Can saliency maps flag chest radiograph classifier errors at a new hospital? An external validation study
Auteurs : Aashish Chapagai, Angad Singh Gurtatta, Erik Cambria
Résumé scientifique
Saliency maps are offered as a safeguard for medical image classifiers, but whether they reveal individual errors at a new hospital remains largely untested. We trained a convolutional network and a vision transformer on NIH ChestX-ray14 and evaluated 303,768 decisions per model at the training hospital and at two external sites, in the USA and Vietnam, with radiologist-consensus labels. We scored each explanation by its anatomical enrichment, the area-normalized concentration of attribution in a segmented thoracic region, and tested whether it detects errors beyond the model's confidence. Grad-CAM localized findings less often than radiologists (hit rate at most 0.575 versus 0.888). Adding enrichment to a confidence-based error detector calibrated at the training hospital never raised its area under the curve by more than 0.011, and for the convolutional network the relation between enrichment and correctness reversed between hospitals, degrading the transferred detector. Model confidence, not saliency, should anchor deployment monitoring.
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Benchmarking saliency methods for chest X-ray interpretationAdriel Saporta, Xiaotong Gui, Ashwin Agrawal et al. · 2022 · Nature Machine Intelligence · cité 325 fois · Pas encore résumé
Benchmarking saliency methods compare la localisation des cartes sur radiographies thoraciques à des références humaines, tandis que cet article teste aussi leur détection d’erreurs en nouvel hôpital.
Résumé scientifique
Saliency methods, which produce heat maps that highlight the areas of the medical image that influence model prediction, are often presented to clinicians as an aid in diagnostic decision-making. However, rigorous investigation of the accuracy and reliability of these strategies is necessary before they are integrated into the clinical setting. In this work, we quantitatively evaluate seven saliency methods, including Grad-CAM, across multiple neural network architectures using two evaluation metrics. We establish the first human benchmark for chest X-ray segmentation in a multilabel classification set-up, and examine under what clinical conditions saliency maps might be more prone to failur…
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Assessing the validity of saliency maps for abnormality localization in medical imagingN. Arun, N. Gaw, Praveer Singh et al. · 2020 · arXiv.org · preprint, non relu par les pairs · cité 24 fois · Pas encore résumé
Assessing the validity mesure si les cartes de saillance localisent les anomalies sur RSNA Pneumonia, comme cet article évalue leur localisation sur des radiographies thoraciques.
Résumé scientifique
Saliency maps have become a widely used method to assess which areas of the input image are most pertinent to the prediction of a trained neural network. However, in the context of medical imaging, there is no study to our knowledge that has examined the efficacy of these techniques and quantified them using overlap with ground truth bounding boxes. In this work, we explored the credibility of the various existing saliency map methods on the RSNA Pneumonia dataset. We found that GradCAM was the most sensitive to model parameter and label randomization, and was highly agnostic to model architecture.
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Revisiting the Trustworthiness teste la robustesse des cartes de saillance sur des radiographies thoraciques, tandis que cet article évalue leur localisation et leur utilité pour détecter les erreurs.
Résumé scientifique
Purpose To determine whether saliency maps in radiology artificial intelligence (AI) are vulnerable to subtle perturbations of the input, which could lead to misleading interpretations, using prediction-saliency correlation (PSC) for evaluating the sensitivity and robustness of saliency methods. Materials and Methods In this retrospective study, locally trained deep learning models and a research prototype provided by a commercial vendor were systematically evaluated on 191 229 chest radiographs from the CheXpert dataset and 7022 MR images from a human brain tumor classification dataset. Two radiologists performed a reader study on 270 chest radiograph pairs. A model-agnostic approach for co…
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Deep learning saliency maps évalue la capacité de Grad-CAM à localiser dix pathologies sur des radiographies thoraciques, comme cet article compare ses cartes aux annotations de radiologues.
