A Multi-Scale and Multi-Level Fusion Approach for Deep Learning-Based Liver Lesion Diagnosis in Magnetic Resonance Images with Visual Explanation

Many computer-aided diagnosis methods, especially ones with deep learning strategies, of liver cancers based on medical images have been proposed. However, most of such methods analyze the images under only one scale, and the deep learning models are always unexplainable. In this paper, we propose a deep learning-based multi-scale and multi-level fusing approach of CNNs for liver lesion diagnosis on magnetic resonance images, termed as MMF-CNN. We introduce a multi-scale representation strategy to encode both the local and semi-local complementary information of the images. To take advantage of the complementary information of multi-scale representations, we propose a multi-level fusion method to combine the information of both the feature level and the decision level hierarchically and generate a robust diagnostic classifier based on deep learning. We further explore the explanation of the diagnosis decision of the deep neural network through visualizing the areas of interest of the network. A new scoring method is designed to evaluate whether the attention maps can highlight the relevant radiological features. The explanation and visualization make the decision-making process of the deep neural network transparent for the clinicians. We apply our proposed approach to various state-of-the-art deep learning architectures. The experimental results demonstrate the effectiveness of our approach.