Attention-Map Augmentation for Hypercomplex Breast Cancer Classification

Breast cancer is the most widespread neoplasm among women and early detection of this disease is critical. Deep learning techniques have become of great interest to improve diagnostic performance. Nonetheless, discriminating between malignant and benign masses from whole mammograms remains challenging due to them being almost identical to an untrained eye and the region of interest (ROI) occupying a minuscule portion of the entire image. In this paper, we propose a framework, parameterized hypercomplex attention maps (PHAM), to overcome these problems. Specifically, we deploy an augmentation step based on computing attention maps. Then, the attention maps are used to condition the classification step by constructing a multi-dimensional input comprised of the original breast cancer image and the corresponding attention map. In this step, a parameterized hypercomplex neural network (PHNN) is employed to perform breast cancer classification. The framework offers two main advantages. First, attention maps provide critical information regarding the ROI and allow the neural model to concentrate on it. Second, the hypercomplex architecture has the ability to model local relations between input dimensions thanks to hypercomplex algebra rules, thus properly exploiting the information provided by the attention map. We demonstrate the efficacy of the proposed framework on both mammography images as well as histopathological ones, surpassing attention-based state-of-the-art networks and the real-valued counterpart of our method. The code of our work is available at https://github.com/elelo22/AttentionBCS.

INCEPTNET: Precise And Early Disease Detection Application For Medical Images Analyses

In view of the recent paradigm shift in deep AI based image processing methods, medical image processing has advanced considerably. In this study, we propose a novel deep neural network (DNN), entitled InceptNet, in the scope of medical image processing, for early disease detection and segmentation of medical images in order to enhance precision and performance. We also investigate the interaction of users with the InceptNet application to present a comprehensive application including the background processes, and foreground interactions with users. Fast InceptNet is shaped by the prominent Unet architecture, and it seizes the power of an Inception module to be fast and cost effective while aiming to approximate an optimal local sparse structure. Adding Inception modules with various parallel kernel sizes can improve the network's ability to capture the variations in the scaled regions of interest. To experiment, the model is tested on four benchmark datasets, including retina blood vessel segmentation, lung nodule segmentation, skin lesion segmentation, and breast cancer cell detection. The improvement was more significant on images with small scale structures. The proposed method improved the accuracy from 0.9531, 0.8900, 0.9872, and 0.9881 to 0.9555, 0.9510, 0.9945, and 0.9945 on the mentioned datasets, respectively, which show outperforming of the proposed method over the previous works. Furthermore, by exploring the procedure from start to end, individuals who have utilized a trial edition of InceptNet, in the form of a complete application, are presented with thirteen multiple choice questions in order to assess the proposed method. The outcomes are evaluated through the means of Human Computer Interaction.

Cross-Shaped Windows Transformer with Self-supervised Pretraining for Clinically Significant Prostate Cancer Detection in Bi-parametric MRI

Multiparametric magnetic resonance imaging (mpMRI) has demonstrated promising results in prostate cancer (PCa) detection using deep convolutional neural networks (CNNs). Recently, transformers have achieved competitive performance compared to CNNs in computer vision. Large-scale transformers need abundant annotated data for training, which are difficult to obtain in medical imaging. Self-supervised learning can effectively leverage unlabeled data to extract useful semantic representations without annotation and its associated costs. This can improve model performance on downstream tasks with limited labelled data and increase generalizability. We introduce a novel end-to-end Cross-Shaped windows (CSwin) transformer UNet model, CSwin UNet, to detect clinically significant prostate cancer (csPCa) in prostate bi-parametric MR imaging (bpMRI) and demonstrate the effectiveness of our proposed self-supervised pre-training framework. Using a large prostate bpMRI dataset with 1500 patients, we first pre-train CSwin transformer using multi-task self-supervised learning to improve data-efficiency and network generalizability. We then finetuned using lesion annotations to perform csPCa detection. Five-fold cross validation shows that self-supervised CSwin UNet achieves 0.888 AUC and 0.545 Average Precision (AP), significantly outperforming four state-of-the-art models (Swin UNETR, DynUNet, Attention UNet, UNet). Using a separate bpMRI dataset with 158 patients, we evaluated our model robustness to external hold-out data. Self-supervised CSwin UNet achieves 0.79 AUC and 0.45 AP, still outperforming all other comparable methods and demonstrating generalization to a dataset shift.

