Interpretable deep learning as a means for decrypting disease signature in multiple sclerosis.

The mechanisms driving multiple sclerosis (MS) are still largely unknown, calling for new methods allowing to detect and characterize tissue degeneration since the early stages of the disease. Our aim is to decrypt the microstructural signatures of the Primary Progressive versus the Relapsing-Remitting state of disease based on diffusion and structural magnetic resonance imaging data.A selection of microstructural descriptors, based on the 3D-Simple Harmonics Oscillator Based Reconstruction and Estimation and the set of new algebraically independent Rotation Invariant spherical harmonics Features, was considered and used to feed convolutional neural networks (CNNs) models. Classical measures derived from diffusion tensor imaging, that are fractional anisotropy and mean diffusivity, were used as benchmark for diffusion MRI (dMRI). Finally, T1-weighted images were also considered for the sake of comparison with the state-of-the-art. A CNN model was fit to each feature map and layerwise relevance propagation (LRP) heatmaps were generated for each model, target class and subject in the test set. Average heatmaps were calculated across correctly classified patients and size-corrected metrics were derived on a set of regions of interest to assess the LRP contrast between the two classes.Our results demonstrated that dMRI features extracted in grey matter tissues can help in disambiguating primary progressive multiple sclerosis from relapsing-remitting multiple sclerosis patients and, moreover, that LRP heatmaps highlight areas of high relevance which relate well with what is known from literature for MS disease.Within a patient stratification task, LRP allows detecting the input voxels that mostly contribute to the classification of the patients in either of the two classes for each feature, potentially bringing to light hidden data properties which might reveal peculiar disease-state factors.