Dynamic Contextual Attention Network: Transforming Spatial Representations into Adaptive Insights for Endoscopic Polyp Diagnosis

Colorectal polyps are key indicators for early detection of colorectal cancer. However, traditional endoscopic imaging often struggles with accurate polyp localization and lacks comprehensive contextual awareness, which can limit the explainability of diagnoses. To address these issues, we propose the Dynamic Contextual Attention Network (DCAN). This novel approach transforms spatial representations into adaptive contextual insights, using an attention mechanism that enhances focus on critical polyp regions without explicit localization modules. By integrating contextual awareness into the classification process, DCAN improves decision interpretability and overall diagnostic performance. This advancement in imaging could lead to more reliable colorectal cancer detection, enabling better patient outcomes.

Mitigating Catastrophic Forgetting in the Incremental Learning of Medical Images

This paper proposes an Incremental Learning (IL) approach to enhance the accuracy and efficiency of deep learning models in analyzing T2-weighted (T2w) MRI medical images prostate cancer detection using the PI-CAI dataset. We used multiple health centers' artificial intelligence and radiology data, focused on different tasks that looked at prostate cancer detection using MRI (PI-CAI). We utilized Knowledge Distillation (KD), as it employs generated images from past tasks to guide the training of models for subsequent tasks. The approach yielded improved performance and faster convergence of the models. To demonstrate the versatility and robustness of our approach, we evaluated it on the PI-CAI dataset, a diverse set of medical imaging modalities including OCT and PathMNIST, and the benchmark continual learning dataset CIFAR-10. Our results indicate that KD can be a promising technique for IL in medical image analysis in which data is sourced from individual health centers and the storage of large datasets is not feasible. By using generated images from prior tasks, our method enables the model to retain and apply previously acquired knowledge without direct access to the original data.

The Application of Deep Learning for Lymph Node Segmentation: A Systematic Review

Automatic lymph node segmentation is the cornerstone for advances in computer vision tasks for early detection and staging of cancer. Traditional segmentation methods are constrained by manual delineation and variability in operator proficiency, limiting their ability to achieve high accuracy. The introduction of deep learning technologies offers new possibilities for improving the accuracy of lymph node image analysis. This study evaluates the application of deep learning in lymph node segmentation and discusses the methodologies of various deep learning architectures such as convolutional neural networks, encoder-decoder networks, and transformers in analyzing medical imaging data across different modalities. Despite the advancements, it still confronts challenges like the shape diversity of lymph nodes, the scarcity of accurately labeled datasets, and the inadequate development of methods that are robust and generalizable across different imaging modalities. To the best of our knowledge, this is the first study that provides a comprehensive overview of the application of deep learning techniques in lymph node segmentation task. Furthermore, this study also explores potential future research directions, including multimodal fusion techniques, transfer learning, and the use of large-scale pre-trained models to overcome current limitations while enhancing cancer diagnosis and treatment planning strategies.

Towards order of magnitude X-ray dose reduction in breast cancer imaging using phase contrast and deep denoising

Breast cancer is the most frequently diagnosed human cancer in the United States at present. Early detection is crucial for its successful treatment. X-ray mammography and digital breast tomosynthesis are currently the main methods for breast cancer screening. However, both have known limitations in terms of their sensitivity and specificity to breast cancers, while also frequently causing patient discomfort due to the requirement for breast compression. Breast computed tomography is a promising alternative, however, to obtain high-quality images, the X-ray dose needs to be sufficiently high. As the breast is highly radiosensitive, dose reduction is particularly important. Phase-contrast computed tomography (PCT) has been shown to produce higher-quality images at lower doses and has no need for breast compression. It is demonstrated in the present study that, when imaging full fresh mastectomy samples with PCT, deep learning-based image denoising can further reduce the radiation dose by a factor of 16 or more, without any loss of image quality. The image quality has been assessed both in terms of objective metrics, such as spatial resolution and contrast-to-noise ratio, as well as in an observer study by experienced medical imaging specialists and radiologists. This work was carried out in preparation for live patient PCT breast cancer imaging, initially at specialized synchrotron facilities.

