Transparency of deep neural networks for medical image analysis: A review of interpretability methods

Zohaib Salahuddin*, Henry C Woodruff, Avishek Chatterjee, Philippe Lambin

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

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Artificial Intelligence (AI) has emerged as a useful aid in numerous clinical applications for diagnosis and treatment decisions. Deep neural networks have shown the same or better performance than clinicians in many tasks owing to the rapid increase in the available data and computational power. In order to conform to the principles of trustworthy AI, it is essential that the AI system be transparent, robust, fair, and ensure accountability. Current deep neural solutions are referred to as black-boxes due to a lack of understanding of the specifics concerning the decision-making process. Therefore, there is a need to ensure the interpretability of deep neural networks before they can be incorporated into the routine clinical workflow. In this narrative review, we utilized systematic keyword searches and domain expertise to identify nine different types of interpretability methods that have been used for understanding deep learning models for medical image analysis applications based on the type of generated explanations and technical similarities. Furthermore, we report the progress made towards evaluating the explanations produced by various interpretability methods. Finally, we discuss limitations, provide guidelines for using interpretability methods and future directions concerning the interpretability of deep neural networks for medical imaging analysis.

Original languageEnglish
Article number105111
Number of pages18
JournalComputers in Biology and Medicine
Early online date4 Dec 2021
Publication statusPublished - Jan 2022


  • Deep neural networks
  • Explainability
  • Explainable artificial intelligence
  • Interpretability
  • Medical imaging

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