Stine Thestrup Hansen

Srishti Gautam, Ahcene Boubekki, Stine Hansen et al.

The need for interpretable models has fostered the development of self-explainable classifiers. Prior approaches are either based on multi-stage optimization schemes, impacting the predictive performance of the model, or produce explanations that are not transparent, trustworthy or do not capture the diversity of the data. To address these shortcomings, we propose ProtoVAE, a variational autoencoder-based framework that learns class-specific prototypes in an end-to-end manner and enforces trustworthiness and diversity by regularizing the representation space and introducing an orthonormality constraint. Finally, the model is designed to be transparent by directly incorporating the prototypes into the decision process. Extensive comparisons with previous self-explainable approaches demonstrate the superiority of ProtoVAE, highlighting its ability to generate trustworthy and diverse explanations, while not degrading predictive performance.

Luca Tomasetti, Stine Hansen, Mahdieh Khanmohammadi et al.

Precise ischemic lesion segmentation plays an essential role in improving diagnosis and treatment planning for ischemic stroke, one of the prevalent diseases with the highest mortality rate. While numerous deep neural network approaches have recently been proposed to tackle this problem, these methods require large amounts of annotated regions during training, which can be impractical in the medical domain where annotated data is scarce. As a remedy, we present a prototypical few-shot segmentation approach for ischemic lesion segmentation using only one annotated sample during training. The proposed approach leverages a novel self-supervised training mechanism that is tailored to the task of ischemic stroke lesion segmentation by exploiting color-coded parametric maps generated from Computed Tomography Perfusion scans. We illustrate the benefits of our proposed training mechanism, leading to considerable improvements in performance in the few-shot setting. Given a single annotated patient, an average Dice score of 0.58 is achieved for the segmentation of ischemic lesions.

Hyeongji Kim, Stine Hansen, Michael Kampffmeyer

Common prototype-based medical image few-shot segmentation (FSS) methods model foreground and background classes using class-specific prototypes. However, given the high variability of the background, a more promising direction is to focus solely on foreground modeling, treating the background as an anomaly -- an approach introduced by ADNet. Yet, ADNet faces three key limitations: dependence on a single prototype per class, a focus on binary classification, and fixed thresholds that fail to adapt to patient and organ variability. To address these shortcomings, we propose the Tied Prototype Model (TPM), a principled reformulation of ADNet with tied prototype locations for foreground and background distributions. Building on its probabilistic foundation, TPM naturally extends to multiple prototypes and multi-class segmentation while effectively separating non-typical background features. Notably, both extensions lead to improved segmentation accuracy. Finally, we leverage naturally occurring class priors to define an ideal target for adaptive thresholds, boosting segmentation performance. Taken together, TPM provides a fresh perspective on prototype-based FSS for medical image segmentation. The code can be found at https://github.com/hjk92g/TPM-FSS.

Srishti Gautam, Marina M. -C. Höhne, Stine Hansen et al.

The recent trend of integrating multi-source Chest X-Ray datasets to improve automated diagnostics raises concerns that models learn to exploit source-specific correlations to improve performance by recognizing the source domain of an image rather than the medical pathology. We hypothesize that this effect is enforced by and leverages label-imbalance across the source domains, i.e, prevalence of a disease corresponding to a source. Therefore, in this work, we perform a thorough study of the effect of label-imbalance in multi-source training for the task of pneumonia detection on the widely used ChestX-ray14 and CheXpert datasets. The results highlight and stress the importance of using more faithful and transparent self-explaining models for automated diagnosis, thus enabling the inherent detection of spurious learning. They further illustrate that this undesirable effect of learning spurious correlations can be reduced considerably when ensuring label-balanced source domain datasets.

Srishti Gautam, Marina M. -C. Höhne, Stine Hansen et al.

Current machine learning models have shown high efficiency in solving a wide variety of real-world problems. However, their black box character poses a major challenge for the understanding and traceability of the underlying decision-making strategies. As a remedy, many post-hoc explanation and self-explanatory methods have been developed to interpret the models' behavior. These methods, in addition, enable the identification of artifacts that can be learned by the model as class-relevant features. In this work, we provide a detailed case study of the self-explaining network, ProtoPNet, in the presence of a spectrum of artifacts. Accordingly, we identify the main drawbacks of ProtoPNet, especially, its coarse and spatially imprecise explanations. We address these limitations by introducing Prototypical Relevance Propagation (PRP), a novel method for generating more precise model-aware explanations. Furthermore, in order to obtain a clean dataset, we propose to use multi-view clustering strategies for segregating the artifact images using the PRP explanations, thereby suppressing the potential artifact learning in the models.