XProtoNet: Diagnosis in Chest Radiography with Global and Local Explanations
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Abstract (arXiv)
Automated diagnosis using deep neural networks in chest radiography can help radiologists detect life-threatening diseases. However, existing methods only provide predictions without accurate explanations, undermining the trustworthiness of the diagnostic methods. Here, we present XProtoNet, a globally and locally interpretable diagnosis framework for chest radiography. XProtoNet learns representative patterns of each disease from X-ray images, which are prototypes, and makes a diagnosis on a given X-ray image based on the patterns. It predicts the area where a sign of the disease is likely to appear and compares the features in the predicted area with the prototypes. It can provide a global explanation, the prototype, and a local explanation, how the prototype contributes to the prediction of a single image. Despite the constraint for interpretability, XProtoNet achieves state-of-the-art classification performance on the public NIH chest X-ray dataset.
Key facts. Cited by 73 papers in the map (data through 14 Oct 2026). Builds on 25 of its 35 references that are in the map. First posted on arXiv 19 Mar 2021.
Builds on
25 of 35 references.
References · 25
- 2015Deep Residual Learning for Image Recognitioncited by 52,096
- 2016Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localizationcited by 6,733
- 2016Densely Connected Convolutional Networkscited by 6,720
- 2016"Why Should I Trust You?": Explaining the Predictions of Any Classifiercited by 5,070
- 2016Feature Pyramid Networks for Object Detectioncited by 5,036
- 2015Learning Deep Features for Discriminative Localizationcited by 2,436
- 2013Deep Inside Convolutional Networks: Visualising Image Classification Models and Saliency Mapscited by 2,371
- 2019CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparisoncited by 1,423
- 2017Interpretability Beyond Feature Attribution: Quantitative Testing with Concept Activation Vectors (TCAV)cited by 1,319
- 2017Explanation in Artificial Intelligence: Insights from the Social Sciencescited by 1,206
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13 more
- 2017ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseasescited by 972
- 2018This Looks Like That: Deep Learning for Interpretable Image Recognitioncited by 737
- 2018Towards Robust Interpretability with Self-Explaining Neural Networkscited by 505
- 2017CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learningcited by 461
- 2020Self-supervised Equivariant Attention Mechanism for Weakly Supervised Semantic Segmentationcited by 300
- 2017Deep Learning for Case-Based Reasoning through Prototypes: A Neural Network that Explains Its Predictionscited by 234
- 2019When Explanations Lie: Why Many Modified BP Attributions Failcited by 92
- 2017Learning how to explain neural networks: PatternNet and PatternAttributioncited by 84
- 2019Interpretable Image Recognition with Hierarchical Prototypescited by 65
- 2017Thoracic Disease Identification and Localization with Limited Supervisioncited by 55
- 2020Multi-label Thoracic Disease Image Classification with Cross-Attention Networkscited by 22
- 2019InfoMask: Masked Variational Latent Representation to Localize Chest Diseasecited by 15
- 2020Region Proposals for Saliency Map Refinement for Weakly-supervised Disease Localisation and Classificationcited by 15
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Citing papers per year: 2021: 7; 2022: 14; 2023: 20; 2024: 16; 2025: 12; 2026: 4.
