In the cancer diagnosis pipeline, digital pathology plays an instrumental role in the identification, staging, and grading of malignant areas on biopsy tissue specimens. High resolution histology images are subject to high variance in appearance, sourcing either from the acquisition devices or the H\&E staining process. Nuclei segmentation is an important task, as it detects the nuclei cells over background tissue and gives rise to the topology, size, and count of nuclei which are determinant factors for cancer detection. Yet, it is a fairly time consuming task for pathologists, with reportedly high subjectivity. Computer Aided Diagnosis (CAD) tools empowered by modern Artificial Intelligence (AI) models enable the automation of nuclei segmentation. This can reduce the subjectivity in analysis and reading time. This paper provides an extensive review, beginning from earlier works use traditional image processing techniques and reaching up to modern approaches following the Deep Learning (DL) paradigm. Our review also focuses on the weak supervision aspect of the problem, motivated by the fact that annotated data is scarce. At the end, the advantages of different models and types of supervision are thoroughly discussed. Furthermore, we try to extrapolate and envision how future research lines will potentially be, so as to minimize the need for labeled data while maintaining high performance. Future methods should emphasize efficient and explainable models with a transparent underlying process so that physicians can trust their output.
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 for accurate diagnosis. To address this issue, computer-aided diagnosis (CAD) 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.
Accurate detection of oral cancer is crucial for improving patient outcomes. However, the field faces two key challenges: the scarcity of deep learning-based image segmentation research specifically targeting oral cancer and the lack of annotated data. Our study proposes OCU-Net, a pioneering U-Net image segmentation architecture exclusively designed to detect oral cancer in hematoxylin and eosin (H&E) stained image datasets. OCU-Net incorporates advanced deep learning modules, such as the Channel and Spatial Attention Fusion (CSAF) module, a novel and innovative feature that emphasizes important channel and spatial areas in H&E images while exploring contextual information. In addition, OCU-Net integrates other innovative components such as Squeeze-and-Excite (SE) attention module, Atrous Spatial Pyramid Pooling (ASPP) module, residual blocks, and multi-scale fusion. The incorporation of these modules showed superior performance for oral cancer segmentation for two datasets used in this research. Furthermore, we effectively utilized the efficient ImageNet pre-trained MobileNet-V2 model as a backbone of our OCU-Net to create OCU-Netm, an enhanced version achieving state-of-the-art results. Comprehensive evaluation demonstrates that OCU-Net and OCU-Netm outperformed existing segmentation methods, highlighting their precision in identifying cancer cells in H&E images from OCDC and ORCA datasets.
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.
Deployment of Deep Neural Networks in medical imaging is hindered by distribution shift between training data and data processed after deployment, causing performance degradation. Post-Deployment Adaptation (PDA) addresses this by tailoring a pre-trained, deployed model to the target data distribution using limited labelled or entirely unlabelled target data, while assuming no access to source training data as they cannot be deployed with the model due to privacy concerns and their large size. This makes reliable adaptation challenging due to limited learning signal. This paper challenges this assumption and introduces FedPDA, a novel adaptation framework that brings the utility of learning from remote data from Federated Learning into PDA. FedPDA enables a deployed model to obtain information from source data via remote gradient exchange, while aiming to optimize the model specifically for the target domain. Tailored for FedPDA, we introduce a novel optimization method StarAlign (Source-Target Remote Gradient Alignment) that aligns gradients between source-target domain pairs by maximizing their inner product, to facilitate learning a target-specific model. We demonstrate the method's effectiveness using multi-center databases for the tasks of cancer metastases detection and skin lesion classification, where our method compares favourably to previous work. Code is available at: https://github.com/FelixWag/StarAlign
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.
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.
Breast cancer is a prevalent form of cancer among women, with over 1.5 million women being diagnosed each year. Unfortunately, the survival rates for breast cancer patients in certain third-world countries, like South Africa, are alarmingly low, with only 40% of diagnosed patients surviving beyond five years. The inadequate availability of resources, including qualified pathologists, delayed diagnoses, and ineffective therapy planning, contribute to this low survival rate. To address this pressing issue, medical specialists and researchers have turned to domain-specific AI approaches, specifically deep learning models, to develop end-to-end solutions that can be integrated into computer-aided diagnosis (CAD) systems. By improving the workflow of pathologists, these AI models have the potential to enhance the detection and diagnosis of breast cancer. This research focuses on evaluating the performance of various cutting-edge convolutional neural network (CNN) architectures in comparison to a relatively new model called the Vision Trans-former (ViT). The objective is to determine the superiority of these models in terms of their accuracy and effectiveness. The experimental results reveal that the ViT models outperform the other selected state-of-the-art CNN architectures, achieving an impressive accuracy rate of 95.15%. This study signifies a significant advancement in the field, as it explores the utilization of data augmentation and other relevant preprocessing techniques in conjunction with deep learning models for the detection and diagnosis of breast cancer using datasets of Breast Cancer Histopathological Image Classification.
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.