However, there are only a few datasets that include concept-level meta-labels and most of these meta-labels are relevant for natural images that do not require domain expertise. Previous densely annotated datasets in medicine focused on meta-labels that are relevant to a single disease such as osteoarthritis or melanoma. In dermatology, skin disease is described using an established clinical lexicon that allows clinicians to describe physical exam findings to one another. To provide a medical dataset densely annotated by domain experts with annotations useful across multiple disease processes, we developed SkinCon: a skin disease dataset densely annotated by dermatologists. SkinCon includes 3230 images from the Fitzpatrick 17k skin disease dataset densely annotated with 48 clinical concepts, 22 of which have at least 50 images representing the concept. The concepts used were chosen by two dermatologists considering the clinical descriptor terms used to describe skin lesions.

Over the past few years, the field of artificial intelligence (AI) has shown great promise in various domains, including medicine. A potential use case for AI in medicine is its application in managing advanced-stage cancer treatment, where limited evidence often makes treatment choices reliant on the personal expertise of the physicians. The complex nature of oncological disease processes and the multitude of factors that need to be considered when making treatment decisions make it difficult to rely solely on evidence-based trial data, which is often limited and may exclude certain patient populations. This results in physicians making decisions on a case-by-case basis, drawing on their experience of previous cases, which is not always objective and may be limited by the small number of cases they have observed. In this context, the use of clinical decision support systems (CDSS) using similaritybased AI approaches can potentially contribute to better oncology treatment by supporting physicians in the selection of treatment methods [1, 2]. One approach is Case-Based Reasoning (CBR), a subfield of AI that deals with experience-based problem solving.

Objective. This paper presents an overview of generalizable and explainable artificial intelligence (XAI) in deep learning (DL) for medical imaging, aimed at addressing the urgent need for transparency and explainability in clinical applications. Methodology. We propose to use four CNNs in three medical datasets (brain tumor, skin cancer, and chest x-ray) for medical image classification tasks. In addition, we perform paired t-tests to show the significance of the differences observed between different methods. Furthermore, we propose to combine ResNet50 with five common XAI techniques to obtain explainable results for model prediction, aiming at improving model transparency. We also involve a quantitative metric (confidence increase) to evaluate the usefulness of XAI techniques. Key findings. The experimental results indicate that ResNet50 can achieve feasible accuracy and F1 score in all datasets (e.g., 86.31\% accuracy in skin cancer). Furthermore, the findings show that while certain XAI methods, such as XgradCAM, effectively highlight relevant abnormal regions in medical images, others, like EigenGradCAM, may perform less effectively in specific scenarios. In addition, XgradCAM indicates higher confidence increase (e.g., 0.12 in glioma tumor) compared to GradCAM++ (0.09) and LayerCAM (0.08). Implications. Based on the experimental results and recent advancements, we outline future research directions to enhance the robustness and generalizability of DL models in the field of biomedical imaging.

Diagnosing diseases through histopathology whole slide images (WSIs) is fundamental in modern pathology but is challenged by the gigapixel scale and complexity of WSIs. Trained histopathologists overcome this challenge by navigating the WSI, looking for relevant patches, taking notes, and compiling them to produce a final holistic diagnostic. Traditional AI approaches, such as multiple instance learning and transformer-based models, fail short of such a holistic, iterative, multi-scale diagnostic procedure, limiting their adoption in the real-world. We introduce PathFinder, a multi-modal, multi-agent framework that emulates the decision-making process of expert pathologists. PathFinder integrates four AI agents, the Triage Agent, Navigation Agent, Description Agent, and Diagnosis Agent, that collaboratively navigate WSIs, gather evidence, and provide comprehensive diagnoses with natural language explanations. The Triage Agent classifies the WSI as benign or risky; if risky, the Navigation and Description Agents iteratively focus on significant regions, generating importance maps and descriptive insights of sampled patches. Finally, the Diagnosis Agent synthesizes the findings to determine the patient's diagnostic classification. Our Experiments show that PathFinder outperforms state-of-the-art methods in skin melanoma diagnosis by 8% while offering inherent explainability through natural language descriptions of diagnostically relevant patches. Qualitative analysis by pathologists shows that the Description Agent's outputs are of high quality and comparable to GPT-4o. PathFinder is also the first AI-based system to surpass the average performance of pathologists in this challenging melanoma classification task by 9%, setting a new record for efficient, accurate, and interpretable AI-assisted diagnostics in pathology. Data, code and models available at https://pathfinder-dx.github.io/

Discriminative classifiers have become a foundational tool in deep learning for medical imaging, excelling at learning separable features of complex data distributions. However, these models often need careful design, augmentation, and training techniques to ensure safe and reliable deployment. Recently, diffusion models have become synonymous with generative modeling in 2D. These models showcase robustness across a range of tasks including natural image classification, where classification is performed by comparing reconstruction errors across images generated for each possible conditioning input. This work presents the first exploration of the potential of class conditional diffusion models for 2D medical image classification. First, we develop a novel majority voting scheme shown to improve the performance of medical diffusion classifiers. Next, extensive experiments on the CheXpert and ISIC Melanoma skin cancer datasets demonstrate that foundation and trained-from-scratch diffusion models achieve competitive performance against SOTA discriminative classifiers without the need for explicit supervision. In addition, we show that diffusion classifiers are intrinsically explainable, and can be used to quantify the uncertainty of their predictions, increasing their trustworthiness and reliability in safety-critical, clinical contexts. Further information is available on our project page: https://faverogian.github.io/med-diffusion-classifier.github.io/

Artificial intelligence has significantly advanced skin cancer diagnosis by enabling rapid and accurate detection of malignant lesions. In this domain, most publicly available image datasets consist of single, isolated skin lesions positioned at the center of the image. While these lesion-centric datasets have been fundamental for developing diagnostic algorithms, they lack the context of the surrounding skin, which is critical for improving lesion detection. The iToBoS dataset was created to address this challenge. It includes 16,954 images of skin regions from 100 participants, captured using 3D total body photography. Each image roughly corresponds to a $7 \times 9$ cm section of skin with all suspicious lesions annotated using bounding boxes. Additionally, the dataset provides metadata such as anatomical location, age group, and sun damage score for each image. This dataset aims to facilitate training and benchmarking of algorithms, with the goal of enabling early detection of skin cancer and deployment of this technology in non-clinical environments.

