Mitigating Multi-Sequence 3D Prostate MRI Data Scarcity through Domain Adaptation using Locally-Trained Latent Diffusion Models for Prostate Cancer Detection

Objective: Latent diffusion models (LDMs) could mitigate data scarcity challenges affecting machine learning development for medical image interpretation. The recent CCELLA LDM improved prostate cancer detection performance using synthetic MRI for classifier training but was limited to the axial T2-weighted (AxT2) sequence, did not investigate inter-institutional domain shift, and prioritized radiology over histopathology outcomes. We propose CCELLA++ to address these limitations and improve clinical utility. Methods: CCELLA++ expands CCELLA for simultaneous biparametric prostate MRI (bpMRI) generation, including the AxT2, high b-value diffusion series (HighB) and apparent diffusion coefficient map (ADC). Domain adaptation was investigated by pretraining classifiers on real or LDM-generated synthetic data from an internal institution, followed with fine-tuning on progressively smaller fractions of an out-of-distribution, external dataset. Results: CCELLA++ improved 3D FID for HighB and ADC but not AxT2 (0.013, 0.012, 0.063 respectively) sequences compared to CCELLA (0.060). Classifier pretraining with CCELLA++ bpMRI outperformed real bpMRI in AP and AUC for all domain adaptation scenarios. CCELLA++ pretraining achieved highest classifier performance below 50% (n=665) external dataset volume. Conclusion: Synthetic bpMRI generated by our method can improve downstream classifier generalization and performance beyond real bpMRI or CCELLA-generated AxT2-only images. Future work should seek to quantify medical image sample quality, balance multi-sequence LDM training, and condition the LDM with additional information. Significance: The proposed CCELLA++ LDM can generate synthetic bpMRI that outperforms real data for domain adaptation with a limited target institution dataset. Our code is available at https://github.com/grabkeem/CCELLA-plus-plus

Towards Human-AI Collaboration System for the Detection of Invasive Ductal Carcinoma in Histopathology Images

Invasive ductal carcinoma (IDC) is the most prevalent form of breast cancer, and early, accurate diagnosis is critical to improving patient survival rates by guiding treatment decisions. Combining medical expertise with artificial intelligence (AI) holds significant promise for enhancing the precision and efficiency of IDC detection. In this work, we propose a human-in-the-loop (HITL) deep learning system designed to detect IDC in histopathology images. The system begins with an initial diagnosis provided by a high-performance EfficientNetV2S model, offering feedback from AI to the human expert. Medical professionals then review the AI-generated results, correct any misclassified images, and integrate the revised labels into the training dataset, forming a feedback loop from the human back to the AI. This iterative process refines the model's performance over time. The EfficientNetV2S model itself achieves state-of-the-art performance compared to existing methods in the literature, with an overall accuracy of 93.65\%. Incorporating the human-in-the-loop system further improves the model's accuracy using four experimental groups with misclassified images. These results demonstrate the potential of this collaborative approach to enhance AI performance in diagnostic systems. This work contributes to advancing automated, efficient, and highly accurate methods for IDC detection through human-AI collaboration, offering a promising direction for future AI-assisted medical diagnostics.

MyGO: Make your Goals Obvious, Avoiding Semantic Confusion in Prostate Cancer Lesion Region Segmentation

Early diagnosis and accurate identification of lesion location and progression in prostate cancer (PCa) are critical for assisting clinicians in formulating effective treatment strategies. However, due to the high semantic homogeneity between lesion and non-lesion areas, existing medical image segmentation methods often struggle to accurately comprehend lesion semantics, resulting in the problem of semantic confusion. To address this challenge, we propose a novel Pixel Anchor Module, which guides the model to discover a sparse set of feature anchors that serve to capture and interpret global contextual information. This mechanism enhances the model's nonlinear representation capacity and improves segmentation accuracy within lesion regions. Moreover, we design a self-attention-based Top_k selection strategy to further refine the identification of these feature anchors, and incorporate a focal loss function to mitigate class imbalance, thereby facilitating more precise semantic interpretation across diverse regions. Our method achieves state-of-the-art performance on the PI-CAI dataset, demonstrating 69.73% IoU and 74.32% Dice scores, and significantly improving prostate cancer lesion detection.

