Hassan M. Fathallah-Shaykh

Ian E. Nielsen, Ravi P. Ramachandran, Nidhal Bouaynaya et al.

The expansion of explainable artificial intelligence as a field of research has generated numerous methods of visualizing and understanding the black box of a machine learning model. Attribution maps are generally used to highlight the parts of the input image that influence the model to make a specific decision. On the other hand, the robustness of machine learning models to natural noise and adversarial attacks is also being actively explored. This paper focuses on evaluating methods of attribution mapping to find whether robust neural networks are more explainable. We explore this problem within the application of classification for medical imaging. Explainability research is at an impasse. There are many methods of attribution mapping, but no current consensus on how to evaluate them and determine the ones that are the best. Our experiments on multiple datasets (natural and medical imaging) and various attribution methods reveal that two popular evaluation metrics, Deletion and Insertion, have inherent limitations and yield contradictory results. We propose a new explainability faithfulness metric (called EvalAttAI) that addresses the limitations of prior metrics. Using our novel evaluation, we found that Bayesian deep neural networks using the Variational Density Propagation technique were consistently more explainable when used with the best performing attribution method, the Vanilla Gradient. However, in general, various types of robust neural networks may not be more explainable, despite these models producing more visually plausible attribution maps.

Raghav Mehta, Angelos Filos, Ujjwal Baid et al.

Deep learning (DL) models have provided state-of-the-art performance in various medical imaging benchmarking challenges, including the Brain Tumor Segmentation (BraTS) challenges. However, the task of focal pathology multi-compartment segmentation (e.g., tumor and lesion sub-regions) is particularly challenging, and potential errors hinder translating DL models into clinical workflows. Quantifying the reliability of DL model predictions in the form of uncertainties could enable clinical review of the most uncertain regions, thereby building trust and paving the way toward clinical translation. Several uncertainty estimation methods have recently been introduced for DL medical image segmentation tasks. Developing scores to evaluate and compare the performance of uncertainty measures will assist the end-user in making more informed decisions. In this study, we explore and evaluate a score developed during the BraTS 2019 and BraTS 2020 task on uncertainty quantification (QU-BraTS) and designed to assess and rank uncertainty estimates for brain tumor multi-compartment segmentation. This score (1) rewards uncertainty estimates that produce high confidence in correct assertions and those that assign low confidence levels at incorrect assertions, and (2) penalizes uncertainty measures that lead to a higher percentage of under-confident correct assertions. We further benchmark the segmentation uncertainties generated by 14 independent participating teams of QU-BraTS 2020, all of which also participated in the main BraTS segmentation task. Overall, our findings confirm the importance and complementary value that uncertainty estimates provide to segmentation algorithms, highlighting the need for uncertainty quantification in medical image analyses. Finally, in favor of transparency and reproducibility, our evaluation code is made publicly available at: https://github.com/RagMeh11/QU-BraTS.

Hongwei Bran Li, Gian Marco Conte, Qingqiao Hu et al.

Automated brain tumor segmentation methods have become well-established and reached performance levels offering clear clinical utility. These methods typically rely on four input magnetic resonance imaging (MRI) modalities: T1-weighted images with and without contrast enhancement, T2-weighted images, and FLAIR images. However, some sequences are often missing in clinical practice due to time constraints or image artifacts, such as patient motion. Consequently, the ability to substitute missing modalities and gain segmentation performance is highly desirable and necessary for the broader adoption of these algorithms in the clinical routine. In this work, we present the establishment of the Brain MR Image Synthesis Benchmark (BraSyn) in conjunction with the Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2023. The primary objective of this challenge is to evaluate image synthesis methods that can realistically generate missing MRI modalities when multiple available images are provided. The ultimate aim is to facilitate automated brain tumor segmentation pipelines. The image dataset used in the benchmark is diverse and multi-modal, created through collaboration with various hospitals and research institutions.

Giuseppina Carannante, Nidhal C. Bouaynaya, Dimah Dera et al.

Deep Learning (DL) holds great promise in reshaping the industry owing to its precision, efficiency, and objectivity. However, the brittleness of DL models to noisy and out-of-distribution inputs is ailing their deployment in sensitive fields. Current models often lack uncertainty quantification, providing only point estimates. We propose SUPER-Net, a Bayesian framework for trustworthy image segmentation via uncertainty propagation. Using Taylor series approximations, SUPER-Net propagates the mean and covariance of the model's posterior distribution across nonlinear layers. It generates two outputs simultaneously: the segmented image and a pixel-wise uncertainty map, eliminating the need for expensive Monte Carlo sampling. SUPER-Net's performance is extensively evaluated on MRI and CT scans under various noisy and adversarial conditions. Results show that SUPER-Net outperforms state-of-the-art models in robustness and accuracy. The uncertainty map identifies low-confidence areas affected by noise or attacks, allowing the model to self-assess segmentation reliability, particularly when errors arise from noise or adversarial examples.

Daniel E. Cahall, Ghulam Rasool, Nidhal C. Bouaynaya et al.

Magnetic resonance imaging (MRI) is routinely used for brain tumor diagnosis, treatment planning, and post-treatment surveillance. Recently, various models based on deep neural networks have been proposed for the pixel-level segmentation of tumors in brain MRIs. However, the structural variations, spatial dissimilarities, and intensity inhomogeneity in MRIs make segmentation a challenging task. We propose a new end-to-end brain tumor segmentation architecture based on U-Net that integrates Inception modules and dilated convolutions into its contracting and expanding paths. This allows us to extract local structural as well as global contextual information. We performed segmentation of glioma sub-regions, including tumor core, enhancing tumor, and whole tumor using Brain Tumor Segmentation (BraTS) 2018 dataset. Our proposed model performed significantly better than the state-of-the-art U-Net-based model ($p<0.05$) for tumor core and whole tumor segmentation.