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XAI-Driven Skin Disease Classification: Leveraging GANs to Augment ResNet-50 Performance

Villanueva, Kim Gerard A., Kumar, Priyanka

arXiv.org Artificial Intelligence

Accurate and timely diagnosis of multi-class skin lesions is hampered by subjective methods, inherent data imbalance in datasets like HAM10000, and the "black box" nature of Deep Learning (DL) models. This study proposes a trustworthy and highly accurate Computer-Aided Diagnosis (CAD) system to overcome these limitations. The approach utilizes Deep Convolutional Generative Adversarial Networks (DCGANs) for per class data augmentation to resolve the critical class imbalance problem. A fine-tuned ResNet-50 classifier is then trained on the augmented dataset to classify seven skin disease categories. Crucially, LIME and SHAP Explainable AI (XAI) techniques are integrated to provide transparency by confirming that predictions are based on clinically relevant features like irregular morphology. The system achieved a high overall Accuracy of 92.50 % and a Macro-AUC of 98.82 %, successfully outperforming various prior benchmarked architectures. This work successfully validates a verifiable framework that combines high performance with the essential clinical interpretability required for safe diagnostic deployment. Future research should prioritize enhancing discrimination for critical categories, such as Melanoma NOS (F1-Score is 0.8602).


Skin-R1: Toward Trustworthy Clinical Reasoning for Dermatological Diagnosis

Liu, Zehao, Ren, Wejieying, Zhang, Jipeng, Zhao, Tianxiang, Zhu, Jingxi, Li, Xiaoting, Honavar, Vasant G.

arXiv.org Artificial Intelligence

The emergence of vision-language models (VLMs) has opened new possibilities for clinical reasoning and has shown promising performance in dermatological diagnosis. However, their trustworthiness and clinical utility are often limited by three major factors: (1) Data heterogeneity, where diverse datasets lack consistent diagnostic labels and clinical concept annotations; (2) Absence of grounded diagnostic rationales, leading to a scarcity of reliable reasoning supervision; and (3) Limited scalability and generalization, as models trained on small, densely annotated datasets struggle to transfer nuanced reasoning to large, sparsely-annotated ones. To address these limitations, we propose SkinR1, a novel dermatological VLM that combines deep, textbook-based reasoning with the broad generalization capabilities of reinforcement learning (RL). SkinR1 systematically resolves the key challenges through a unified, end-to-end framework. First, we design a textbook-based reasoning generator that synthesizes high-fidelity, hierarchy-aware, and differential-diagnosis (DDx)-informed trajectories, providing reliable expert-level supervision. Second, we leverage the constructed trajectories for supervised fine-tuning (SFT) empowering the model with grounded reasoning ability. Third, we develop a novel RL paradigm that, by incorporating the hierarchical structure of diseases, effectively transfers these grounded reasoning patterns to large-scale, sparse data. Extensive experiments on multiple dermatology datasets demonstrate that SkinR1 achieves superior diagnostic accuracy. The ablation study demonstrates the importance of the reasoning foundation instilled by SFT.


Evaluating Open-Weight Large Language Models for Structured Data Extraction from Narrative Medical Reports Across Multiple Use Cases and Languages

Spaanderman, Douwe J., Prathaban, Karthik, Zelina, Petr, Mouheb, Kaouther, Hejtmánek, Lukáš, Marzetti, Matthew, Schurink, Antonius W., Chan, Damian, Niemantsverdriet, Ruben, Hartmann, Frederik, Qian, Zhen, Thomeer, Maarten G. J., Holub, Petr, Akram, Farhan, Wolters, Frank J., Vernooij, Meike W., Verhoef, Cornelis, Bron, Esther E., Nováček, Vít, Grünhagen, Dirk J., Niessen, Wiro J., Starmans, Martijn P. A., Klein, Stefan

arXiv.org Artificial Intelligence

Large language models (LLMs) are increasingly used to extract structured information from free-text clinical records, but prior work often focuses on single tasks, limited models, and English-language reports. We evaluated 15 open-weight LLMs on pathology and radiology reports across six use cases, colorectal liver metastases, liver tumours, neurodegenerative diseases, soft-tissue tumours, melanomas, and sarcomas, at three institutes in the Netherlands, UK, and Czech Republic. Models included general-purpose and medical-specialised LLMs of various sizes, and six prompting strategies were compared: zero-shot, one-shot, few-shot, chain-of-thought, self-consistency, and prompt graph. Performance was assessed using task-appropriate metrics, with consensus rank aggregation and linear mixed-effects models quantifying variance. Top-ranked models achieved macro-average scores close to inter-rater agreement across tasks. Small-to-medium general-purpose models performed comparably to large models, while tiny and specialised models performed worse. Prompt graph and few-shot prompting improved performance by ~13%. Task-specific factors, including variable complexity and annotation variability, influenced results more than model size or prompting strategy. These findings show that open-weight LLMs can extract structured data from clinical reports across diseases, languages, and institutions, offering a scalable approach for clinical data curation.