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- 2021Interpretable Image Classification with Differentiable Prototypes Assignmentcited by 97
- 2021Transparency of Deep Neural Networks for Medical Image Analysis: A Review of Interpretability Methodscited by 83
- 2022Delving into Masked Autoencoders for Multi-Label Thorax Disease Classificationcited by 65
- 2021This looks more like that: Enhancing Self-Explaining Models by Prototypical Relevance Propagationcited by 43
- 2023Learning Support and Trivial Prototypes for Interpretable Image Classificationcited by 38
- 2022ProtoVAE: A Trustworthy Self-Explainable Prototypical Variational Modelcited by 34
- 2023ProtoSeg: Interpretable Semantic Segmentation with Prototypical Partscited by 33
- 2022Explainable Deep Learning Methods in Medical Image Classification: A Surveycited by 32
- 2021A Systematic Benchmarking Analysis of Transfer Learning for Medical Image Analysiscited by 31
- 2022Explaining Chest X-ray Pathologies in Natural Languagecited by 27
- 2023Interpretability Benchmark for Evaluating Spatial Misalignment of Prototypical Parts Explanationscited by 27
- 2024EVA-X: A Foundation Model for General Chest X-ray Analysis with Self-supervised Learningcited by 25
38 more
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- 2021ProtoMIL: Multiple Instance Learning with Prototypical Parts for Whole-Slide Image Classificationcited by 22
- 2021Label-Assemble: Leveraging Multiple Datasets with Partial Labelscited by 20
- 2023Pixel-Grounded Prototypical Part Networkscited by 18
- 2024Self-eXplainable AI for Medical Image Analysis: A Survey and New Outlookscited by 18
- 2025A Comprehensive Survey on Self-Interpretable Neural Networkscited by 18
- 2024LucidPPN: Unambiguous Prototypical Parts Network for User-centric Interpretable Computer Visioncited by 15
- 2022Knowledge Distillation to Ensemble Global and Interpretable Prototype-Based Mammogram Classification Modelscited by 11
- 2023MProtoNet: A Case-Based Interpretable Model for Brain Tumor Classification with 3D Multi-parametric Magnetic Resonance Imagingcited by 11
- 2023Towards Medical Artificial General Intelligence via Knowledge-Enhanced Multimodal Pretrainingcited by 11
- 2023ProtoASNet: Dynamic Prototypes for Inherently Interpretable and Uncertainty-Aware Aortic Stenosis Classification in Echocardiographycited by 11
- 2022Probabilistic Integration of Object Level Annotations in Chest X-ray Classificationcited by 10
- 2023Concept Distillation: Leveraging Human-Centered Explanations for Model Improvementcited by 10
- 2023Keep the Faith: Faithful Explanations in Convolutional Neural Networks for Case-Based Reasoningcited by 10
- 2023A Framework for Interpretability in Machine Learning for Medical Imagingcited by 9
- 2022ProGReST: Prototypical Graph Regression Soft Trees for Molecular Property Predictioncited by 8
- 2024A survey on Concept-based Approaches For Model Improvementcited by 8
- 2023Don't PANIC: Prototypical Additive Neural Network for Interpretable Classification of Alzheimer's Diseasecited by 7
- 2023ProtoArgNet: Interpretable Image Classification with Super-Prototypes and Argumentation [Technical Report]cited by 7
- 2024This actually looks like that: Proto-BagNets for local and global interpretability-by-designcited by 7
- 2023Prototypical Self-Explainable Models Without Re-trainingcited by 6
- 2023ProtoExplorer: Interpretable Forensic Analysis of Deepfake Videos using Prototype Exploration and Refinementcited by 5
- 2024Learning Low-Rank Feature for Thorax Disease Classificationcited by 4
- 2024Cross- and Intra-image Prototypical Learning for Multi-label Disease Diagnosis and Interpretationcited by 4
- 2025ProtoECGNet: Case-Based Interpretable Deep Learning for Multi-Label ECG Classification with Contrastive Learningcited by 4
- 2025SIDE: Sparse Information Disentanglement for Explainable Artificial Intelligencecited by 4
- 2023Interpretable Alzheimer's Disease Classification Via a Contrastive Diffusion Autoencodercited by 3
- 2023Robust Text Classification: Analyzing Prototype-Based Networkscited by 3
- 2024Prototype-based Interpretable Breast Cancer Prediction Models: Analysis and Challengescited by 3
- 2024ProtoAL: Interpretable Deep Active Learning with prototypes for medical imagingcited by 3
- 2024Concept Complement Bottleneck Model for Interpretable Medical Image Diagnosiscited by 3
