# A Weakly Supervised and Globally Explainable Learning Framework for Brain Tumor Segmentation

arXiv: https://arxiv.org/abs/2408.01191 · HTML: https://mlsanity.com/paper/2408.01191/

## Key facts

- Cited by 6 papers in the map (data through 14 Oct 2026).
- Builds on 14 of its 34 references that are in the map.
- First posted on arXiv 2 Aug 2024.

## Builds on (most cited first, 14 of 14)

- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [Learning Deep Features for Discriminative Localization](https://mlsanity.com/paper/1512.04150/) (2015)
- [Learning Important Features Through Propagating Activation Differences](https://mlsanity.com/paper/1704.02685/) (2017)
- [Sanity Checks for Saliency Maps](https://mlsanity.com/paper/1810.03292/) (2018)
- [The RSNA-ASNR-MICCAI BraTS 2021 Benchmark on Brain Tumor Segmentation and Radiogenomic Classification](https://mlsanity.com/paper/2107.02314/) (2021)
- [Attention-based Dropout Layer for Weakly Supervised Object Localization](https://mlsanity.com/paper/1908.10028/) (2019)
- [TS-CAM: Token Semantic Coupled Attention Map for Weakly Supervised Object Localization](https://mlsanity.com/paper/2103.14862/) (2021)
- [Unveiling the Potential of Structure Preserving for Weakly Supervised Object Localization](https://mlsanity.com/paper/2103.04523/) (2021)
- [Bridging the Gap between Classification and Localization for Weakly Supervised Object Localization](https://mlsanity.com/paper/2204.00220/) (2022)
- [Weakly Supervised Object Localization via Transformer with Implicit Spatial Calibration](https://mlsanity.com/paper/2207.10447/) (2022)
- [ICAM-reg: Interpretable Classification and Regression with Feature Attribution for Mapping Neurological Phenotypes in Individual Scans](https://mlsanity.com/paper/2103.02561/) (2021)
- [3D AGSE-VNet: An Automatic Brain Tumor MRI Data Segmentation Framework](https://mlsanity.com/paper/2107.12046/) (2021)
- [Accurate Explanation Model for Image Classifiers using Class Association Embedding](https://mlsanity.com/paper/2406.07961/) (2024)
- [Dilated Inception U-Net (DIU-Net) for Brain Tumor Segmentation](https://mlsanity.com/paper/2108.06772/) (2021)

## Built on by (most cited first, 6 of 6)

- [Prompt Categories Cluster for Weakly Supervised Semantic Segmentation](https://mlsanity.com/paper/2412.13823/) (2024)
- [Hierarchical Modeling for Medical Visual Question Answering with Cross-Attention Fusion](https://mlsanity.com/paper/2504.03135/) (2025)
- [MSA-UNet3+: Multi-Scale Attention UNet3+ with New Supervised Prototypical Contrastive Loss for Coronary DSA Image Segmentation](https://mlsanity.com/paper/2504.05184/) (2025)
- [Contrastive Prompt Clustering for Weakly Supervised Semantic Segmentation](https://mlsanity.com/paper/2508.17009/) (2025)
- [Automated Learning of Semantic Embedding Representations for Diffusion Models](https://mlsanity.com/paper/2505.05732/) (2025)
- [RASALoRE: Region Aware Spatial Attention with Location-based Random Embeddings for Weakly Supervised Anomaly Detection in Brain MRI Scans](https://mlsanity.com/paper/2510.08052/) (2025)

## Abstract (arXiv)

Machine-based brain tumor segmentation can help doctors make better diagnoses. However, the complex structure of brain tumors and expensive pixel-level annotations present challenges for automatic tumor segmentation. In this paper, we propose a counterfactual generation framework that not only achieves exceptional brain tumor segmentation performance without the need for pixel-level annotations, but also provides explainability. Our framework effectively separates class-related features from class-unrelated features of the samples, and generate new samples that preserve identity features while altering class attributes by embedding different class-related features. We perform topological data analysis on the extracted class-related features and obtain a globally explainable manifold, and for each abnormal sample to be segmented, a meaningful normal sample could be effectively generated with the guidance of the rule-based paths designed within the manifold for comparison for identifying the tumor regions. We evaluate our proposed method on two datasets, which demonstrates superior performance of brain tumor segmentation. The code is available at https://github.com/xrt11/tumor-segmentation.