An Inclusive Foundation Model for Generalizable Cytogenetics in Precision Oncology

Chromosome analysis is vital for diagnosing genetic disorders and guiding cancer therapy decisions through the identification of somatic clonal aberrations. However, developing an AI model are hindered by the overwhelming complexity and diversity of chromosomal abnormalities, requiring extensive annotation efforts, while automated methods remain task-specific and lack generalizability due to the scarcity of comprehensive datasets spanning diverse resource conditions. Here, we introduce CHROMA, a foundation model for cytogenomics, designed to overcome these challenges by learning generalizable representations of chromosomal abnormalities. Pre-trained on over 84,000 specimens (~4 million chromosomal images) via self-supervised learning, CHROMA outperforms other methods across all types of abnormalities, even when trained on fewer labelled data and more imbalanced datasets. By facilitating comprehensive mapping of instability and clonal leisons across various aberration types, CHROMA offers a scalable and generalizable solution for reliable and automated clinical analysis, reducing the annotation workload for experts and advancing precision oncology through the early detection of rare genomic abnormalities, enabling broad clinical AI applications and making advanced genomic analysis more accessible.

Automated Quality Evaluation of Cervical Cytopathology Whole Slide Images Based on Content Analysis

The ThinPrep Cytologic Test (TCT) is the most widely used method for cervical cancer screening, and the sample quality directly impacts the accuracy of the diagnosis. Traditional manual evaluation methods rely on the observation of pathologist under microscopes. These methods exhibit high subjectivity, high cost, long duration, and low reliability. With the development of computer-aided diagnosis (CAD), an automated quality assessment system that performs at the level of a professional pathologist is necessary. To address this need, we propose a fully automated quality assessment method for Cervical Cytopathology Whole Slide Images (WSIs) based on The Bethesda System (TBS) diagnostic standards, artificial intelligence algorithms, and the characteristics of clinical data. The method analysis the context of WSIs to quantify quality evaluation metrics which are focused by TBS such as staining quality, cell counts and cell mass proportion through multiple models including object detection, classification and segmentation. Subsequently, the XGBoost model is used to mine the attention paid by pathologists to different quality evaluation metrics when evaluating samples, thereby obtaining a comprehensive WSI sample score calculation model. Experimental results on 100 WSIs demonstrate that the proposed evaluation method has significant advantages in terms of speed and consistency.

Robustness and sex differences in skin cancer detection: logistic regression vs CNNs

Deep learning has been reported to achieve high performances in the detection of skin cancer, yet many challenges regarding the reproducibility of results and biases remain. This study is a replication (different data, same analysis) of a study on Alzheimer's disease [28] which studied robustness of logistic regression (LR) and convolutional neural networks (CNN) across patient sexes. We explore sex bias in skin cancer detection, using the PAD-UFES-20 dataset with LR trained on handcrafted features reflecting dermatological guidelines (ABCDE and the 7-point checklist), and a pre-trained ResNet-50 model. We evaluate these models in alignment with [28]: across multiple training datasets with varied sex composition to determine their robustness. Our results show that both the LR and the CNN were robust to the sex distributions, but the results also revealed that the CNN had a significantly higher accuracy (ACC) and area under the receiver operating characteristics (AUROC) for male patients than for female patients. We hope these findings to contribute to the growing field of investigating potential bias in popular medical machine learning methods. The data and relevant scripts to reproduce our results can be found in our Github.

