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. 2020 Jun 12;10:9556. doi: 10.1038/s41598-020-66674-7

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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A 44-year-old woman who visited the ER with abdominal pain and a normal appendix. Original CT images within extracted 3D isotropic cubes show a normal appendix as an air-filled tubular structure (left side). Corresponding heatmap overlay using Grad-CAM highlights a normal appendix that is correctly recognized by the trained CNN (true negative) (right side).