# Enhancing Interpretability of Vertebrae Fracture Grading using Human-interpretable Prototypes

arXiv: https://arxiv.org/abs/2404.02830 · HTML: https://mlsanity.com/paper/2404.02830/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 37 of its 57 references that are in the map.
- First posted on arXiv 3 Apr 2024.

## Builds on (most cited first, 30 of 37)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [Axiomatic Attribution for Deep Networks](https://mlsanity.com/paper/1703.01365/) (2017)
- [Learning Deep Features for Discriminative Localization](https://mlsanity.com/paper/1512.04150/) (2015)
- [Concept Bottleneck Models](https://mlsanity.com/paper/2007.04612/) (2020)
- [Grad-CAM++: Improved Visual Explanations for Deep Convolutional Networks](https://mlsanity.com/paper/1710.11063/) (2017)
- [This Looks Like That: Deep Learning for Interpretable Image Recognition](https://mlsanity.com/paper/1806.10574/) (2018)
- [Deep Learning for Case-Based Reasoning through Prototypes: A Neural Network that Explains Its Predictions](https://mlsanity.com/paper/1710.04806/) (2017)
- [Neural Prototype Trees for Interpretable Fine-grained Image Recognition](https://mlsanity.com/paper/2012.02046/) (2020)
- [Axiom-based Grad-CAM: Towards Accurate Visualization and Explanation of CNNs](https://mlsanity.com/paper/2008.02312/) (2020)
- [Net2Vec: Quantifying and Explaining how Concepts are Encoded by Filters in Deep Neural Networks](https://mlsanity.com/paper/1801.03454/) (2018)
- [Deformable ProtoPNet: An Interpretable Image Classifier Using Deformable Prototypes](https://mlsanity.com/paper/2111.15000/) (2021)
- [VerSe: A Vertebrae Labelling and Segmentation Benchmark for Multi-detector CT Images](https://mlsanity.com/paper/2001.09193/) (2020)
- [Towards Explainable Artificial Intelligence](https://mlsanity.com/paper/1909.12072/) (2019)
- [XProtoNet: Diagnosis in Chest Radiography with Global and Local Explanations](https://mlsanity.com/paper/2103.10663/) (2021)
- [Understanding Neural Networks via Feature Visualization: A survey](https://mlsanity.com/paper/1904.08939/) (2019)
- [This Looks Like That... Does it? Shortcomings of Latent Space Prototype Interpretability in Deep Networks](https://mlsanity.com/paper/2105.02968/) (2021)
- [Now You See Me (CME): Concept-based Model Extraction](https://mlsanity.com/paper/2010.13233/) (2020)
- [This looks more like that: Enhancing Self-Explaining Models by Prototypical Relevance Propagation](https://mlsanity.com/paper/2108.12204/) (2021)
- [Learning Support and Trivial Prototypes for Interpretable Image Classification](https://mlsanity.com/paper/2301.04011/) (2023)
- [Evaluation and Improvement of Interpretability for Self-Explainable Part-Prototype Networks](https://mlsanity.com/paper/2212.05946/) (2022)
- [Concept Embedding Analysis: A Review](https://mlsanity.com/paper/2203.13909/) (2022)
- [Pixel-Grounded Prototypical Part Networks](https://mlsanity.com/paper/2309.14531/) (2023)
- [Right for the Wrong Reason: Can Interpretable ML Techniques Detect Spurious Correlations?](https://mlsanity.com/paper/2307.12344/) (2023)
- [MProtoNet: A Case-Based Interpretable Model for Brain Tumor Classification with 3D Multi-parametric Magnetic Resonance Imaging](https://mlsanity.com/paper/2304.06258/) (2023)
- [Detection of vertebral fractures in CT using 3D Convolutional Neural Networks](https://mlsanity.com/paper/1911.01816/) (2019)
- [Keypoints Localization for Joint Vertebra Detection and Fracture Severity Quantification](https://mlsanity.com/paper/2005.11960/) (2020)
- [Grading Loss: A Fracture Grade-based Metric Loss for Vertebral Fracture Detection](https://mlsanity.com/paper/2008.07831/) (2020)

## Abstract (arXiv)

Vertebral fracture grading classifies the severity of vertebral fractures, which is a challenging task in medical imaging and has recently attracted Deep Learning (DL) models. Only a few works attempted to make such models human-interpretable despite the need for transparency and trustworthiness in critical use cases like DL-assisted medical diagnosis. Moreover, such models either rely on post-hoc methods or additional annotations. In this work, we propose a novel interpretable-by-design method, ProtoVerse, to find relevant sub-parts of vertebral fractures (prototypes) that reliably explain the model's decision in a human-understandable way. Specifically, we introduce a novel diversity-promoting loss to mitigate prototype repetitions in small datasets with intricate semantics. We have experimented with the VerSe'19 dataset and outperformed the existing prototype-based method. Further, our model provides superior interpretability against the post-hoc method. Importantly, expert radiologists validated the visual interpretability of our results, showing clinical applicability.