Evaluating Visual Explanations of Attention Maps for Transformer-based Medical Imaging

Although Vision Transformers (ViTs) have recently demonstrated superior performance in medical imaging problems, they face explainability issues similar to previous architectures such as convolutional neural networks. Recent research efforts suggest that attention maps, which are part of decision-making process of ViTs can potentially address the explainability issue by identifying regions influencing predictions, especially in models pretrained with self-supervised learning. In this work, we compare the visual explanations of attention maps to other commonly used methods for medical imaging problems. To do so, we employ four distinct medical imaging datasets that involve the identification of (1) colonic polyps, (2) breast tumors, (3) esophageal inflammation, and (4) bone fractures and hardware implants. Through large-scale experiments on the aforementioned datasets using various supervised and self-supervised pretrained ViTs, we find that although attention maps show promise under certain conditions and generally surpass GradCAM in explainability, they are outperformed by transformer-specific interpretability methods. Our findings indicate that the efficacy of attention maps as a method of interpretability is context-dependent and may be limited as they do not consistently provide the comprehensive insights required for robust medical decision-making.

One Patient's Annotation is Another One's Initialization: Towards Zero-Shot Surgical Video Segmentation with Cross-Patient Initialization

Video object segmentation is an emerging technology that is well-suited for real-time surgical video segmentation, offering valuable clinical assistance in the operating room by ensuring consistent frame tracking. However, its adoption is limited by the need for manual intervention to select the tracked object, making it impractical in surgical settings. In this work, we tackle this challenge with an innovative solution: using previously annotated frames from other patients as the tracking frames. We find that this unconventional approach can match or even surpass the performance of using patients' own tracking frames, enabling more autonomous and efficient AI-assisted surgical workflows. Furthermore, we analyze the benefits and limitations of this approach, highlighting its potential to enhance segmentation accuracy while reducing the need for manual input. Our findings provide insights into key factors influencing performance, offering a foundation for future research on optimizing cross-patient frame selection for real-time surgical video analysis.

Less is More? Revisiting the Importance of Frame Rate in Real-Time Zero-Shot Surgical Video Segmentation

Real-time video segmentation is a promising feature for AI-assisted surgery, providing intraoperative guidance by identifying surgical tools and anatomical structures. However, deploying state-of-the-art segmentation models, such as SAM2, in real-time settings is computationally demanding, which makes it essential to balance frame rate and segmentation performance. In this study, we investigate the impact of frame rate on zero-shot surgical video segmentation, evaluating SAM2's effectiveness across multiple frame sampling rates for cholecystectomy procedures. Surprisingly, our findings indicate that in conventional evaluation settings, frame rates as low as a single frame per second can outperform 25 FPS, as fewer frames smooth out segmentation inconsistencies. However, when assessed in a real-time streaming scenario, higher frame rates yield superior temporal coherence and stability, particularly for dynamic objects such as surgical graspers. Finally, we investigate human perception of real-time surgical video segmentation among professionals who work closely with such data and find that respondents consistently prefer high FPS segmentation mask overlays, reinforcing the importance of real-time evaluation in AI-assisted surgery.

Exploring Patient Data Requirements in Training Effective AI Models for MRI-based Breast Cancer Classification

The past decade has witnessed a substantial increase in the number of startups and companies offering AI-based solutions for clinical decision support in medical institutions. However, the critical nature of medical decision-making raises several concerns about relying on external software. Key issues include potential variations in image modalities and the medical devices used to obtain these images, potential legal issues, and adversarial attacks. Fortunately, the open-source nature of machine learning research has made foundation models publicly available and straightforward to use for medical applications. This accessibility allows medical institutions to train their own AI-based models, thereby mitigating the aforementioned concerns. Given this context, an important question arises: how much data do medical institutions need to train effective AI models? In this study, we explore this question in relation to breast cancer detection, a particularly contested area due to the prevalence of this disease, which affects approximately 1 in every 8 women. Through large-scale experiments on various patient sizes in the training set, we show that medical institutions do not need a decade's worth of MRI images to train an AI model that performs competitively with the state-of-the-art, provided the model leverages foundation models. Furthermore, we observe that for patient counts greater than 50, the number of patients in the training set has a negligible impact on the performance of models and that simple ensembles further improve the results without additional complexity.

Color Flow Imaging Microscopy Improves Identification of Stress Sources of Protein Aggregates in Biopharmaceuticals

Protein-based therapeutics play a pivotal role in modern medicine targeting various diseases. Despite their therapeutic importance, these products can aggregate and form subvisible particles (SvPs), which can compromise their efficacy and trigger immunological responses, emphasizing the critical need for robust monitoring techniques. Flow Imaging Microscopy (FIM) has been a significant advancement in detecting SvPs, evolving from monochrome to more recently incorporating color imaging. Complementing SvP images obtained via FIM, deep learning techniques have recently been employed successfully for stress source identification of monochrome SvPs. In this study, we explore the potential of color FIM to enhance the characterization of stress sources in SvPs. To achieve this, we curate a new dataset comprising 16,000 SvPs from eight commercial monoclonal antibodies subjected to heat and mechanical stress. Using both supervised and self-supervised convolutional neural networks, as well as vision transformers in large-scale experiments, we demonstrate that deep learning with color FIM images consistently outperforms monochrome images, thus highlighting the potential of color FIM in stress source classification compared to its monochrome counterparts.

