Towards Self-explainable Transformers for Cell Classification in Flow Cytometry Data

Decisions of automated systems in healthcare can have far-reaching consequences such as delayed or incorrect treatment and thus must be explainable and comprehensible for medical experts. This also applies to the field of automated Flow Cytometry (FCM) data analysis. In leukemic cancer therapy, FCM samples are obtained from the patient's bone marrow to determine the number of remaining leukemic cells. In a manual process, called gating, medical experts draw several polygons among different cell populations on 2D plots in order to hierarchically sub-select and track down cancer cell populations in an FCM sample. Several approaches exist that aim at automating this task. However, predictions of state-of-the-art models for automatic cell-wise classification act as black-boxes and lack the explainability of human-created gating hierarchies. We propose a novel transformer-based approach that classifies cells in FCM data by mimicking the decision process of medical experts. Our network considers all events of a sample at once and predicts the corresponding polygons of the gating hierarchy, thus, producing a verifiable visualization in the same way a human operator does. The proposed model has been evaluated on three publicly available datasets for acute lymphoblastic leukemia (ALL). In experimental comparison it reaches state-of-the-art performance for automated blast cell identification while providing transparent results and explainable visualizations for human experts.

Automated summary

This study proposes a Transformer-based approach that mimics the decision process of medical experts to classify cells in Flow Cytometry (FCM) data. The model achieves state-of-the-art performance for automated blast cell identification in leukemia therapy, while providing transparent results and explainable visualizations for human experts.