Patient-Level Diagnosis of Acute Myeloid Leukemia via Deep Learning Analysis of Bone Marrow Smear

Bone marrow smear review remains important for acute myeloid leukemia (AML) assessment, but manual single-cell interpretation is labor-intensive and patient-level diagnosis requires aggregation of many cellular observations. We present a cell-to-patient deep learning pipeline for AML-assisted diagnosis from bone marrow smear images. The study included 258 patients from six anonymized centers, including a main cohort of 169 patients from Centers 1-3 and an external validation cohort of 89 patients from Centers 4-6. A 16-category cell annotation vocabulary was used to describe the global cellular composition, including granulocytic, monocytic, erythroid, lymphoid, eosinophilic, and other cells. Rather than identifying strict AML blasts or leukemic blasts, the model targets an expert-defined composite category termed Composite Blast-like Cells (CBLC), comprising N, N1, M, M1, R, R1, J, and J1 according to the project-wide morphological standard. A fixed YOLO-based segmentation module detected cells, predicted contours were matched to expert polygon annotations by contour IoU, and standardized single-cell crops were generated. An EfficientNet-B0 classifier was trained through a two-stage GT-to-YOLO and YOLO-to-YOLO strategy with class-imbalance correction, center-border regularization, and morphology-assisted supervision. Cell-level predictions were aggregated into patient-level CBLC ratios for AML-oriented diagnostic support. The pipeline achieved stable internal validation and maintained external generalization, with ensemble weighted F1-scores of 0.9076, 0.8696, and 0.9124 on Centers 4, 5, and 6, respectively.

Dense Point-to-Mask Optimization with Reinforced Point Selection for Crowd Instance Segmentation

Crowd instance segmentation is a crucial task with a wide range of applications, including surveillance and transportation. Currently, point labels are common in crowd datasets, while region labels (e.g., boxes) are rare and inaccurate. The masks obtained through segmentation help to improve the accuracy of region labels and resolve the correspondence between individual location coordinates and crowd density maps. However, directly applying currently popular large foundation models such as SAM does not yield ideal results in dense crowds. To this end, we first propose Dense Point-to-Mask Optimization (DPMO), which integrates SAM with the Nearest Neighbor Exclusive Circle (NNEC) constraint to generate dense instance segmentation from point annotations. With DPMO and manual correction, we obtain mask annotations from the existing point annotations for traditional crowd datasets. Then, to predict instance segmentation in dense crowds, we propose a Reinforced Point Selection (RPS) framework trained with Group Relative Policy Optimization (GRPO), which selects the best predicted point from a sampling of the initial point prediction. Through extensive experiments, we achieve state-of-the-art crowd instance segmentation performance on ShanghaiTech, UCF-QNRF, JHU-CROWD++, and NWPU-Crowd datasets. Furthermore, we design new loss functions supervised by masks that boost counting performance across different models, demonstrating the significant role of mask annotations in enhancing counting accuracy.