Zihao Jin

Yingying Fang, Shuang Wu, Zihao Jin et al.

In the field of medical imaging, particularly in tasks related to early disease detection and prognosis, understanding the reasoning behind AI model predictions is imperative for assessing their reliability. Conventional explanation methods encounter challenges in identifying decisive features in medical image classifications, especially when discriminative features are subtle or not immediately evident. To address this limitation, we propose an agent model capable of generating counterfactual images that prompt different decisions when plugged into a black box model. By employing this agent model, we can uncover influential image patterns that impact the black model's final predictions. Through our methodology, we efficiently identify features that influence decisions of the deep black box. We validated our approach in the rigorous domain of medical prognosis tasks, showcasing its efficacy and potential to enhance the reliability of deep learning models in medical image classification compared to existing interpretation methods. The code will be publicly available at https://github.com/ayanglab/DiffExplainer.

Zhenxuan Zhang, Kinhei Lee, Peiyuan Jing et al.

Automatic medical report generation has the potential to support clinical diagnosis, reduce the workload of radiologists, and demonstrate potential for enhancing diagnostic consistency. However, current evaluation metrics often fail to reflect the clinical reliability of generated reports. Early overlap-based methods focus on textual matches between predicted and ground-truth entities but miss fine-grained clinical details (e.g., anatomical location, severity). Some diagnostic metrics are limited by fixed vocabularies or templates, reducing their ability to capture diverse clinical expressions. LLM-based approaches further lack interpretable reasoning steps, making it hard to assess or trust their behavior in safety-critical settings. These limitations hinder the comprehensive assessment of the reliability of generated reports and pose risks in their selection for clinical use. Therefore, we propose a Granular Explainable Multi-Agent Score (GEMA-Score) in this paper, which conducts both objective quantification and subjective evaluation through a large language model-based multi-agent workflow. Our GEMA-Score parses structured reports and employs stable calculations through interactive exchanges of information among agents to assess disease diagnosis, location, severity, and uncertainty. Additionally, an LLM-based scoring agent evaluates completeness, readability, and clinical terminology while providing explanatory feedback. Extensive experiments validate that GEMA-Score achieves the highest correlation with human expert evaluations on a public dataset, demonstrating its effectiveness in clinical scoring (Kendall coefficient = $0.69$ for ReXVal dataset and Kendall coefficient = $0.45$ for RadEvalX dataset). The anonymous project demo is available at: https://github.com/Zhenxuan-Zhang/GEMA_score.

Weiyi Zhang, Peranut Chotcomwongse, Yinwen Li et al.

Diabetic macular edema (DME) significantly contributes to visual impairment in diabetic patients. Treatment responses to intravitreal therapies vary, highlighting the need for patient stratification to predict therapeutic benefits and enable personalized strategies. To our knowledge, this study is the first to explore pre-treatment stratification for predicting DME treatment responses. To advance this research, we organized the 2nd Asia-Pacific Tele-Ophthalmology Society (APTOS) Big Data Competition in 2021. The competition focused on improving predictive accuracy for anti-VEGF therapy responses using ophthalmic OCT images. We provided a dataset containing tens of thousands of OCT images from 2,000 patients with labels across four sub-tasks. This paper details the competition's structure, dataset, leading methods, and evaluation metrics. The competition attracted strong scientific community participation, with 170 teams initially registering and 41 reaching the final round. The top-performing team achieved an AUC of 80.06%, highlighting the potential of AI in personalized DME treatment and clinical decision-making.

Yingying Fang, Zihao Jin, Shaojie Guo et al.

Despite significant advancements in automated report generation, the opaqueness of text interpretability continues to cast doubt on the reliability of the content produced. This paper introduces a novel approach to identify specific image features in X-ray images that influence the outputs of report generation models. Specifically, we propose Cyclic Vision-Language Manipulator CVLM, a module to generate a manipulated X-ray from an original X-ray and its report from a designated report generator. The essence of CVLM is that cycling manipulated X-rays to the report generator produces altered reports aligned with the alterations pre-injected into the reports for X-ray generation, achieving the term "cyclic manipulation". This process allows direct comparison between original and manipulated X-rays, clarifying the critical image features driving changes in reports and enabling model users to assess the reliability of the generated texts. Empirical evaluations demonstrate that CVLM can identify more precise and reliable features compared to existing explanation methods, significantly enhancing the transparency and applicability of AI-generated reports.

Yingying Fang, Zihao Jin, Xiaodan Xing et al.

In medical imaging, particularly in early disease detection and prognosis tasks, discerning the rationale behind an AI model's predictions is crucial for evaluating the reliability of its decisions. Conventional explanation methods face challenges in identifying discernible decisive features in medical image classifications, where discriminative features are subtle or not immediately apparent. To bridge this gap, we propose an explainable model that is equipped with both decision reasoning and feature identification capabilities. Our approach not only detects influential image patterns but also uncovers the decisive features that drive the model's final predictions. By implementing our method, we can efficiently identify and visualise class-specific features leveraged by the data-driven model, providing insights into the decision-making processes of deep learning models. We validated our model in the demanding realm of medical prognosis task, demonstrating its efficacy and potential in enhancing the reliability of AI in healthcare and in discovering new knowledge in diseases where prognostic understanding is limited.

Zihao Jin, Yingying Fang, Jiahao Huang et al.

The manifestation of symptoms associated with lung diseases can vary in different depths for individual patients, highlighting the significance of 3D information in CT scans for medical image classification. While Vision Transformer has shown superior performance over convolutional neural networks in image classification tasks, their effectiveness is often demonstrated on sufficiently large 2D datasets and they easily encounter overfitting issues on small medical image datasets. To address this limitation, we propose a Diffusion-based 3D Vision Transformer (Diff3Dformer), which utilizes the latent space of the Diffusion model to form the slice sequence for 3D analysis and incorporates clustering attention into ViT to aggregate repetitive information within 3D CT scans, thereby harnessing the power of the advanced transformer in 3D classification tasks on small datasets. Our method exhibits improved performance on two different scales of small datasets of 3D lung CT scans, surpassing the state of the art 3D methods and other transformer-based approaches that emerged during the COVID-19 pandemic, demonstrating its robust and superior performance across different scales of data. Experimental results underscore the superiority of our proposed method, indicating its potential for enhancing medical image classification tasks in real-world scenarios.