Out-of-distribution multi-view auto-encoders for prostate cancer lesion detection

Traditional deep learning (DL) approaches based on supervised learning paradigms require large amounts of annotated data that are rarely available in the medical domain. Unsupervised Out-of-distribution (OOD) detection is an alternative that requires less annotated data. Further, OOD applications exploit the class skewness commonly present in medical data. Magnetic resonance imaging (MRI) has proven to be useful for prostate cancer (PCa) diagnosis and management, but current DL approaches rely on T2w axial MRI, which suffers from low out-of-plane resolution. We propose a multi-stream approach to accommodate different T2w directions to improve the performance of PCa lesion detection in an OOD approach. We evaluate our approach on a publicly available data-set, obtaining better detection results in terms of AUC when compared to a single direction approach (73.1 vs 82.3). Our results show the potential of OOD approaches for PCa lesion detection based on MRI.

Improving Image Quality of Sparse-view Lung Cancer CT Images with a Convolutional Neural Network

Purpose: To improve the image quality of sparse-view computed tomography (CT) images with a U-Net for lung cancer detection and to determine the best trade-off between number of views, image quality, and diagnostic confidence. Methods: CT images from 41 subjects (34 with lung cancer, seven healthy) were retrospectively selected (01.2016-12.2018) and forward projected onto 2048-view sinograms. Six corresponding sparse-view CT data subsets at varying levels of undersampling were reconstructed from sinograms using filtered backprojection with 16, 32, 64, 128, 256, and 512 views, respectively. A dual-frame U-Net was trained and evaluated for each subsampling level on 8,658 images from 22 diseased subjects. A representative image per scan was selected from 19 subjects (12 diseased, seven healthy) for a single-blinded reader study. The selected slices, for all levels of subsampling, with and without post-processing by the U-Net model, were presented to three readers. Image quality and diagnostic confidence were ranked using pre-defined scales. Subjective nodule segmentation was evaluated utilizing sensitivity (Se) and Dice Similarity Coefficient (DSC) with 95% confidence intervals (CI). Results: The 64-projection sparse-view images resulted in Se = 0.89 and DSC = 0.81 [0.75,0.86] while their counterparts, post-processed with the U-Net, had improved metrics (Se = 0.94, DSC = 0.85 [0.82,0.87]). Fewer views lead to insufficient quality for diagnostic purposes. For increased views, no substantial discrepancies were noted between the sparse-view and post-processed images. Conclusion: Projection views can be reduced from 2048 to 64 while maintaining image quality and the confidence of the radiologists on a satisfactory level.

The Whole Pathological Slide Classification via Weakly Supervised Learning

Due to its superior efficiency in utilizing annotations and addressing gigapixel-sized images, multiple instance learning (MIL) has shown great promise as a framework for whole slide image (WSI) classification in digital pathology diagnosis. However, existing methods tend to focus on advanced aggregators with different structures, often overlooking the intrinsic features of H\&E pathological slides. To address this limitation, we introduced two pathological priors: nuclear heterogeneity of diseased cells and spatial correlation of pathological tiles. Leveraging the former, we proposed a data augmentation method that utilizes stain separation during extractor training via a contrastive learning strategy to obtain instance-level representations. We then described the spatial relationships between the tiles using an adjacency matrix. By integrating these two views, we designed a multi-instance framework for analyzing H\&E-stained tissue images based on pathological inductive bias, encompassing feature extraction, filtering, and aggregation. Extensive experiments on the Camelyon16 breast dataset and TCGA-NSCLC Lung dataset demonstrate that our proposed framework can effectively handle tasks related to cancer detection and differentiation of subtypes, outperforming state-of-the-art medical image classification methods based on MIL. The code will be released later.