Artificial intelligence (AI) has potential to revolutionize the field of oncology by enhancing the precision of cancer diagnosis, optimizing treatment strategies, and personalizing therapies for a variety of cancers. This review examines the limitations of conventional diagnostic techniques and explores the transformative role of AI in diagnosing and treating cancers such as lung, breast, colorectal, liver, stomach, esophageal, cervical, thyroid, prostate, and skin cancers. The primary objective of this paper is to highlight the significant advancements that AI algorithms have brought to oncology within the medical industry. By enabling early cancer detection, improving diagnostic accuracy, and facilitating targeted treatment delivery, AI contributes to substantial improvements in patient outcomes. The integration of AI in medical imaging, genomic analysis, and pathology enhances diagnostic precision and introduces a novel, less invasive approach to cancer screening. This not only boosts the effectiveness of medical facilities but also reduces operational costs. The study delves into the application of AI in radiomics for detailed cancer characterization, predictive analytics for identifying associated risks, and the development of algorithm-driven robots for immediate diagnosis. Furthermore, it investigates the impact of AI on addressing healthcare challenges, particularly in underserved and remote regions. The overarching goal of this platform is to support the development of expert recommendations and to provide universal, efficient diagnostic procedures. By reviewing existing research and clinical studies, this paper underscores the pivotal role of AI in improving the overall cancer care system. It emphasizes how AI-enabled systems can enhance clinical decision-making and expand treatment options, thereby underscoring the importance of AI in advancing precision oncology

As deep learning models gain attraction in medical data, ensuring transparent and trustworthy decision-making is essential. In skin cancer diagnosis, while advancements in lesion detection and classification have improved accuracy, the black-box nature of these methods poses challenges in understanding their decision processes, leading to trust issues among physicians. This study leverages the CLIP (Contrastive Language-Image Pretraining) model, trained on different skin lesion datasets, to capture meaningful relationships between visual features and diagnostic criteria terms. To further enhance transparency, we propose a method called MedGrad E-CLIP, which builds on gradient-based E-CLIP by incorporating a weighted entropy mechanism designed for complex medical imaging like skin lesions. This approach highlights critical image regions linked to specific diagnostic descriptions. The developed integrated pipeline not only classifies skin lesions by matching corresponding descriptions but also adds an essential layer of explainability developed especially for medical data. By visually explaining how different features in an image relates to diagnostic criteria, this approach demonstrates the potential of advanced vision-language models in medical image analysis, ultimately improving transparency, robustness, and trust in AI-driven diagnostic systems.

The skin, as the largest organ of the human body, is vulnerable to a diverse array of conditions collectively known as skin lesions, which encompass various dermatoses. Diagnosing these lesions presents significant challenges for medical practitioners due to the subtle visual differences that are often imperceptible to the naked eye. While not all skin lesions are life-threatening, certain types can act as early indicators of severe diseases, including skin cancers, underscoring the critical need for timely and accurate diagnostic methods. Deep learning algorithms have demonstrated remarkable potential in facilitating the early detection and prognosis of skin lesions. This study advances the field by curating a comprehensive and diverse dataset comprising 39 categories of skin lesions, synthesized from five publicly available datasets. Using this dataset, the performance of five state-of-the-art deep learning models -- MobileNetV2, Xception, InceptionV3, EfficientNetB1, and Vision Transformer - is rigorously evaluated. To enhance the accuracy and robustness of these models, attention mechanisms such as the Efficient Channel Attention (ECA) and the Convolutional Block Attention Module (CBAM) are incorporated into their architectures. Comprehensive evaluation across multiple performance metrics reveals that the Vision Transformer model integrated with CBAM outperforms others, achieving an accuracy of 93.46%, precision of 94%, recall of 93%, F1-score of 93%, and specificity of 93.67%. These results underscore the significant potential of the proposed system in supporting medical professionals with accurate and efficient prognostic tools for diagnosing a broad spectrum of skin lesions. The dataset and code used in this study can be found at https://github.com/akabircs/Skin-Lesions-Classification.

Unlike human-engineered systems such as aeroplanes, where each component's role and dependencies are well understood, the inner workings of AI models remain largely opaque, hindering verifiability and undermining trust. This paper introduces SemanticLens, a universal explanation method for neural networks that maps hidden knowledge encoded by components (e.g., individual neurons) into the semantically structured, multimodal space of a foundation model such as CLIP. In this space, unique operations become possible, including (i) textual search to identify neurons encoding specific concepts, (ii) systematic analysis and comparison of model representations, (iii) automated labelling of neurons and explanation of their functional roles, and (iv) audits to validate decision-making against requirements. Fully scalable and operating without human input, SemanticLens is shown to be effective for debugging and validation, summarizing model knowledge, aligning reasoning with expectations (e.g., adherence to the ABCDE-rule in melanoma classification), and detecting components tied to spurious correlations and their associated training data. By enabling component-level understanding and validation, the proposed approach helps bridge the "trust gap" between AI models and traditional engineered systems. We provide code for SemanticLens on https://github.com/jim-berend/semanticlens and a demo on https://semanticlens.hhi-research-insights.eu.