Accurate grading of brain tumors plays a crucial role in the diagnosis and treatment of glioma. While convolutional neural networks (CNNs) have shown promising performance in this task, their clinical applicability is still constrained by the interpretability and robustness of the models. In the conventional framework, the classification model is trained first, and then visual explanations are generated. However, this approach often leads to models that prioritize classification performance or complexity, making it difficult to achieve a precise visual explanation. Motivated by these challenges, we propose the Unified Visualization and Classification Network (UniVisNet), a novel framework that aims to improve both the classification performance and the generation of high-resolution visual explanations. UniVisNet addresses attention misalignment by introducing a subregion-based attention mechanism, which replaces traditional down-sampling operations. Additionally, multiscale feature maps are fused to achieve higher resolution, enabling the generation of detailed visual explanations. To streamline the process, we introduce the Unified Visualization and Classification head (UniVisHead), which directly generates visual explanations without the need for additional separation steps. Through extensive experiments, our proposed UniVisNet consistently outperforms strong baseline classification models and prevalent visualization methods. Notably, UniVisNet achieves remarkable results on the glioma grading task, including an AUC of 94.7%, an accuracy of 89.3%, a sensitivity of 90.4%, and a specificity of 85.3%. Moreover, UniVisNet provides visually interpretable explanations that surpass existing approaches. In conclusion, UniVisNet innovatively generates visual explanations in brain tumor grading by simultaneously improving the classification performance and generating high-resolution visual explanations. This work contributes to the clinical application of deep learning, empowering clinicians with comprehensive insights into the spatial heterogeneity of glioma.
Copyright © 2023 Elsevier Ltd. All rights reserved.