Transformer-based interpretable multi-modal data fusion for skin lesion classification

A lot of deep learning (DL) research these days is mainly focused on improving on quantitative metrics regardless of other factors. In human centered applications, like skin lesion classification in dermatology, DL-driven clinical decision support systems are still in their infancy due to the limited transparency of their decision-making process. Moreover, the lack of procedures that can explain the behavior of trained DL algorithms leads to almost no trust from the clinical physicians. To diagnose skin lesions, dermatologists rely on both visual assessment of the disease and the data gathered from the anamnesis of the patient. Data-driven algorithms dealing with multi-modal data are limited by the separation of feature-level and decision-level fusion procedures required by convolutional architectures. To address this issue, we enable single-stage multi-modal data fusion via the attention mechanism of transformer-based architectures to aid in the diagnosis of skin diseases. Our method beats other state-of-the-art single- and multi-modal DL architectures in both image rich and patient-data rich environments. Additionally, the choice of the architecture enables native interpretability support for the classification task both in image and metadata domain with no additional modifications necessary.Comment: Submitted to IEEE TMI in March 202

On Interpretability of Deep Learning based Skin Lesion Classifiers using Concept Activation Vectors

Deep learning based medical image classifiers have shown remarkable prowess in various application areas like ophthalmology, dermatology, pathology, and radiology. However, the acceptance of these Computer-Aided Diagnosis (CAD) systems in real clinical setups is severely limited primarily because their decision-making process remains largely obscure. This work aims at elucidating a deep learning based medical image classifier by verifying that the model learns and utilizes similar disease-related concepts as described and employed by dermatologists. We used a well-trained and high performing neural network developed by REasoning for COmplex Data (RECOD) Lab for classification of three skin tumours, i.e. Melanocytic Naevi, Melanoma and Seborrheic Keratosis and performed a detailed analysis on its latent space. Two well established and publicly available skin disease datasets, PH2 and derm7pt, are used for experimentation. Human understandable concepts are mapped to RECOD image classification model with the help of Concept Activation Vectors (CAVs), introducing a novel training and significance testing paradigm for CAVs. Our results on an independent evaluation set clearly shows that the classifier learns and encodes human understandable concepts in its latent representation. Additionally, TCAV scores (Testing with CAVs) suggest that the neural network indeed makes use of disease-related concepts in the correct way when making predictions. We anticipate that this work can not only increase confidence of medical practitioners on CAD but also serve as a stepping stone for further development of CAV-based neural network interpretation methods.Comment: Accepted for the IEEE International Joint Conference on Neural Networks (IJCNN) 202

Graph-Based Intercategory and Intermodality Network for Multilabel Classification and Melanoma Diagnosis of Skin Lesions in Dermoscopy and Clinical Images

The identification of melanoma involves an integrated analysis of skin lesion images acquired using the clinical and dermoscopy modalities. Dermoscopic images provide a detailed view of the subsurface visual structures that supplement the macroscopic clinical images. Melanoma diagnosis is commonly based on the 7-point visual category checklist (7PC). The 7PC contains intrinsic relationships between categories that can aid classification, such as shared features, correlations, and the contributions of categories towards diagnosis. Manual classification is subjective and prone to intra- and interobserver variability. This presents an opportunity for automated methods to improve diagnosis. Current state-of-the-art methods focus on a single image modality and ignore information from the other, or do not fully leverage the complementary information from both modalities. Further, there is not a method to exploit the intercategory relationships in the 7PC. In this study, we address these issues by proposing a graph-based intercategory and intermodality network (GIIN) with two modules. A graph-based relational module (GRM) leverages intercategorical relations, intermodal relations, and prioritises the visual structure details from dermoscopy by encoding category representations in a graph network. The category embedding learning module (CELM) captures representations that are specialised for each category and support the GRM. We show that our modules are effective at enhancing classification performance using a public dataset of dermoscopy-clinical images, and show that our method outperforms the state-of-the-art at classifying the 7PC categories and diagnosis

Graph-Ensemble Learning Model for Multi-label Skin Lesion Classification using Dermoscopy and Clinical Images

Many skin lesion analysis (SLA) methods recently focused on developing a multi-modal-based multi-label classification method due to two factors. The first is multi-modal data, i.e., clinical and dermoscopy images, which can provide complementary information to obtain more accurate results than single-modal data. The second one is that multi-label classification, i.e., seven-point checklist (SPC) criteria as an auxiliary classification task can not only boost the diagnostic accuracy of melanoma in the deep learning (DL) pipeline but also provide more useful functions to the clinical doctor as it is commonly used in clinical dermatologist's diagnosis. However, most methods only focus on designing a better module for multi-modal data fusion; few methods explore utilizing the label correlation between SPC and skin disease for performance improvement. This study fills the gap that introduces a Graph Convolution Network (GCN) to exploit prior co-occurrence between each category as a correlation matrix into the DL model for the multi-label classification. However, directly applying GCN degraded the performances in our experiments; we attribute this to the weak generalization ability of GCN in the scenario of insufficient statistical samples of medical data. We tackle this issue by proposing a Graph-Ensemble Learning Model (GELN) that views the prediction from GCN as complementary information of the predictions from the fusion model and adaptively fuses them by a weighted averaging scheme, which can utilize the valuable information from GCN while avoiding its negative influences as much as possible. To evaluate our method, we conduct experiments on public datasets. The results illustrate that our GELN can consistently improve the classification performance on different datasets and that the proposed method can achieve state-of-the-art performance in SPC and diagnosis classification.Comment: Submitted to TNNLS in 1st July 202

Computer-Aided Diagnosis for Melanoma using Ontology and Deep Learning Approaches

The emergence of deep-learning algorithms provides great potential to enhance the prediction performance of computer-aided supporting diagnosis systems. Recent research efforts indicated that well-trained algorithms could achieve the accuracy level of experienced senior clinicians in the Dermatology field. However, the lack of interpretability and transparency hinders the algorithms’ utility in real-life. Physicians and patients require a certain level of interpretability for them to accept and trust the results. Another limitation of AI algorithms is the lack of consideration of other information related to the disease diagnosis, for example some typical dermoscopic features and diagnostic guidelines. Clinical guidelines for skin disease diagnosis are designed based on dermoscopic features. However, a structured and standard representation of the relevant knowledge in the skin disease domain is lacking. To address the above challenges, this dissertation builds an ontology capable of formally representing the knowledge of dermoscopic features and develops an explainable deep learning model able to diagnose skin diseases and dermoscopic features. Additionally, large-scale, unlabeled datasets can learn from the trained model and automate the feature generation process. The computer vision aided feature extraction algorithms are combined with the deep learning model to improve the overall classification accuracy and save manual annotation efforts