  While deep learning methods are increasingly being applied to tasks such as
computer-aided diagnosis, these models are difficult to interpret, do not
incorporate prior domain knowledge, and are often considered as a "black-box."
The lack of model interpretability hinders them from being fully understood by
target users such as radiologists. In this paper, we present a novel
interpretable deep hierarchical semantic convolutional neural network (HSCNN)
to predict whether a given pulmonary nodule observed on a computed tomography
(CT) scan is malignant. Our network provides two levels of output: 1) low-level
radiologist semantic features, and 2) a high-level malignancy prediction score.
The low-level semantic outputs quantify the diagnostic features used by
radiologists and serve to explain how the model interprets the images in an
expert-driven manner. The information from these low-level tasks, along with
the representations learned by the convolutional layers, are then combined and
used to infer the high-level task of predicting nodule malignancy. This unified
architecture is trained by optimizing a global loss function including both
low- and high-level tasks, thereby learning all the parameters within a joint
framework. Our experimental results using the Lung Image Database Consortium
(LIDC) show that the proposed method not only produces interpretable lung
cancer predictions but also achieves significantly better results compared to
common 3D CNN approaches.
