Improving Data Quality, Model Transparency and Performance in Lung Histopathology with Explainable AI

Convolutional neural networks (CNNs) have shown strong capabilities for image analysis. However, deploying these models in medical settings is complicated by their limited transparency. Over recent years, many approaches have been developed to overcome the so-called "black box" problem of deep neural networks. Here, we show how such explainable AI (XAI) approaches can be applied to not only improve transparency but also training data quality and model performance, with classification of lung damage in histopathology images as use case. First, we conducted a thorough exploratory data analysis and visually compared the compressed multi-dimensional representations of the histology images from the last CNN layers with labels given by pathologists to reveal flaws in the training data. Second, we used Gradient-based Class Activation Mapping (Grad-CAM) as well as SHapley Additive exPlanations (SHAP) values to identify image regions that significantly contributed to the model decisions. To overcome identified shortcomings, we then finetuned additional top layers of the CNNs and introduced model architectures with attention which improved model performance. In summary, we developed a practical workflow that uses interpretability analyses to examine model perception, assess label consistency, and guide model refinement on the example of lung histopathology scoring, demonstrating how XAI approaches can increase both transparency and model performance. The code for this paper is shared at https://github.com/Aitslab/Histology_XAI.git.