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.

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.

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.

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

A Novel Channel Boosted Residual CNN-Transformer with Regional-Boundary Learning for Breast Cancer Detection

Recent advancements in detecting tumors using deep learning on breast ultrasound images (BUSI) have demonstrated significant success. Deep CNNs and vision-transformers (ViTs) have demonstrated individually promising initial performance. However, challenges related to model complexity and contrast, texture, and tumor morphology variations introduce uncertainties that hinder the effectiveness of current methods. This study introduces a novel hybrid framework, CB-Res-RBCMT, combining customized residual CNNs and new ViT components for detailed BUSI cancer analysis. The proposed RBCMT uses stem convolution blocks with CNN Meet Transformer (CMT) blocks, followed by new Regional and boundary (RB) feature extraction operations for capturing contrast and morphological variations. Moreover, the CMT block incorporates global contextual interactions through multi-head attention, enhancing computational efficiency with a lightweight design. Additionally, the customized inverse residual and stem CNNs within the CMT effectively extract local texture information and handle vanishing gradients. Finally, the new channel-boosted (CB) strategy enriches the feature diversity of the limited dataset by combining the original RBCMT channels with transfer learning-based residual CNN-generated maps. These diverse channels are processed through a spatial attention block for optimal pixel selection, reducing redundancy and improving the discrimination of minor contrast and texture variations. The proposed CB-Res-RBCMT achieves an F1-score of 95.57%, accuracy of 95.63%, sensitivity of 96.42%, and precision of 94.79% on the standard harmonized stringent BUSI dataset, outperforming existing ViT and CNN methods. These results demonstrate the versatility of our integrated CNN-Transformer framework in capturing diverse features and delivering superior performance in BUSI cancer diagnosis.

ColonScopeX: Leveraging Explainable Expert Systems with Multimodal Data for Improved Early Diagnosis of Colorectal Cancer

Colorectal cancer (CRC) ranks as the second leading cause of cancer-related deaths and the third most prevalent malignant tumour worldwide. Early detection of CRC remains problematic due to its non-specific and often embarrassing symptoms, which patients frequently overlook or hesitate to report to clinicians. Crucially, the stage at which CRC is diagnosed significantly impacts survivability, with a survival rate of 80-95\% for Stage I and a stark decline to 10\% for Stage IV. Unfortunately, in the UK, only 14.4\% of cases are diagnosed at the earliest stage (Stage I). In this study, we propose ColonScopeX, a machine learning framework utilizing explainable AI (XAI) methodologies to enhance the early detection of CRC and pre-cancerous lesions. Our approach employs a multimodal model that integrates signals from blood sample measurements, processed using the Savitzky-Golay algorithm for fingerprint smoothing, alongside comprehensive patient metadata, including medication history, comorbidities, age, weight, and BMI. By leveraging XAI techniques, we aim to render the model's decision-making process transparent and interpretable, thereby fostering greater trust and understanding in its predictions. The proposed framework could be utilised as a triage tool or a screening tool of the general population. This research highlights the potential of combining diverse patient data sources and explainable machine learning to tackle critical challenges in medical diagnostics.

Improving the generalization of deep learning models in the segmentation of mammography images

Mammography stands as the main screening method for detecting breast cancer early, enhancing treatment success rates. The segmentation of landmark structures in mammography images can aid the medical assessment in the evaluation of cancer risk and the image acquisition adequacy. We introduce a series of data-centric strategies aimed at enriching the training data for deep learning-based segmentation of landmark structures. Our approach involves augmenting the training samples through annotation-guided image intensity manipulation and style transfer to achieve better generalization than standard training procedures. These augmentations are applied in a balanced manner to ensure the model learns to process a diverse range of images generated by different vendor equipments while retaining its efficacy on the original data. We present extensive numerical and visual results that demonstrate the superior generalization capabilities of our methods when compared to the standard training. For this evaluation, we consider a large dataset that includes mammography images generated by different vendor equipments. Further, we present complementary results that show both the strengths and limitations of our methods across various scenarios. The accuracy and robustness demonstrated in the experiments suggest that our method is well-suited for integration into clinical practice.

Automating tumor-infiltrating lymphocyte assessment in breast cancer histopathology images using QuPath: a transparent and accessible machine learning pipeline

In this study, we built an end-to-end tumor-infiltrating lymphocytes (TILs) assessment pipeline within QuPath, demonstrating the potential of easily accessible tools to perform complex tasks in a fully automatic fashion. First, we trained a pixel classifier to segment tumor, tumor-associated stroma, and other tissue compartments in breast cancer H&E-stained whole-slide images (WSI) to isolate tumor-associated stroma for subsequent analysis. Next, we applied a pre-trained StarDist deep learning model in QuPath for cell detection and used the extracted cell features to train a binary classifier distinguishing TILs from other cells. To evaluate our TILs assessment pipeline, we calculated the TIL density in each WSI and categorized them as low, medium, or high TIL levels. Our pipeline was evaluated against pathologist-assigned TIL scores, achieving a Cohen's kappa of 0.71 on the external test set, corroborating previous research findings. These results confirm that existing software can offer a practical solution for the assessment of TILs in H&E-stained WSIs of breast cancer.

Adaptive Deep Learning for Multiclass Breast Cancer Classification via Misprediction Risk Analysis

Breast cancer remains one of the leading causes of cancer-related deaths worldwide. Early detection is crucial for improving patient outcomes, yet the diagnostic process is often complex and prone to inconsistencies among pathologists. Computer-aided diagnostic approaches have significantly enhanced breast cancer detection, particularly in binary classification (benign vs. malignant). However, these methods face challenges in multiclass classification, leading to frequent mispredictions. In this work, we propose a novel adaptive learning approach for multiclass breast cancer classification using H&E-stained histopathology images. First, we introduce a misprediction risk analysis framework that quantifies and ranks the likelihood of an image being mislabeled by a classifier. This framework leverages an interpretable risk model that requires only a small number of labeled samples for training. Next, we present an adaptive learning strategy that fine-tunes classifiers based on the specific characteristics of a given dataset. This approach minimizes misprediction risk, allowing the classifier to adapt effectively to the target workload. We evaluate our proposed solutions on real benchmark datasets, demonstrating that our risk analysis framework more accurately identifies mispredictions compared to existing methods. Furthermore, our adaptive learning approach significantly improves the performance of state-of-the-art deep neural network classifiers.