PS3C: An Ensemble-Based Two-Step Framework for Classification of Pep Smear Cell Images

Early detection of cervical cancer is crucial for improving patient outcomes and reducing mortality by identifying precancerous lesions as soon as possible. As a result, the use of pap smear screening has significantly increased, leading to a growing demand for automated tools that can assist cytologists managing their rising workload. To address this, the Pep Smear Cell Classification Challenge (PS3C) has been organized in association with ISBI in 2025. This project aims to promote the development of automated tools for pep smear images classification. The analyzed images are grouped into four categories: healthy, unhealthy, both, and rubbish images which are considered as unsuitable for diagnosis. In this work, we propose a two-stage ensemble approach: first, a neural network determines whether an image is rubbish or not. If not, a second neural network classifies the image as containing a healthy cell, an unhealthy cell, or both.

An ensemble deep learning approach to detect tumors on Mohs micrographic surgery slides

Mohs micrographic surgery (MMS) is the gold standard technique for removing high risk nonmelanoma skin cancer however, intraoperative histopathological examination demands significant time, effort, and professionality. The objective of this study is to develop a deep learning model to detect basal cell carcinoma (BCC) and artifacts on Mohs slides. A total of 731 Mohs slides from 51 patients with BCCs were used in this study, with 91 containing tumor and 640 without tumor which was defined as non-tumor. The dataset was employed to train U-Net based models that segment tumor and non-tumor regions on the slides. The segmented patches were classified as tumor, or non-tumor to produce predictions for whole slide images (WSIs). For the segmentation phase, the deep learning model success was measured using a Dice score with 0.70 and 0.67 value, area under the curve (AUC) score with 0.98 and 0.96 for tumor and non-tumor, respectively. For the tumor classification, an AUC of 0.98 for patch-based detection, and AUC of 0.91 for slide-based detection was obtained on the test dataset. We present an AI system that can detect tumors and non-tumors in Mohs slides with high success. Deep learning can aid Mohs surgeons and dermatopathologists in making more accurate decisions.

Identifying regions of interest in whole slide images of renal cell carcinoma

The histopathological images contain a huge amount of information, which can make diagnosis an extremely timeconsuming and tedious task. In this study, we developed a completely automated system to detect regions of interest (ROIs) in whole slide images (WSI) of renal cell carcinoma (RCC), to reduce time analysis and assist pathologists in making more accurate decisions. The proposed approach is based on an efficient texture descriptor named dominant rotated local binary pattern (DRLBP) and color transformation to reveal and exploit the immense texture variability at the microscopic high magnifications level. Thereby, the DRLBPs retain the structural information and utilize the magnitude values in a local neighborhood for more discriminative power. For the classification of the relevant ROIs, feature extraction of WSIs patches was performed on the color channels separately to form the histograms. Next, we used the most frequently occurring patterns as a feature selection step to discard non-informative features. The performances of different classifiers on a set of 1800 kidney cancer patches originating from 12 whole slide images were compared and evaluated. Furthermore, the small size of the image dataset allows to investigate deep learning approach based on transfer learning for image patches classification by using deep features and fine-tuning methods. High recognition accuracy was obtained and the classifiers are efficient, the best precision result was 99.17% achieved with SVM. Moreover, transfer learning models perform well with comparable performance, and the highest precision using ResNet-50 reached 98.50%. The proposed approach results revealed a very efficient image classification and demonstrated efficacy in identifying ROIs. This study presents an automatic system to detect regions of interest relevant to the diagnosis of kidney cancer in whole slide histopathology images.

