SPARS: Self-Play Adversarial Reinforcement Learning for Segmentation of Liver Tumours

Accurate tumour segmentation is vital for various targeted diagnostic and therapeutic procedures for cancer, e.g., planning biopsies or tumour ablations. Manual delineation is extremely labour-intensive, requiring substantial expert time. Fully-supervised machine learning models aim to automate such localisation tasks, but require a large number of costly and often subjective 3D voxel-level labels for training. The high-variance and subjectivity in such labels impacts model generalisability, even when large datasets are available. Histopathology labels may offer more objective labels but the infeasibility of acquiring pixel-level annotations to develop tumour localisation methods based on histology remains challenging in-vivo. In this work, we propose a novel weakly-supervised semantic segmentation framework called SPARS (Self-Play Adversarial Reinforcement Learning for Segmentation), which utilises an object presence classifier, trained on a small number of image-level binary cancer presence labels, to localise cancerous regions on CT scans. Such binary labels of patient-level cancer presence can be sourced more feasibly from biopsies and histopathology reports, enabling a more objective cancer localisation on medical images. Evaluating with real patient data, we observed that SPARS yielded a mean dice score of $77.3 \pm 9.4$, which outperformed other weakly-supervised methods by large margins. This performance was comparable with recent fully-supervised methods that require voxel-level annotations. Our results demonstrate the potential of using SPARS to reduce the need for extensive human-annotated labels to detect cancer in real-world healthcare settings.

DCSNet: A Lightweight Knowledge Distillation-Based Model with Explainable AI for Lung Cancer Diagnosis from Histopathological Images

Lung cancer is a leading cause of cancer-related deaths globally, where early detection and accurate diagnosis are critical for improving survival rates. While deep learning, particularly convolutional neural networks (CNNs), has revolutionized medical image analysis by detecting subtle patterns indicative of early-stage lung cancer, its adoption faces challenges. These models are often computationally expensive and require significant resources, making them unsuitable for resource constrained environments. Additionally, their lack of transparency hinders trust and broader adoption in sensitive fields like healthcare. Knowledge distillation addresses these challenges by transferring knowledge from large, complex models (teachers) to smaller, lightweight models (students). We propose a knowledge distillation-based approach for lung cancer detection, incorporating explainable AI (XAI) techniques to enhance model transparency. Eight CNNs, including ResNet50, EfficientNetB0, EfficientNetB3, and VGG16, are evaluated as teacher models. We developed and trained a lightweight student model, Distilled Custom Student Network (DCSNet) using ResNet50 as the teacher. This approach not only ensures high diagnostic performance in resource-constrained settings but also addresses transparency concerns, facilitating the adoption of AI-driven diagnostic tools in healthcare.

Prostate Cancer Screening with Artificial Intelligence-Enhanced Micro-Ultrasound: A Comparative Study with Traditional Methods

Background and objective: Micro-ultrasound (micro-US) is a novel imaging modality with diagnostic accuracy comparable to MRI for detecting clinically significant prostate cancer (csPCa). We investigated whether artificial intelligence (AI) interpretation of micro-US can outperform clinical screening methods using PSA and digital rectal examination (DRE). Methods: We retrospectively studied 145 men who underwent micro-US guided biopsy (79 with csPCa, 66 without). A self-supervised convolutional autoencoder was used to extract deep image features from 2D micro-US slices. Random forest classifiers were trained using five-fold cross-validation to predict csPCa at the slice level. Patients were classified as csPCa-positive if 88 or more consecutive slices were predicted positive. Model performance was compared with a classifier using PSA, DRE, prostate volume, and age. Key findings and limitations: The AI-based micro-US model and clinical screening model achieved AUROCs of 0.871 and 0.753, respectively. At a fixed threshold, the micro-US model achieved 92.5% sensitivity and 68.1% specificity, while the clinical model showed 96.2% sensitivity but only 27.3% specificity. Limitations include a retrospective single-center design and lack of external validation. Conclusions and clinical implications: AI-interpreted micro-US improves specificity while maintaining high sensitivity for csPCa detection. This method may reduce unnecessary biopsies and serve as a low-cost alternative to PSA-based screening. Patient summary: We developed an AI system to analyze prostate micro-ultrasound images. It outperformed PSA and DRE in detecting aggressive cancer and may help avoid unnecessary biopsies.

