Title: IMIL: Interactive Medical Image Learning Framework

Abstract: Data augmentations are widely used in training medical image deep learning models to increase the diversity and size of sparse datasets. However, commonly used augmentation techniques can result in loss of clinically relevant information from medical images, leading to incorrect predictions at inference time. We propose the Interactive Medical Image Learning (IMIL) framework, a novel approach for improving the training of medical image analysis algorithms that enables clinician-guided intermediate training data augmentations on misprediction outliers, focusing the algorithm on relevant visual information. To prevent the model from using irrelevant features during training, IMIL will 'blackout' clinician-designated irrelevant regions and replace the original images with the augmented samples. This ensures that for originally mispredicted samples, the algorithm subsequently attends only to relevant regions and correctly correlates them with the respective diagnosis. We validate the efficacy of IMIL using radiology residents and compare its performance to state-of-the-art data augmentations. A 4.2% improvement in accuracy over ResNet-50 was observed when using IMIL on only 4% of the training set. Our study demonstrates the utility of clinician-guided interactive training to achieve meaningful data augmentations for medical image analysis algorithms.