Swin-Tempo: Temporal-Aware Lung Nodule Detection in CT Scans as Video Sequences Using Swin Transformer-Enhanced UNet

Lung cancer is highly lethal, emphasizing the critical need for early detection. However, identifying lung nodules poses significant challenges for radiologists, who rely heavily on their expertise and experience for accurate diagnosis. To address this issue, computer-aided diagnosis systems based on machine learning techniques have emerged to assist doctors in identifying lung nodules from computed tomography (CT) scans. Unfortunately, existing networks in this domain often suffer from computational complexity, leading to high rates of false negatives and false positives, limiting their effectiveness. To address these challenges, we present an innovative model that harnesses the strengths of both convolutional neural networks and vision transformers. Inspired by object detection in videos, we treat each 3D CT image as a video, individual slices as frames, and lung nodules as objects, enabling a time-series application. The primary objective of our work is to overcome hardware limitations during model training, allowing for efficient processing of 2D data while utilizing inter-slice information for accurate identification based on 3D image context. We validated the proposed network by applying a 10-fold cross-validation technique to the publicly available Lung Nodule Analysis 2016 dataset. Our proposed architecture achieves an average sensitivity criterion of 97.84% and a competition performance metrics (CPM) of 96.0% with few parameters. Comparative analysis with state-of-the-art advancements in lung nodule identification demonstrates the significant accuracy achieved by our proposed model.

Cluster-Induced Mask Transformers for Effective Opportunistic Gastric Cancer Screening on Non-contrast CT Scans

Gastric cancer is the third leading cause of cancer-related mortality worldwide, but no guideline-recommended screening test exists. Existing methods can be invasive, expensive, and lack sensitivity to identify early-stage gastric cancer. In this study, we explore the feasibility of using a deep learning approach on non-contrast CT scans for gastric cancer detection. We propose a novel cluster-induced Mask Transformer that jointly segments the tumor and classifies abnormality in a multi-task manner. Our model incorporates learnable clusters that encode the texture and shape prototypes of gastric cancer, utilizing self- and cross-attention to interact with convolutional features. In our experiments, the proposed method achieves a sensitivity of 85.0% and specificity of 92.6% for detecting gastric tumors on a hold-out test set consisting of 100 patients with cancer and 148 normal. In comparison, two radiologists have an average sensitivity of 73.5% and specificity of 84.3%. We also obtain a specificity of 97.7% on an external test set with 903 normal cases. Our approach performs comparably to established state-of-the-art gastric cancer screening tools like blood testing and endoscopy, while also being more sensitive in detecting early-stage cancer. This demonstrates the potential of our approach as a novel, non-invasive, low-cost, and accurate method for opportunistic gastric cancer screening.

Automatic Endoscopic Ultrasound Station Recognition with Limited Data

Pancreatic cancer is a lethal form of cancer that significantly contributes to cancer-related deaths worldwide. Early detection is essential to improve patient prognosis and survival rates. Despite advances in medical imaging techniques, pancreatic cancer remains a challenging disease to detect. Endoscopic ultrasound (EUS) is the most effective diagnostic tool for detecting pancreatic cancer. However, it requires expert interpretation of complex ultrasound images to complete a reliable patient scan. To obtain complete imaging of the pancreas, practitioners must learn to guide the endoscope into multiple "EUS stations" (anatomical locations), which provide different views of the pancreas. This is a difficult skill to learn, involving over 225 proctored procedures with the support of an experienced doctor. We build an AI-assisted tool that utilizes deep learning techniques to identify these stations of the stomach in real time during EUS procedures. This computer-assisted diagnostic (CAD) will help train doctors more efficiently. Historically, the challenge faced in developing such a tool has been the amount of retrospective labeling required by trained clinicians. To solve this, we developed an open-source user-friendly labeling web app that streamlines the process of annotating stations during the EUS procedure with minimal effort from the clinicians. Our research shows that employing only 43 procedures with no hyperparameter fine-tuning obtained a balanced accuracy of 90%, comparable to the current state of the art. In addition, we employ Grad-CAM, a visualization technology that provides clinicians with interpretable and explainable visualizations.

Design and Development of a Novel Soft and Inflatable Tactile Sensing Balloon for Early Diagnosis of Colorectal Cancer Polyps

In this paper, with the goal of addressing the high early-detection miss rate of colorectal cancer (CRC) polyps during a colonoscopy procedure, we propose the design and fabrication of a unique inflatable vision-based tactile sensing balloon (VTSB). The proposed soft VTSB can readily be integrated with the existing colonoscopes and provide a radiation-free, safe, and high-resolution textural mapping and morphology characterization of CRC polyps. The performance of the proposed VTSB has been thoroughly characterized and evaluated on four different types of additively manufactured CRC polyp phantoms with three different stiffness levels. Additionally, we integrated the VTSB with a colonoscope and successfully performed a simulated colonoscopic procedure inside a tube with a few CRC polyp phantoms attached to its internal surface.