Melanoma Classification Through Deep Ensemble Learning and Explainable AI

Perera, Wadduwage Shanika, Islam, ABM, Pham, Van Vung, An, Min Kyung

arXiv.org Artificial Intelligence

The skin is the largest organ in the human body, and approximately a third of the total number of cancer cases are represented by skin cancers. Melanoma is the deadliest form of skin cancer, which is responsible for an overwhelming majority of skin cancer deaths. The number of melanoma deaths is expected to increase by 4.4% in 2023. Although the mortality is significant, when detected e arly, the 5-year survival rate for melanoma is over 99% (American Cancer Society, 2022). Currently, the most accurate way to diagnose melanoma is a biopsy. This is a penetrative surgical procedure that involves higher costs but also incorporates risks of developing various infectious diseases (Lakhtakia et al., 2009). Thus, the usual clinical practice of melanoma diagnosis is visual inspection using Dermoscopy by dermatologists or specially trained clinicians. This approach presents challenges, primarily due to its resource-intensive nature in terms of time and cost. This method's accuracy of melanoma diagnosis is approximately


A PBN-RL-XAI Framework for Discovering a "Hit-and-Run" Therapeutic Strategy in Melanoma

Liu, Zhonglin

arXiv.org Artificial Intelligence

Innate resistance to anti-PD-1 immunotherapy remains a major clinical challenge in metastatic melanoma, with the underlying molecular networks being poorly understood. To address this, we constructed a dynamic Probabilistic Boolean Network model using transcriptomic data from patient tumor biopsies to elucidate the regulatory logic governing therapy response. We then employed a reinforcement learning agent to systematically discover optimal, multi-step therapeutic interventions and used explainable artificial intelligence to mechanistically interpret the agent's control policy. The analysis revealed that a precisely timed, 4-step temporary inhibition of the lysyl oxidase like 2 protein (LOXL2) was the most effective strategy. Our explainable analysis showed that this ''hit-and-run" intervention is sufficient to erase the molecular signature driving resistance, allowing the network to self-correct without requiring sustained intervention. This study presents a novel, time-dependent therapeutic hypothesis for overcoming immunotherapy resistance and provides a powerful computational framework for identifying non-obvious intervention protocols in complex biological systems.


A Multi-Task Deep Learning Framework for Skin Lesion Classification, ABCDE Feature Quantification, and Evolution Simulation

Kotla, Harsha, Rajasekaran, Arun Kumar, Rana, Hannah

arXiv.org Artificial Intelligence

Early detection of melanoma has grown to be essential because it significantly improves survival rates, but automated analysis of skin lesions still remains challenging. ABCDE, which stands for Asymmetry, Border irregularity, Color variation, Diameter, and Evolving, is a well-known classification method for skin lesions, but most deep learning mechanisms treat it as a black box, as most of the human interpretable features are not explained. In this work, we propose a deep learning framework that both classifies skin lesions into categories and also quantifies scores for each ABCD feature. It simulates the evolution of these features over time in order to represent the E aspect, opening more windows for future exploration. The A, B, C, and D values are quantified particularly within this work. Moreover, this framework also visualizes ABCD feature trajectories in latent space as skin lesions evolve from benign nevuses to malignant melanoma. The experiments are conducted using the HAM10000 dataset that contains around ten thousand images of skin lesions of varying stages. In summary, the classification worked with an accuracy of around 89 percent, with melanoma AUC being 0.96, while the feature evaluation performed well in predicting asymmetry, color variation, and diameter, though border irregularity remains more difficult to model. Overall, this work provides a deep learning framework that will allow doctors to link ML diagnoses to clinically relevant criteria, thus improving our understanding of skin cancer progression. Introduction Melanoma, an aggressive form of skin cancer, is one of the leading causes of death due to skin cancer [6]. Early diagnosis is important because the 5-year survival rate exceeds 90% for early-stage melanoma, but drops below 20% for advanced stages [6]. In order to differentiate between harmful and harmless lesions, dermatologists utilize the ABCDE method. "A" stands for "asymmetry," as malignant skin lesions often appear to be uneven; "B" stands for "border irregularity," as scientists search for jagged or notched edges; "C" If a lesion displays two or more of the attributes described above, the lesion is most likely harmful melanoma.


