Yanchen Liu, Srishti Gautam, Jiaqi Ma, Himabindu Lakkaraju. Proceedings of the 2024 Conference of the North American Chapter of the Association for Computational Linguistics: Human Language Technologies (Volume 1: Long Papers). 2024.

A major barrier to applying deep segmentation models in the medical domain is their typical data-hungry nature, requiring experts to collect and label large amounts of data for training. As a reaction, prototypical few-shot segmentation (FSS) models have recently gained traction as data-efficient alternatives. Nevertheless, despite the recent progress of these models, they still have some essential shortcomings that must be addressed. In this work, we focus on three of these shortcomings: (i) the lack of uncertainty estimation, (ii) the lack of a guiding mechanism to help locate edges and encourage spatial consistency in the segmentation maps, and (iii) the models' inability to do one-step multi-class segmentation. Without modifying or requiring a specific backbone architecture, we propose a modified prototype extraction module that facilitates the computation of uncertainty maps in prototypical FSS models, and show that the resulting maps are useful indicators of the model uncertainty. To improve the segmentation around boundaries and to encourage spatial consistency, we propose a novel feature refinement module that leverages structural information in the input space to help guide the segmentation in the feature space. Furthermore, we demonstrate how uncertainty maps can be used to automatically guide this feature refinement. Finally, to avoid ambiguous voxel predictions that occur when images are segmented class-by-class, we propose a procedure to perform one-step multi-class FSS. The efficiency of our proposed methodology is evaluated on two representative datasets for abdominal organ segmentation (CHAOS dataset and BTCV dataset) and one dataset for cardiac segmentation (MS-CMRSeg dataset). The results show that our proposed methodology significantly (one-sided Wilcoxon signed rank test, p<0.05) improves the baseline, increasing the overall dice score with +5.2, +5.1, and +2.8 percentage points for the CHAOS dataset, the BTCV dataset, and the MS-CMRSeg dataset, respectively.

Current machine learning models have shown high efficiency in solving a wide variety of real-world problems. However, their black box character poses a major challenge for the comprehensibility and traceability of the underlying decision-making strategies. As a remedy, numerous post-hoc and self-explanation methods have been developed to interpret the models’ behavior. Those methods, in addition, enable the identification of artifacts that, inherent in the training data, can be erroneously learned by the model as class-relevant features. In this work, we provide a detailed case study of a representative for the state-of-the-art self-explaining network, ProtoPNet, in the presence of a spectrum of artifacts. Accordingly, we identify the main drawbacks of ProtoPNet, especially its coarse and spatially imprecise explanations. We address these limitations by introducing Prototypical Relevance Propagation (PRP), a novel method for generating more precise model-aware explanations. Furthermore, in order to obtain a clean, artifact-free dataset, we propose to use multi-view clustering strategies for segregating the artifact images using the PRP explanations, thereby suppressing the potential artifact learning in the models.

The need for interpretable models has fostered the development of self-explainable classifiers. Prior approaches are either based on multi-stage optimization schemes, impacting the predictive performance of the model, or produce explanations that are not transparent, trustworthy or do not capture the diversity of the data. To address these shortcomings, we propose ProtoVAE, a variational autoencoder-based framework that learns class-specific prototypes in an end-to-end manner and enforces trustworthiness and diversity by regularizing the representation space and introducing an orthonormality constraint. Finally, the model is designed to be transparent by directly incorporating the prototypes into the decision process. Extensive comparisons with previous self-explainable approaches demonstrate the superiority of ProtoVAE, highlighting its ability to generate trustworthy and diverse explanations, while not degrading predictive performance.

Recent work has shown that label-efficient few-shot learning through self-supervision can achieve promising medical image segmentation results. However, few-shot segmentation models typically rely on prototype representations of the semantic classes, resulting in a loss of local information that can degrade performance. This is particularly problematic for the typically large and highly heterogeneous background class in medical image segmentation problems. Previous works have attempted to address this issue by learning additional prototypes for each class, but since the prototypes are based on a limited number of slices, we argue that this ad-hoc solution is insufficient to capture the background properties. Motivated by this, and the observation that the foreground class (e.g., one organ) is relatively homogeneous, we propose a novel anomaly detection-inspired approach to few-shot medical image segmentation in which we refrain from modeling the background explicitly. Instead, we rely solely on a single foreground prototype to compute anomaly scores for all query pixels. The segmentation is then performed by thresholding these anomaly scores using a learned threshold. Assisted by a novel self-supervision task that exploits the 3D structure of medical images through supervoxels, our proposed anomaly detection-inspired few-shot medical image segmentation model outperforms previous state-of-the-art approaches on two representative MRI datasets for the tasks of abdominal organ segmentation and cardiac segmentation.