From 2D to 3D Without Extra Baggage: Data-Efficient Cancer Detection in Digital Breast Tomosynthesis

Digital Breast Tomosynthesis (DBT) enhances finding visibility for breast cancer detection by providing volumetric information that reduces the impact of overlapping tissues; however, limited annotated data has constrained the development of deep learning models for DBT. To address data scarcity, existing methods attempt to reuse 2D full-field digital mammography (FFDM) models by either flattening DBT volumes or processing slices individually, thus discarding volumetric information. Alternatively, 3D reasoning approaches introduce complex architectures that require more DBT training data. Tackling these drawbacks, we propose M&M-3D, an architecture that enables learnable 3D reasoning while remaining parameter-free relative to its FFDM counterpart, M&M. M&M-3D constructs malignancy-guided 3D features, and 3D reasoning is learned through repeatedly mixing these 3D features with slice-level information. This is achieved by modifying operations in M&M without adding parameters, thus enabling direct weight transfer from FFDM. Extensive experiments show that M&M-3D surpasses 2D projection and 3D slice-based methods by 11-54% for localization and 3-10% for classification. Additionally, M&M-3D outperforms complex 3D reasoning variants by 20-47% for localization and 2-10% for classification in the low-data regime, while matching their performance in high-data regime. On the popular BCS-DBT benchmark, M&M-3D outperforms previous top baseline by 4% for classification and 10% for localization.

Real-time prediction of breast cancer sites using deformation-aware graph neural network

Early diagnosis of breast cancer is crucial, enabling the establishment of appropriate treatment plans and markedly enhancing patient prognosis. While direct magnetic resonance imaging-guided biopsy demonstrates promising performance in detecting cancer lesions, its practical application is limited by prolonged procedure times and high costs. To overcome these issues, an indirect MRI-guided biopsy that allows the procedure to be performed outside of the MRI room has been proposed, but it still faces challenges in creating an accurate real-time deformable breast model. In our study, we tackled this issue by developing a graph neural network (GNN)-based model capable of accurately predicting deformed breast cancer sites in real time during biopsy procedures. An individual-specific finite element (FE) model was developed by incorporating magnetic resonance (MR) image-derived structural information of the breast and tumor to simulate deformation behaviors. A GNN model was then employed, designed to process surface displacement and distance-based graph data, enabling accurate prediction of overall tissue displacement, including the deformation of the tumor region. The model was validated using phantom and real patient datasets, achieving an accuracy within 0.2 millimeters (mm) for cancer node displacement (RMSE) and a dice similarity coefficient (DSC) of 0.977 for spatial overlap with actual cancerous regions. Additionally, the model enabled real-time inference and achieved a speed-up of over 4,000 times in computational cost compared to conventional FE simulations. The proposed deformation-aware GNN model offers a promising solution for real-time tumor displacement prediction in breast biopsy, with high accuracy and real-time capability. Its integration with clinical procedures could significantly enhance the precision and efficiency of breast cancer diagnosis.

On the Role of Calibration in Benchmarking Algorithmic Fairness for Skin Cancer Detection

Artificial Intelligence (AI) models have demonstrated expert-level performance in melanoma detection, yet their clinical adoption is hindered by performance disparities across demographic subgroups such as gender, race, and age. Previous efforts to benchmark the performance of AI models have primarily focused on assessing model performance using group fairness metrics that rely on the Area Under the Receiver Operating Characteristic curve (AUROC), which does not provide insights into a model's ability to provide accurate estimates. In line with clinical assessments, this paper addresses this gap by incorporating calibration as a complementary benchmarking metric to AUROC-based fairness metrics. Calibration evaluates the alignment between predicted probabilities and observed event rates, offering deeper insights into subgroup biases. We assess the performance of the leading skin cancer detection algorithm of the ISIC 2020 Challenge on the ISIC 2020 Challenge dataset and the PROVE-AI dataset, and compare it with the second and third place models, focusing on subgroups defined by sex, race (Fitzpatrick Skin Tone), and age. Our findings reveal that while existing models enhance discriminative accuracy, they often over-diagnose risk and exhibit calibration issues when applied to new datasets. This study underscores the necessity for comprehensive model auditing strategies and extensive metadata collection to achieve equitable AI-driven healthcare solutions. All code is publicly available at https://github.com/bdominique/testing_strong_calibration.