Towards Comprehensive Cellular Characterisation of H&E slides

Cell detection, segmentation and classification are essential for analyzing tumor microenvironments (TME) on hematoxylin and eosin (H&E) slides. Existing methods suffer from poor performance on understudied cell types (rare or not present in public datasets) and limited cross-domain generalization. To address these shortcomings, we introduce HistoPLUS, a state-of-the-art model for cell analysis, trained on a novel curated pan-cancer dataset of 108,722 nuclei covering 13 cell types. In external validation across 4 independent cohorts, HistoPLUS outperforms current state-of-the-art models in detection quality by 5.2% and overall F1 classification score by 23.7%, while using 5x fewer parameters. Notably, HistoPLUS unlocks the study of 7 understudied cell types and brings significant improvements on 8 of 13 cell types. Moreover, we show that HistoPLUS robustly transfers to two oncology indications unseen during training. To support broader TME biomarker research, we release the model weights and inference code at https://github.com/owkin/histoplus/.

A computationally frugal open-source foundation model for thoracic disease detection in lung cancer screening programs

Low-dose computed tomography (LDCT) imaging employed in lung cancer screening (LCS) programs is increasing in uptake worldwide. LCS programs herald a generational opportunity to simultaneously detect cancer and non-cancer-related early-stage lung disease. Yet these efforts are hampered by a shortage of radiologists to interpret scans at scale. Here, we present TANGERINE, a computationally frugal, open-source vision foundation model for volumetric LDCT analysis. Designed for broad accessibility and rapid adaptation, TANGERINE can be fine-tuned off the shelf for a wide range of disease-specific tasks with limited computational resources and training data. Relative to models trained from scratch, TANGERINE demonstrates fast convergence during fine-tuning, thereby requiring significantly fewer GPU hours, and displays strong label efficiency, achieving comparable or superior performance with a fraction of fine-tuning data. Pretrained using self-supervised learning on over 98,000 thoracic LDCTs, including the UK's largest LCS initiative to date and 27 public datasets, TANGERINE achieves state-of-the-art performance across 14 disease classification tasks, including lung cancer and multiple respiratory diseases, while generalising robustly across diverse clinical centres. By extending a masked autoencoder framework to 3D imaging, TANGERINE offers a scalable solution for LDCT analysis, departing from recent closed, resource-intensive models by combining architectural simplicity, public availability, and modest computational requirements. Its accessible, open-source lightweight design lays the foundation for rapid integration into next-generation medical imaging tools that could transform LCS initiatives, allowing them to pivot from a singular focus on lung cancer detection to comprehensive respiratory disease management in high-risk populations.

Attention-Enhanced Deep Learning Ensemble for Breast Density Classification in Mammography

Breast density assessment is a crucial component of mammographic interpretation, with high breast density (BI-RADS categories C and D) representing both a significant risk factor for developing breast cancer and a technical challenge for tumor detection. This study proposes an automated deep learning system for robust binary classification of breast density (low: A/B vs. high: C/D) using the VinDr-Mammo dataset. We implemented and compared four advanced convolutional neural networks: ResNet18, ResNet50, EfficientNet-B0, and DenseNet121, each enhanced with channel attention mechanisms. To address the inherent class imbalance, we developed a novel Combined Focal Label Smoothing Loss function that integrates focal loss, label smoothing, and class-balanced weighting. Our preprocessing pipeline incorporated advanced techniques, including contrast-limited adaptive histogram equalization (CLAHE) and comprehensive data augmentation. The individual models were combined through an optimized ensemble voting approach, achieving superior performance (AUC: 0.963, F1-score: 0.952) compared to any single model. This system demonstrates significant potential to standardize density assessments in clinical practice, potentially improving screening efficiency and early cancer detection rates while reducing inter-observer variability among radiologists.

Cyst-X: AI-Powered Pancreatic Cancer Risk Prediction from Multicenter MRI in Centralized and Federated Learning

Pancreatic cancer is projected to become the second-deadliest malignancy in Western countries by 2030, highlighting the urgent need for better early detection. Intraductal papillary mucinous neoplasms (IPMNs), key precursors to pancreatic cancer, are challenging to assess with current guidelines, often leading to unnecessary surgeries or missed malignancies. We present Cyst-X, an AI framework that predicts IPMN malignancy using multicenter MRI data, leveraging MRI's superior soft tissue contrast over CT. Trained on 723 T1- and 738 T2-weighted scans from 764 patients across seven institutions, our models (AUC=0.82) significantly outperform both Kyoto guidelines (AUC=0.75) and expert radiologists. The AI-derived imaging features align with known clinical markers and offer biologically meaningful insights. We also demonstrate strong performance in a federated learning setting, enabling collaborative training without sharing patient data. To promote privacy-preserving AI development and improve IPMN risk stratification, the Cyst-X dataset is released as the first large-scale, multi-center pancreatic cysts MRI dataset.

