CBVLM: Training-free Explainable Concept-based Large Vision Language Models for Medical Image Classification

Fuente: arXiv
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Main Authors: Patrício, Cristiano, Rio-Torto, Isabel, Cardoso, Jaime S., Teixeira, Luís F., Neves, João C.
Format: Preprint
Published: 2025
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author Patrício, Cristiano
Rio-Torto, Isabel
Cardoso, Jaime S.
Teixeira, Luís F.
Neves, João C.
author_facet Patrício, Cristiano
Rio-Torto, Isabel
Cardoso, Jaime S.
Teixeira, Luís F.
Neves, João C.
contents The main challenges limiting the adoption of deep learning-based solutions in medical workflows are the availability of annotated data and the lack of interpretability of such systems. Concept Bottleneck Models (CBMs) tackle the latter by constraining the model output on a set of predefined and human-interpretable concepts. However, the increased interpretability achieved through these concept-based explanations implies a higher annotation burden. Moreover, if a new concept needs to be added, the whole system needs to be retrained. Inspired by the remarkable performance shown by Large Vision-Language Models (LVLMs) in few-shot settings, we propose a simple, yet effective, methodology, CBVLM, which tackles both of the aforementioned challenges. First, for each concept, we prompt the LVLM to answer if the concept is present in the input image. Then, we ask the LVLM to classify the image based on the previous concept predictions. Moreover, in both stages, we incorporate a retrieval module responsible for selecting the best examples for in-context learning. By grounding the final diagnosis on the predicted concepts, we ensure explainability, and by leveraging the few-shot capabilities of LVLMs, we drastically lower the annotation cost. We validate our approach with extensive experiments across four medical datasets and twelve LVLMs (both generic and medical) and show that CBVLM consistently outperforms CBMs and task-specific supervised methods without requiring any training and using just a few annotated examples. More information on our project page: https://cristianopatricio.github.io/CBVLM/.
format Preprint
id arxiv_https___arxiv_org_abs_2501_12266
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle CBVLM: Training-free Explainable Concept-based Large Vision Language Models for Medical Image Classification
Patrício, Cristiano
Rio-Torto, Isabel
Cardoso, Jaime S.
Teixeira, Luís F.
Neves, João C.
Computer Vision and Pattern Recognition
Artificial Intelligence
Computation and Language
The main challenges limiting the adoption of deep learning-based solutions in medical workflows are the availability of annotated data and the lack of interpretability of such systems. Concept Bottleneck Models (CBMs) tackle the latter by constraining the model output on a set of predefined and human-interpretable concepts. However, the increased interpretability achieved through these concept-based explanations implies a higher annotation burden. Moreover, if a new concept needs to be added, the whole system needs to be retrained. Inspired by the remarkable performance shown by Large Vision-Language Models (LVLMs) in few-shot settings, we propose a simple, yet effective, methodology, CBVLM, which tackles both of the aforementioned challenges. First, for each concept, we prompt the LVLM to answer if the concept is present in the input image. Then, we ask the LVLM to classify the image based on the previous concept predictions. Moreover, in both stages, we incorporate a retrieval module responsible for selecting the best examples for in-context learning. By grounding the final diagnosis on the predicted concepts, we ensure explainability, and by leveraging the few-shot capabilities of LVLMs, we drastically lower the annotation cost. We validate our approach with extensive experiments across four medical datasets and twelve LVLMs (both generic and medical) and show that CBVLM consistently outperforms CBMs and task-specific supervised methods without requiring any training and using just a few annotated examples. More information on our project page: https://cristianopatricio.github.io/CBVLM/.
title CBVLM: Training-free Explainable Concept-based Large Vision Language Models for Medical Image Classification
topic Computer Vision and Pattern Recognition
Artificial Intelligence
Computation and Language
url https://arxiv.org/abs/2501.12266