Résumé scientifique
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Résumé scientifique
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Gradient-Based Saliency Maps étudie la fiabilité des cartes de saillance pour diagnostiquer des radiographies des membres supérieurs, plutôt que des radiographies thoraciques.
Résumé scientifique
Saliency maps are popularly used to “explain” decisions made by modern machine learning models, including deep convolutional neural networks (DCNNs). While the resulting heatmaps purportedly indicate important image features, their “trustworthiness,” i.e., utility and robustness, has not been evaluated for musculoskeletal imaging. The purpose of this study was to systematically evaluate the trustworthiness of saliency maps used in disease diagnosis on upper extremity X-ray images. The underlying DCNNs were trained using the Stanford MURA dataset. We studied four trustworthiness criteria—(1) localization accuracy of abnormalities, (2) repeatability, (3) reproducibility, and (4) sensitivity to…
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Assessing the (Un)Trustworthiness of Saliency Maps for Localizing Abnormalities in Medical ImagingN. Arun, N. Gaw, P. Singh et al. · 2020 · medRxiv · preprint, non relu par les pairs · cité 116 fois · Pas encore résumé
Assessing the (Un)Trustworthiness évalue l’utilité de localisation et la robustesse des cartes de saillance en imagerie médicale, comme cet article étudie leur fiabilité.
Résumé scientifique
Saliency maps have become a widely used method to make deep learning models more interpretable by providing post-hoc explanations of classifiers through identification of the most pertinent areas of the input medical image. They are increasingly being used in medical imaging to provide clinically plausible explanations for the decisions the neural network makes. However, the utility and robustness of these visualization maps has not yet been rigorously examined in the context of medical imaging. We posit that trustworthiness in this context requires 1) localization utility, 2) sensitivity to model weight randomization, 3) repeatability, and 4) reproducibility. Using the localization informat…
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Mask of Truth: Model Sensitivity to Unexpected Regions of Medical ImagesThéo Sourget, Michelle Hestbek-Moller, Amelia Jiménez-Sánchez et al. · 2024 · Journal of Imaging Informatics in Medicine · cité 9 fois · Pas encore résumé
Mask of Truth masque des régions pertinentes de radiographies thoraciques et d’images du fond d’œil pour révéler des raccourcis, plutôt que d’évaluer les cartes de saillance.
Résumé scientifique
The development of larger models for medical image analysis has led to increased performance. However, it also affected our ability to explain and validate model decisions. Models can use non-relevant parts of images, also called spurious correlations or shortcuts, to obtain high performance on benchmark datasets but fail in real-world scenarios. In this work, we challenge the capacity of convolutional neural networks (CNN) to classify chest X-rays and eye fundus images while masking out clinically relevant parts of the image. We show that all models trained on the PadChest dataset, irrespective of the masking strategy, are able to obtain an area under the curve (AUC) above random. Moreover,…
Les travaux antérieurs sur lesquels il s’appuie
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Sanity Checks for Saliency MapsJulius Adebayo, J. Gilmer, M. Muelly et al. · 2018 · Neural Information Processing Systems · cité 3 032 fois · Pas encore résumé
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Résumé scientifique
Saliency methods have emerged as a popular tool to highlight features in an input deemed relevant for the prediction of a learned model. Several saliency methods have been proposed, often guided by visual appeal on image data. In this work, we propose an actionable methodology to evaluate what kinds of explanations a given method can and cannot provide. We find that reliance, solely, on visual assessment can be misleading. Through extensive experiments we show that some existing saliency methods are independent both of the model and of the data generating process. Consequently, methods that fail the proposed tests are inadequate for tasks that are sensitive to either data or model, such as, …
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Failure Detection in Medical Image Classification: A Reality Check and Benchmarking TestbedMélanie Bernhardt, Fabio De Sousa Ribeiro, Ben Glocker · 2022 · Trans. Mach. Learn. Res. · cité 18 fois · Pas encore résumé
Failure Detection benchmarke des scores de confiance pour repérer les erreurs de classification médicale, tandis que cet article teste si la saillance ajoute une information utile.