- 2025This looks like what? Challenges and Future Research Directions for Part-Prototype Modelscited by 3
- 2025DeepChest: Dynamic Gradient-Free Task Weighting for Effective Multi-Task Learning in Chest X-ray Classificationcited by 2
- 2025ProtoEFNet: Dynamic Prototype Learning for Inherently Interpretable Ejection Fraction Estimation in Echocardiographycited by 2
- 2021Ethical Implementation of Artificial Intelligence to Select Embryos in In Vitro Fertilizationcited by 1
- 2022Learning by Erasing: Conditional Entropy based Transferable Out-Of-Distribution Detectioncited by 1
- 2022XADLiME: eXplainable Alzheimer's Disease Likelihood Map Estimation via Clinically-guided Prototype Learningcited by 1
- 2023On Model Explanations with Transferable Neural Pathwayscited by 1
50 most cited of 73 All 73 (JSON)
- 2026ProtoPointNet: Prototype-Based Interpretable Classification of 3D Dental Point Clouds with Verifiable Spatial Activations14 Jul 2026
- 2026Evidential Reasoning Advances Interpretable Real-World Disease Screening14 May 2026
- 2026ProtoSSL: Self-Supervised Pretraining and Downstream Transfer for Projection-Based Prototype Models7 May 2026
- 2026ProtoQuant: Quantization of Prototypical Parts For General and Fine-Grained Image Classification6 Feb 2026
- 2025ProtoEFNet: Dynamic Prototype Learning for Inherently Interpretable Ejection Fraction Estimation in Echocardiography3 Dec 2025
- 2025ProteinPNet: Prototypical Part Networks for Concept Learning in Spatial Proteomics2 Dec 2025
- 2025SIDE: Sparse Information Disentanglement for Explainable Artificial Intelligence25 Jul 2025
- 2025Comprehensive Evaluation of Prototype Neural Networks9 Jul 2025
- 2025DeepChest: Dynamic Gradient-Free Task Weighting for Effective Multi-Task Learning in Chest X-ray Classification29 May 2025
- 2025MERA: Multimodal and Multiscale Self-Explanatory Model with Considerably Reduced Annotation for Lung Nodule Diagnosis27 Apr 2025
- 2025ProtoECGNet: Case-Based Interpretable Deep Learning for Multi-Label ECG Classification with Contrastive Learning11 Apr 2025
- 2025Interpretable Machine Learning for Oral Lesion Diagnosis through Prototypical Instances Identification21 Mar 2025
38 more
- 2025Artificially Generated Visual Scanpath Improves Multi-label Thoracic Disease Classification in Chest X-Ray Images1 Mar 2025
- 2025This looks like what? Challenges and Future Research Directions for Part-Prototype Models13 Feb 2025
- 2025SIC: Similarity-Based Interpretable Image Classification with Neural Networks28 Jan 2025
- 2025A Comprehensive Survey on Self-Interpretable Neural Networks26 Jan 2025
- 2024Cross- and Intra-image Prototypical Learning for Multi-label Disease Diagnosis and Interpretation7 Nov 2024
- 2024ParseCaps: An Interpretable Parsing Capsule Network for Medical Image Diagnosis3 Nov 2024
- 2024Learning local discrete features in explainable-by-design convolutional neural networks31 Oct 2024
- 2024Concept Complement Bottleneck Model for Interpretable Medical Image Diagnosis20 Oct 2024
- 2024Self-eXplainable AI for Medical Image Analysis: A Survey and New Outlooks3 Oct 2024
- 2024This actually looks like that: Proto-BagNets for local and global interpretability-by-design21 Jun 2024
- 2024LucidPPN: Unambiguous Prototypical Parts Network for User-centric Interpretable Computer Vision23 May 2024
- 2024EVA-X: A Foundation Model for General Chest X-ray Analysis with Self-supervised Learning8 May 2024
- 2024MAProtoNet: A Multi-scale Attentive Interpretable Prototypical Part Network for 3D Magnetic Resonance Imaging Brain Tumor Classification13 Apr 2024
- 2024ProtoAL: Interpretable Deep Active Learning with prototypes for medical imaging6 Apr 2024
- 2024Enhancing Interpretability of Vertebrae Fracture Grading using Human-interpretable Prototypes3 Apr 2024
- 2024Prototype-based Interpretable Breast Cancer Prediction Models: Analysis and Challenges29 Mar 2024
- 2024A survey on Concept-based Approaches For Model Improvement21 Mar 2024
- 2024Explainable Transformer Prototypes for Medical Diagnoses11 Mar 2024
- 2024Learning Low-Rank Feature for Thorax Disease Classification14 Feb 2024
- 2024Enabling Collaborative Clinical Diagnosis of Infectious Keratitis by Integrating Expert Knowledge and Interpretable Data-driven Intelligence14 Jan 2024
- 2023Keep the Faith: Faithful Explanations in Convolutional Neural Networks for Case-Based Reasoning15 Dec 2023
