Anatomy-Guided Multitask Learning for MRI-Based Classification of Placenta Accreta Spectrum and its Subtypes

Placenta Accreta Spectrum Disorders (PAS) pose significant risks during pregnancy, frequently leading to postpartum hemorrhage during cesarean deliveries and other severe clinical complications, with bleeding severity correlating to the degree of placental invasion. Consequently, accurate prenatal diagnosis of PAS and its subtypes-placenta accreta (PA), placenta increta (PI), and placenta percreta (PP)-is crucial. However, existing guidelines and methodologies predominantly focus on the presence of PAS, with limited research addressing subtype recognition. Additionally, previous multi-class diagnostic efforts have primarily relied on inefficient two-stage cascaded binary classification tasks. In this study, we propose a novel convolutional neural network (CNN) architecture designed for efficient one-stage multiclass diagnosis of PAS and its subtypes, based on 4,140 magnetic resonance imaging (MRI) slices. Our model features two branches: the main classification branch utilizes a residual block architecture comprising multiple residual blocks, while the second branch integrates anatomical features of the uteroplacental area and the adjacent uterine serous layer to enhance the model's attention during classification. Furthermore, we implement a multitask learning strategy to leverage both branches effectively. Experiments conducted on a real clinical dataset demonstrate that our model achieves state-of-the-art performance.

DECT-based Space-Squeeze Method for Multi-Class Classification of Metastatic Lymph Nodes in Breast Cancer

Background: Accurate assessment of metastatic burden in axillary lymph nodes is crucial for guiding breast cancer treatment decisions, yet conventional imaging modalities struggle to differentiate metastatic burden levels and capture comprehensive lymph node characteristics. This study leverages dual-energy computed tomography (DECT) to exploit spectral-spatial information for improved multi-class classification. Purpose: To develop a noninvasive DECT-based model classifying sentinel lymph nodes into three categories: no metastasis ($N_0$), low metastatic burden ($N_{+(1-2)}$), and heavy metastatic burden ($N_{+(\geq3)}$), thereby aiding therapeutic planning. Methods: We propose a novel space-squeeze method combining two innovations: (1) a channel-wise attention mechanism to compress and recalibrate spectral-spatial features across 11 energy levels, and (2) virtual class injection to sharpen inter-class boundaries and compact intra-class variations in the representation space. Results: Evaluated on 227 biopsy-confirmed cases, our method achieved an average test AUC of 0.86 (95% CI: 0.80-0.91) across three cross-validation folds, outperforming established CNNs (VGG, ResNet, etc). The channel-wise attention and virtual class components individually improved AUC by 5.01% and 5.87%, respectively, demonstrating complementary benefits. Conclusions: The proposed framework enhances diagnostic AUC by effectively integrating DECT's spectral-spatial data and mitigating class ambiguity, offering a promising tool for noninvasive metastatic burden assessment in clinical practice.