Live(r) Die: Predicting Survival in Colorectal Liver Metastasis

Colorectal cancer frequently metastasizes to the liver, significantly reducing long-term survival. While surgical resection is the only potentially curative treatment for colorectal liver metastasis (CRLM), patient outcomes vary widely depending on tumor characteristics along with clinical and genomic factors. Current prognostic models, often based on limited clinical or molecular features, lack sufficient predictive power, especially in multifocal CRLM cases. We present a fully automated framework for surgical outcome prediction from pre- and post-contrast MRI acquired before surgery. Our framework consists of a segmentation pipeline and a radiomics pipeline. The segmentation pipeline learns to segment the liver, tumors, and spleen from partially annotated data by leveraging promptable foundation models to complete missing labels. Also, we propose SAMONAI, a novel zero-shot 3D prompt propagation algorithm that leverages the Segment Anything Model to segment 3D regions of interest from a single point prompt, significantly improving our segmentation pipeline's accuracy and efficiency. The predicted pre- and post-contrast segmentations are then fed into our radiomics pipeline, which extracts features from each tumor and predicts survival using SurvAMINN, a novel autoencoder-based multiple instance neural network for survival analysis. SurvAMINN jointly learns dimensionality reduction and hazard prediction from right-censored survival data, focusing on the most aggressive tumors. Extensive evaluation on an institutional dataset comprising 227 patients demonstrates that our framework surpasses existing clinical and genomic biomarkers, delivering a C-index improvement exceeding 10%. Our results demonstrate the potential of integrating automated segmentation algorithms and radiomics-based survival analysis to deliver accurate, annotation-efficient, and interpretable outcome prediction in CRLM.

CoMoTo: Unpaired Cross-Modal Lesion Distillation Improves Breast Lesion Detection in Tomosynthesis

Digital Breast Tomosynthesis (DBT) is an advanced breast imaging modality that offers superior lesion detection accuracy compared to conventional mammography, albeit at the trade-off of longer reading time. Accelerating lesion detection from DBT using deep learning is hindered by limited data availability and huge annotation costs. A possible solution to this issue could be to leverage the information provided by a more widely available modality, such as mammography, to enhance DBT lesion detection. In this paper, we present a novel framework, CoMoTo, for improving lesion detection in DBT. Our framework leverages unpaired mammography data to enhance the training of a DBT model, improving practicality by eliminating the need for mammography during inference. Specifically, we propose two novel components, Lesion-specific Knowledge Distillation (LsKD) and Intra-modal Point Alignment (ImPA). LsKD selectively distills lesion features from a mammography teacher model to a DBT student model, disregarding background features. ImPA further enriches LsKD by ensuring the alignment of lesion features within the teacher before distilling knowledge to the student. Our comprehensive evaluation shows that CoMoTo is superior to traditional pretraining and image-level KD, improving performance by 7% Mean Sensitivity under low-data setting. Our code is available at https://github.com/Muhammad-Al-Barbary/CoMoTo .