Explainability Through Human-Centric Design for XAI in Lung Cancer Detection

Deep learning models have shown promise in lung pathology detection from chest X-rays, but widespread clinical adoption remains limited due to opaque model decision-making. In prior work, we introduced ClinicXAI, a human-centric, expert-guided concept bottleneck model (CBM) designed for interpretable lung cancer diagnosis. We now extend that approach and present XpertXAI, a generalizable expert-driven model that preserves human-interpretable clinical concepts while scaling to detect multiple lung pathologies. Using a high-performing InceptionV3-based classifier and a public dataset of chest X-rays with radiology reports, we compare XpertXAI against leading post-hoc explainability methods and an unsupervised CBM, XCBs. We assess explanations through comparison with expert radiologist annotations and medical ground truth. Although XpertXAI is trained for multiple pathologies, our expert validation focuses on lung cancer. We find that existing techniques frequently fail to produce clinically meaningful explanations, omitting key diagnostic features and disagreeing with radiologist judgments. XpertXAI not only outperforms these baselines in predictive accuracy but also delivers concept-level explanations that better align with expert reasoning. While our focus remains on explainability in lung cancer detection, this work illustrates how human-centric model design can be effectively extended to broader diagnostic contexts - offering a scalable path toward clinically meaningful explainable AI in medical diagnostics.

EndoFinder: Online Lesion Retrieval for Explainable Colorectal Polyp Diagnosis Leveraging Latent Scene Representations

Colorectal cancer (CRC) remains a leading cause of cancer-related mortality, underscoring the importance of timely polyp detection and diagnosis. While deep learning models have improved optical-assisted diagnostics, they often demand extensive labeled datasets and yield "black-box" outputs with limited interpretability. In this paper, we propose EndoFinder, an online polyp retrieval framework that leverages multi-view scene representations for explainable and scalable CRC diagnosis. First, we develop a Polyp-aware Image Encoder by combining contrastive learning and a reconstruction task, guided by polyp segmentation masks. This self-supervised approach captures robust features without relying on large-scale annotated data. Next, we treat each polyp as a three-dimensional "scene" and introduce a Scene Representation Transformer, which fuses multiple views of the polyp into a single latent representation. By discretizing this representation through a hashing layer, EndoFinder enables real-time retrieval from a compiled database of historical polyp cases, where diagnostic information serves as interpretable references for new queries. We evaluate EndoFinder on both public and newly collected polyp datasets for re-identification and pathology classification. Results show that EndoFinder outperforms existing methods in accuracy while providing transparent, retrieval-based insights for clinical decision-making. By contributing a novel dataset and a scalable, explainable framework, our work addresses key challenges in polyp diagnosis and offers a promising direction for more efficient AI-driven colonoscopy workflows. The source code is available at https://github.com/ku262/EndoFinder-Scene.

Breast Cancer Detection from Multi-View Screening Mammograms with Visual Prompt Tuning

Accurate detection of breast cancer from high-resolution mammograms is crucial for early diagnosis and effective treatment planning. Previous studies have shown the potential of using single-view mammograms for breast cancer detection. However, incorporating multi-view data can provide more comprehensive insights. Multi-view classification, especially in medical imaging, presents unique challenges, particularly when dealing with large-scale, high-resolution data. In this work, we propose a novel Multi-view Visual Prompt Tuning Network (MVPT-NET) for analyzing multiple screening mammograms. We first pretrain a robust single-view classification model on high-resolution mammograms and then innovatively adapt multi-view feature learning into a task-specific prompt tuning process. This technique selectively tunes a minimal set of trainable parameters (7\%) while retaining the robustness of the pre-trained single-view model, enabling efficient integration of multi-view data without the need for aggressive downsampling. Our approach offers an efficient alternative to traditional feature fusion methods, providing a more robust, scalable, and efficient solution for high-resolution mammogram analysis. Experimental results on a large multi-institution dataset demonstrate that our method outperforms conventional approaches while maintaining detection efficiency, achieving an AUROC of 0.852 for distinguishing between Benign, DCIS, and Invasive classes. This work highlights the potential of MVPT-NET for medical imaging tasks and provides a scalable solution for integrating multi-view data in breast cancer detection.