UGPL: Uncertainty-Guided Progressive Learning for Evidence-Based Classification in Computed Tomography

Accurate classification of computed tomography (CT) images is essential for diagnosis and treatment planning, but existing methods often struggle with the subtle and spatially diverse nature of pathological features. Current approaches typically process images uniformly, limiting their ability to detect localized abnormalities that require focused analysis. We introduce UGPL, an uncertainty-guided progressive learning framework that performs a global-to-local analysis by first identifying regions of diagnostic ambiguity and then conducting detailed examination of these critical areas. Our approach employs evidential deep learning to quantify predictive uncertainty, guiding the extraction of informative patches through a non-maximum suppression mechanism that maintains spatial diversity. This progressive refinement strategy, combined with an adaptive fusion mechanism, enables UGPL to integrate both contextual information and fine-grained details. Experiments across three CT datasets demonstrate that UGPL consistently outperforms state-of-the-art methods, achieving improvements of 3.29%, 2.46%, and 8.08% in accuracy for kidney abnormality, lung cancer, and COVID-19 detection, respectively. Our analysis shows that the uncertainty-guided component provides substantial benefits, with performance dramatically increasing when the full progressive learning pipeline is implemented. Our code is available at: https://github.com/shravan-18/UGPL

EndoFinder: Online Lesion Retrieval for Explainable Colorectal Polyp Diagnosis Leveraging Latent Scene Representations

Colorectal cancer (CRC) remains a leading cause of cancer-related mortality, underscoring the importance of timely polyp detection and diagnosis. While deep learning models have improved optical-assisted diagnostics, they often demand extensive labeled datasets and yield "black-box" outputs with limited interpretability. In this paper, we propose EndoFinder, an online polyp retrieval framework that leverages multi-view scene representations for explainable and scalable CRC diagnosis. First, we develop a Polyp-aware Image Encoder by combining contrastive learning and a reconstruction task, guided by polyp segmentation masks. This self-supervised approach captures robust features without relying on large-scale annotated data. Next, we treat each polyp as a three-dimensional "scene" and introduce a Scene Representation Transformer, which fuses multiple views of the polyp into a single latent representation. By discretizing this representation through a hashing layer, EndoFinder enables real-time retrieval from a compiled database of historical polyp cases, where diagnostic information serves as interpretable references for new queries. We evaluate EndoFinder on both public and newly collected polyp datasets for re-identification and pathology classification. Results show that EndoFinder outperforms existing methods in accuracy while providing transparent, retrieval-based insights for clinical decision-making. By contributing a novel dataset and a scalable, explainable framework, our work addresses key challenges in polyp diagnosis and offers a promising direction for more efficient AI-driven colonoscopy workflows. The source code is available at https://github.com/ku262/EndoFinder-Scene.

Reconsidering Explicit Longitudinal Mammography Alignment for Enhanced Breast Cancer Risk Prediction

Regular mammography screening is essential for early breast cancer detection. Deep learning-based risk prediction methods have sparked interest to adjust screening intervals for high-risk groups. While early methods focused only on current mammograms, recent approaches leverage the temporal aspect of screenings to track breast tissue changes over time, requiring spatial alignment across different time points. Two main strategies for this have emerged: explicit feature alignment through deformable registration and implicit learned alignment using techniques like transformers, with the former providing more control. However, the optimal approach for explicit alignment in mammography remains underexplored. In this study, we provide insights into where explicit alignment should occur (input space vs. representation space) and if alignment and risk prediction should be jointly optimized. We demonstrate that jointly learning explicit alignment in representation space while optimizing risk estimation performance, as done in the current state-of-the-art approach, results in a trade-off between alignment quality and predictive performance and show that image-level alignment is superior to representation-level alignment, leading to better deformation field quality and enhanced risk prediction accuracy. The code is available at https://github.com/sot176/Longitudinal_Mammogram_Alignment.git.