IMPA-Net: Interpretable Multi-Part Attention Network for Trustworthy Brain Tumor Classification from MRI

Author:

Xie Yuting12,Zaccagna Fulvio34,Rundo Leonardo5ORCID,Testa Claudia67,Zhu Ruifeng8,Tonon Caterina12ORCID,Lodi Raffaele12,Manners David Neil29ORCID

Affiliation:

1. Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy

2. Functional and Molecular Neuroimaging Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bellaria Hospital, 40139 Bologna, Italy

3. Department of Imaging, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0SL, UK

4. Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK

5. Department of Information and Electrical Engineering and Applied Mathematics, University of Salerno, 84084 Fisciano, Italy

6. INFN Bologna Division, Viale C. Berti Pichat, 6/2, 40127 Bologna, Italy

7. Department of Physics and Astronomy, University of Bologna, 40127 Bologna, Italy

8. Department of Engineering “Enzo Ferrari”, University of Modena and Reggio Emilia, 41125 Modena, Italy

9. Department for Life Quality Studies, University of Bologna, 40126 Bologna, Italy

Abstract

Deep learning (DL) networks have shown attractive performance in medical image processing tasks such as brain tumor classification. However, they are often criticized as mysterious “black boxes”. The opaqueness of the model and the reasoning process make it difficult for health workers to decide whether to trust the prediction outcomes. In this study, we develop an interpretable multi-part attention network (IMPA-Net) for brain tumor classification to enhance the interpretability and trustworthiness of classification outcomes. The proposed model not only predicts the tumor grade but also provides a global explanation for the model interpretability and a local explanation as justification for the proffered prediction. Global explanation is represented as a group of feature patterns that the model learns to distinguish high-grade glioma (HGG) and low-grade glioma (LGG) classes. Local explanation interprets the reasoning process of an individual prediction by calculating the similarity between the prototypical parts of the image and a group of pre-learned task-related features. Experiments conducted on the BraTS2017 dataset demonstrate that IMPA-Net is a verifiable model for the classification task. A percentage of 86% of feature patterns were assessed by two radiologists to be valid for representing task-relevant medical features. The model shows a classification accuracy of 92.12%, of which 81.17% were evaluated as trustworthy based on local explanations. Our interpretable model is a trustworthy model that can be used for decision aids for glioma classification. Compared with black-box CNNs, it allows health workers and patients to understand the reasoning process and trust the prediction outcomes.

Funder

China Scholarship Council

Italian Ministry of Health

Publisher

MDPI AG

Reference43 articles.

1. Cancer Research UK (2023, December 06). Brain, Other CNS and Intracranial Tumours Statistics. Available online: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/brain-other-cns-and-intracranial-tumours/incidence%23collapseTen#heading-One.

2. The 2021 WHO Classification of Tumors of the Central Nervous System: A Summary;Louis;Neuro. Oncol.,2021

3. Malignant Gliomas in Adults;Norden;Blue Books Neurol.,2010

4. Wirsching, H.G., and Weller, M. (2016). Malignant Brain Tumors: State-of-the-Art Treatment, Springer International Publishing.

5. Multimodality Brain Tumor Imaging: MR Imaging, PET, and PET/MR Imaging;Fink;J. Nucl. Med.,2015

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