Mamba Guided Boundary Prior Matters: A New Perspective for Generalized Polyp Segmentation

Polyp segmentation in colonoscopy images is crucial for early detection and diagnosis of colorectal cancer. However, this task remains a significant challenge due to the substantial variations in polyp shape, size, and color, as well as the high similarity between polyps and surrounding tissues, often compounded by indistinct boundaries. While existing encoder-decoder CNN and transformer-based approaches have shown promising results, they struggle with stable segmentation performance on polyps with weak or blurry boundaries. These methods exhibit limited abilities to distinguish between polyps and non-polyps and capture essential boundary cues. Moreover, their generalizability still falls short of meeting the demands of real-time clinical applications. To address these limitations, we propose SAM-MaGuP, a groundbreaking approach for robust polyp segmentation. By incorporating a boundary distillation module and a 1D-2D Mamba adapter within the Segment Anything Model (SAM), SAM-MaGuP excels at resolving weak boundary challenges and amplifies feature learning through enriched global contextual interactions. Extensive evaluations across five diverse datasets reveal that SAM-MaGuP outperforms state-of-the-art methods, achieving unmatched segmentation accuracy and robustness. Our key innovations, a Mamba-guided boundary prior and a 1D-2D Mamba block, set a new benchmark in the field, pushing the boundaries of polyp segmentation to new heights.

A Cytology Dataset for Early Detection of Oral Squamous Cell Carcinoma

Oral squamous cell carcinoma OSCC is a major global health burden, particularly in several regions across Asia, Africa, and South America, where it accounts for a significant proportion of cancer cases. Early detection dramatically improves outcomes, with stage I cancers achieving up to 90 percent survival. However, traditional diagnosis based on histopathology has limited accessibility in low-resource settings because it is invasive, resource-intensive, and reliant on expert pathologists. On the other hand, oral cytology of brush biopsy offers a minimally invasive and lower cost alternative, provided that the remaining challenges, inter observer variability and unavailability of expert pathologists can be addressed using artificial intelligence. Development and validation of robust AI solutions requires access to large, labeled, and multi-source datasets to train high capacity models that generalize across domain shifts. We introduce the first large and multicenter oral cytology dataset, comprising annotated slides stained with Papanicolaou(PAP) and May-Grunwald-Giemsa(MGG) protocols, collected from ten tertiary medical centers in India. The dataset is labeled and annotated by expert pathologists for cellular anomaly classification and detection, is designed to advance AI driven diagnostic methods. By filling the gap in publicly available oral cytology datasets, this resource aims to enhance automated detection, reduce diagnostic errors, and improve early OSCC diagnosis in resource-constrained settings, ultimately contributing to reduced mortality and better patient outcomes worldwide.

Fast Trajectory-Independent Model-Based Reconstruction Algorithm for Multi-Dimensional Magnetic Particle Imaging

Magnetic Particle Imaging (MPI) is a promising tomographic technique for visualizing the spatio-temporal distribution of superparamagnetic nanoparticles, with applications ranging from cancer detection to real-time cardiovascular monitoring. Traditional MPI reconstruction relies on either time-consuming calibration (measured system matrix) or model-based simulation of the forward operator. Recent developments have shown the applicability of Chebyshev polynomials to multi-dimensional Lissajous Field-Free Point (FFP) scans. This method is bound to the particular choice of sinusoidal scanning trajectories. In this paper, we present the first reconstruction on real 2D MPI data with a trajectory-independent model-based MPI reconstruction algorithm. We further develop the zero-shot Plug-and-Play (PnP) algorithm of the authors -- with automatic noise level estimation -- to address the present deconvolution problem, leveraging a state-of-the-art denoiser trained on natural images without retraining on MPI-specific data. We evaluate our method on the publicly available 2D FFP MPI dataset ``MPIdata: Equilibrium Model with Anisotropy", featuring scans of six phantoms acquired using a Bruker preclinical scanner. Moreover, we show reconstruction performed on custom data on a 2D scanner with additional high-frequency excitation field and partial data. Our results demonstrate strong reconstruction capabilities across different scanning scenarios -- setting a precedent for general-purpose, flexible model-based MPI reconstruction.

Bluish Veil Detection and Lesion Classification using Custom Deep Learnable Layers with Explainable Artificial Intelligence (XAI)

Melanoma, one of the deadliest types of skin cancer, accounts for thousands of fatalities globally. The bluish, blue-whitish, or blue-white veil (BWV) is a critical feature for diagnosing melanoma, yet research into detecting BWV in dermatological images is limited. This study utilizes a non-annotated skin lesion dataset, which is converted into an annotated dataset using a proposed imaging algorithm based on color threshold techniques on lesion patches and color palettes. A Deep Convolutional Neural Network (DCNN) is designed and trained separately on three individual and combined dermoscopic datasets, using custom layers instead of standard activation function layers. The model is developed to categorize skin lesions based on the presence of BWV. The proposed DCNN demonstrates superior performance compared to conventional BWV detection models across different datasets. The model achieves a testing accuracy of 85.71% on the augmented PH2 dataset, 95.00% on the augmented ISIC archive dataset, 95.05% on the combined augmented (PH2+ISIC archive) dataset, and 90.00% on the Derm7pt dataset. An explainable artificial intelligence (XAI) algorithm is subsequently applied to interpret the DCNN's decision-making process regarding BWV detection. The proposed approach, coupled with XAI, significantly improves the detection of BWV in skin lesions, outperforming existing models and providing a robust tool for early melanoma diagnosis.

