Current data augmentation techniques and transformations are well suited for improving the size and quality of natural image datasets but are not yet optimized for medical imaging. We hypothesize that sub-optimal data augmentations can easily distort or occlude medical images, leading to false positives or negatives during patient diagnosis, prediction, or therapy/surgery evaluation. In our experimental results, we found that utilizing commonly used intensity-based data augmentation distorts the MRI scans and leads to texture information loss, thus negatively affecting the overall performance of classification. Additionally, we observed that commonly used data augmentation methods cannot be used with a plug-and-play approach in medical imaging, and requires manual tuning and adjustment.
Early detection of precancerous cysts or neoplasms, i.e., Intraductal Papillary Mucosal Neoplasms (IPMN), in pancreas is a challenging and complex task, and it may lead to a more favourable outcome. Once detected, grading IPMNs accurately is also necessary, since low-risk IPMNs can be under surveillance program, while high-risk IPMNs have to be surgically resected before they turn into cancer. Current standards (Fukuoka and others) for IPMN classification show significant intra- and inter-operator variability, beside being error-prone, making a proper diagnosis unreliable. The established progress in artificial intelligence, through the deep learning paradigm, may provide a key tool for an effective support to medical decision for pancreatic cancer. In this work, we follow this trend, by proposing a novel AI-based IPMN classifier that leverages the recent success of transformer networks in generalizing across a wide variety of tasks, including vision ones. We specifically show that our transformer-based model exploits pre-training better than standard convolutional neural networks, thus supporting the sought architectural universalism of transformers in vision, including the medical image domain and it allows for a better interpretation of the obtained results.