A Comprehensive Study on Medical Image Segmentation using Deep Neural Networks

Over the past decade, Medical Image Segmentation (MIS) using Deep Neural Networks (DNNs) has achieved significant performance improvements and holds great promise for future developments. This paper presents a comprehensive study on MIS based on DNNs. Intelligent Vision Systems are often evaluated based on their output levels, such as Data, Information, Knowledge, Intelligence, and Wisdom (DIKIW),and the state-of-the-art solutions in MIS at these levels are the focus of research. Additionally, Explainable Artificial Intelligence (XAI) has become an important research direction, as it aims to uncover the "black box" nature of previous DNN architectures to meet the requirements of transparency and ethics. The study emphasizes the importance of MIS in disease diagnosis and early detection, particularly for increasing the survival rate of cancer patients through timely diagnosis. XAI and early prediction are considered two important steps in the journey from "intelligence" to "wisdom." Additionally, the paper addresses existing challenges and proposes potential solutions to enhance the efficiency of implementing DNN-based MIS.

Model-Independent Machine Learning Approach for Nanometric Axial Localization and Tracking

Accurately tracking particles and determining their position along the optical axis is a major challenge in optical microscopy, especially when extremely high precision is needed. In this study, we introduce a deep learning approach using convolutional neural networks (CNNs) that can determine axial positions from dual-focal plane images without relying on predefined models. Our method achieves an axial localization accuracy of 40 nanometers - six times better than traditional single-focal plane techniques. The model's simple design and strong performance make it suitable for a wide range of uses, including dark matter detection, proton therapy for cancer, and radiation protection in space. It also shows promise in fields like biological imaging, materials science, and environmental monitoring. This work highlights how machine learning can turn complex image data into reliable, precise information, offering a flexible and powerful tool for many scientific applications.

Discovering Pathology Rationale and Token Allocation for Efficient Multimodal Pathology Reasoning

Multimodal pathological image understanding has garnered widespread interest due to its potential to improve diagnostic accuracy and enable personalized treatment through integrated visual and textual data. However, existing methods exhibit limited reasoning capabilities, which hamper their ability to handle complex diagnostic scenarios. Additionally, the enormous size of pathological images leads to severe computational burdens, further restricting their practical deployment. To address these limitations, we introduce a novel bilateral reinforcement learning framework comprising two synergistic branches. One reinforcement branch enhances the reasoning capability by enabling the model to learn task-specific decision processes, i.e., pathology rationales, directly from labels without explicit reasoning supervision. While the other branch dynamically allocates a tailored number of tokens to different images based on both their visual content and task context, thereby optimizing computational efficiency. We apply our method to various pathological tasks such as visual question answering, cancer subtyping, and lesion detection. Extensive experiments show an average +41.7 absolute performance improvement with 70.3% lower inference costs over the base models, achieving both reasoning accuracy and computational efficiency.

Lung Nodule-SSM: Self-Supervised Lung Nodule Detection and Classification in Thoracic CT Images

Lung cancer remains among the deadliest types of cancer in recent decades, and early lung nodule detection is crucial for improving patient outcomes. The limited availability of annotated medical imaging data remains a bottleneck in developing accurate computer-aided diagnosis (CAD) systems. Self-supervised learning can help leverage large amounts of unlabeled data to develop more robust CAD systems. With the recent advent of transformer-based architecture and their ability to generalize to unseen tasks, there has been an effort within the healthcare community to adapt them to various medical downstream tasks. Thus, we propose a novel "LungNodule-SSM" method, which utilizes selfsupervised learning with DINOv2 as a backbone to enhance lung nodule detection and classification without annotated data. Our methodology has two stages: firstly, the DINOv2 model is pre-trained on unlabeled CT scans to learn robust feature representations, then secondly, these features are fine-tuned using transformer-based architectures for lesionlevel detection and accurate lung nodule diagnosis. The proposed method has been evaluated on the challenging LUNA 16 dataset, consisting of 888 CT scans, and compared with SOTA methods. Our experimental results show the superiority of our proposed method with an accuracy of 98.37%, explaining its effectiveness in lung nodule detection. The source code, datasets, and pre-processed data can be accessed using the link:https://github.com/EMeRALDsNRPU/Lung-Nodule-SSM-Self-Supervised-Lung-Nodule-Detection-and-Classification/tree/main

Automated Detection of Clinical Entities in Lung and Breast Cancer Reports Using NLP Techniques

Research projects, including those focused on cancer, rely on the manual extraction of information from clinical reports. This process is time-consuming and prone to errors, limiting the efficiency of data-driven approaches in healthcare. To address these challenges, Natural Language Processing (NLP) offers an alternative for automating the extraction of relevant data from electronic health records (EHRs). In this study, we focus on lung and breast cancer due to their high incidence and the significant impact they have on public health. Early detection and effective data management in both types of cancer are crucial for improving patient outcomes. To enhance the accuracy and efficiency of data extraction, we utilized GMV's NLP tool uQuery, which excels at identifying relevant entities in clinical texts and converting them into standardized formats such as SNOMED and OMOP. uQuery not only detects and classifies entities but also associates them with contextual information, including negated entities, temporal aspects, and patient-related details. In this work, we explore the use of NLP techniques, specifically Named Entity Recognition (NER), to automatically identify and extract key clinical information from EHRs related to these two cancers. A dataset from Health Research Institute Hospital La Fe (IIS La Fe), comprising 200 annotated breast cancer and 400 lung cancer reports, was used, with eight clinical entities manually labeled using the Doccano platform. To perform NER, we fine-tuned the bsc-bio-ehr-en3 model, a RoBERTa-based biomedical linguistic model pre-trained in Spanish. Fine-tuning was performed using the Transformers architecture, enabling accurate recognition of clinical entities in these cancer types. Our results demonstrate strong overall performance, particularly in identifying entities like MET and PAT, although challenges remain with less frequent entities like EVOL.

