White Light Specular Reflection Data Augmentation for Deep Learning Polyp Detection

Colorectal cancer is one of the deadliest cancers today, but it can be prevented through early detection of malignant polyps in the colon, primarily via colonoscopies. While this method has saved many lives, human error remains a significant challenge, as missing a polyp could have fatal consequences for the patient. Deep learning (DL) polyp detectors offer a promising solution. However, existing DL polyp detectors often mistake white light reflections from the endoscope for polyps, which can lead to false positives.To address this challenge, in this paper, we propose a novel data augmentation approach that artificially adds more white light reflections to create harder training scenarios. Specifically, we first generate a bank of artificial lights using the training dataset. Then we find the regions of the training images that we should not add these artificial lights on. Finally, we propose a sliding window method to add the artificial light to the areas that fit of the training images, resulting in augmented images. By providing the model with more opportunities to make mistakes, we hypothesize that it will also have more chances to learn from those mistakes, ultimately improving its performance in polyp detection. Experimental results demonstrate the effectiveness of our new data augmentation method.

UNet-3D with Adaptive TverskyCE Loss for Pancreas Medical Image Segmentation

Pancreatic cancer, which has a low survival rate, is the most intractable one among all cancers. Most diagnoses of this cancer heavily depend on abdominal computed tomography (CT) scans. Therefore, pancreas segmentation is crucial but challenging. Because of the obscure position of the pancreas, surrounded by other large organs, and its small area, the pancreas has often been impeded and difficult to detect. With these challenges , the segmentation results based on Deep Learning (DL) models still need to be improved. In this research, we propose a novel adaptive TverskyCE loss for DL model training, which combines Tversky loss with cross-entropy loss using learnable weights. Our method enables the model to adjust the loss contribution automatically and find the best objective function during training. All experiments were conducted on the National Institutes of Health (NIH) Pancreas-CT dataset. We evaluated the adaptive TverskyCE loss on the UNet-3D and Dilated UNet-3D, and our method achieved a Dice Similarity Coefficient (DSC) of 85.59%, with peak performance up to 95.24%, and the score of 85.14%. DSC and the score were improved by 9.47% and 8.98% respectively compared with the baseline UNet-3D with Tversky loss for pancreas segmentation. Keywords: Pancreas segmentation, Tversky loss, Cross-entropy loss, UNet-3D, Dilated UNet-3D

Vision-Language Model-Based Semantic-Guided Imaging Biomarker for Early Lung Cancer Detection

Objective: A number of machine learning models have utilized semantic features, deep features, or both to assess lung nodule malignancy. However, their reliance on manual annotation during inference, limited interpretability, and sensitivity to imaging variations hinder their application in real-world clinical settings. Thus, this research aims to integrate semantic features derived from radiologists' assessments of nodules, allowing the model to learn clinically relevant, robust, and explainable features for predicting lung cancer. Methods: We obtained 938 low-dose CT scans from the National Lung Screening Trial with 1,246 nodules and semantic features. The Lung Image Database Consortium dataset contains 1,018 CT scans, with 2,625 lesions annotated for nodule characteristics. Three external datasets were obtained from UCLA Health, the LUNGx Challenge, and the Duke Lung Cancer Screening. We finetuned a pretrained Contrastive Language-Image Pretraining model with a parameter-efficient fine-tuning approach to align imaging and semantic features and predict the one-year lung cancer diagnosis. Results: We evaluated the performance of the one-year diagnosis of lung cancer with AUROC and AUPRC and compared it to three state-of-the-art models. Our model demonstrated an AUROC of 0.90 and AUPRC of 0.78, outperforming baseline state-of-the-art models on external datasets. Using CLIP, we also obtained predictions on semantic features, such as nodule margin (AUROC: 0.81), nodule consistency (0.81), and pleural attachment (0.84), that can be used to explain model predictions. Conclusion: Our approach accurately classifies lung nodules as benign or malignant, providing explainable outputs, aiding clinicians in comprehending the underlying meaning of model predictions. This approach also prevents the model from learning shortcuts and generalizes across clinical settings.

