让医学影像模型学会关注真正重要的区域,提升可解释性。
Explanation-Aware Learning for Enhanced Interpretability in Biomedical Imaging

- 在训练中加入解释损失,引导模型关注临床相关区域。
- 解释质量与损失系数存在权衡,但整体提升解释一致性。
- 适用于带标注的医学影像,尤其适合信任度要求高的场景。
用于医学影像诊断的深度神经网络虽预测准确,却常依赖无关视觉线索,影响实际可信度。现有后处理解释方法仅生成热力图,无法影响模型学习过程,导致非因果特征持续存在。为此,本文提出将解释监督直接引入训练目标,引导模型关注临床有意义区域,促进基于临床依据的决策。系统研究了不同解释损失设计与监督强度对预测性能和解释空间忠实度的影响。为量化评估可解释性,引入两个互补指标:标注覆盖度与显著性精度,实现超越定性可视化的严格评估。实验表明解释质量与损失系数间存在明确权衡;统计分析显示解释对齐性显著提升,同时保持相当的准确性。实验基于标注的胸部X光数据集开展,但该框架可推广至多种标注的生物医学影像模态。结果表明,解释监督并非单一选择,为在噪声临床标注下合理融入解释损失提供了实用指导。
原文摘要 · Abstract (English)
Deep neural networks for medical image diagnosis often achieve high predictive accuracy while relying on spurious or clinically irrelevant visual cues, limiting their trustworthiness in practice. Post-hoc explanation methods are widely used to visualize model decisions in the form of saliency maps; however, these explanations do not influence how models learn during training, allowing non-causal or confounding features to persist. This motivates the incorporation of explanation supervision directly into the training objective to guide model attention toward clinically meaningful regions and promote clinically grounded decision-making. This paper presents a systematic approach to integrate explanation loss into model training and analyzes how different explanation loss designs and supervision strengths influence both predictive performance and spatial faithfulness of explanations. To quantitatively assess interpretability, two complementary explanation performance metrics-annotation coverage and saliency precision-are introduced, enabling rigorous evaluation beyond qualitative visualization. Our experimental results reveal a clear trade-off between explanation quality and explanation loss coefficients. Furthermore, quantitative statistical analysis yields consistently improved explanation alignment while maintaining comparable accuracy. Experiments were conducted on annotated chest X-ray datasets; however, the proposed framework is applicable to a broad range of annotated biomedical imaging modalities. Overall, these findings demonstrate that explanation supervision is not a monolithic design choice and provide practical guidance for incorporating explanation loss into training objectives under noisy clinical annotations.
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