Animesh Tandon

Grace Guo, Lifu Deng, Animesh Tandon et al.

The recent prevalence of publicly accessible, large medical imaging datasets has led to a proliferation of artificial intelligence (AI) models for cardiovascular image classification and analysis. At the same time, the potentially significant impacts of these models have motivated the development of a range of explainable AI (XAI) methods that aim to explain model predictions given certain image inputs. However, many of these methods are not developed or evaluated with domain experts, and explanations are not contextualized in terms of medical expertise or domain knowledge. In this paper, we propose a novel framework and python library, MiMICRI, that provides domain-centered counterfactual explanations of cardiovascular image classification models. MiMICRI helps users interactively select and replace segments of medical images that correspond to morphological structures. From the counterfactuals generated, users can then assess the influence of each segment on model predictions, and validate the model against known medical facts. We evaluate this library with two medical experts. Our evaluation demonstrates that a domain-centered XAI approach can enhance the interpretability of model explanations, and help experts reason about models in terms of relevant domain knowledge. However, concerns were also surfaced about the clinical plausibility of the counterfactuals generated. We conclude with a discussion on the generalizability and trustworthiness of the MiMICRI framework, as well as the implications of our findings on the development of domain-centered XAI methods for model interpretability in healthcare contexts.

Sven Koehler, Animesh Tandon, Tarique Hussain et al.

Planning the optimal time of intervention for pulmonary valve replacement surgery in patients with the congenital heart disease Tetralogy of Fallot (TOF) is mainly based on ventricular volume and function according to current guidelines. Both of these two biomarkers are most reliably assessed by segmentation of 3D cardiac magnetic resonance (CMR) images. In several grand challenges in the last years, U-Net architectures have shown impressive results on the provided data. However, in clinical practice, data sets are more diverse considering individual pathologies and image properties derived from different scanner properties. Additionally, specific training data for complex rare diseases like TOF is scarce. For this work, 1) we assessed the accuracy gap when using a publicly available labelled data set (the Automatic Cardiac Diagnosis Challenge (ACDC) data set) for training and subsequent applying it to CMR data of TOF patients and vice versa and 2) whether we can achieve similar results when applying the model to a more heterogeneous data base. Multiple deep learning models were trained with four-fold cross validation. Afterwards they were evaluated on the respective unseen CMR images from the other collection. Our results confirm that current deep learning models can achieve excellent results (left ventricle dice of $0.951\pm{0.003}$/$0.941\pm{0.007}$ train/validation) within a single data collection. But once they are applied to other pathologies, it becomes apparent how much they overfit to the training pathologies (dice score drops between $0.072\pm{0.001}$ for the left and $0.165\pm{0.001}$ for the right ventricle).