GraphDerm: Fusing Imaging, Physical Scale, and Metadata in a Population-Graph Classifier for Dermoscopic Lesions

Yousefzadeh, Mehdi, Esfahanian, Parsa, Rashidifar, Sara, Gavalan, Hossein Salahshoor, Tabatabaee, Negar Sadat Rafiee, Gorgin, Saeid, Rahmati, Dara, Daneshpazhooh, Maryam

arXiv.org Artificial Intelligence

Introduction. Dermoscopy aids melanoma triage, yet image-only AI often ignores patient metadata (age, sex, site) and the physical scale needed for geometric analysis. We present GraphDerm, a population-graph framework that fuses imaging, millimeter-scale calibration, and metadata for multiclass dermoscopic classification, to the best of our knowledge the first ISIC-scale application of GNNs to dermoscopy. Methods. We curate ISIC 2018/2019, synthesize ruler-embedded images with exact masks, and train U-Nets (SE-ResNet-18) for lesion and ruler segmentation. Pixels-per-millimeter are regressed from the ruler-mask two-point correlation via a lightweight 1D-CNN. From lesion masks we compute real-scale descriptors (area, perimeter, radius of gyration). Node features use EfficientNet-B3; edges encode metadata/geometry similarity (fully weighted or thresholded). A spectral GNN performs semi-supervised node classification; an image-only ANN is the baseline. Results. Ruler and lesion segmentation reach Dice 0.904 and 0.908; scale regression attains MAE 1.5 px (RMSE 6.6). The graph attains AUC 0.9812, with a thresholded variant using about 25% of edges preserving AUC 0.9788 (vs. 0.9440 for the image-only baseline); per-class AUCs typically fall in the 0.97-0.99 range. Conclusion. Unifying calibrated scale, lesion geometry, and metadata in a population graph yields substantial gains over image-only pipelines on ISIC-2019. Sparser graphs retain near-optimal accuracy, suggesting efficient deployment. Scale-aware, graph-based AI is a promising direction for dermoscopic decision support; future work will refine learned edge semantics and evaluate on broader curated benchmarks.


Optimizing Neuro-Fuzzy and Colonial Competition Algorithms for Skin Cancer Diagnosis in Dermatoscopic Images

Khaleghpour, Hamideh, McKinney, Brett

arXiv.org Artificial Intelligence

The rising incidence of skin cancer, coupled with limited public awareness and a shortfall in clinical expertise, underscores an urgent need for advanced diagnostic aids. Artificial Intelligence (AI) has emerged as a promising tool in this domain, particularly for distinguishing malignant from benign skin lesions. Leveraging publicly available datasets of skin lesions, researchers have been developing AI-based diagnostic solutions. However, the integration of such computer systems in clinical settings is still nascent. This study aims to bridge this gap by employing a fusion of image processing techniques and machine learning algorithms, specifically neuro-fuzzy and colonial competition approaches. Applied to dermoscopic images from the ISIC database, our method achieved a notable accuracy of 94% on a dataset of 560 images. These results underscore the potential of our approach in aiding clinicians in the early detection of melanoma, thereby contributing significantly to skin cancer diagnostics.


The year in cancer: Advances made in 2024, predictions for 2025

FOX News

At the beginning of 2024, the American Cancer Society predicted that 2,001,140 new cancer cases and 611,720 cancer deaths would occur in the United States. Now, as the year draws to a close, experts are looking back and reflecting on the discoveries and advances that have been made in the field of cancer treatment and prevention. Fox News Digital spoke with four oncologists from the Sarah Cannon Research Institute in Nashville, Tennessee, about the most notable accomplishments of 2024 and what they see on the horizon for 2025. See the answers and questions below. Krish Patel, M.D., is director of lymphoma research at Sarah Cannon Research Institute in Nashville, Tennessee.


MaskMedPaint: Masked Medical Image Inpainting with Diffusion Models for Mitigation of Spurious Correlations

Jin, Qixuan, Gerych, Walter, Ghassemi, Marzyeh

arXiv.org Artificial Intelligence

Spurious features associated with class labels can lead image classifiers to rely on shortcuts that don't generalize well to new domains. This is especially problematic in medical settings, where biased models fail when applied to different hospitals or systems. In such cases, data-driven methods to reduce spurious correlations are preferred, as clinicians can directly validate the modified images. While Denoising Diffusion Probabilistic Models (Diffusion Models) show promise for natural images, they are impractical for medical use due to the difficulty of describing spurious medical features. To address this, we propose Masked Medical Image Inpainting (MaskMedPaint), which uses text-to-image diffusion models to augment training images by inpainting areas outside key classification regions to match the target domain. We demonstrate that MaskMedPaint enhances generalization to target domains across both natural (Waterbirds, iWildCam) and medical (ISIC 2018, Chest X-ray) datasets, given limited unlabeled target images.