A Shape-Aware Total Body Photography System for In-focus Surface Coverage Optimization

Total Body Photography (TBP) is becoming a useful screening tool for patients at high risk for skin cancer. While much progress has been made, existing TBP systems can be further improved for automatic detection and analysis of suspicious skin lesions, which is in part related to the resolution and sharpness of acquired images. This paper proposes a novel shape-aware TBP system automatically capturing full-body images while optimizing image quality in terms of resolution and sharpness over the body surface. The system uses depth and RGB cameras mounted on a 360-degree rotary beam, along with 3D body shape estimation and an in-focus surface optimization method to select the optimal focus distance for each camera pose. This allows for optimizing the focused coverage over the complex 3D geometry of the human body given the calibrated camera poses. We evaluate the effectiveness of the system in capturing high-fidelity body images. The proposed system achieves an average resolution of 0.068 mm/pixel and 0.0566 mm/pixel with approximately 85% and 95% of surface area in-focus, evaluated on simulation data of diverse body shapes and poses as well as a real scan of a mannequin respectively. Furthermore, the proposed shape-aware focus method outperforms existing focus protocols (e.g. auto-focus). We believe the high-fidelity imaging enabled by the proposed system will improve automated skin lesion analysis for skin cancer screening.

Knowledge-guided Contextual Gene Set Analysis Using Large Language Models

Gene set analysis (GSA) is a foundational approach for interpreting genomic data of diseases by linking genes to biological processes. However, conventional GSA methods overlook clinical context of the analyses, often generating long lists of enriched pathways with redundant, nonspecific, or irrelevant results. Interpreting these requires extensive, ad-hoc manual effort, reducing both reliability and reproducibility. To address this limitation, we introduce cGSA, a novel AI-driven framework that enhances GSA by incorporating context-aware pathway prioritization. cGSA integrates gene cluster detection, enrichment analysis, and large language models to identify pathways that are not only statistically significant but also biologically meaningful. Benchmarking on 102 manually curated gene sets across 19 diseases and ten disease-related biological mechanisms shows that cGSA outperforms baseline methods by over 30%, with expert validation confirming its increased precision and interpretability. Two independent case studies in melanoma and breast cancer further demonstrate its potential to uncover context-specific insights and support targeted hypothesis generation.

Transfer Learning and Explainable AI for Brain Tumor Classification: A Study Using MRI Data from Bangladesh

Brain tumors, regardless of being benign or malignant, pose considerable health risks, with malignant tumors being more perilous due to their swift and uncontrolled proliferation, resulting in malignancy. Timely identification is crucial for enhancing patient outcomes, particularly in nations such as Bangladesh, where healthcare infrastructure is constrained. Manual MRI analysis is arduous and susceptible to inaccuracies, rendering it inefficient for prompt diagnosis. This research sought to tackle these problems by creating an automated brain tumor classification system utilizing MRI data obtained from many hospitals in Bangladesh. Advanced deep learning models, including VGG16, VGG19, and ResNet50, were utilized to classify glioma, meningioma, and various brain cancers. Explainable AI (XAI) methodologies, such as Grad-CAM and Grad-CAM++, were employed to improve model interpretability by emphasizing the critical areas in MRI scans that influenced the categorization. VGG16 achieved the most accuracy, attaining 99.17%. The integration of XAI enhanced the system's transparency and stability, rendering it more appropriate for clinical application in resource-limited environments such as Bangladesh. This study highlights the capability of deep learning models, in conjunction with explainable artificial intelligence (XAI), to enhance brain tumor detection and identification in areas with restricted access to advanced medical technologies.