Identifying Critical Tokens for Accurate Predictions in Transformer-based Medical Imaging Models

With the advancements in self-supervised learning (SSL), transformer-based computer vision models have recently demonstrated superior results compared to convolutional neural networks (CNNs) and are poised to dominate the field of artificial intelligence (AI)-based medical imaging in the upcoming years. Nevertheless, similar to CNNs, unveiling the decision-making process of transformer-based models remains a challenge. In this work, we take a step towards demystifying the decision-making process of transformer-based medical imaging models and propose Token Insight, a novel method that identifies the critical tokens that contribute to the prediction made by the model. Our method relies on the principled approach of token discarding native to transformer-based models, requires no additional module, and can be applied to any transformer model. Using the proposed approach, we quantify the importance of each token based on its contribution to the prediction and enable a more nuanced understanding of the model's decisions. Our experimental results which are showcased on the problem of colonic polyp identification using both supervised and self-supervised pretrained vision transformers indicate that Token Insight contributes to a more transparent and interpretable transformer-based medical imaging model, fostering trust and facilitating broader adoption in clinical settings.

Self-supervised Benchmark Lottery on ImageNet: Do Marginal Improvements Translate to Improvements on Similar Datasets?

Machine learning (ML) research strongly relies on benchmarks in order to determine the relative effectiveness of newly proposed models. Recently, a number of prominent research effort argued that a number of models that improve the state-of-the-art by a small margin tend to do so by winning what they call a "benchmark lottery". An important benchmark in the field of machine learning and computer vision is the ImageNet where newly proposed models are often showcased based on their performance on this dataset. Given the large number of self-supervised learning (SSL) frameworks that has been proposed in the past couple of years each coming with marginal improvements on the ImageNet dataset, in this work, we evaluate whether those marginal improvements on ImageNet translate to improvements on similar datasets or not. To do so, we investigate twelve popular SSL frameworks on five ImageNet variants and discover that models that seem to perform well on ImageNet may experience significant performance declines on similar datasets. Specifically, state-of-the-art frameworks such as DINO and Swav, which are praised for their performance, exhibit substantial drops in performance while MoCo and Barlow Twins displays comparatively good results. As a result, we argue that otherwise good and desirable properties of models remain hidden when benchmarking is only performed on the ImageNet validation set, making us call for more adequate benchmarking. To avoid the "benchmark lottery" on ImageNet and to ensure a fair benchmarking process, we investigate the usage of a unified metric that takes into account the performance of models on other ImageNet variant datasets.

Know Your Self-supervised Learning: A Survey on Image-based Generative and Discriminative Training

Although supervised learning has been highly successful in improving the state-of-the-art in the domain of image-based computer vision in the past, the margin of improvement has diminished significantly in recent years, indicating that a plateau is in sight. Meanwhile, the use of self-supervised learning (SSL) for the purpose of natural language processing (NLP) has seen tremendous successes during the past couple of years, with this new learning paradigm yielding powerful language models. Inspired by the excellent results obtained in the field of NLP, self-supervised methods that rely on clustering, contrastive learning, distillation, and information-maximization, which all fall under the banner of discriminative SSL, have experienced a swift uptake in the area of computer vision. Shortly afterwards, generative SSL frameworks that are mostly based on masked image modeling, complemented and surpassed the results obtained with discriminative SSL. Consequently, within a span of three years, over $100$ unique general-purpose frameworks for generative and discriminative SSL, with a focus on imaging, were proposed. In this survey, we review a plethora of research efforts conducted on image-oriented SSL, providing a historic view and paying attention to best practices as well as useful software packages. While doing so, we discuss pretext tasks for image-based SSL, as well as techniques that are commonly used in image-based SSL. Lastly, to aid researchers who aim at contributing to image-focused SSL, we outline a number of promising research directions.

Utilizing Mutations to Evaluate Interpretability of Neural Networks on Genomic Data

Even though deep neural networks (DNNs) achieve state-of-the-art results for a number of problems involving genomic data, getting DNNs to explain their decision-making process has been a major challenge due to their black-box nature. One way to get DNNs to explain their reasoning for prediction is via attribution methods which are assumed to highlight the parts of the input that contribute to the prediction the most. Given the existence of numerous attribution methods and a lack of quantitative results on the fidelity of those methods, selection of an attribution method for sequence-based tasks has been mostly done qualitatively. In this work, we take a step towards identifying the most faithful attribution method by proposing a computational approach that utilizes point mutations. Providing quantitative results on seven popular attribution methods, we find Layerwise Relevance Propagation (LRP) to be the most appropriate one for translation initiation, with LRP identifying two important biological features for translation: the integrity of Kozak sequence as well as the detrimental effects of premature stop codons.

Exact Feature Collisions in Neural Networks

Predictions made by deep neural networks were shown to be highly sensitive to small changes made in the input space where such maliciously crafted data points containing small perturbations are being referred to as adversarial examples. On the other hand, recent research suggests that the same networks can also be extremely insensitive to changes of large magnitude, where predictions of two largely different data points can be mapped to approximately the same output. In such cases, features of two data points are said to approximately collide, thus leading to the largely similar predictions. Our results improve and extend the work of Li et al.(2019), laying out theoretical grounds for the data points that have colluding features from the perspective of weights of neural networks, revealing that neural networks not only suffer from features that approximately collide but also suffer from features that exactly collide. We identify the necessary conditions for the existence of such scenarios, hereby investigating a large number of DNNs that have been used to solve various computer vision problems. Furthermore, we propose the Null-space search, a numerical approach that does not rely on heuristics, to create data points with colliding features for any input and for any task, including, but not limited to, classification, localization, and segmentation.