nnMIL: A generalizable multiple instance learning framework for computational pathology

Computational pathology holds substantial promise for improving diagnosis and guiding treatment decisions. Recent pathology foundation models enable the extraction of rich patch-level representations from large-scale whole-slide images (WSIs), but current approaches for aggregating these features into slide-level predictions remain constrained by design limitations that hinder generalizability and reliability. Here, we developed nnMIL, a simple yet broadly applicable multiple-instance learning framework that connects patch-level foundation models to robust slide-level clinical inference. nnMIL introduces random sampling at both the patch and feature levels, enabling large-batch optimization, task-aware sampling strategies, and efficient and scalable training across datasets and model architectures. A lightweight aggregator performs sliding-window inference to generate ensemble slide-level predictions and supports principled uncertainty estimation. Across 40,000 WSIs encompassing 35 clinical tasks and four pathology foundation models, nnMIL consistently outperformed existing MIL methods for disease diagnosis, histologic subtyping, molecular biomarker detection, and pan- cancer prognosis prediction. It further demonstrated strong cross-model generalization, reliable uncertainty quantification, and robust survival stratification in multiple external cohorts. In conclusion, nnMIL offers a practical and generalizable solution for translating pathology foundation models into clinically meaningful predictions, advancing the development and deployment of reliable AI systems in real-world settings.

Anatomy-Aware Lymphoma Lesion Detection in Whole-Body PET/CT

Early cancer detection is crucial for improving patient outcomes, and 18F FDG PET/CT imaging plays a vital role by combining metabolic and anatomical information. Accurate lesion detection remains challenging due to the need to identify multiple lesions of varying sizes. In this study, we investigate the effect of adding anatomy prior information to deep learning-based lesion detection models. In particular, we add organ segmentation masks from the TotalSegmentator tool as auxiliary inputs to provide anatomical context to nnDetection, which is the state-of-the-art for lesion detection, and Swin Transformer. The latter is trained in two stages that combine self-supervised pre-training and supervised fine-tuning. The method is tested in the AutoPET and Karolinska lymphoma datasets. The results indicate that the inclusion of anatomical priors substantially improves the detection performance within the nnDetection framework, while it has almost no impact on the performance of the vision transformer. Moreover, we observe that Swin Transformer does not offer clear advantages over conventional convolutional neural network (CNN) encoders used in nnDetection. These findings highlight the critical role of the anatomical context in cancer lesion detection, especially in CNN-based models.

Multimodal RGB-HSI Feature Fusion with Patient-Aware Incremental Heuristic Meta-Learning for Oral Lesion Classification

Early detection of oral cancer and potentially malignant disorders is challenging in low-resource settings due to limited annotated data. We present a unified four-class oral lesion classifier that integrates deep RGB embeddings, hyperspectral reconstruction, handcrafted spectral-textural descriptors, and demographic metadata. A pathologist-verified subset of oral cavity images was curated and processed using a fine-tuned ConvNeXt-v2 encoder, followed by RGB-to-HSI reconstruction into 31-band hyperspectral cubes. Haemoglobin-sensitive indices, texture features, and spectral-shape measures were extracted and fused with deep and clinical features. Multiple machine-learning models were assessed with patient-wise validation. We further introduce an incremental heuristic meta-learner (IHML) that combines calibrated base classifiers through probabilistic stacking and patient-level posterior smoothing. On an unseen patient split, the proposed framework achieved a macro F1 of 66.23% and an accuracy of 64.56%. Results demonstrate that hyperspectral reconstruction and uncertainty-aware meta-learning substantially improve robustness for real-world oral lesion screening.

The Impact of Longitudinal Mammogram Alignment on Breast Cancer Risk Assessment

Regular mammography screening is crucial for early breast cancer detection. By leveraging deep learning-based risk models, screening intervals can be personalized, especially for high-risk individuals. While recent methods increasingly incorporate longitudinal information from prior mammograms, accurate spatial alignment across time points remains a key challenge. Misalignment can obscure meaningful tissue changes and degrade model performance. In this study, we provide insights into various alignment strategies, image-based registration, feature-level (representation space) alignment with and without regularization, and implicit alignment methods, for their effectiveness in longitudinal deep learning-based risk modeling. Using two large-scale mammography datasets, we assess each method across key metrics, including predictive accuracy, precision, recall, and deformation field quality. Our results show that image-based registration consistently outperforms the more recently favored feature-based and implicit approaches across all metrics, enabling more accurate, temporally consistent predictions and generating smooth, anatomically plausible deformation fields. Although regularizing the deformation field improves deformation quality, it reduces the risk prediction performance of feature-level alignment. Applying image-based deformation fields within the feature space yields the best risk prediction performance. These findings underscore the importance of image-based deformation fields for spatial alignment in longitudinal risk modeling, offering improved prediction accuracy and robustness. This approach has strong potential to enhance personalized screening and enable earlier interventions for high-risk individuals. The code is available at https://github.com/sot176/Mammogram_Alignment_Study_Risk_Prediction.git, allowing full reproducibility of the results.