Breast Cancer Detection from Multi-View Screening Mammograms with Visual Prompt Tuning

Accurate detection of breast cancer from high-resolution mammograms is crucial for early diagnosis and effective treatment planning. Previous studies have shown the potential of using single-view mammograms for breast cancer detection. However, incorporating multi-view data can provide more comprehensive insights. Multi-view classification, especially in medical imaging, presents unique challenges, particularly when dealing with large-scale, high-resolution data. In this work, we propose a novel Multi-view Visual Prompt Tuning Network (MVPT-NET) for analyzing multiple screening mammograms. We first pretrain a robust single-view classification model on high-resolution mammograms and then innovatively adapt multi-view feature learning into a task-specific prompt tuning process. This technique selectively tunes a minimal set of trainable parameters (7\%) while retaining the robustness of the pre-trained single-view model, enabling efficient integration of multi-view data without the need for aggressive downsampling. Our approach offers an efficient alternative to traditional feature fusion methods, providing a more robust, scalable, and efficient solution for high-resolution mammogram analysis. Experimental results on a large multi-institution dataset demonstrate that our method outperforms conventional approaches while maintaining detection efficiency, achieving an AUROC of 0.852 for distinguishing between Benign, DCIS, and Invasive classes. This work highlights the potential of MVPT-NET for medical imaging tasks and provides a scalable solution for integrating multi-view data in breast cancer detection.

Enhancing breast cancer detection on screening mammogram using self-supervised learning and a hybrid deep model of Swin Transformer and Convolutional Neural Network

Purpose: The scarcity of high-quality curated labeled medical training data remains one of the major limitations in applying artificial intelligence (AI) systems to breast cancer diagnosis. Deep models for mammogram analysis and mass (or micro-calcification) detection require training with a large volume of labeled images, which are often expensive and time-consuming to collect. To reduce this challenge, we proposed a novel method that leverages self-supervised learning (SSL) and a deep hybrid model, named \textbf{HybMNet}, which combines local self-attention and fine-grained feature extraction to enhance breast cancer detection on screening mammograms. Approach: Our method employs a two-stage learning process: (1) SSL Pretraining: We utilize EsViT, a SSL technique, to pretrain a Swin Transformer (Swin-T) using a limited set of mammograms. The pretrained Swin-T then serves as the backbone for the downstream task. (2) Downstream Training: The proposed HybMNet combines the Swin-T backbone with a CNN-based network and a novel fusion strategy. The Swin-T employs local self-attention to identify informative patch regions from the high-resolution mammogram, while the CNN-based network extracts fine-grained local features from the selected patches. A fusion module then integrates global and local information from both networks to generate robust predictions. The HybMNet is trained end-to-end, with the loss function combining the outputs of the Swin-T and CNN modules to optimize feature extraction and classification performance. Results: The proposed method was evaluated for its ability to detect breast cancer by distinguishing between benign (normal) and malignant mammograms. Leveraging SSL pretraining and the HybMNet model, it achieved AUC of 0.864 (95% CI: 0.852, 0.875) on the CMMD dataset and 0.889 (95% CI: 0.875, 0.903) on the INbreast dataset, highlighting its effectiveness.

Dynamic Contextual Attention Network: Transforming Spatial Representations into Adaptive Insights for Endoscopic Polyp Diagnosis

Colorectal polyps are key indicators for early detection of colorectal cancer. However, traditional endoscopic imaging often struggles with accurate polyp localization and lacks comprehensive contextual awareness, which can limit the explainability of diagnoses. To address these issues, we propose the Dynamic Contextual Attention Network (DCAN). This novel approach transforms spatial representations into adaptive contextual insights, using an attention mechanism that enhances focus on critical polyp regions without explicit localization modules. By integrating contextual awareness into the classification process, DCAN improves decision interpretability and overall diagnostic performance. This advancement in imaging could lead to more reliable colorectal cancer detection, enabling better patient outcomes.

Mitigating Catastrophic Forgetting in the Incremental Learning of Medical Images

This paper proposes an Incremental Learning (IL) approach to enhance the accuracy and efficiency of deep learning models in analyzing T2-weighted (T2w) MRI medical images prostate cancer detection using the PI-CAI dataset. We used multiple health centers' artificial intelligence and radiology data, focused on different tasks that looked at prostate cancer detection using MRI (PI-CAI). We utilized Knowledge Distillation (KD), as it employs generated images from past tasks to guide the training of models for subsequent tasks. The approach yielded improved performance and faster convergence of the models. To demonstrate the versatility and robustness of our approach, we evaluated it on the PI-CAI dataset, a diverse set of medical imaging modalities including OCT and PathMNIST, and the benchmark continual learning dataset CIFAR-10. Our results indicate that KD can be a promising technique for IL in medical image analysis in which data is sourced from individual health centers and the storage of large datasets is not feasible. By using generated images from prior tasks, our method enables the model to retain and apply previously acquired knowledge without direct access to the original data.

