Tumor monitoring and detection of lymph node metastasis using quantitative ultrasound and immune cytokine profiling in dogs undergoing radiation therapy: a pilot study

Quantitative ultrasound (QUS) characterizes the composition of cells to distinguish diseased from healthy tissue. QUS can reflect the complexity of the tumor and detect early lymph node (LN) metastasis ex vivo. The objective in this study was to gather preliminary QUS and cytokine data from dogs undergoing radiation therapy and correlate QUS data with both LN metastasis and tumor response. Spontaneous solid tumors were evaluated with QUS before and up to one year after receiving RT. Additionally, regional LNs were evaluated with QUS in vivo, then excised and examined with histopathology to detect metastasis. Paired t-tests were used to compare QUS data of metastatic and non-metastatic LNs within patients. Furthermore, paired t-tests compared pre- versus post-RT QUS data. Serum was collected at each time point for cytokine profiles. Most statistical tests were underpowered to produce significant p values, but interesting trends were observed. The lowest p values for LN tests were found with the envelope statistics K (p = 0.142) and mu (p = 0.181), which correspond to cell structure and number of scatterers. For tumor response, the lowest p values were found with K (p = 0.115) and mu (p = 0.127) when comparing baseline QUS data with QUS data 1 week after RT. Monocyte chemoattractant protein 1 (MCP-1) was significantly higher in dogs with cancer when compared to healthy controls (p = 1.12e-4). A weak correlation was found between effective scatterer diameter (ESD) and Transforming growth factor beta 1 (TGFB-1). While statistical tests on the preliminary QUS data alone were underpowered to detect significant differences among groups, our methods create a basis for future studies.

SMILE: a Scale-aware Multiple Instance Learning Method for Multicenter STAS Lung Cancer Histopathology Diagnosis

Spread through air spaces (STAS) represents a newly identified aggressive pattern in lung cancer, which is known to be associated with adverse prognostic factors and complex pathological features. Pathologists currently rely on time consuming manual assessments, which are highly subjective and prone to variation. This highlights the urgent need for automated and precise diag nostic solutions. 2,970 lung cancer tissue slides are comprised from multiple centers, re-diagnosed them, and constructed and publicly released three lung cancer STAS datasets: STAS CSU (hospital), STAS TCGA, and STAS CPTAC. All STAS datasets provide corresponding pathological feature diagnoses and related clinical data. To address the bias, sparse and heterogeneous nature of STAS, we propose an scale-aware multiple instance learning(SMILE) method for STAS diagnosis of lung cancer. By introducing a scale-adaptive attention mechanism, the SMILE can adaptively adjust high attention instances, reducing over-reliance on local regions and promoting consistent detection of STAS lesions. Extensive experiments show that SMILE achieved competitive diagnostic results on STAS CSU, diagnosing 251 and 319 STAS samples in CPTAC andTCGA,respectively, surpassing clinical average AUC. The 11 open baseline results are the first to be established for STAS research, laying the foundation for the future expansion, interpretability, and clinical integration of computational pathology technologies. The datasets and code are available at https://anonymous.4open.science/r/IJCAI25-1DA1.

Leveraging Sparse Annotations for Leukemia Diagnosis on the Large Leukemia Dataset

Leukemia is 10th most frequently diagnosed cancer and one of the leading causes of cancer related deaths worldwide. Realistic analysis of Leukemia requires White Blook Cells (WBC) localization, classification, and morphological assessment. Despite deep learning advances in medical imaging, leukemia analysis lacks a large, diverse multi-task dataset, while existing small datasets lack domain diversity, limiting real world applicability. To overcome dataset challenges, we present a large scale WBC dataset named Large Leukemia Dataset (LLD) and novel methods for detecting WBC with their attributes. Our contribution here is threefold. First, we present a large-scale Leukemia dataset collected through Peripheral Blood Films (PBF) from several patients, through multiple microscopes, multi cameras, and multi magnification. To enhance diagnosis explainability and medical expert acceptance, each leukemia cell is annotated at 100x with 7 morphological attributes, ranging from Cell Size to Nuclear Shape. Secondly, we propose a multi task model that not only detects WBCs but also predicts their attributes, providing an interpretable and clinically meaningful solution. Third, we propose a method for WBC detection with attribute analysis using sparse annotations. This approach reduces the annotation burden on hematologists, requiring them to mark only a small area within the field of view. Our method enables the model to leverage the entire field of view rather than just the annotated regions, enhancing learning efficiency and diagnostic accuracy. From diagnosis explainability to overcoming domain shift challenges, presented datasets could be used for many challenging aspects of microscopic image analysis. The datasets, code, and demo are available at: https://im.itu.edu.pk/sparse-leukemiaattri/