Towards order of magnitude X-ray dose reduction in breast cancer imaging using phase contrast and deep denoising

Breast cancer is the most frequently diagnosed human cancer in the United States at present. Early detection is crucial for its successful treatment. X-ray mammography and digital breast tomosynthesis are currently the main methods for breast cancer screening. However, both have known limitations in terms of their sensitivity and specificity to breast cancers, while also frequently causing patient discomfort due to the requirement for breast compression. Breast computed tomography is a promising alternative, however, to obtain high-quality images, the X-ray dose needs to be sufficiently high. As the breast is highly radiosensitive, dose reduction is particularly important. Phase-contrast computed tomography (PCT) has been shown to produce higher-quality images at lower doses and has no need for breast compression. It is demonstrated in the present study that, when imaging full fresh mastectomy samples with PCT, deep learning-based image denoising can further reduce the radiation dose by a factor of 16 or more, without any loss of image quality. The image quality has been assessed both in terms of objective metrics, such as spatial resolution and contrast-to-noise ratio, as well as in an observer study by experienced medical imaging specialists and radiologists. This work was carried out in preparation for live patient PCT breast cancer imaging, initially at specialized synchrotron facilities.

Efficient Parameter Adaptation for Multi-Modal Medical Image Segmentation and Prognosis

Cancer detection and prognosis relies heavily on medical imaging, particularly CT and PET scans. Deep Neural Networks (DNNs) have shown promise in tumor segmentation by fusing information from these modalities. However, a critical bottleneck exists: the dependency on CT-PET data concurrently for training and inference, posing a challenge due to the limited availability of PET scans. Hence, there is a clear need for a flexible and efficient framework that can be trained with the widely available CT scans and can be still adapted for PET scans when they become available. In this work, we propose a parameter-efficient multi-modal adaptation (PEMMA) framework for lightweight upgrading of a transformer-based segmentation model trained only on CT scans such that it can be efficiently adapted for use with PET scans when they become available. This framework is further extended to perform prognosis task maintaining the same efficient cross-modal fine-tuning approach. The proposed approach is tested with two well-known segementation backbones, namely UNETR and Swin UNETR. Our approach offers two main advantages. Firstly, we leverage the inherent modularity of the transformer architecture and perform low-rank adaptation (LoRA) as well as decomposed low-rank adaptation (DoRA) of the attention weights to achieve parameter-efficient adaptation. Secondly, by minimizing cross-modal entanglement, PEMMA allows updates using only one modality without causing catastrophic forgetting in the other. Our method achieves comparable performance to early fusion, but with only 8% of the trainable parameters, and demonstrates a significant +28% Dice score improvement on PET scans when trained with a single modality. Furthermore, in prognosis, our method improves the concordance index by +10% when adapting a CT-pretrained model to include PET scans, and by +23% when adapting for both PET and EHR data.

Optimizing Breast Cancer Detection in Mammograms: A Comprehensive Study of Transfer Learning, Resolution Reduction, and Multi-View Classification

This study explores open questions in the application of machine learning for breast cancer detection in mammograms. Current approaches often employ a two-stage transfer learning process: first, adapting a backbone model trained on natural images to develop a patch classifier, which is then used to create a single-view whole-image classifier. Additionally, many studies leverage both mammographic views to enhance model performance. In this work, we systematically investigate five key questions: (1) Is the intermediate patch classifier essential for optimal performance? (2) Do backbone models that excel in natural image classification consistently outperform others on mammograms? (3) When reducing mammogram resolution for GPU processing, does the learn-to-resize technique outperform conventional methods? (4) Does incorporating both mammographic views in a two-view classifier significantly improve detection accuracy? (5) How do these findings vary when analyzing low-quality versus high-quality mammograms? By addressing these questions, we developed models that outperform previous results for both single-view and two-view classifiers. Our findings provide insights into model architecture and transfer learning strategies contributing to more accurate and efficient mammogram analysis.

Cohort-attention Evaluation Metric against Tied Data: Studying Performance of Classification Models in Cancer Detection

Artificial intelligence (AI) has significantly improved medical screening accuracy, particularly in cancer detection and risk assessment. However, traditional classification metrics often fail to account for imbalanced data, varying performance across cohorts, and patient-level inconsistencies, leading to biased evaluations. We propose the Cohort-Attention Evaluation Metrics (CAT) framework to address these challenges. CAT introduces patient-level assessment, entropy-based distribution weighting, and cohort-weighted sensitivity and specificity. Key metrics like CATSensitivity (CATSen), CATSpecificity (CATSpe), and CATMean ensure balanced and fair evaluation across diverse populations. This approach enhances predictive reliability, fairness, and interpretability, providing a robust evaluation method for AI-driven medical screening models.