GS-TransUNet: Integrated 2D Gaussian Splatting and Transformer UNet for Accurate Skin Lesion Analysis

We can achieve fast and consistent early skin cancer detection with recent developments in computer vision and deep learning techniques. However, the existing skin lesion segmentation and classification prediction models run independently, thus missing potential efficiencies from their integrated execution. To unify skin lesion analysis, our paper presents the Gaussian Splatting - Transformer UNet (GS-TransUNet), a novel approach that synergistically combines 2D Gaussian splatting with the Transformer UNet architecture for automated skin cancer diagnosis. Our unified deep learning model efficiently delivers dual-function skin lesion classification and segmentation for clinical diagnosis. Evaluated on ISIC-2017 and PH2 datasets, our network demonstrates superior performance compared to existing state-of-the-art models across multiple metrics through 5-fold cross-validation. Our findings illustrate significant advancements in the precision of segmentation and classification. This integration sets new benchmarks in the field and highlights the potential for further research into multi-task medical image analysis methodologies, promising enhancements in automated diagnostic systems.

An Efficient Approach to Detecting Lung Nodules Using Swin Transformer

Lung cancer has the highest rate of cancer-caused deaths, and early-stage diagnosis could increase the survival rate. Lung nodules are common indicators of lung cancer, making their detection crucial. Various lung nodule detection models exist, but many lack efficiency. Hence, we propose a more efficient approach by leveraging 2D CT slices, reducing computational load and complexity in training and inference. We employ the tiny version of Swin Transformer to benefit from Vision Transformers (ViT) while maintaining low computational cost. A Feature Pyramid Network is added to enhance detection, particularly for small nodules. Additionally, Transfer Learning is used to accelerate training. Our experimental results show that the proposed model outperforms state-of-the-art methods, achieving higher mAP and mAR for small nodules by 1.3% and 1.6%, respectively. Overall, our model achieves the highest mAP of 94.7% and mAR of 94.9%.

Contrasting Low and High-Resolution Features for HER2 Scoring using Deep Learning

Breast cancer, the most common malignancy among women, requires precise detection and classification for effective treatment. Immunohistochemistry (IHC) biomarkers like HER2, ER, and PR are critical for identifying breast cancer subtypes. However, traditional IHC classification relies on pathologists' expertise, making it labor-intensive and subject to significant inter-observer variability. To address these challenges, this study introduces the India Pathology Breast Cancer Dataset (IPD-Breast), comprising of 1,272 IHC slides (HER2, ER, and PR) aimed at automating receptor status classification. The primary focus is on developing predictive models for HER2 3-way classification (0, Low, High) to enhance prognosis. Evaluation of multiple deep learning models revealed that an end-to-end ConvNeXt network utilizing low-resolution IHC images achieved an AUC, F1, and accuracy of 91.79%, 83.52%, and 83.56%, respectively, for 3-way classification, outperforming patch-based methods by over 5.35% in F1 score. This study highlights the potential of simple yet effective deep learning techniques to significantly improve accuracy and reproducibility in breast cancer classification, supporting their integration into clinical workflows for better patient outcomes.

Optimized Pap Smear Image Enhancement: Hybrid PMD Filter-CLAHE Using Spider Monkey Optimization

Pap smear image quality is crucial for cervical cancer detection. This study introduces an optimized hybrid approach that combines the Perona-Malik Diffusion (PMD) filter with contrast-limited adaptive histogram equalization (CLAHE) to enhance Pap smear image quality. The PMD filter reduces the image noise, whereas CLAHE improves the image contrast. The hybrid method was optimized using spider monkey optimization (SMO PMD-CLAHE). BRISQUE and CEIQ are the new objective functions for the PMD filter and CLAHE optimization, respectively. The simulations were conducted using the SIPaKMeD dataset. The results indicate that SMO outperforms state-of-the-art methods in optimizing the PMD filter and CLAHE. The proposed method achieved an average effective measure of enhancement (EME) of 5.45, root mean square (RMS) contrast of 60.45, Michelson's contrast (MC) of 0.995, and entropy of 6.80. This approach offers a new perspective for improving Pap smear image quality.

