Meghal Dani

Manu Sheoran, Meghal Dani, Monika Sharma et al.

Incorporating data-specific domain knowledge in deep networks explicitly can provide important cues beneficial for lesion detection and can mitigate the need for diverse heterogeneous datasets for learning robust detectors. In this paper, we exploit the domain information present in computed tomography (CT) scans and propose a robust universal lesion detection (ULD) network that can detect lesions across all organs of the body by training on a single dataset, DeepLesion. We analyze CT-slices of varying intensities, generated using heuristically determined Hounsfield Unit(HU) windows that individually highlight different organs and are given as inputs to the deep network. The features obtained from the multiple intensity images are fused using a novel convolution augmented multi-head self-attention module and subsequently, passed to a Region Proposal Network (RPN) for lesion detection. In addition, we observed that traditional anchor boxes used in RPN for natural images are not suitable for lesion sizes often found in medical images. Therefore, we propose to use lesion-specific anchor sizes and ratios in the RPN for improving the detection performance. We use self-supervision to initialize weights of our network on the DeepLesion dataset to further imbibe domain knowledge. Our proposed Domain Knowledge augmented Multi-head Attention based Universal Lesion Detection Network DMKA-ULD produces refined and precise bounding boxes around lesions across different organs. We evaluate the efficacy of our network on the publicly available DeepLesion dataset which comprises of approximately 32K CT scans with annotated lesions across all organs of the body. Results demonstrate that we outperform existing state-of-the-art methods achieving an overall sensitivity of 87.16%.

Meghal Dani, Muthu Jeyanthi Prakash, Zeynep Akata et al.

Large Language Models (LLMs) have been shown to encode clinical knowledge. Many evaluations, however, rely on structured question-answer benchmarks, overlooking critical challenges of interpreting and reasoning about unstructured clinical narratives in real-world settings. Using free-text clinical descriptions, we present SemioLLM, an evaluation framework that benchmarks 6 state-of-the-art models (GPT-3.5, GPT-4, Mixtral-8x7B, Qwen-72B, LlaMa2, LlaMa3) on a core diagnostic task in epilepsy. Leveraging a database of 1,269 seizure descriptions, we show that most LLMs are able to accurately and confidently generate probabilistic predictions of seizure onset zones in the brain. Most models approach clinician-level performance after prompt engineering, with expert-guided chain-of-thought reasoning leading to the most consistent improvements. Performance was further strongly modulated by clinical in-context impersonation, narrative length and language context (13.7%, 32.7% and 14.2% performance variation, respectively). However, expert analysis of reasoning outputs revealed that correct prediction can be based on hallucinated knowledge and deficient source citation accuracy, underscoring the need to improve interpretability of LLMs in clinical use. Overall, SemioLLM provides a scalable, domain-adaptable framework for evaluating LLMs in clinical disciplines where unstructured verbal descriptions encode diagnostic information. By identifying both the strengths and limitations of state-of-the-art models, our work supports the development of clinically robust and globally applicable AI systems for healthcare.

Meghal Dani, Isabel Rio-Torto, Stephan Alaniz et al.

Post-hoc explanation methods have often been criticised for abstracting away the decision-making process of deep neural networks. In this work, we would like to provide natural language descriptions for what different layers of a vision backbone have learned. Our DeViL method decodes vision features into language, not only highlighting the attribution locations but also generating textual descriptions of visual features at different layers of the network. We train a transformer network to translate individual image features of any vision layer into a prompt that a separate off-the-shelf language model decodes into natural language. By employing dropout both per-layer and per-spatial-location, our model can generalize training on image-text pairs to generate localized explanations. As it uses a pre-trained language model, our approach is fast to train, can be applied to any vision backbone, and produces textual descriptions at different layers of the vision network. Moreover, DeViL can create open-vocabulary attribution maps corresponding to words or phrases even outside the training scope of the vision model. We demonstrate that DeViL generates textual descriptions relevant to the image content on CC3M surpassing previous lightweight captioning models and attribution maps uncovering the learned concepts of the vision backbone. Finally, we show DeViL also outperforms the current state-of-the-art on the neuron-wise descriptions of the MILANNOTATIONS dataset. Code available at https://github.com/ExplainableML/DeViL

Manu Sheoran, Meghal Dani, Monika Sharma et al.

Existing universal lesion detection (ULD) methods utilize compute-intensive anchor-based architectures which rely on predefined anchor boxes, resulting in unsatisfactory detection performance, especially in small and mid-sized lesions. Further, these default fixed anchor-sizes and ratios do not generalize well to different datasets. Therefore, we propose a robust one-stage anchor-free lesion detection network that can perform well across varying lesions sizes by exploiting the fact that the box predictions can be sorted for relevance based on their center rather than their overlap with the object. Furthermore, we demonstrate that the ULD can be improved by explicitly providing it the domain-specific information in the form of multi-intensity images generated using multiple HU windows, followed by self-attention based feature-fusion and backbone initialization using weights learned via self-supervision over CT-scans. We obtain comparable results to the state-of-the-art methods, achieving an overall sensitivity of 86.05% on the DeepLesion dataset, which comprises of approximately 32K CT-scans with lesions annotated across various body organs.