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.

Detecting the Sensing Area of A Laparoscopic Probe in Minimally Invasive Cancer Surgery

In surgical oncology, it is challenging for surgeons to identify lymph nodes and completely resect cancer even with pre-operative imaging systems like PET and CT, because of the lack of reliable intraoperative visualization tools. Endoscopic radio-guided cancer detection and resection has recently been evaluated whereby a novel tethered laparoscopic gamma detector is used to localize a preoperatively injected radiotracer. This can both enhance the endoscopic imaging and complement preoperative nuclear imaging data. However, gamma activity visualization is challenging to present to the operator because the probe is non-imaging and it does not visibly indicate the activity origination on the tissue surface. Initial failed attempts used segmentation or geometric methods, but led to the discovery that it could be resolved by leveraging high-dimensional image features and probe position information. To demonstrate the effectiveness of this solution, we designed and implemented a simple regression network that successfully addressed the problem. To further validate the proposed solution, we acquired and publicly released two datasets captured using a custom-designed, portable stereo laparoscope system. Through intensive experimentation, we demonstrated that our method can successfully and effectively detect the sensing area, establishing a new performance benchmark. Code and data are available at https://github.com/br0202/Sensing_area_detection.git

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.

FLDNet: A Foreground-Aware Network for Polyp Segmentation Leveraging Long-Distance Dependencies

Given the close association between colorectal cancer and polyps, the diagnosis and identification of colorectal polyps play a critical role in the detection and surgical intervention of colorectal cancer. In this context, the automatic detection and segmentation of polyps from various colonoscopy images has emerged as a significant problem that has attracted broad attention. Current polyp segmentation techniques face several challenges: firstly, polyps vary in size, texture, color, and pattern; secondly, the boundaries between polyps and mucosa are usually blurred, existing studies have focused on learning the local features of polyps while ignoring the long-range dependencies of the features, and also ignoring the local context and global contextual information of the combined features. To address these challenges, we propose FLDNet (Foreground-Long-Distance Network), a Transformer-based neural network that captures long-distance dependencies for accurate polyp segmentation. Specifically, the proposed model consists of three main modules: a pyramid-based Transformer encoder, a local context module, and a foreground-Aware module. Multilevel features with long-distance dependency information are first captured by the pyramid-based transformer encoder. On the high-level features, the local context module obtains the local characteristics related to the polyps by constructing different local context information. The coarse map obtained by decoding the reconstructed highest-level features guides the feature fusion process in the foreground-Aware module of the high-level features to achieve foreground enhancement of the polyps. Our proposed method, FLDNet, was evaluated using seven metrics on common datasets and demonstrated superiority over state-of-the-art methods on widely-used evaluation measures.

Exploring Regions of Interest: Visualizing Histological Image Classification for Breast Cancer using Deep Learning

Computer aided detection and diagnosis systems based on deep learning have shown promising performance in breast cancer detection. However, there are cases where the obtained results lack justification. In this study, our objective is to highlight the regions of interest used by a convolutional neural network (CNN) for classifying histological images as benign or malignant. We compare these regions with the regions identified by pathologists. To achieve this, we employed the VGG19 architecture and tested three visualization methods: Gradient, LRP Z, and LRP Epsilon. Additionally, we experimented with three pixel selection methods: Bins, K-means, and MeanShift. Based on the results obtained, the Gradient visualization method and the MeanShift selection method yielded satisfactory outcomes for visualizing the images.

Metastatic Breast Cancer Prognostication Through Multimodal Integration of Dimensionality Reduction Algorithms and Classification Algorithms

Machine learning (ML) is a branch of Artificial Intelligence (AI) where computers analyze data and find patterns in the data. The study focuses on the detection of metastatic cancer using ML. Metastatic cancer is the point where the cancer has spread to other parts of the body and is the cause of approximately 90% of cancer related deaths. Normally, pathologists spend hours each day to manually classify whether tumors are benign or malignant. This tedious task contributes to mislabeling metastasis being over 60% of time and emphasizes the importance to be aware of human error, and other inefficiencies. ML is a good candidate to improve the correct identification of metastatic cancer saving thousands of lives and can also improve the speed and efficiency of the process thereby taking less resources and time. So far, deep learning methodology of AI has been used in the research to detect cancer. This study is a novel approach to determine the potential of using preprocessing algorithms combined with classification algorithms in detecting metastatic cancer. The study used two preprocessing algorithms: principal component analysis (PCA) and the genetic algorithm to reduce the dimensionality of the dataset, and then used three classification algorithms: logistic regression, decision tree classifier, and k-nearest neighbors to detect metastatic cancer in the pathology scans. The highest accuracy of 71.14% was produced by the ML pipeline comprising of PCA, the genetic algorithm, and the k-nearest neighbors algorithm, suggesting that preprocessing and classification algorithms have great potential for detecting metastatic cancer.