The impact of tissue detection on diagnostic artificial intelligence algorithms in digital pathology

Tissue detection is a crucial first step in most digital pathology applications. Details of the segmentation algorithm are rarely reported, and there is a lack of studies investigating the downstream effects of a poor segmentation algorithm. Disregarding tissue detection quality could create a bottleneck for downstream performance and jeopardize patient safety if diagnostically relevant parts of the specimen are excluded from analysis in clinical applications. This study aims to determine whether performance of downstream tasks is sensitive to the tissue detection method, and to compare performance of classical and AI-based tissue detection. To this end, we trained an AI model for Gleason grading of prostate cancer in whole slide images (WSIs) using two different tissue detection algorithms: thresholding (classical) and UNet++ (AI). A total of 33,823 WSIs scanned on five digital pathology scanners were used to train the tissue detection AI model. The downstream Gleason grading algorithm was trained and tested using 70,524 WSIs from 13 clinical sites scanned on 13 different scanners. There was a decrease from 116 (0.43%) to 22 (0.08%) fully undetected tissue samples when switching from thresholding-based tissue detection to AI-based, suggesting an AI model may be more reliable than a classical model for avoiding total failures on slides with unusual appearance. On the slides where tissue could be detected by both algorithms, no significant difference in overall Gleason grading performance was observed. However, tissue detection dependent clinically significant variations in AI grading were observed in 3.5% of malignant slides, highlighting the importance of robust tissue detection for optimal clinical performance of diagnostic AI.

Exploring Patient Data Requirements in Training Effective AI Models for MRI-based Breast Cancer Classification

The past decade has witnessed a substantial increase in the number of startups and companies offering AI-based solutions for clinical decision support in medical institutions. However, the critical nature of medical decision-making raises several concerns about relying on external software. Key issues include potential variations in image modalities and the medical devices used to obtain these images, potential legal issues, and adversarial attacks. Fortunately, the open-source nature of machine learning research has made foundation models publicly available and straightforward to use for medical applications. This accessibility allows medical institutions to train their own AI-based models, thereby mitigating the aforementioned concerns. Given this context, an important question arises: how much data do medical institutions need to train effective AI models? In this study, we explore this question in relation to breast cancer detection, a particularly contested area due to the prevalence of this disease, which affects approximately 1 in every 8 women. Through large-scale experiments on various patient sizes in the training set, we show that medical institutions do not need a decade's worth of MRI images to train an AI model that performs competitively with the state-of-the-art, provided the model leverages foundation models. Furthermore, we observe that for patient counts greater than 50, the number of patients in the training set has a negligible impact on the performance of models and that simple ensembles further improve the results without additional complexity.

TRUSWorthy: Toward Clinically Applicable Deep Learning for Confident Detection of Prostate Cancer in Micro-Ultrasound

While deep learning methods have shown great promise in improving the effectiveness of prostate cancer (PCa) diagnosis by detecting suspicious lesions from trans-rectal ultrasound (TRUS), they must overcome multiple simultaneous challenges. There is high heterogeneity in tissue appearance, significant class imbalance in favor of benign examples, and scarcity in the number and quality of ground truth annotations available to train models. Failure to address even a single one of these problems can result in unacceptable clinical outcomes.We propose TRUSWorthy, a carefully designed, tuned, and integrated system for reliable PCa detection. Our pipeline integrates self-supervised learning, multiple-instance learning aggregation using transformers, random-undersampled boosting and ensembling: these address label scarcity, weak labels, class imbalance, and overconfidence, respectively. We train and rigorously evaluate our method using a large, multi-center dataset of micro-ultrasound data. Our method outperforms previous state-of-the-art deep learning methods in terms of accuracy and uncertainty calibration, with AUROC and balanced accuracy scores of 79.9% and 71.5%, respectively. On the top 20% of predictions with the highest confidence, we can achieve a balanced accuracy of up to 91%. The success of TRUSWorthy demonstrates the potential of integrated deep learning solutions to meet clinical needs in a highly challenging deployment setting, and is a significant step towards creating a trustworthy system for computer-assisted PCa diagnosis.