Computer-aided diagnosis (CADx) has become vital in medical imaging, but automated systems often struggle to replicate the nuanced process of clinical interpretation. Expert diagnosis requires a comprehensive analysis of how abnormalities relate to each other across various views and time points, but current multi-view CADx methods frequently overlook these complex dependencies. Specifically, they fail to model the crucial relationships within a single view and the dynamic changes lesions exhibit across different views. This limitation, combined with the common challenge of incomplete data, greatly reduces their predictive reliability. To address these gaps, we reframe the diagnostic task as one of relationship modeling and propose GIIM, a novel graph-based approach. Our framework is uniquely designed to simultaneously capture both critical intra-view dependencies between abnormalities and inter-view dynamics. Furthermore, it ensures diagnostic robustness by incorporating specific techniques to effectively handle missing data, a common clinical issue. We demonstrate the generality of this approach through extensive evaluations on diverse imaging modalities, including CT, MRI, and mammography. The results confirm that our GIIM model significantly enhances diagnostic accuracy and robustness over existing methods, establishing a more effective framework for future CADx systems.

The ability to interpret and intervene model decisions is important for the adoption of computer-aided diagnosis methods in clinical workflows. Recent concept-based methods link the model predictions with interpretable concepts and modify their activation scores to interact with the model. However, these concepts are at the image level, which hinders the model from pinpointing the exact patches the concepts are activated. Alternatively, prototype-based methods learn representations from training image patches and compare these with test image patches, using the similarity scores for final class prediction. However, interpreting the underlying concepts of these patches can be challenging and often necessitates post-hoc guesswork. To address this issue, this paper introduces the novel Concept-based Similarity Reasoning network (CSR), which offers (i) patch-level prototype with intrinsic concept interpretation, and (ii) spatial interactivity. First, the proposed CSR provides localized explanation by grounding prototypes of each concept on image regions. Second, our model introduces novel spatial-level interaction, allowing doctors to engage directly with specific image areas, making it an intuitive and transparent tool for medical imaging. CSR improves upon prior state-of-the-art interpretable methods by up to 4.5% across three biomedical datasets. Our code is released at https://github.com/tadeephuy/InteractCSR.