A Foundation Model Framework for Multi-View MRI Classification of Extramural Vascular Invasion and Mesorectal Fascia Invasion in Rectal Cancer

Background: Accurate MRI-based identification of extramural vascular invasion (EVI) and mesorectal fascia invasion (MFI) is pivotal for risk-stratified management of rectal cancer, yet visual assessment is subjective and vulnerable to inter-institutional variability. Purpose: To develop and externally evaluate a multicenter, foundation-model-driven framework that automatically classifies EVI and MFI on axial and sagittal T2-weighted MRI. Methods: This retrospective study used 331 pre-treatment rectal cancer MRI examinations from three European hospitals. After TotalSegmentator-guided rectal patch extraction, a self-supervised frequency-domain harmonization pipeline was trained to minimize scanner-related contrast shifts. Four classifiers were compared: ResNet50, SeResNet, the universal biomedical pretrained transformer (UMedPT) with a lightweight MLP head, and a logistic-regression variant using frozen UMedPT features (UMedPT_LR). Results: UMedPT_LR achieved the best EVI detection when axial and sagittal features were fused (AUC = 0.82; sensitivity = 0.75; F1 score = 0.73), surpassing the Chaimeleon Grand-Challenge winner (AUC = 0.74). The highest MFI performance was attained by UMedPT on axial harmonized images (AUC = 0.77), surpassing the Chaimeleon Grand-Challenge winner (AUC = 0.75). Frequency-domain harmonization improved MFI classification but variably affected EVI performance. Conventional CNNs (ResNet50, SeResNet) underperformed, especially in F1 score and balanced accuracy. Conclusion: These findings demonstrate that combining foundation model features, harmonization, and multi-view fusion significantly enhances diagnostic performance in rectal MRI.

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.

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.

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.

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.

CPLOYO: A Pulmonary Nodule Detection Model with Multi-Scale Feature Fusion and Nonlinear Feature Learning

The integration of Internet of Things (IoT) technology in pulmonary nodule detection significantly enhances the intelligence and real-time capabilities of the detection system. Currently, lung nodule detection primarily focuses on the identification of solid nodules, but different types of lung nodules correspond to various forms of lung cancer. Multi-type detection contributes to improving the overall lung cancer detection rate and enhancing the cure rate. To achieve high sensitivity in nodule detection, targeted improvements were made to the YOLOv8 model. Firstly, the C2f\_RepViTCAMF module was introduced to augment the C2f module in the backbone, thereby enhancing detection accuracy for small lung nodules and achieving a lightweight model design. Secondly, the MSCAF module was incorporated to reconstruct the feature fusion section of the model, improving detection accuracy for lung nodules of varying scales. Furthermore, the KAN network was integrated into the model. By leveraging the KAN network's powerful nonlinear feature learning capability, detection accuracy for small lung nodules was further improved, and the model's generalization ability was enhanced. Tests conducted on the LUNA16 dataset demonstrate that the improved model outperforms the original model as well as other mainstream models such as YOLOv9 and RT-DETR across various evaluation metrics.

An Inclusive Foundation Model for Generalizable Cytogenetics in Precision Oncology

Chromosome analysis is vital for diagnosing genetic disorders and guiding cancer therapy decisions through the identification of somatic clonal aberrations. However, developing an AI model are hindered by the overwhelming complexity and diversity of chromosomal abnormalities, requiring extensive annotation efforts, while automated methods remain task-specific and lack generalizability due to the scarcity of comprehensive datasets spanning diverse resource conditions. Here, we introduce CHROMA, a foundation model for cytogenomics, designed to overcome these challenges by learning generalizable representations of chromosomal abnormalities. Pre-trained on over 84,000 specimens (~4 million chromosomal images) via self-supervised learning, CHROMA outperforms other methods across all types of abnormalities, even when trained on fewer labelled data and more imbalanced datasets. By facilitating comprehensive mapping of instability and clonal leisons across various aberration types, CHROMA offers a scalable and generalizable solution for reliable and automated clinical analysis, reducing the annotation workload for experts and advancing precision oncology through the early detection of rare genomic abnormalities, enabling broad clinical AI applications and making advanced genomic analysis more accessible.

