A Model for the Explainable Malignancy Assessment of Pulmonary Nodules on CT Images

To increase the transparency of modern computer-aided diagnosis (CAD) systems for assessing the malignancy of lung nodules, an interpretable model based on the application of generalized additive models and concept-based learning is proposed. This model detects a set of clinically significant attributes in addition to a final malignancy regression score and learns the association between the attributes of lung nodules and a final diagnosis decision, as well as their contributions into the decision. The proposed concept-based learning framework provides human-readable explanations in terms of different concepts (numerical and categorical), their values, and their contribution to the final prediction. Numerical experiments with the LIDC-IDRI dataset demonstrate that the diagnosis results obtained using the proposed model, which explicitly explores internal relationships, are in line with similar patterns observed in clinical practice. Additionally, the proposed model shows the competitive classification and the nodule attribute scoring performance, highlighting its potential for effective decision-making in the lung nodule diagnosis.