Résumé scientifique
Failure detection in automated image classification is a critical safeguard for clinical deployment. Detected failure cases can be referred to human assessment, ensuring patient safety in computer-aided clinical decision making. Despite its paramount importance, there is insufficient evidence about the ability of state-of-the-art confidence scoring methods to detect test-time failures of classification models in the context of medical imaging. This paper provides a reality check, establishing the performance of in-domain misclassification detection methods, benchmarking 9 widely used confidence scores on 6 medical imaging datasets with different imaging modalities, in multiclass and binary c…
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Seeing Isn't Always Believing: Analysis of Grad-CAM Faithfulness and Localization Reliability in Lung Cancer CT ClassificationTeerapong Panboonyuen · 2026 · International Conference on Knowledge and Smart Technology · cité 9 fois · Pas encore résumé
Seeing Isn't Always Believing examine la fidélité et la fiabilité de localisation de Grad-CAM pour classer des CT du cancer pulmonaire, comme cet article pour les radiographies.
Résumé scientifique
Explainable Artificial Intelligence (XAI) techniques, such as Gradient-weighted Class Activation Mapping (GradCAM), have become indispensable for visualizing the reasoning process of deep neural networks in medical image analysis. Despite their popularity, the faithfulness and reliability of these heatmap-based explanations remain under scrutiny. This study critically investigates whether Grad-CAM truly represents the internal decision-making of deep models trained for lung cancer image classification. Using the publicly available IQ-OTH/NCCD dataset, we evaluate five representative architectures - ResNet50, ResNet-101, DenseNet-161, EfficientNet-B0, and ViT-Base-Patch16-224 - to explore mod…
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Variable generalization performance of a deep learning model to detect pneumonia in chest radiographs: A cross-sectional studyJ. Zech, Marcus A. Badgeley, Man-Way Liu et al. · 2018 · PLoS Medicine · cité 1 890 fois · Pas encore résumé
Variable generalization mesure la généralisation interhospitalière de classificateurs de pneumonie sur radiographies, tandis que cet article étudie le transfert de détecteurs d’erreurs fondés sur la saillance.
Résumé scientifique
Background There is interest in using convolutional neural networks (CNNs) to analyze medical imaging to provide computer-aided diagnosis (CAD). Recent work has suggested that image classification CNNs may not generalize to new data as well as previously believed. We assessed how well CNNs generalized across three hospital systems for a simulated pneumonia screening task. Methods and findings A cross-sectional design with multiple model training cohorts was used to evaluate model generalizability to external sites using split-sample validation. A total of 158,323 chest radiographs were drawn from three institutions: National Institutes of Health Clinical Center (NIH; 112,120 from 30,805 pati…
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Beyond Accuracy: Quantifying Pulmonary Attribution in Anatomy-Guided Chest X-Ray Classification Under Domain ShiftA. al Mamun, Md. Nasif Khansur, Md. Ashraful Hossen Akash et al. · 2026 · arXiv.org · preprint, non relu par les pairs · cité 1 fois · Pas encore résumé
Beyond Accuracy mesure la concentration anatomique des attributions pulmonaires et l’intègre au modèle, tandis que cet article quantifie l’enrichissement anatomique des cartes de saillance.
Résumé scientifique
Deep-learning models can achieve strong chest X-ray (CXR) classification performance without establishing whether their predictions predominantly rely on pulmonary image content. This study evaluates pulmonary attribution containment as an anatomy-related reliability property distinct from diagnostic performance. We propose DBCA-SegNet-MGAP, a multi-task anatomy-guided CNN-Transformer framework that combines complementary feature representations through bidirectional cross-backbone attention, predicts a soft lung mask, and incorporates this anatomical prior directly into classification through Mask-Guided Adaptive Global Average Pooling (MGAP). Pulmonary attribution containment is quantified…
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