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Vessel segmentation is an essential task in many clinical applications. Although supervised methods have achieved state-of-art performance, acquiring expert annotation is laborious and mostly limited for two-dimensional datasets with a small sample size. On the contrary, unsupervised methods rely on handcrafted features to detect tube-like structures such as vessels. However, those methods require complex pipelines involving several hyper-parameters and design choices rendering the procedure sensitive, dataset-specific, and not generalizable. We propose a self-supervised method with a limited number of hyper-parameters that is generalizable across modalities. Our method uses tube-like structure properties, such as connectivity, profile consistency, and bifurcation, to introduce inductive bias into a learning algorithm. To model those properties, we generate a vector field that we refer to as a flow. Our experiments on various public datasets in 2D and 3D show that our method performs better than unsupervised methods while learning useful transferable features from unlabeled data. Unlike generic self-supervised methods, the learned features learn vessel-relevant features that are transferable for supervised approaches, which is essential when the number of annotated data is limited. 

Model explainability is essential for the creation of trustworthy Machine Learning models in healthcare. An ideal explanation resembles the decision-making process of a domain expert and is expressed using concepts or terminology that is meaningful to the clinicians. To provide such explanation, we first associate the hidden units of the classifier to clinically relevant concepts. We take advantage of radiology reports accompanying the chest X-ray images to define concepts. We discover sparse associations between concepts and hidden units using a linear sparse logistic regression. To ensure that the identified units truly influence the classifier’s outcome, we adopt tools from Causal Inference literature and, more specifically, mediation analysis through counterfactual interventions. Finally, we construct a low-depth decision tree to translate all the discovered concepts into a straightforward decision rule, expressed to the radiologist. We evaluated our approach on a large chest x-ray dataset, where our model produces a global explanation consistent with clinical knowledge. 

A highly accurate but overconfident model is ill-suited for deployment in critical applications such as healthcare and autonomous driving. The classification outcome should reflect a high uncertainty on ambiguous in-distribution samples that lie close to the decision boundary. The model should also refrain from making overconfident decisions on samples that lie far outside its training distribution, far-out-of-distribution (far-OOD), or on unseen samples from novel classes that lie near its training distribution (near-OOD). This paper proposes an application of counterfactual explanations in fixing an over-confident classifier. Specifically, we propose to fine-tune a given pre-trained classifier using augmentations from a counterfactual explainer (ACE) to fix its uncertainty characteristics while retaining its predictive performance. We perform extensive experiments with detecting far-OOD, near-OOD, and ambiguous samples. Our empirical results show that the revised model has improved uncertainty measures, and its performance is competitive to the state-of-the-art methods. 

Purpose: To develop and evaluate a deep learning (DL) approach to extract rich information from high-resolution computed tomography (HRCT) of patients with chronic obstructive pulmonary disease (COPD). Methods: We develop a DL-based model to learn a compact representation of a subject, which is predictive of COPD physiologic severity and other outcomes. Our DL model learned: (a) to extract informative regional image features from HRCT; (b) to adaptively weight these features and form an aggregate patient representation; and finally, (c) to predict several COPD outcomes. The adaptive weights correspond to the regional lung contribution to the disease. We evaluate the model on 10 300 participants from the COPDGene cohort. Results: Our model was strongly predictive of spirometric obstruction ( r2 = 0.67) and grouped 65.4% of subjects correctly and 89.1% within one stage of their GOLD severity stage. Our model achieved an accuracy of 41.7% and 52.8% in stratifying the population-based on centrilobular (5-grade) and paraseptal (3-grade) emphysema severity score, respectively. For predicting future exacerbation, combining subjects' representations from our model with their past exacerbation histories achieved an accuracy of 80.8% (area under the ROC curve of 0.73). For all-cause mortality, in Cox regression analysis, we outperformed the BODE index improving the concordance metric (ours: 0.61 vs BODE: 0.56). Conclusions: Our model independently predicted spirometric obstruction, emphysema severity, exacerbation risk, and mortality from CT imaging alone. This method has potential applicability in both research and clinical practice. 

As machine learning methods see greater adoption and implementation in high-stakes applications such as medical image diagnosis, the need for model interpretability and explanation has become more critical. Classical approaches that assess feature importance (e.g., saliency maps) do not explain how and why a particular region of an image is relevant to the prediction. We propose a method that explains the outcome of a classification black-box by gradually exaggerating the semantic effect of a given class. Given a query input to a classifier, our method produces a progressive set of plausible variations of that query, which gradually changes the posterior probability from its original class to its negation. These counter-factually generated samples preserve features unrelated to the classification decision, such that a user can employ our method as a “tuning knob” to traverse a data manifold while crossing the decision boundary. Our method is model agnostic and only requires the output value and gradient of the predictor with respect to its input.