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.

This study introduces the SHAP-integrated convolutional diagnostic network (SICDN), an interpretable feature selection method designed for limited datasets, to address the challenge posed by data privacy regulations that restrict access to medical datasets. The SICDN model was tested on classification tasks using pneumonia and breast cancer datasets, demonstrating over 97% accuracy and surpassing four popular CNN models. We also integrated a historical weighted moving average technique to enhance feature selection. The SICDN shows potential in medical image prediction, with the code available on https://github.com/AIPMLab/SICDN.

--Despite the remarkable performance of vision language models (VLMs) such as Contrastive Language Image Pre-training (CLIP), the large size of these models is a considerable obstacle to their use in federated learning (FL) systems where the parameters of local client models need to be transferred to a global server for aggregation. Another challenge in FL is the heterogeneity of data from different clients, which affects the generalization performance of the solution. In addition, natural pre-trained VLMs exhibit poor generalization ability in the medical datasets, suggests there exists a domain gap. T o solve these issues, we introduce a novel method for the Federated Adversarial Adaptation (F AA) of CLIP . Our method, named F AA-CLIP, handles the large communication costs of CLIP using a light-weight feature adaptation module (F AM) for aggregation, effectively adapting this VLM to each client's data while greatly reducing the number of parameters to transfer . By keeping CLIP frozen and only updating the F AM parameters, our method is also computationally efficient. Unlike existing approaches, our F AA-CLIP method directly addresses the problem of domain shifts across clients via a domain adaptation (DA) module. This module employs a domain classifier to predict if a given sample is from the local client or the global server, allowing the model to learn domain-invariant representations. Extensive experiments on six different datasets containing both natural and medical images demonstrate that F AA-CLIP can generalize well on both natural and medical datasets compared to recent FL approaches. Our codes are available at https://github.com/AIPMLab/F While models based on deep learning (DL) have achieved ground-breaking results in a broad range of computer vision and natural language understanding tasks, their performance is often dependent on the availability of large datasets [1]. In recent years, there has been a growing concern on ensuring data privacy and security, with many organizations implementing regulations and laws such as the EU General Data Protection Regulation (GDPR) [2]. These restrictions on sharing raw data from different organizations poses a siginificant challenge for training robust DL models in fields like medical imaging where privacy is of utmost importance. One of the most promising solutions to this problem is federated learning (FL).

With the rapid development of artificial intelligence (AI), especially in the medical field, the need for its explainability has grown. In medical image analysis, a high degree of transparency and model interpretability can help clinicians better understand and trust the decision-making process of AI models. In this study, we propose a Knowledge Distillation (KD)-based approach that aims to enhance the transparency of the AI model in medical image analysis. The initial step is to use traditional CNN to obtain a teacher model and then use KD to simplify the CNN architecture, retain most of the features of the data set, and reduce the number of network layers. It also uses the feature map of the student model to perform hierarchical analysis to identify key features and decision-making processes. This leads to intuitive visual explanations. We selected three public medical data sets (brain tumor, eye disease, and Alzheimer's disease) to test our method. It shows that even when the number of layers is reduced, our model provides a remarkable result in the test set and reduces the time required for the interpretability analysis.

Traditional machine learning assumes that training and test sets are derived from the same distribution; however, this assumption does not always hold in practical applications. This distribution disparity can lead to severe performance drops when the trained model is used in new data sets. Domain adaptation (DA) is a machine learning technique that aims to address this problem by reducing the differences between domains. This paper presents simulation-based algorithms of recent DA techniques, mainly related to unsupervised domain adaptation (UDA), where labels are available only in the source domain. Our study compares these techniques with public data sets and diverse characteristics, highlighting their respective strengths and drawbacks. For example, Safe Self-Refinement for Transformer-based DA (SSRT) achieved the highest accuracy (91.6\%) in the office-31 data set during our simulations, however, the accuracy dropped to 72.4\% in the Office-Home data set when using limited batch sizes. In addition to improving the reader's comprehension of recent techniques in DA, our study also highlights challenges and upcoming directions for research in this domain. The codes are available at https://github.com/AIPMLab/Domain_Adaptation.

Federated learning (FL) has emerged as a promising approach to medical image analysis that allows deep model training using decentralized data while ensuring data privacy. However, in the field of FL, communication cost plays a critical role in evaluating the performance of the model. Thus, transferring vision foundation models can be particularly challenging due to the significant resource costs involved. In this paper, we introduce a federated adaptive Contrastive Language Image Pretraining (CLIP) model designed for classification tasks. We employ a light-weight and efficient feature attention module for CLIP that selects suitable features for each client's data. Additionally, we propose a domain adaptation technique to reduce differences in data distribution between clients. Experimental results on four publicly available datasets demonstrate the superior performance of FACMIC in dealing with realworld and multisource medical imaging data. Our codes are available at https://github.com/AIPMLab/FACMIC.

Artificial intelligence (AI) continues to transform data analysis in many domains. Progress in each domain is driven by a growing body of annotated data, increased computational resources, and technological innovations. In medicine, the sensitivity of the data, the complexity of the tasks, the potentially high stakes, and a requirement of accountability give rise to a particular set of challenges. In this review, we focus on three key methodological approaches that address some of the particular challenges in AI-driven medical decision making. (1) Explainable AI aims to produce a human-interpretable justification for each output. Such models increase confidence if the results appear plausible and match the clinicians expectations. However, the absence of a plausible explanation does not imply an inaccurate model. Especially in highly non-linear, complex models that are tuned to maximize accuracy, such interpretable representations only reflect a small portion of the justification. (2) Domain adaptation and transfer learning enable AI models to be trained and applied across multiple domains. For example, a classification task based on images acquired on different acquisition hardware. (3) Federated learning enables learning large-scale models without exposing sensitive personal health information. Unlike centralized AI learning, where the centralized learning machine has access to the entire training data, the federated learning process iteratively updates models across multiple sites by exchanging only parameter updates, not personal health data. This narrative review covers the basic concepts, highlights relevant corner-stone and state-of-the-art research in the field, and discusses perspectives.

This paper proposes a principled information theoretic analysis of classification for deep neural network structures, e.g. convolutional neural networks (CNN). The output of convolutional filters is modeled as a random variable Y conditioned on the object class C and network filter bank F. The conditional entropy (CENT) H(Y |C,F) is shown in theory and experiments to be a highly compact and class-informative code, that can be computed from the filter outputs throughout an existing CNN and used to obtain higher classification results than the original CNN itself. Experiments demonstrate the effectiveness of CENT feature analysis in two separate CNN classification contexts. 1) In the classification of neurodegeneration due to Alzheimer's disease (AD) and natural aging from 3D magnetic resonance image (MRI) volumes, 3 CENT features result in an AUC=94.6% for whole-brain AD classification, the highest reported accuracy on the public OASIS dataset used and 12% higher than the softmax output of the original CNN trained for the task. 2) In the context of visual object classification from 2D photographs, transfer learning based on a small set of CENT features identified throughout an existing CNN leads to AUC values comparable to the 1000-feature softmax output of the original network when classifying previously unseen object categories. The general information theoretical analysis explains various recent CNN design successes, e.g. densely connected CNN architectures, and provides insights for future research directions in deep learning.