To develop an interpretable machine learning (ML) model using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) radiomic data, dosimetric parameters, and clinical data for predicting radiation-induced hepatic toxicity (RIHT) in patients with hepatocellular carcinoma (HCC) following intensity-modulated radiation therapy (IMRT). A retrospective analysis of 150 HCC patients was performed, with a 7:3 ratio used to divide the data into training and validation cohorts. Radiomic features from the original MRI sequences and Delta-radiomic features were extracted. Seven ML models based on radiomics were developed: logistic regression (LR), random forest (RF), support vector machine (SVM), eXtreme Gradient Boosting (XGBoost), adaptive boosting (AdaBoost), decision tree (DT), and artificial neural network (ANN). The predictive performance of the models was evaluated using receiver operating characteristic (ROC) curve analysis and calibration curves. Shapley additive explanations (SHAP) were employed to interpret the contribution of each variable and its risk threshold. Original radiomic features and Delta-radiomic features were extracted from DCE-MRI images and filtered to generate Radiomics-scores and Delta-Radiomics-scores. These were then combined with independent risk factors (Body Mass Index (BMI), V5, and pre-Child-Pugh score(pre-CP)) identified through univariate and multivariate logistic regression and Spearman correlation analysis to construct the ML models. In the training cohort, the AUC values were 0.8651 for LR, 0.7004 for RF, 0.6349 for SVM, 0.6706 for XGBoost, 0.7341 for AdaBoost, 0.6806 for Decision Tree, and 0.6786 for ANN. The corresponding accuracies were 84.4%, 65.6%, 75.0%, 65.6%, 71.9%, 68.8%, and 71.9%, respectively. The validation cohort further confirmed the superiority of the LR model, which was selected as the optimal model. SHAP analysis revealed that Delta-radiomics made a substantial positive contribution to the model. The interpretable ML model based on radiomics provides a non-invasive tool for predicting RIHT in patients with HCC, demonstrating satisfactory discriminative performance.

While Artificial Intelligence (AI) has demonstrated human-level capabilities in many prediction tasks, collaboration between humans and machines is crucial in mission-critical applications, especially in the healthcare sector. An important factor that enables successful human-AI collaboration is the user interface (UI). This paper evaluated the UI of BiTNet, an intelligent assisting tool for human biliary tract diagnosis via ultrasound images. We evaluated the UI of the assisting tool with 11 healthcare professionals through two main research questions: 1) did the assisting tool help improve the diagnosis performance of the healthcare professionals who use the tool? and 2) how did different UI elements of the assisting tool influence the users' decisions? To analyze the impacts of different UI elements without multiple rounds of experiments, we propose the novel AISIM strategy. We demonstrated that our proposed strategy, AISIM, can be used to analyze the influence of different elements in the user interface in one go. Our main findings show that the assisting tool improved the diagnostic performance of healthcare professionals from different levels of experience (OR  = 3.326, p-value <10-15). In addition, high AI prediction confidence and correct AI attention area provided higher than twice the odds that the users would follow the AI suggestion. Finally, the interview results agreed with the experimental result that BiTNet boosted the users' confidence when they were assigned to diagnose abnormality in the biliary tract from the ultrasound images.