Advanced cervical cancer classification: enhancing pap smear images with hybrid PMD Filter-CLAHE

Cervical cancer remains a significant health problem, especially in developing countries. Early detection is critical for effective treatment. Convolutional neural networks (CNN) have shown promise in automated cervical cancer screening, but their performance depends on Pap smear image quality. This study investigates the impact of various image preprocessing techniques on CNN performance for cervical cancer classification using the SIPaKMeD dataset. Three preprocessing techniques were evaluated: perona-malik diffusion (PMD) filter for noise reduction, contrast-limited adaptive histogram equalization (CLAHE) for image contrast enhancement, and the proposed hybrid PMD filter-CLAHE approach. The enhanced image datasets were evaluated on pretrained models, such as ResNet-34, ResNet-50, SqueezeNet-1.0, MobileNet-V2, EfficientNet-B0, EfficientNet-B1, DenseNet-121, and DenseNet-201. The results show that hybrid preprocessing PMD filter-CLAHE can improve the Pap smear image quality and CNN architecture performance compared to the original images. The maximum metric improvements are 13.62% for accuracy, 10.04% for precision, 13.08% for recall, and 14.34% for F1-score. The proposed hybrid PMD filter-CLAHE technique offers a new perspective in improving cervical cancer classification performance using CNN architectures.

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.

GuidedMorph: Two-Stage Deformable Registration for Breast MRI

Accurately registering breast MR images from different time points enables the alignment of anatomical structures and tracking of tumor progression, supporting more effective breast cancer detection, diagnosis, and treatment planning. However, the complexity of dense tissue and its highly non-rigid nature pose challenges for conventional registration methods, which primarily focus on aligning general structures while overlooking intricate internal details. To address this, we propose \textbf{GuidedMorph}, a novel two-stage registration framework designed to better align dense tissue. In addition to a single-scale network for global structure alignment, we introduce a framework that utilizes dense tissue information to track breast movement. The learned transformation fields are fused by introducing the Dual Spatial Transformer Network (DSTN), improving overall alignment accuracy. A novel warping method based on the Euclidean distance transform (EDT) is also proposed to accurately warp the registered dense tissue and breast masks, preserving fine structural details during deformation. The framework supports paradigms that require external segmentation models and with image data only. It also operates effectively with the VoxelMorph and TransMorph backbones, offering a versatile solution for breast registration. We validate our method on ISPY2 and internal dataset, demonstrating superior performance in dense tissue, overall breast alignment, and breast structural similarity index measure (SSIM), with notable improvements by over 13.01% in dense tissue Dice, 3.13% in breast Dice, and 1.21% in breast SSIM compared to the best learning-based baseline.

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.

MAMBO: High-Resolution Generative Approach for Mammography Images

Mammography is the gold standard for the detection and diagnosis of breast cancer. This procedure can be significantly enhanced with Artificial Intelligence (AI)-based software, which assists radiologists in identifying abnormalities. However, training AI systems requires large and diverse datasets, which are often difficult to obtain due to privacy and ethical constraints. To address this issue, the paper introduces MAMmography ensemBle mOdel (MAMBO), a novel patch-based diffusion approach designed to generate full-resolution mammograms. Diffusion models have shown breakthrough results in realistic image generation, yet few studies have focused on mammograms, and none have successfully generated high-resolution outputs required to capture fine-grained features of small lesions. To achieve this, MAMBO integrates separate diffusion models to capture both local and global (image-level) contexts. The contextual information is then fed into the final patch-based model, significantly aiding the noise removal process. This thoughtful design enables MAMBO to generate highly realistic mammograms of up to 3840x3840 pixels. Importantly, this approach can be used to enhance the training of classification models and extended to anomaly detection. Experiments, both numerical and radiologist validation, assess MAMBO's capabilities in image generation, super-resolution, and anomaly detection, highlighting its potential to enhance mammography analysis for more accurate diagnoses and earlier lesion detection.

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.

Lightweight Relational Embedding in Task-Interpolated Few-Shot Networks for Enhanced Gastrointestinal Disease Classification

Traditional diagnostic methods like colonoscopy are invasive yet critical tools necessary for accurately diagnosing colorectal cancer (CRC). Detection of CRC at early stages is crucial for increasing patient survival rates. However, colonoscopy is dependent on obtaining adequate and high-quality endoscopic images. Prolonged invasive procedures are inherently risky for patients, while suboptimal or insufficient images hamper diagnostic accuracy. These images, typically derived from video frames, often exhibit similar patterns, posing challenges in discrimination. To overcome these challenges, we propose a novel Deep Learning network built on a Few-Shot Learning architecture, which includes a tailored feature extractor, task interpolation, relational embedding, and a bi-level routing attention mechanism. The Few-Shot Learning paradigm enables our model to rapidly adapt to unseen fine-grained endoscopic image patterns, and the task interpolation augments the insufficient images artificially from varied instrument viewpoints. Our relational embedding approach discerns critical intra-image features and captures inter-image transitions between consecutive endoscopic frames, overcoming the limitations of Convolutional Neural Networks (CNNs). The integration of a light-weight attention mechanism ensures a concentrated analysis of pertinent image regions. By training on diverse datasets, the model's generalizability and robustness are notably improved for handling endoscopic images. Evaluated on Kvasir dataset, our model demonstrated superior performance, achieving an accuracy of 90.1\%, precision of 0.845, recall of 0.942, and an F1 score of 0.891. This surpasses current state-of-the-art methods, presenting a promising solution to the challenges of invasive colonoscopy by optimizing CRC detection through advanced image analysis.