In the last years, artificial intelligence (AI) in clinical decision support systems (CDSS) played a key role in harnessing machine learning and deep learning architectures. Despite their promising capabilities, the lack of transparency and explainability of AI models poses significant challenges, particularly in medical contexts where reliability is a mandatory aspect. Achieving transparency without compromising predictive accuracy remains a key challenge. This paper presents a novel method, namely Rad4XCNN, to enhance the predictive power of CNN-derived features with the interpretability inherent in radiomic features. Rad4XCNN diverges from conventional methods based on saliency map, by associating intelligible meaning to CNN-derived features by means of Radiomics, offering new perspectives on explanation methods beyond visualization maps. Using a breast cancer classification task as a case study, we evaluated Rad4XCNN on ultrasound imaging datasets, including an online dataset and two in-house datasets for internal and external validation. Some key results are: i) CNN-derived features guarantee more robust accuracy when compared against ViT-derived and radiomic features; ii) conventional visualization map methods for explanation present several pitfalls; iii) Rad4XCNN does not sacrifice model accuracy for their explainability; iv) Rad4XCNN provides global explanation insights enabling the physician to analyze the model outputs and findings. In addition, we highlight the importance of integrating interpretability into AI models for enhanced trust and adoption in clinical practice, emphasizing how our method can mitigate some concerns related to explainable AI methods.

通过结合放射学特征与基于卷积神经网络的特征，本文提出了一种名为Rad4XCNN的新方法来提高医学图像分类的预测能力，同时保持解释性，强调了在临床实践中将解释性整合到人工智能模型中的重要性。

Rad4XCNN: 基于放射计算的全局解释CNN派生特征的新型不可知方法