Ifrat Ikhtear Uddin

Longwei Wang, Ifrat Ikhtear Uddin, KC Santosh

Medical image analysis faces two critical challenges: scarcity of labeled data and lack of model interpretability, both hindering clinical AI deployment. Few-shot learning (FSL) addresses data limitations but lacks transparency in predictions. Active learning (AL) methods optimize data acquisition but overlook interpretability of acquired samples. We propose a dual-framework solution: Expert-Guided Explainable Few-Shot Learning (EGxFSL) and Explainability-Guided AL (xGAL). EGxFSL integrates radiologist-defined regions-of-interest as spatial supervision via Grad-CAM-based Dice loss, jointly optimized with prototypical classification for interpretable few-shot learning. xGAL introduces iterative sample acquisition prioritizing both predictive uncertainty and attention misalignment, creating a closed-loop framework where explainability guides training and sample selection synergistically. On the BraTS (MRI), VinDr-CXR (chest X-ray), and SIIM-COVID-19 (chest X-ray) datasets, we achieve accuracies of 92\%, 76\%, and 62\%, respectively, consistently outperforming non-guided baselines across all datasets. Under severe data constraints, xGAL achieves 76\% accuracy with only 680 samples versus 57\% for random sampling. Grad-CAM visualizations demonstrate guided models focus on diagnostically relevant regions, with generalization validated on breast ultrasound confirming cross-modality applicability.

Ifrat Ikhtear Uddin, Longwei Wang, KC Santosh

Medical image analysis often faces significant challenges due to limited expert-annotated data, hindering both model generalization and clinical adoption. We propose an expert-guided explainable few-shot learning framework that integrates radiologist-provided regions of interest (ROIs) into model training to simultaneously enhance classification performance and interpretability. Leveraging Grad-CAM for spatial attention supervision, we introduce an explanation loss based on Dice similarity to align model attention with diagnostically relevant regions during training. This explanation loss is jointly optimized with a standard prototypical network objective, encouraging the model to focus on clinically meaningful features even under limited data conditions. We evaluate our framework on two distinct datasets: BraTS (MRI) and VinDr-CXR (Chest X-ray), achieving significant accuracy improvements from 77.09% to 83.61% on BraTS and from 54.33% to 73.29% on VinDr-CXR compared to non-guided models. Grad-CAM visualizations further confirm that expert-guided training consistently aligns attention with diagnostic regions, improving both predictive reliability and clinical trustworthiness. Our findings demonstrate the effectiveness of incorporating expert-guided attention supervision to bridge the gap between performance and interpretability in few-shot medical image diagnosis.

Longwei Wang, Ifrat Ikhtear Uddin, KC Santosh et al.

Adversarial examples reveal critical vulnerabilities in deep neural networks by exploiting their sensitivity to imperceptible input perturbations. While adversarial training remains the predominant defense strategy, it often incurs significant computational cost and may compromise clean-data accuracy. In this work, we investigate an architectural approach to adversarial robustness by embedding group-equivariant convolutions-specifically, rotation- and scale-equivariant layers-into standard convolutional neural networks (CNNs). These layers encode symmetry priors that align model behavior with structured transformations in the input space, promoting smoother decision boundaries and greater resilience to adversarial attacks. We propose and evaluate two symmetry-aware architectures: a parallel design that processes standard and equivariant features independently before fusion, and a cascaded design that applies equivariant operations sequentially. Theoretically, we demonstrate that such models reduce hypothesis space complexity, regularize gradients, and yield tighter certified robustness bounds under the CLEVER (Cross Lipschitz Extreme Value for nEtwork Robustness) framework. Empirically, our models consistently improve adversarial robustness and generalization across CIFAR-10, CIFAR-100, and CIFAR-10C under both FGSM and PGD attacks, without requiring adversarial training. These findings underscore the potential of symmetry-enforcing architectures as efficient and principled alternatives to data augmentation-based defenses.