ItpCtrl-AI: End-to-end interpretable and controllable artificial intelligence by modeling radiologists' intentions

Using Deep Learning in computer-aided diagnosis systems has been of great interest due to its impressive performance in the general domain and medical domain. However, a notable challenge is the lack of explainability of many advanced models, which poses risks in critical applications such as diagnosing findings in CXR. To address this problem, we propose ItpCtrl-AI, a novel end-to-end interpretable and controllable framework that mirrors the decision-making process of the radiologist. By emulating the eye gaze patterns of radiologists, our framework initially determines the focal areas and assesses the significance of each pixel within those regions. As a result, the model generates an attention heatmap representing radiologists' attention, which is then used to extract attended visual information to diagnose the findings. By allowing the directional input, our framework is controllable by the user. Furthermore, by displaying the eye gaze heatmap which guides the diagnostic conclusion, the underlying rationale behind the model's decision is revealed, thereby making it interpretable. In addition to developing an interpretable and controllable framework, our work includes the creation of a dataset, named Diagnosed-Gaze++, which aligns medical findings with eye gaze data. Our extensive experimentation validates the effectiveness of our approach in generating accurate attention heatmaps and diagnoses. The experimental results show that our model not only accurately identifies medical findings but also precisely produces the eye gaze attention of radiologists. The dataset, models, and source code will be made publicly available upon acceptance.