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.

A Unified Multi-Scale Attention-Based Network for Automatic 3D Segmentation of Lung Parenchyma & Nodules In Thoracic CT Images

Lung cancer has been one of the major threats across the world with the highest mortalities. Computer-aided detection (CAD) can help in early detection and thus can help increase the survival rate. Accurate lung parenchyma segmentation (to include the juxta-pleural nodules) and lung nodule segmentation, the primary symptom of lung cancer, play a crucial role in the overall accuracy of the Lung CAD pipeline. Lung nodule segmentation is quite challenging because of the diverse nodule types and other inhibit structures present within the lung lobes. Traditional machine/deep learning methods suffer from generalization and robustness. Recent Vision Language Models/Foundation Models perform well on the anatomical level, but they suffer on fine-grained segmentation tasks, and their semi-automatic nature limits their effectiveness in real-time clinical scenarios. In this paper, we propose a novel method for accurate 3D segmentation of lung parenchyma and lung nodules. The proposed architecture is an attention-based network with residual blocks at each encoder-decoder state. Max pooling is replaced by strided convolutions at the encoder, and trilinear interpolation is replaced by transposed convolutions at the decoder to maximize the number of learnable parameters. Dilated convolutions at each encoder-decoder stage allow the model to capture the larger context without increasing computational costs. The proposed method has been evaluated extensively on one of the largest publicly available datasets, namely LUNA16, and is compared with recent notable work in the domain using standard performance metrics like Dice score, IOU, etc. It can be seen from the results that the proposed method achieves better performance than state-of-the-art methods. The source code, datasets, and pre-processed data can be accessed using the link: https://github.com/EMeRALDsNRPU/Attention-Based-3D-ResUNet.

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.

Semi-Automated Quality Assurance in Digital Pathology: Tile Classification Approach

Quality assurance is a critical but underexplored area in digital pathology, where even minor artifacts can have significant effects. Artifacts have been shown to negatively impact the performance of AI diagnostic models. In current practice, trained staff manually review digitized images prior to release of these slides to pathologists which are then used to render a diagnosis. Conventional image processing approaches, provide a foundation for detecting artifacts on digital pathology slides. However, current tools do not leverage deep learning, which has the potential to improve detection accuracy and scalability. Despite these advancements, methods for quality assurance in digital pathology remain limited, presenting a gap for innovation. We propose an AI algorithm designed to screen digital pathology slides by analyzing tiles and categorizing them into one of 10 predefined artifact types or as background. This algorithm identifies and localizes artifacts, creating a map that highlights regions of interest. By directing human operators to specific tiles affected by artifacts, the algorithm minimizes the time and effort required to manually review entire slides for quality issues. From internal archives and The Cancer Genome Atlas, 133 whole slide images were selected and 10 artifacts were annotated using an internally developed software ZAPP (Mayo Clinic, Jacksonville, FL). Ablation study of multiple models at different tile sizes and magnification was performed. InceptionResNet was selected. Single artifact models were trained and tested, followed by a limited multiple instance model with artifacts that performed well together (chatter, fold, and pen). From the results of this study we suggest a hybrid design for artifact screening composed of both single artifact binary models as well as multiple instance models to optimize detection of each artifact.

Quantum Machine Learning in Healthcare: Evaluating QNN and QSVM Models

Effective and accurate diagnosis of diseases such as cancer, diabetes, and heart failure is crucial for timely medical intervention and improving patient survival rates. Machine learning has revolutionized diagnostic methods in recent years by developing classification models that detect diseases based on selected features. However, these classification tasks are often highly imbalanced, limiting the performance of classical models. Quantum models offer a promising alternative, exploiting their ability to express complex patterns by operating in a higher-dimensional computational space through superposition and entanglement. These unique properties make quantum models potentially more effective in addressing the challenges of imbalanced datasets. This work evaluates the potential of quantum classifiers in healthcare, focusing on Quantum Neural Networks (QNNs) and Quantum Support Vector Machines (QSVMs), comparing them with popular classical models. The study is based on three well-known healthcare datasets -- Prostate Cancer, Heart Failure, and Diabetes. The results indicate that QSVMs outperform QNNs across all datasets due to their susceptibility to overfitting. Furthermore, quantum models prove the ability to overcome classical models in scenarios with high dataset imbalance. Although preliminary, these findings highlight the potential of quantum models in healthcare classification tasks and lead the way for further research in this domain.

A Shape-Aware Total Body Photography System for In-focus Surface Coverage Optimization

Total Body Photography (TBP) is becoming a useful screening tool for patients at high risk for skin cancer. While much progress has been made, existing TBP systems can be further improved for automatic detection and analysis of suspicious skin lesions, which is in part related to the resolution and sharpness of acquired images. This paper proposes a novel shape-aware TBP system automatically capturing full-body images while optimizing image quality in terms of resolution and sharpness over the body surface. The system uses depth and RGB cameras mounted on a 360-degree rotary beam, along with 3D body shape estimation and an in-focus surface optimization method to select the optimal focus distance for each camera pose. This allows for optimizing the focused coverage over the complex 3D geometry of the human body given the calibrated camera poses. We evaluate the effectiveness of the system in capturing high-fidelity body images. The proposed system achieves an average resolution of 0.068 mm/pixel and 0.0566 mm/pixel with approximately 85% and 95% of surface area in-focus, evaluated on simulation data of diverse body shapes and poses as well as a real scan of a mannequin respectively. Furthermore, the proposed shape-aware focus method outperforms existing focus protocols (e.g. auto-focus). We believe the high-fidelity imaging enabled by the proposed system will improve automated skin lesion analysis for skin cancer screening.

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.

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.

Knowledge-guided Contextual Gene Set Analysis Using Large Language Models

Gene set analysis (GSA) is a foundational approach for interpreting genomic data of diseases by linking genes to biological processes. However, conventional GSA methods overlook clinical context of the analyses, often generating long lists of enriched pathways with redundant, nonspecific, or irrelevant results. Interpreting these requires extensive, ad-hoc manual effort, reducing both reliability and reproducibility. To address this limitation, we introduce cGSA, a novel AI-driven framework that enhances GSA by incorporating context-aware pathway prioritization. cGSA integrates gene cluster detection, enrichment analysis, and large language models to identify pathways that are not only statistically significant but also biologically meaningful. Benchmarking on 102 manually curated gene sets across 19 diseases and ten disease-related biological mechanisms shows that cGSA outperforms baseline methods by over 30%, with expert validation confirming its increased precision and interpretability. Two independent case studies in melanoma and breast cancer further demonstrate its potential to uncover context-specific insights and support targeted hypothesis generation.

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.