Interpretable Aneurysm Classification via 3D Concept Bottleneck Models: Integrating Morphological and Hemodynamic Clinical Features
This study addresses the lack of clinical interpretability in deep learning models for intracranial aneurysm classification by proposing the first end-to-end 3D concept bottleneck model. The model maps CTA image features to clinically meaningful concepts—such as morphological and hemodynamic attributes—thereby embedding interpretability aligned with neurosurgical principles directly into the architecture. Built upon pretrained 3D ResNet-34 and DenseNet-121 backbones, the framework incorporates a soft concept bottleneck layer, a composite loss function combining focal loss and concept mean squared error, and eight-fold test-time augmentation (TTA). Experimental results demonstrate that ResNet-34 achieves an accuracy of 93.33% ± 4.5%, while DenseNet-121 reaches 91.43% ± 5.8%; under TTA, the model maintains a stable accuracy of 88.31% with an accuracy–generalization gap below 0.04, effectively balancing high performance with clinical transparency.