Joint chest X-ray diagnosis and clinical visual attention prediction with multi-stage cooperative learning: enhancing interpretability

As deep learning has become the state-of-the-art for computer-assisted diagnosis, interpretability of the automatic decisions is crucial for clinical deployment. While various methods were proposed in this domain, visual attention maps of clinicians during radiological screening offer a unique asset to provide important insights and can potentially enhance the quality of computer-assisted diagnosis. With this paper, we introduce a novel deep-learning framework for joint disease diagnosis and prediction of corresponding visual saliency maps for chest X-ray scans. Specifically, we designed a novel dual-encoder multi-task UNet, which leverages both a DenseNet201 backbone and a Residual and Squeeze-and-Excitation block-based encoder to extract diverse features for saliency map prediction, and a multi-scale feature-fusion classifier to perform disease classification. To tackle the issue of asynchronous training schedules of individual tasks in multi-task learning, we proposed a multi-stage cooperative learning strategy, with contrastive learning for feature encoder pretraining to boost performance. Experiments show that our proposed method outperformed existing techniques for chest X-ray diagnosis and the quality of visual saliency map prediction.

Is visual explanation with Grad-CAM more reliable for deeper neural networks? a case study with automatic pneumothorax diagnosis

While deep learning techniques have provided the state-of-the-art performance in various clinical tasks, explainability regarding their decision-making process can greatly enhance the credence of these methods for safer and quicker clinical adoption. With high flexibility, Gradient-weighted Class Activation Mapping (Grad-CAM) has been widely adopted to offer intuitive visual interpretation of various deep learning models' reasoning processes in computer-assisted diagnosis. However, despite the popularity of the technique, there is still a lack of systematic study on Grad-CAM's performance on different deep learning architectures. In this study, we investigate its robustness and effectiveness across different popular deep learning models, with a focus on the impact of the networks' depths and architecture types, by using a case study of automatic pneumothorax diagnosis in X-ray scans. Our results show that deeper neural networks do not necessarily contribute to a strong improvement of pneumothorax diagnosis accuracy, and the effectiveness of GradCAM also varies among different network architectures.