

The (Un)reliability of saliency methods

Saliency methods aim to explain the predictions of deep neural networks. These methods lack reliability when the explanation is sensitive to factors that do not contribute to the model prediction. We use a simple and common pre-processing step ---adding a constant shift to the input data--- to show that a transformation with no effect on the model can cause numerous methods to incorrectly attribute. In order to guarantee reliability, we posit that methods should fulfill input invariance, the requirement that a saliency method mirror the sensitivity of the model with respect to transformations of the input. We show, through several examples, that saliency methods that do not satisfy input invariance result in misleading attribution.