- 2023Prototypical Self-Explainable Models Without Re-training13 Dec 2023
- 2023FeaInfNet: Diagnosis in Medical Image with Feature-Driven Inference and Visual Explanations4 Dec 2023
- 2023ProtoArgNet: Interpretable Image Classification with Super-Prototypes and Argumentation [Technical Report]26 Nov 2023
- 2023Concept Distillation: Leveraging Human-Centered Explanations for Model Improvement26 Nov 2023
- 2023Robust Text Classification: Analyzing Prototype-Based Networks11 Nov 2023
- 2023A Framework for Interpretability in Machine Learning for Medical Imaging2 Oct 2023
- 2023Pixel-Grounded Prototypical Part Networks25 Sep 2023
- 2023ProtoExplorer: Interpretable Forensic Analysis of Deepfake Videos using Prototype Exploration and Refinement20 Sep 2023
- 2023On Model Explanations with Transferable Neural Pathways18 Sep 2023
- 2023Interpretability Benchmark for Evaluating Spatial Misalignment of Prototypical Parts Explanations16 Aug 2023
- 2023ProtoASNet: Dynamic Prototypes for Inherently Interpretable and Uncertainty-Aware Aortic Stenosis Classification in Echocardiography26 Jul 2023
- 2023Prototype Learning for Explainable Brain Age Prediction16 Jun 2023
- 2023Interpretable Alzheimer's Disease Classification Via a Contrastive Diffusion Autoencoder5 Jun 2023
- 2023Towards Medical Artificial General Intelligence via Knowledge-Enhanced Multimodal Pretraining26 Apr 2023
- 2023MProtoNet: A Case-Based Interpretable Model for Brain Tumor Classification with 3D Multi-parametric Magnetic Resonance Imaging13 Apr 2023
- 2023ICICLE: Interpretable Class Incremental Continual Learning14 Mar 2023
- 2023Don't PANIC: Prototypical Additive Neural Network for Interpretable Classification of Alzheimer's Disease13 Mar 2023
50 newest of 73 All 73 (JSON)
- 2021Interpretable Image Classification with Differentiable Prototypes Assignmentcited by 97
- 2021Transparency of Deep Neural Networks for Medical Image Analysis: A Review of Interpretability Methodscited by 83
- 2022Delving into Masked Autoencoders for Multi-Label Thorax Disease Classificationcited by 65
- 2021This looks more like that: Enhancing Self-Explaining Models by Prototypical Relevance Propagationcited by 43
- 2023Learning Support and Trivial Prototypes for Interpretable Image Classificationcited by 38
- 2022ProtoVAE: A Trustworthy Self-Explainable Prototypical Variational Modelcited by 34
- 2023ProtoSeg: Interpretable Semantic Segmentation with Prototypical Partscited by 33
- 2022Explainable Deep Learning Methods in Medical Image Classification: A Surveycited by 32
- 2021A Systematic Benchmarking Analysis of Transfer Learning for Medical Image Analysiscited by 31
- 2022Explaining Chest X-ray Pathologies in Natural Languagecited by 27
- 2023Interpretability Benchmark for Evaluating Spatial Misalignment of Prototypical Parts Explanationscited by 27
- 2024EVA-X: A Foundation Model for General Chest X-ray Analysis with Self-supervised Learningcited by 25
12 most cited of 72 All 72 (JSON)
- 2026ProtoPointNet: Prototype-Based Interpretable Classification of 3D Dental Point Clouds with Verifiable Spatial Activations14 Jul 2026
- 2026Evidential Reasoning Advances Interpretable Real-World Disease Screening14 May 2026
- 2026ProtoSSL: Self-Supervised Pretraining and Downstream Transfer for Projection-Based Prototype Models7 May 2026
- 2026ProtoQuant: Quantization of Prototypical Parts For General and Fine-Grained Image Classification6 Feb 2026
- 2025ProtoEFNet: Dynamic Prototype Learning for Inherently Interpretable Ejection Fraction Estimation in Echocardiography3 Dec 2025
- 2025ProteinPNet: Prototypical Part Networks for Concept Learning in Spatial Proteomics2 Dec 2025
- 2025SIDE: Sparse Information Disentanglement for Explainable Artificial Intelligence25 Jul 2025
- 2025Comprehensive Evaluation of Prototype Neural Networks9 Jul 2025
- 2025DeepChest: Dynamic Gradient-Free Task Weighting for Effective Multi-Task Learning in Chest X-ray Classification29 May 2025
- 2025MERA: Multimodal and Multiscale Self-Explanatory Model with Considerably Reduced Annotation for Lung Nodule Diagnosis27 Apr 2025
- 2025ProtoECGNet: Case-Based Interpretable Deep Learning for Multi-Label ECG Classification with Contrastive Learning11 Apr 2025
- 2025Interpretable Machine Learning for Oral Lesion Diagnosis through Prototypical Instances Identification21 Mar 2025
12 newest of 72 All 72 (JSON)