Subgroup Performance of a Commercial Digital Breast Tomosynthesis Model for Breast Cancer Detection

While research has established the potential of AI models for mammography to improve breast cancer screening outcomes, there have not been any detailed subgroup evaluations performed to assess the strengths and weaknesses of commercial models for digital breast tomosynthesis (DBT) imaging. This study presents a granular evaluation of the Lunit INSIGHT DBT model on a large retrospective cohort of 163,449 screening mammography exams from the Emory Breast Imaging Dataset (EMBED). Model performance was evaluated in a binary context with various negative exam types (162,081 exams) compared against screen detected cancers (1,368 exams) as the positive class. The analysis was stratified across demographic, imaging, and pathologic subgroups to identify potential disparities. The model achieved an overall AUC of 0.91 (95% CI: 0.90-0.92) with a precision of 0.08 (95% CI: 0.08-0.08), and a recall of 0.73 (95% CI: 0.71-0.76). Performance was found to be robust across demographics, but cases with non-invasive cancers (AUC: 0.85, 95% CI: 0.83-0.87), calcifications (AUC: 0.80, 95% CI: 0.78-0.82), and dense breast tissue (AUC: 0.90, 95% CI: 0.88-0.91) were associated with significantly lower performance compared to other groups. These results highlight the need for detailed evaluation of model characteristics and vigilance in considering adoption of new tools for clinical deployment.

FedSAF: A Federated Learning Framework for Enhanced Gastric Cancer Detection and Privacy Preservation

Gastric cancer is one of the most commonly diagnosed cancers and has a high mortality rate. Due to limited medical resources, developing machine learning models for gastric cancer recognition provides an efficient solution for medical institutions. However, such models typically require large sample sizes for training and testing, which can challenge patient privacy. Federated learning offers an effective alternative by enabling model training across multiple institutions without sharing sensitive patient data. This paper addresses the limited sample size of publicly available gastric cancer data with a modified data processing method. This paper introduces FedSAF, a novel federated learning algorithm designed to improve the performance of existing methods, particularly in non-independent and identically distributed (non-IID) data scenarios. FedSAF incorporates attention-based message passing and the Fisher Information Matrix to enhance model accuracy, while a model splitting function reduces computation and transmission costs. Hyperparameter tuning and ablation studies demonstrate the effectiveness of this new algorithm, showing improvements in test accuracy on gastric cancer datasets, with FedSAF outperforming existing federated learning methods like FedAMP, FedAvg, and FedProx. The framework's robustness and generalization ability were further validated across additional datasets (SEED, BOT, FashionMNIST, and CIFAR-10), achieving high performance in diverse environments.

Artificial Intelligence-Assisted Prostate Cancer Diagnosis for Reduced Use of Immunohistochemistry

Prostate cancer diagnosis heavily relies on histopathological evaluation, which is subject to variability. While immunohistochemical staining (IHC) assists in distinguishing benign from malignant tissue, it involves increased work, higher costs, and diagnostic delays. Artificial intelligence (AI) presents a promising solution to reduce reliance on IHC by accurately classifying atypical glands and borderline morphologies in hematoxylin & eosin (H&E) stained tissue sections. In this study, we evaluated an AI model's ability to minimize IHC use without compromising diagnostic accuracy by retrospectively analyzing prostate core needle biopsies from routine diagnostics at three different pathology sites. These cohorts were composed exclusively of difficult cases where the diagnosing pathologists required IHC to finalize the diagnosis. The AI model demonstrated area under the curve values of 0.951-0.993 for detecting cancer in routine H&E-stained slides. Applying sensitivity-prioritized diagnostic thresholds reduced the need for IHC staining by 44.4%, 42.0%, and 20.7% in the three cohorts investigated, without a single false negative prediction. This AI model shows potential for optimizing IHC use, streamlining decision-making in prostate pathology, and alleviating resource burdens.