Radiomics-driven neuro-fuzzy framework for rule generation to enhance explainability in MRI-based brain tumor segmentation.

Introduction: Brain tumors are a leading cause of mortality worldwide, with early and accurate diagnosis being essential for effective treatment. Although Deep Learning (DL) models offer strong performance in tumor detection and segmentation using MRI, their black-box nature hinders clinical adoption due to a lack of interpretability.

Methods: We present a hybrid AI framework that integrates a 3D U-Net Convolutional Neural Network for MRI-based tumor segmentation with radiomic feature extraction. Dimensionality reduction is performed using machine learning, and an Adaptive Neuro-Fuzzy Inference System (ANFIS) is employed to produce interpretable decision rules. Each experiment is constrained to a small set of high-impact radiomic features to enhance clarity and reduce complexity.

Results: The framework was validated on the BraTS2020 dataset, achieving an average DICE Score of 82.94% for tumor core segmentation and 76.06% for edema segmentation. Classification tasks yielded accuracies of 95.43% for binary (healthy vs. tumor) and 92.14% for multi-class (healthy vs. tumor core vs. edema) problems. A concise set of 18 fuzzy rules was generated to provide clinically interpretable outputs.

Discussion: Our approach balances high diagnostic accuracy with enhanced interpretability, addressing a critical barrier in applying DL models in clinical settings. Integrating of ANFIS and radiomics supports transparent decision-making, facilitating greater trust and applicability in real-world medical diagnostics assistance.