CLIP-IT: CLIP-based Pairing for Histology Images Classification

Multimodal learning has shown significant promise for improving medical image analysis by integrating information from complementary data sources. This is widely employed for training vision-language models (VLMs) for cancer detection based on histology images and text reports. However, one of the main limitations in training these VLMs is the requirement for large paired datasets, raising concerns over privacy, and data collection, annotation, and maintenance costs. To address this challenge, we introduce CLIP-IT method to train a vision backbone model to classify histology images by pairing them with privileged textual information from an external source. At first, the modality pairing step relies on a CLIP-based model to match histology images with semantically relevant textual report data from external sources, creating an augmented multimodal dataset without the need for manually paired samples. Then, we propose a multimodal training procedure that distills the knowledge from the paired text modality to the unimodal image classifier for enhanced performance without the need for the textual data during inference. A parameter-efficient fine-tuning method is used to efficiently address the misalignment between the main (image) and paired (text) modalities. During inference, the improved unimodal histology classifier is used, with only minimal additional computational complexity. Our experiments on challenging PCAM, CRC, and BACH histology image datasets show that CLIP-IT can provide a cost-effective approach to leverage privileged textual information and outperform unimodal classifiers for histology.

MSAD-Net: Multiscale and Spatial Attention-based Dense Network for Lung Cancer Classification

Lung cancer, a severe form of malignant tumor that originates in the tissues of the lungs, can be fatal if not detected in its early stages. It ranks among the top causes of cancer-related mortality worldwide. Detecting lung cancer manually using chest X-Ray image or Computational Tomography (CT) scans image poses significant challenges for radiologists. Hence, there is a need for automatic diagnosis system of lung cancers from radiology images. With the recent emergence of deep learning, particularly through Convolutional Neural Networks (CNNs), the automated detection of lung cancer has become a much simpler task. Nevertheless, numerous researchers have addressed that the performance of conventional CNNs may be hindered due to class imbalance issue, which is prevalent in medical images. In this research work, we have proposed a novel CNN architecture ``Multi-Scale Dense Network (MSD-Net)'' (trained-from-scratch). The novelties we bring in the proposed model are (I) We introduce novel dense modules in the 4th block and 5th block of the CNN model. We have leveraged 3 depthwise separable convolutional (DWSC) layers, and one 1x1 convolutional layer in each dense module, in order to reduce complexity of the model considerably. (II) Additionally, we have incorporated one skip connection from 3rd block to 5th block and one parallel branch connection from 4th block to Global Average Pooling (GAP) layer. We have utilized dilated convolutional layer (with dilation rate=2) in the last parallel branch in order to extract multi-scale features. Extensive experiments reveal that our proposed model has outperformed latest CNN model ConvNext-Tiny, recent trend Vision Transformer (ViT), Pooling-based ViT (PiT), and other existing models by significant margins.

Efficient Parameter Adaptation for Multi-Modal Medical Image Segmentation and Prognosis

Cancer detection and prognosis relies heavily on medical imaging, particularly CT and PET scans. Deep Neural Networks (DNNs) have shown promise in tumor segmentation by fusing information from these modalities. However, a critical bottleneck exists: the dependency on CT-PET data concurrently for training and inference, posing a challenge due to the limited availability of PET scans. Hence, there is a clear need for a flexible and efficient framework that can be trained with the widely available CT scans and can be still adapted for PET scans when they become available. In this work, we propose a parameter-efficient multi-modal adaptation (PEMMA) framework for lightweight upgrading of a transformer-based segmentation model trained only on CT scans such that it can be efficiently adapted for use with PET scans when they become available. This framework is further extended to perform prognosis task maintaining the same efficient cross-modal fine-tuning approach. The proposed approach is tested with two well-known segementation backbones, namely UNETR and Swin UNETR. Our approach offers two main advantages. Firstly, we leverage the inherent modularity of the transformer architecture and perform low-rank adaptation (LoRA) as well as decomposed low-rank adaptation (DoRA) of the attention weights to achieve parameter-efficient adaptation. Secondly, by minimizing cross-modal entanglement, PEMMA allows updates using only one modality without causing catastrophic forgetting in the other. Our method achieves comparable performance to early fusion, but with only 8% of the trainable parameters, and demonstrates a significant +28% Dice score improvement on PET scans when trained with a single modality. Furthermore, in prognosis, our method improves the concordance index by +10% when adapting a CT-pretrained model to include PET scans, and by +23% when adapting for both PET and EHR data.