Anomaly-Driven Approach for Enhanced Prostate Cancer Segmentation

Magnetic Resonance Imaging (MRI) plays an important role in identifying clinically significant prostate cancer (csPCa), yet automated methods face challenges such as data imbalance, variable tumor sizes, and a lack of annotated data. This study introduces Anomaly-Driven U-Net (adU-Net), which incorporates anomaly maps derived from biparametric MRI sequences into a deep learning-based segmentation framework to improve csPCa identification. We conduct a comparative analysis of anomaly detection methods and evaluate the integration of anomaly maps into the segmentation pipeline. Anomaly maps, generated using Fixed-Point GAN reconstruction, highlight deviations from normal prostate tissue, guiding the segmentation model to potential cancerous regions. We compare the performance by using the average score, computed as the mean of the AUROC and Average Precision (AP). On the external test set, adU-Net achieves the best average score of 0.618, outperforming the baseline nnU-Net model (0.605). The results demonstrate that incorporating anomaly detection into segmentation improves generalization and performance, particularly with ADC-based anomaly maps, offering a promising direction for automated csPCa identification.

MERA: Multimodal and Multiscale Self-Explanatory Model with Considerably Reduced Annotation for Lung Nodule Diagnosis

Lung cancer, a leading cause of cancer-related deaths globally, emphasises the importance of early detection for better patient outcomes. Pulmonary nodules, often early indicators of lung cancer, necessitate accurate, timely diagnosis. Despite Explainable Artificial Intelligence (XAI) advances, many existing systems struggle providing clear, comprehensive explanations, especially with limited labelled data. This study introduces MERA, a Multimodal and Multiscale self-Explanatory model designed for lung nodule diagnosis with considerably Reduced Annotation requirements. MERA integrates unsupervised and weakly supervised learning strategies (self-supervised learning techniques and Vision Transformer architecture for unsupervised feature extraction) and a hierarchical prediction mechanism leveraging sparse annotations via semi-supervised active learning in the learned latent space. MERA explains its decisions on multiple levels: model-level global explanations via semantic latent space clustering, instance-level case-based explanations showing similar instances, local visual explanations via attention maps, and concept explanations using critical nodule attributes. Evaluations on the public LIDC dataset show MERA's superior diagnostic accuracy and self-explainability. With only 1% annotated samples, MERA achieves diagnostic accuracy comparable to or exceeding state-of-the-art methods requiring full annotation. The model's inherent design delivers comprehensive, robust, multilevel explanations aligned closely with clinical practice, enhancing trustworthiness and transparency. Demonstrated viability of unsupervised and weakly supervised learning lowers the barrier to deploying diagnostic AI in broader medical domains. Our complete code is open-source available: https://github.com/diku-dk/credanno.

CLIP-IT: CLIP-based Pairing for Histology Images Classification

Multimodal learning has shown significant promise for improving medical image analysis by integrating information from complementary data sources. This is widely employed for training vision-language models (VLMs) for cancer detection based on histology images and text reports. However, one of the main limitations in training these VLMs is the requirement for large paired datasets, raising concerns over privacy, and data collection, annotation, and maintenance costs. To address this challenge, we introduce CLIP-IT method to train a vision backbone model to classify histology images by pairing them with privileged textual information from an external source. At first, the modality pairing step relies on a CLIP-based model to match histology images with semantically relevant textual report data from external sources, creating an augmented multimodal dataset without the need for manually paired samples. Then, we propose a multimodal training procedure that distills the knowledge from the paired text modality to the unimodal image classifier for enhanced performance without the need for the textual data during inference. A parameter-efficient fine-tuning method is used to efficiently address the misalignment between the main (image) and paired (text) modalities. During inference, the improved unimodal histology classifier is used, with only minimal additional computational complexity. Our experiments on challenging PCAM, CRC, and BACH histology image datasets show that CLIP-IT can provide a cost-effective approach to leverage privileged textual information and outperform unimodal classifiers for histology.