Learning from Anatomy: Supervised Anatomical Pretraining (SAP) for Improved Metastatic Bone Disease Segmentation in Whole-Body MRI

The segmentation of metastatic bone disease (MBD) in whole-body MRI (WB-MRI) is a challenging problem. Due to varying appearances and anatomical locations of lesions, ambiguous boundaries, and severe class imbalance, obtaining reliable segmentations requires large, well-annotated datasets capturing lesion variability. Generating such datasets requires substantial time and expertise, and is prone to error. While self-supervised learning (SSL) can leverage large unlabeled datasets, learned generic representations often fail to capture the nuanced features needed for accurate lesion detection. In this work, we propose a Supervised Anatomical Pretraining (SAP) method that learns from a limited dataset of anatomical labels. First, an MRI-based skeletal segmentation model is developed and trained on WB-MRI scans from healthy individuals for high-quality skeletal delineation. Then, we compare its downstream efficacy in segmenting MBD on a cohort of 44 patients with metastatic prostate cancer, against both a baseline random initialization and a state-of-the-art SSL method. SAP significantly outperforms both the baseline and SSL-pretrained models, achieving a normalized surface Dice of 0.76 and a Dice coefficient of 0.64. The method achieved a lesion detection F2 score of 0.44, improving on 0.24 (baseline) and 0.31 (SSL). When considering only clinically relevant lesions larger than 1~ml, SAP achieves a detection sensitivity of 100% in 28 out of 32 patients. Learning bone morphology from anatomy yields an effective and domain-relevant inductive bias that can be leveraged for the downstream segmentation task of bone lesions. All code and models are made publicly available.

A Multi-Modal AI System for Screening Mammography: Integrating 2D and 3D Imaging to Improve Breast Cancer Detection in a Prospective Clinical Study

Although digital breast tomosynthesis (DBT) improves diagnostic performance over full-field digital mammography (FFDM), false-positive recalls remain a concern in breast cancer screening. We developed a multi-modal artificial intelligence system integrating FFDM, synthetic mammography, and DBT to provide breast-level predictions and bounding-box localizations of suspicious findings. Our AI system, trained on approximately 500,000 mammography exams, achieved 0.945 AUROC on an internal test set. It demonstrated capacity to reduce recalls by 31.7% and radiologist workload by 43.8% while maintaining 100% sensitivity, underscoring its potential to improve clinical workflows. External validation confirmed strong generalizability, reducing the gap to a perfect AUROC by 35.31%-69.14% relative to strong baselines. In prospective deployment across 18 sites, the system reduced recall rates for low-risk cases. An improved version, trained on over 750,000 exams with additional labels, further reduced the gap by 18.86%-56.62% across large external datasets. Overall, these results underscore the importance of utilizing all available imaging modalities, demonstrate the potential for clinical impact, and indicate feasibility of further reduction of the test error with increased training set when using large-capacity neural networks.

Deep Learning Enabled Segmentation, Classification and Risk Assessment of Cervical Cancer

Cervical cancer, the fourth leading cause of cancer in women globally, requires early detection through Pap smear tests to identify precancerous changes and prevent disease progression. In this study, we performed a focused analysis by segmenting the cellular boundaries and drawing bounding boxes to isolate the cancer cells. A novel Deep Learning (DL) architecture, the ``Multi-Resolution Fusion Deep Convolutional Network", was proposed to effectively handle images with varying resolutions and aspect ratios, with its efficacy showcased using the SIPaKMeD dataset. The performance of this DL model was observed to be similar to the state-of-the-art models, with accuracy variations of a mere 2\% to 3\%, achieved using just 1.7 million learnable parameters, which is approximately 85 times less than the VGG-19 model. Furthermore, we introduced a multi-task learning technique that simultaneously performs segmentation and classification tasks and begets an Intersection over Union score of 0.83 and a classification accuracy of 90\%. The final stage of the workflow employs a probabilistic approach for risk assessment, extracting feature vectors to predict the likelihood of normal cells progressing to malignant states, which can be utilized for the prognosis of cervical cancer.

An Integrated AI-Enabled System Using One Class Twin Cross Learning (OCT-X) for Early Gastric Cancer Detection

Early detection of gastric cancer, a leading cause of cancer-related mortality worldwide, remains hampered by the limitations of current diagnostic technologies, leading to high rates of misdiagnosis and missed diagnoses. To address these challenges, we propose an integrated system that synergizes advanced hardware and software technologies to balance speed-accuracy. Our study introduces the One Class Twin Cross Learning (OCT-X) algorithm. Leveraging a novel fast double-threshold grid search strategy (FDT-GS) and a patch-based deep fully convolutional network, OCT-X maximizes diagnostic accuracy through real-time data processing and seamless lesion surveillance. The hardware component includes an all-in-one point-of-care testing (POCT) device with high-resolution imaging sensors, real-time data processing, and wireless connectivity, facilitated by the NI CompactDAQ and LabVIEW software. Our integrated system achieved an unprecedented diagnostic accuracy of 99.70%, significantly outperforming existing models by up to 4.47%, and demonstrated a 10% improvement in multirate adaptability. These findings underscore the potential of OCT-X as well as the integrated system in clinical diagnostics, offering a path toward more accurate, efficient, and less invasive early gastric cancer detection. Future research will explore broader applications, further advancing oncological diagnostics. Code is available at https://github.com/liu37972/Multirate-Location-on-OCT-X-Learning.git.

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.