Early Detection and Localization of Pancreatic Cancer by Label-Free Tumor Synthesis

Early detection and localization of pancreatic cancer can increase the 5-year survival rate for patients from 8.5% to 20%. Artificial intelligence (AI) can potentially assist radiologists in detecting pancreatic tumors at an early stage. Training AI models require a vast number of annotated examples, but the availability of CT scans obtaining early-stage tumors is constrained. This is because early-stage tumors may not cause any symptoms, which can delay detection, and the tumors are relatively small and may be almost invisible to human eyes on CT scans. To address this issue, we develop a tumor synthesis method that can synthesize enormous examples of small pancreatic tumors in the healthy pancreas without the need for manual annotation. Our experiments demonstrate that the overall detection rate of pancreatic tumors, measured by Sensitivity and Specificity, achieved by AI trained on synthetic tumors is comparable to that of real tumors. More importantly, our method shows a much higher detection rate for small tumors. We further investigate the per-voxel segmentation performance of pancreatic tumors if AI is trained on a combination of CT scans with synthetic tumors and CT scans with annotated large tumors at an advanced stage. Finally, we show that synthetic tumors improve AI generalizability in tumor detection and localization when processing CT scans from different hospitals. Overall, our proposed tumor synthesis method has immense potential to improve the early detection of pancreatic cancer, leading to better patient outcomes.

Synthesis of Contrast-Enhanced Breast MRI Using Multi-b-Value DWI-based Hierarchical Fusion Network with Attention Mechanism

Magnetic resonance imaging (MRI) is the most sensitive technique for breast cancer detection among current clinical imaging modalities. Contrast-enhanced MRI (CE-MRI) provides superior differentiation between tumors and invaded healthy tissue, and has become an indispensable technique in the detection and evaluation of cancer. However, the use of gadolinium-based contrast agents (GBCA) to obtain CE-MRI may be associated with nephrogenic systemic fibrosis and may lead to bioaccumulation in the brain, posing a potential risk to human health. Moreover, and likely more important, the use of gadolinium-based contrast agents requires the cannulation of a vein, and the injection of the contrast media which is cumbersome and places a burden on the patient. To reduce the use of contrast agents, diffusion-weighted imaging (DWI) is emerging as a key imaging technique, although currently usually complementing breast CE-MRI. In this study, we develop a multi-sequence fusion network to synthesize CE-MRI based on T1-weighted MRI and DWIs. DWIs with different b-values are fused to efficiently utilize the difference features of DWIs. Rather than proposing a pure data-driven approach, we invent a multi-sequence attention module to obtain refined feature maps, and leverage hierarchical representation information fused at different scales while utilizing the contributions from different sequences from a model-driven approach by introducing the weighted difference module. The results show that the multi-b-value DWI-based fusion model can potentially be used to synthesize CE-MRI, thus theoretically reducing or avoiding the use of GBCA, thereby minimizing the burden to patients. Our code is available at \url{https://github.com/Netherlands-Cancer-Institute/CE-MRI}.

A Combined PCA-MLP Network for Early Breast Cancer Detection

Breast cancer is the second most responsible for all cancer types and has been the cause of numerous deaths over the years, especially among women. Any improvisation of the existing diagnosis system for the detection of cancer can contribute to minimizing the death ratio. Moreover, cancer detection at an early stage has recently been a prime research area in the scientific community to enhance the survival rate. Proper choice of machine learning tools can ensure early-stage prognosis with high accuracy. In this paper, we have studied different machine learning algorithms to detect whether a patient is likely to face breast cancer or not. Due to the implicit behavior of early-stage features, we have implemented a multilayer perception model with the integration of PCA and suggested it to be more viable than other detection algorithms. Our 4 layers MLP-PCA network has obtained the best accuracy of 100% with a mean of 90.48% accuracy on the BCCD dataset.