A Retrospective Systematic Study on Hierarchical Sparse Query Transformer-assisted Ultrasound Screening for Early Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) ranks as the third leading cause of cancer-related mortality worldwide, with early detection being crucial for improving patient survival rates. However, early screening for HCC using ultrasound suffers from insufficient sensitivity and is highly dependent on the expertise of radiologists for interpretation. Leveraging the latest advancements in artificial intelligence (AI) in medical imaging, this study proposes an innovative Hierarchical Sparse Query Transformer (HSQformer) model that combines the strengths of Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs) to enhance the accuracy of HCC diagnosis in ultrasound screening. The HSQformer leverages sparse latent space representations to capture hierarchical details at various granularities without the need for complex adjustments, and adopts a modular, plug-and-play design philosophy, ensuring the model's versatility and ease of use. The HSQformer's performance was rigorously tested across three distinct clinical scenarios: single-center, multi-center, and high-risk patient testing. In each of these settings, it consistently outperformed existing state-of-the-art models, such as ConvNext and SwinTransformer. Notably, the HSQformer even matched the diagnostic capabilities of senior radiologists and comprehensively surpassed those of junior radiologists. The experimental results from this study strongly demonstrate the effectiveness and clinical potential of AI-assisted tools in HCC screening. The full code is available at https://github.com/Asunatan/HSQformer.

Efficient Brain Tumor Segmentation Using a Dual-Decoder 3D U-Net with Attention Gates (DDUNet)

Cancer remains one of the leading causes of mortality worldwide, and among its many forms, brain tumors are particularly notorious due to their aggressive nature and the critical challenges involved in early diagnosis. Recent advances in artificial intelligence have shown great promise in assisting medical professionals with precise tumor segmentation, a key step in timely diagnosis and treatment planning. However, many state-of-the-art segmentation methods require extensive computational resources and prolonged training times, limiting their practical application in resource-constrained settings. In this work, we present a novel dual-decoder U-Net architecture enhanced with attention-gated skip connections, designed specifically for brain tumor segmentation from MRI scans. Our approach balances efficiency and accuracy by achieving competitive segmentation performance while significantly reducing training demands. Evaluated on the BraTS 2020 dataset, the proposed model achieved Dice scores of 85.06% for Whole Tumor (WT), 80.61% for Tumor Core (TC), and 71.26% for Enhancing Tumor (ET) in only 50 epochs, surpassing several commonly used U-Net variants. Our model demonstrates that high-quality brain tumor segmentation is attainable even under limited computational resources, thereby offering a viable solution for researchers and clinicians operating with modest hardware. This resource-efficient model has the potential to improve early detection and diagnosis of brain tumors, ultimately contributing to better patient outcomes

Brain Tumor Identification using Improved YOLOv8

Identifying the extent of brain tumors is a significant challenge in brain cancer treatment. The main difficulty is in the approximate detection of tumor size. Magnetic resonance imaging (MRI) has become a critical diagnostic tool. However, manually detecting the boundaries of brain tumors from MRI scans is a labor-intensive task that requires extensive expertise. Deep learning and computer-aided detection techniques have led to notable advances in machine learning for this purpose. In this paper, we propose a modified You Only Look Once (YOLOv8) model to accurately detect the tumors within the MRI images. The proposed model replaced the Non-Maximum Suppression (NMS) algorithm with a Real-Time Detection Transformer (RT- DETR) in the detection head. NMS filters out redundant or overlapping bounding boxes in the detected tumors, but they are hand-designed and pre-set. RT-DETR removes hand-designed components. The second improvement was made by replacing the normal convolution block with ghost convolution. Ghost Convolution reduces computational and memory costs while maintaining high accuracy and enabling faster inference, making it ideal for resource-constrained environments and real-time applications. The third improvement was made by introducing a vision transformer block in the backbone of YOLOv8 to extract context-aware features. We used a publicly available dataset of brain tumors in the proposed model. The proposed model performed better than the original YOLOv8 model and also performed better than other object detectors (Faster R- CNN, Mask R-CNN, YOLO, YOLOv3, YOLOv4, YOLOv5, SSD, RetinaNet, EfficientDet, and DETR). The proposed model achieved 0.91 mAP (mean Average Precision)@0.5.

