Explaining COVID-19 and Thoracic Pathology Model Predictions by Identifying Informative Input Features

Neural networks have demonstrated remarkable performance in classification and regression tasks on chest X-rays. In order to establish trust in the clinical routine, the networks’ prediction mechanism needs to be interpretable. One principal approach to interpretation is feature attribution. Feature attribution methods identify the importance of input features for the output prediction. Building on Information Bottleneck Attribution (IBA) method, for each prediction we identify the chest X-ray regions that have high mutual information with the network’s output. Original IBA identifies input regions that have sufficient predictive information. We propose Inverse IBA to identify all informative regions. Thus all predictive cues for pathologies are highlighted on the X-rays, a desirable property for chest X-ray diagnosis. Moreover, we propose Regression IBA for explaining regression models. Using Regression IBA we observe that a model trained on cumulative severity score labels implicitly learns the severity of different X-ray regions. Finally, we propose Multi-layer IBA to generate higher resolution and more detailed attribution/saliency maps. We evaluate our methods using both human-centric (ground-truth-based) interpretability metrics, and human-agnostic feature importance metrics on NIH Chest X-ray8 and BrixIA datasets. The code (https://github.com/CAMP-eXplain-AI/CheXplain-IBA ) is publicly available. © 2021, Springer Nature Switzerland AG.

[1]  Roger G. Mark,et al.  MIMIC-CXR: A large publicly available database of labeled chest radiographs , 2019, ArXiv.

[2]  Nassir Navab,et al.  Explaining Neural Networks via Perturbing Important Learned Features , 2019, ArXiv.

[3]  Alexander Binder,et al.  Evaluating the Visualization of What a Deep Neural Network Has Learned , 2015, IEEE Transactions on Neural Networks and Learning Systems.

[4]  Andrew Zisserman,et al.  Deep Inside Convolutional Networks: Visualising Image Classification Models and Saliency Maps , 2013, ICLR.

[5]  Jong Chul Ye,et al.  Deep Learning COVID-19 Features on CXR Using Limited Training Data Sets , 2020, IEEE Transactions on Medical Imaging.

[6]  Alexander Binder,et al.  Explaining nonlinear classification decisions with deep Taylor decomposition , 2015, Pattern Recognit..

[7]  Singh Rk,et al.  COVIDScreen: explainable deep learning framework for differential diagnosis of COVID-19 using chest X-rays , 2020, Neural Comput. Appl..

[8]  Sonali Agarwal,et al.  Automated diagnosis of COVID-19 with limited posteroanterior chest X-ray images using fine-tuned deep neural networks , 2020, Applied Intelligence.

[9]  Andrea Borghesi,et al.  BS-Net: Learning COVID-19 pneumonia severity on a large chest X-ray dataset , 2021, Medical Image Analysis.

[10]  Nassir Navab,et al.  Neural Response Interpretation through the Lens of Critical Pathways , 2021, 2021 IEEE/CVF Conference on Computer Vision and Pattern Recognition (CVPR).

[11]  N. Adami,et al.  End-to-end learning for semiquantitative rating of COVID-19 severity on Chest X-rays , 2020, ArXiv.

[12]  Ankur Taly,et al.  Axiomatic Attribution for Deep Networks , 2017, ICML.

[13]  Bolei Zhou,et al.  Learning Deep Features for Discriminative Localization , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[14]  Andrew Y. Ng,et al.  CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning , 2017, ArXiv.

[15]  Alexander A. Alemi,et al.  Deep Variational Information Bottleneck , 2017, ICLR.

[16]  Nassir Navab,et al.  Rethinking Positive Aggregation and Propagation of Gradients in Gradient-based Saliency Methods , 2020, ArXiv.

[17]  Alexander Binder,et al.  On Pixel-Wise Explanations for Non-Linear Classifier Decisions by Layer-Wise Relevance Propagation , 2015, PloS one.

[18]  Ronald M. Summers,et al.  ChestX-ray: Hospital-Scale Chest X-ray Database and Benchmarks on Weakly Supervised Classification and Localization of Common Thorax Diseases , 2019, Deep Learning and Convolutional Neural Networks for Medical Imaging and Clinical Informatics.

[19]  Yang Zhang,et al.  A Theoretical Explanation for Perplexing Behaviors of Backpropagation-based Visualizations , 2018, ICML.

[20]  Been Kim,et al.  Sanity Checks for Saliency Maps , 2018, NeurIPS.

[21]  Steven Horng,et al.  MIMIC-CXR, a de-identified publicly available database of chest radiographs with free-text reports , 2019, Scientific Data.

[22]  Cengiz Öztireli,et al.  Towards better understanding of gradient-based attribution methods for Deep Neural Networks , 2017, ICLR.

[23]  Kate Saenko,et al.  RISE: Randomized Input Sampling for Explanation of Black-box Models , 2018, BMVC.

[24]  Nassir Navab,et al.  Learning Interpretable Features via Adversarially Robust Optimization , 2019, MICCAI.

[25]  Ghassan Hamarneh,et al.  InfoMask: Masked Variational Latent Representation to Localize Chest Disease , 2019, MICCAI.

[26]  Till Döhmen,et al.  DeepCOVIDExplainer: Explainable COVID-19 Predictions Based on Chest X-ray Images , 2020, ArXiv.

[27]  Rohan Pandey,et al.  COVIDScreen: explainable deep learning framework for differential diagnosis of COVID-19 using chest X-rays , 2021, Neural Comput. Appl..

[28]  Dumitru Erhan,et al.  A Benchmark for Interpretability Methods in Deep Neural Networks , 2018, NeurIPS.

[29]  Yifan Yu,et al.  CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison , 2019, AAAI.

[30]  Thomas Brox,et al.  Striving for Simplicity: The All Convolutional Net , 2014, ICLR.

[31]  Zhe L. Lin,et al.  Top-Down Neural Attention by Excitation Backprop , 2016, International Journal of Computer Vision.

[32]  Wei Wei,et al.  Thoracic Disease Identification and Localization with Limited Supervision , 2017, 2018 IEEE/CVF Conference on Computer Vision and Pattern Recognition.