The Right Direction Needed to Develop White-Box Deep Learning in Radiology, Pathology, and Ophthalmology: A Short Review

The popularity of deep learning (DL) in the machine learning community has been dramatically increasing since 2012. The theoretical foundations of DL are well-rooted in the classical neural network (NN). Rule extraction is not a new concept, but was originally devised for a shallow NN. For about the past 30 years, extensive efforts have been made by many researchers to resolve the “black box” problem of trained shallow NNs using rule extraction technology. A rule extraction technology that is well-balanced between accuracy and interpretability has recently been proposed for shallow NNs as a promising means to address this black box problem. Recently, we have been confronting a “new black box” problem caused by highly complex deep NNs (DNNs) generated by DL. In this paper, we first review four rule extraction approaches to resolve the black box problem of DNNs trained by DL in computer vision. Next, we discuss the fundamental limitations and criticisms of current DL approaches in radiology, pathology, and ophthalmology from the black box point of view. We also review the conversion methods from DNNs to decision trees and point out their limitations. Furthermore, we describe a transparent approach for resolving the black box problem of DNNs trained by a deep belief network. Finally, we provide a brief description to realize the transparency of DNNs generated by a convolutional NN and discuss a practical way to realize the transparency of DL in radiology, pathology, and ophthalmology.