Advancing Precision Oncology Through Modeling of Longitudinal and Multimodal Data

Cancer evolves continuously over time through a complex interplay of genetic, epigenetic, microenvironmental, and phenotypic changes. This dynamic behavior drives uncontrolled cell growth, metastasis, immune evasion, and therapy resistance, posing challenges for effective monitoring and treatment. However, today's data-driven research in oncology has primarily focused on cross-sectional analysis using data from a single modality, limiting the ability to fully characterize and interpret the disease's dynamic heterogeneity. Advances in multiscale data collection and computational methods now enable the discovery of longitudinal multimodal biomarkers for precision oncology. Longitudinal data reveal patterns of disease progression and treatment response that are not evident from single-timepoint data, enabling timely abnormality detection and dynamic treatment adaptation. Multimodal data integration offers complementary information from diverse sources for more precise risk assessment and targeting of cancer therapy. In this review, we survey methods of longitudinal and multimodal modeling, highlighting their synergy in providing multifaceted insights for personalized care tailored to the unique characteristics of a patient's cancer. We summarize the current challenges and future directions of longitudinal multimodal analysis in advancing precision oncology.

How Good is my Histopathology Vision-Language Foundation Model? A Holistic Benchmark

Recently, histopathology vision-language foundation models (VLMs) have gained popularity due to their enhanced performance and generalizability across different downstream tasks. However, most existing histopathology benchmarks are either unimodal or limited in terms of diversity of clinical tasks, organs, and acquisition instruments, as well as their partial availability to the public due to patient data privacy. As a consequence, there is a lack of comprehensive evaluation of existing histopathology VLMs on a unified benchmark setting that better reflects a wide range of clinical scenarios. To address this gap, we introduce HistoVL, a fully open-source comprehensive benchmark comprising images acquired using up to 11 various acquisition tools that are paired with specifically crafted captions by incorporating class names and diverse pathology descriptions. Our Histo-VL includes 26 organs, 31 cancer types, and a wide variety of tissue obtained from 14 heterogeneous patient cohorts, totaling more than 5 million patches obtained from over 41K WSIs viewed under various magnification levels. We systematically evaluate existing histopathology VLMs on Histo-VL to simulate diverse tasks performed by experts in real-world clinical scenarios. Our analysis reveals interesting findings, including large sensitivity of most existing histopathology VLMs to textual changes with a drop in balanced accuracy of up to 25% in tasks such as Metastasis detection, low robustness to adversarial attacks, as well as improper calibration of models evident through high ECE values and low model prediction confidence, all of which can affect their clinical implementation.

SCFANet: Style Distribution Constraint Feature Alignment Network For Pathological Staining Translation

Immunohistochemical (IHC) staining serves as a valuable technique for detecting specific antigens or proteins through antibody-mediated visualization. However, the IHC staining process is both time-consuming and costly. To address these limitations, the application of deep learning models for direct translation of cost-effective Hematoxylin and Eosin (H&E) stained images into IHC stained images has emerged as an efficient solution. Nevertheless, the conversion from H&E to IHC images presents significant challenges, primarily due to alignment discrepancies between image pairs and the inherent diversity in IHC staining style patterns. To overcome these challenges, we propose the Style Distribution Constraint Feature Alignment Network (SCFANet), which incorporates two innovative modules: the Style Distribution Constrainer (SDC) and Feature Alignment Learning (FAL). The SDC ensures consistency between the generated and target images' style distributions while integrating cycle consistency loss to maintain structural consistency. To mitigate the complexity of direct image-to-image translation, the FAL module decomposes the end-to-end translation task into two subtasks: image reconstruction and feature alignment. Furthermore, we ensure pathological consistency between generated and target images by maintaining pathological pattern consistency and Optical Density (OD) uniformity. Extensive experiments conducted on the Breast Cancer Immunohistochemical (BCI) dataset demonstrate that our SCFANet model outperforms existing methods, achieving precise transformation of H&E-stained images into their IHC-stained counterparts. The proposed approach not only addresses the technical challenges in H&E to IHC image translation but also provides a robust framework for accurate and efficient stain conversion in pathological analysis.

SYN-LUNGS: Towards Simulating Lung Nodules with Anatomy-Informed Digital Twins for AI Training

AI models for lung cancer screening are limited by data scarcity, impacting generalizability and clinical applicability. Generative models address this issue but are constrained by training data variability. We introduce SYN-LUNGS, a framework for generating high-quality 3D CT images with detailed annotations. SYN-LUNGS integrates XCAT3 phantoms for digital twin generation, X-Lesions for nodule simulation (varying size, location, and appearance), and DukeSim for CT image formation with vendor and parameter variability. The dataset includes 3,072 nodule images from 1,044 simulated CT scans, with 512 lesions and 174 digital twins. Models trained on clinical + simulated data outperform clinical only models, achieving 10% improvement in detection, 2-9% in segmentation and classification, and enhanced synthesis.By incorporating anatomy-informed simulations, SYN-LUNGS provides a scalable approach for AI model development, particularly in rare disease representation and improving model reliability.