Gradient Attention Map Based Verification of Deep Convolutional Neural Networks with Application to X-ray Image Datasets

Deep learning models have great potential in medical imaging, including orthodontics and skeletal maturity assessment. However, applying a model to data different from its training set can lead to unreliable predictions that may impact patient care. To address this, we propose a comprehensive verification framework that evaluates model suitability through multiple complementary strategies. First, we introduce a Gradient Attention Map (GAM)-based approach that analyzes attention patterns using Grad-CAM and compares them via similarity metrics such as IoU, Dice Similarity, SSIM, Cosine Similarity, Pearson Correlation, KL Divergence, and Wasserstein Distance. Second, we extend verification to early convolutional feature maps, capturing structural mis-alignments missed by attention alone. Finally, we incorporate an additional garbage class into the classification model to explicitly reject out-of-distribution inputs. Experimental results demonstrate that these combined methods effectively identify unsuitable models and inputs, promoting safer and more reliable deployment of deep learning in medical imaging.

Classification of the Cervical Vertebrae Maturation (CVM) stages Using the Tripod Network

We present a novel deep learning method for fully automated detection and classification of the Cervical Vertebrae Maturation (CVM) stages. The deep convolutional neural network consists of three parallel networks (TriPodNet) independently trained with different initialization parameters. They also have a built-in set of novel directional filters that highlight the Cervical Verte edges in X-ray images. Outputs of the three parallel networks are combined using a fully connected layer. 1018 cephalometric radiographs were labeled, divided by gender, and classified according to the CVM stages. Resulting images, using different training techniques and patches, were used to train TripodNet together with a set of tunable directional edge enhancers. Data augmentation is implemented to avoid overfitting. TripodNet achieves the state-of-the-art accuracy of 81.18\% in female patients and 75.32\% in male patients. The proposed TripodNet achieves a higher accuracy in our dataset than the Swin Transformers and the previous network models that we investigated for CVM stage estimation.