EndoSight AI: Deep Learning-Driven Real-Time Gastrointestinal Polyp Detection and Segmentation for Enhanced Endoscopic Diagnostics

Precise and real-time detection of gastrointestinal polyps during endoscopic procedures is crucial for early diagnosis and prevention of colorectal cancer. This work presents EndoSight AI, a deep learning architecture developed and evaluated independently to enable accurate polyp localization and detailed boundary delineation. Leveraging the publicly available Hyper-Kvasir dataset, the system achieves a mean Average Precision (mAP) of 88.3% for polyp detection and a Dice coefficient of up to 69% for segmentation, alongside real-time inference speeds exceeding 35 frames per second on GPU hardware. The training incorporates clinically relevant performance metrics and a novel thermal-aware procedure to ensure model robustness and efficiency. This integrated AI solution is designed for seamless deployment in endoscopy workflows, promising to advance diagnostic accuracy and clinical decision-making in gastrointestinal healthcare.

H-CNN-ViT: A Hierarchical Gated Attention Multi-Branch Model for Bladder Cancer Recurrence Prediction

Bladder cancer is one of the most prevalent malignancies worldwide, with a recurrence rate of up to 78%, necessitating accurate post-operative monitoring for effective patient management. Multi-sequence contrast-enhanced MRI is commonly used for recurrence detection; however, interpreting these scans remains challenging, even for experienced radiologists, due to post-surgical alterations such as scarring, swelling, and tissue remodeling. AI-assisted diagnostic tools have shown promise in improving bladder cancer recurrence prediction, yet progress in this field is hindered by the lack of dedicated multi-sequence MRI datasets for recurrence assessment study. In this work, we first introduce a curated multi-sequence, multi-modal MRI dataset specifically designed for bladder cancer recurrence prediction, establishing a valuable benchmark for future research. We then propose H-CNN-ViT, a new Hierarchical Gated Attention Multi-Branch model that enables selective weighting of features from the global (ViT) and local (CNN) paths based on contextual demands, achieving a balanced and targeted feature fusion. Our multi-branch architecture processes each modality independently, ensuring that the unique properties of each imaging channel are optimally captured and integrated. Evaluated on our dataset, H-CNN-ViT achieves an AUC of 78.6%, surpassing state-of-the-art models. Our model is publicly available at https://github.com/XLIAaron/H-CNN-ViT.

A Second-Order Attention Mechanism For Prostate Cancer Segmentation and Detection in Bi-Parametric MRI

The detection of clinically significant prostate cancer lesions (csPCa) from biparametric magnetic resonance imaging (bp-MRI) has emerged as a noninvasive imaging technique for improving accurate diagnosis. Nevertheless, the analysis of such images remains highly dependent on the subjective expert interpretation. Deep learning approaches have been proposed for csPCa lesions detection and segmentation, but they remain limited due to their reliance on extensively annotated datasets. Moreover, the high lesion variability across prostate zones poses additional challenges, even for expert radiologists. This work introduces a second-order geometric attention (SOGA) mechanism that guides a dedicated segmentation network, through skip connections, to detect csPCa lesions. The proposed attention is modeled on the Riemannian manifold, learning from symmetric positive definitive (SPD) representations. The proposed mechanism was integrated into standard U-Net and nnU-Net backbones, and was validated on the publicly available PI-CAI dataset, achieving an Average Precision (AP) of 0.37 and an Area Under the ROC Curve (AUC-ROC) of 0.83, outperforming baseline networks and attention-based methods. Furthermore, the approach was evaluated on the Prostate158 dataset as an independent test cohort, achieving an AP of 0.37 and an AUC-ROC of 0.75, confirming robust generalization and suggesting discriminative learned representations.