Enhancing breast cancer detection on screening mammogram using self-supervised learning and a hybrid deep model of Swin Transformer and Convolutional Neural Network

Purpose: The scarcity of high-quality curated labeled medical training data remains one of the major limitations in applying artificial intelligence (AI) systems to breast cancer diagnosis. Deep models for mammogram analysis and mass (or micro-calcification) detection require training with a large volume of labeled images, which are often expensive and time-consuming to collect. To reduce this challenge, we proposed a novel method that leverages self-supervised learning (SSL) and a deep hybrid model, named \textbf{HybMNet}, which combines local self-attention and fine-grained feature extraction to enhance breast cancer detection on screening mammograms. Approach: Our method employs a two-stage learning process: (1) SSL Pretraining: We utilize EsViT, a SSL technique, to pretrain a Swin Transformer (Swin-T) using a limited set of mammograms. The pretrained Swin-T then serves as the backbone for the downstream task. (2) Downstream Training: The proposed HybMNet combines the Swin-T backbone with a CNN-based network and a novel fusion strategy. The Swin-T employs local self-attention to identify informative patch regions from the high-resolution mammogram, while the CNN-based network extracts fine-grained local features from the selected patches. A fusion module then integrates global and local information from both networks to generate robust predictions. The HybMNet is trained end-to-end, with the loss function combining the outputs of the Swin-T and CNN modules to optimize feature extraction and classification performance. Results: The proposed method was evaluated for its ability to detect breast cancer by distinguishing between benign (normal) and malignant mammograms. Leveraging SSL pretraining and the HybMNet model, it achieved AUC of 0.864 (95% CI: 0.852, 0.875) on the CMMD dataset and 0.889 (95% CI: 0.875, 0.903) on the INbreast dataset, highlighting its effectiveness.

Robustness and sex differences in skin cancer detection: logistic regression vs CNNs

Deep learning has been reported to achieve high performances in the detection of skin cancer, yet many challenges regarding the reproducibility of results and biases remain. This study is a replication (different data, same analysis) of a study on Alzheimer's disease [28] which studied robustness of logistic regression (LR) and convolutional neural networks (CNN) across patient sexes. We explore sex bias in skin cancer detection, using the PAD-UFES-20 dataset with LR trained on handcrafted features reflecting dermatological guidelines (ABCDE and the 7-point checklist), and a pre-trained ResNet-50 model. We evaluate these models in alignment with [28]: across multiple training datasets with varied sex composition to determine their robustness. Our results show that both the LR and the CNN were robust to the sex distributions, but the results also revealed that the CNN had a significantly higher accuracy (ACC) and area under the receiver operating characteristics (AUROC) for male patients than for female patients. We hope these findings to contribute to the growing field of investigating potential bias in popular medical machine learning methods. The data and relevant scripts to reproduce our results can be found in our Github.

DCSNet: A Lightweight Knowledge Distillation-Based Model with Explainable AI for Lung Cancer Diagnosis from Histopathological Images

Lung cancer is a leading cause of cancer-related deaths globally, where early detection and accurate diagnosis are critical for improving survival rates. While deep learning, particularly convolutional neural networks (CNNs), has revolutionized medical image analysis by detecting subtle patterns indicative of early-stage lung cancer, its adoption faces challenges. These models are often computationally expensive and require significant resources, making them unsuitable for resource constrained environments. Additionally, their lack of transparency hinders trust and broader adoption in sensitive fields like healthcare. Knowledge distillation addresses these challenges by transferring knowledge from large, complex models (teachers) to smaller, lightweight models (students). We propose a knowledge distillation-based approach for lung cancer detection, incorporating explainable AI (XAI) techniques to enhance model transparency. Eight CNNs, including ResNet50, EfficientNetB0, EfficientNetB3, and VGG16, are evaluated as teacher models. We developed and trained a lightweight student model, Distilled Custom Student Network (DCSNet) using ResNet50 as the teacher. This approach not only ensures high diagnostic performance in resource-constrained settings but also addresses transparency concerns, facilitating the adoption of AI-driven diagnostic tools in healthcare.