Automated Quality Evaluation of Cervical Cytopathology Whole Slide Images Based on Content Analysis

The ThinPrep Cytologic Test (TCT) is the most widely used method for cervical cancer screening, and the sample quality directly impacts the accuracy of the diagnosis. Traditional manual evaluation methods rely on the observation of pathologist under microscopes. These methods exhibit high subjectivity, high cost, long duration, and low reliability. With the development of computer-aided diagnosis (CAD), an automated quality assessment system that performs at the level of a professional pathologist is necessary. To address this need, we propose a fully automated quality assessment method for Cervical Cytopathology Whole Slide Images (WSIs) based on The Bethesda System (TBS) diagnostic standards, artificial intelligence algorithms, and the characteristics of clinical data. The method analysis the context of WSIs to quantify quality evaluation metrics which are focused by TBS such as staining quality, cell counts and cell mass proportion through multiple models including object detection, classification and segmentation. Subsequently, the XGBoost model is used to mine the attention paid by pathologists to different quality evaluation metrics when evaluating samples, thereby obtaining a comprehensive WSI sample score calculation model. Experimental results on 100 WSIs demonstrate that the proposed evaluation method has significant advantages in terms of speed and consistency.

Multimodal AI-driven Biomarker for Early Detection of Cancer Cachexia

Cancer cachexia is a multifactorial syndrome characterized by progressive muscle wasting, metabolic dysfunction, and systemic inflammation, leading to reduced quality of life and increased mortality. Despite extensive research, no single definitive biomarker exists, as cachexia-related indicators such as serum biomarkers, skeletal muscle measurements, and metabolic abnormalities often overlap with other conditions. Existing composite indices, including the Cancer Cachexia Index (CXI), Modified CXI (mCXI), and Cachexia Score (CASCO), integrate multiple biomarkers but lack standardized thresholds, limiting their clinical utility. This study proposes a multimodal AI-based biomarker for early cancer cachexia detection, leveraging open-source large language models (LLMs) and foundation models trained on medical data. The approach integrates heterogeneous patient data, including demographics, disease status, lab reports, radiological imaging (CT scans), and clinical notes, using a machine learning framework that can handle missing data. Unlike previous AI-based models trained on curated datasets, this method utilizes routinely collected clinical data, enhancing real-world applicability. Additionally, the model incorporates confidence estimation, allowing the identification of cases requiring expert review for precise clinical interpretation. Preliminary findings demonstrate that integrating multiple data modalities improves cachexia prediction accuracy at the time of cancer diagnosis. The AI-based biomarker dynamically adapts to patient-specific factors such as age, race, ethnicity, weight, cancer type, and stage, avoiding the limitations of fixed-threshold biomarkers. This multimodal AI biomarker provides a scalable and clinically viable solution for early cancer cachexia detection, facilitating personalized interventions and potentially improving treatment outcomes and patient survival.

Advancements in Real-Time Oncology Diagnosis: Harnessing AI and Image Fusion Techniques

Real-time computer-aided diagnosis using artificial intelligence (AI), with images, can help oncologists diagnose cancer with high accuracy and in an early phase. We reviewed real-time AI-based analyzed images for decision-making in different cancer types. This paper provides insights into the present and future potential of real-time imaging and image fusion. It explores various real-time techniques, encompassing technical solutions, AI-based imaging, and image fusion diagnosis across multiple anatomical areas, and electromagnetic needle tracking. To provide a thorough overview, this paper discusses ultrasound image fusion, real-time in vivo cancer diagnosis with different spectroscopic techniques, different real-time optical imaging-based cancer diagnosis techniques, elastography-based cancer diagnosis, cervical cancer detection using neuromorphic architectures, different fluorescence image-based cancer diagnosis techniques, and hyperspectral imaging-based cancer diagnosis. We close by offering a more futuristic overview to solve existing problems in real-time image-based cancer diagnosis.