VisTA: Vision-Text Alignment Model with Contrastive Learning using Multimodal Data for Evidence-Driven, Reliable, and Explainable Alzheimer's Disease Diagnosis
This work addresses the problem of reliable and explainable AI-assisted diagnosis for Alzheimer's disease in clinical settings, representing an incremental improvement by fine-tuning an existing model with a small dataset.
The paper tackled the challenge of designing AI models for Alzheimer's disease diagnosis that are both predictable and explainable, proposing VisTA, a multimodal vision-text alignment model using contrastive learning, which achieved 88% accuracy and an AUC of 0.82 for dementia prediction with only 170 fine-tuning samples.
Objective: Assessing Alzheimer's disease (AD) using high-dimensional radiology images is clinically important but challenging. Although Artificial Intelligence (AI) has advanced AD diagnosis, it remains unclear how to design AI models embracing predictability and explainability. Here, we propose VisTA, a multimodal language-vision model assisted by contrastive learning, to optimize disease prediction and evidence-based, interpretable explanations for clinical decision-making. Methods: We developed VisTA (Vision-Text Alignment Model) for AD diagnosis. Architecturally, we built VisTA from BiomedCLIP and fine-tuned it using contrastive learning to align images with verified abnormalities and their descriptions. To train VisTA, we used a constructed reference dataset containing images, abnormality types, and descriptions verified by medical experts. VisTA produces four outputs: predicted abnormality type, similarity to reference cases, evidence-driven explanation, and final AD diagnoses. To illustrate VisTA's efficacy, we reported accuracy metrics for abnormality retrieval and dementia prediction. To demonstrate VisTA's explainability, we compared its explanations with human experts' explanations. Results: Compared to 15 million images used for baseline pretraining, VisTA only used 170 samples for fine-tuning and obtained significant improvement in abnormality retrieval and dementia prediction. For abnormality retrieval, VisTA reached 74% accuracy and an AUC of 0.87 (26% and 0.74, respectively, from baseline models). For dementia prediction, VisTA achieved 88% accuracy and an AUC of 0.82 (30% and 0.57, respectively, from baseline models). The generated explanations agreed strongly with human experts' and provided insights into the diagnostic process. Taken together, VisTA optimize prediction, clinical reasoning, and explanation.