Precision Learning: Towards Use of Known Operators in Neural Networks

In this paper, we consider the use of prior knowledge within neural networks. In particular, we investigate the effect of a known transform within the mapping from input data space to the output domain. We demonstrate that use of known transforms is able to change maximal error bounds. In order to explore the effect further, we consider the problem of X-ray material decomposition as an example to incorporate additional prior knowledge. We demonstrate that inclusion of a non-linear function known from the physical properties of the system is able to reduce prediction errors therewith improving prediction quality from SSIM values of 0.54 to 0.88. This approach is applicable to a wide set of applications in physics and signal processing that provide prior knowledge on such transforms. Also maximal error estimation and network understanding could be facilitated within the context of precision learning.Comment: accepted on ICPR 201

Deep Learning in Breast Cancer Imaging: A Decade of Progress and Future Directions

Breast cancer has reached the highest incidence rate worldwide among all malignancies since 2020. Breast imaging plays a significant role in early diagnosis and intervention to improve the outcome of breast cancer patients. In the past decade, deep learning has shown remarkable progress in breast cancer imaging analysis, holding great promise in interpreting the rich information and complex context of breast imaging modalities. Considering the rapid improvement in the deep learning technology and the increasing severity of breast cancer, it is critical to summarize past progress and identify future challenges to be addressed. In this paper, we provide an extensive survey of deep learning-based breast cancer imaging research, covering studies on mammogram, ultrasound, magnetic resonance imaging, and digital pathology images over the past decade. The major deep learning methods, publicly available datasets, and applications on imaging-based screening, diagnosis, treatment response prediction, and prognosis are described in detail. Drawn from the findings of this survey, we present a comprehensive discussion of the challenges and potential avenues for future research in deep learning-based breast cancer imaging.Comment: Survey, 41 page

Machine Learning and Quantitative Imaging for the Management of Brain Metastasis

Significantly affecting patients’ clinical course and quality of life, a growing number of cancer cases are diagnosed with brain metastasis annually. Although a considerable percentage of cancer patients survive for several years if the disease is discovered at an early stage while it is still localized, when the tumour is metastasized to the brain, the median survival decreases considerably. Early detection followed by precise and effective treatment of brain metastasis may lead to improved patient survival and quality of life. A main challenge to prescribe an effective treatment regimen is the variability of tumour response to treatments, e.g., radiotherapy as a main treatment option for brain metastasis, despite similar cancer therapy, due to many patient-related factors. Stratifying patients based on their predicted response and consequently assessing their response to therapy are challenging yet crucial tasks. While risk assessment models with standard clinical attributes have been proposed for patient stratification, the imaging data acquired for these patients as a part of the standard-of-care are not computationally analyzed or directly incorporated in these models. Further, therapy response monitoring and assessment is a cumbersome task for patients with brain metastasis that requires longitudinal tumour delineation on MRI volumes before and at multiple follow-up sessions after treatment. This is aggravated by the time-sensitive nature of the disease. In an effort to address these challenges, a number of machine learning frameworks and computational techniques in areas of automatic tumour segmentation, radiotherapy outcome assessment, and therapy outcome prediction have been introduced and investigated in this dissertation. Powered by advanced machine learning algorithms, a complex attention-guided segmentation framework is introduced and investigated for segmenting brain tumours on serial MRI. The experimental results demonstrate that the proposed framework can achieve a dice score of 91.5% and 84.1% to 87.4% on the baseline and follow-up scans, respectively. This framework is then applied in a proposed system that follows standard clinical criteria based on changes in tumour size at post-treatment to assess tumour response to radiotherapy automatically. The system demonstrates a very good agreement with expert clinicians in detecting local response, with an accuracy of over 90%. Next, innovative machine-learning-based solutions are proposed and investigated for radiotherapy outcome prediction before or early after therapy, using MRI radiomic models and novel deep learning architectures that analyze treatment-planning MRI with and without standard clinical attributes. The developed models demonstrate an accuracy of up to 82.5% in predicting radiotherapy outcome before the treatment initiation. The ground-breaking machine learning platforms presented in this dissertation along with the promising results obtained in the conducted experiments are steps forward towards realizing important decision support tools for oncologists and radiologists and, can eventually, pave the way towards the personalized therapeutics paradigm for cancer patient

Benchmarking weakly-supervised deep learning pipelines for whole slide classification in computational pathology.

Artificial intelligence (AI) can extract visual information from histopathological slides and yield biological insight and clinical biomarkers. Whole slide images are cut into thousands of tiles and classification problems are often weakly-supervised: the ground truth is only known for the slide, not for every single tile. In classical weakly-supervised analysis pipelines, all tiles inherit the slide label while in multiple-instance learning (MIL), only bags of tiles inherit the label. However, it is still unclear how these widely used but markedly different approaches perform relative to each other. We implemented and systematically compared six methods in six clinically relevant end-to-end prediction tasks using data from N=2980 patients for training with rigorous external validation. We tested three classical weakly-supervised approaches with convolutional neural networks and vision transformers (ViT) and three MIL-based approaches with and without an additional attention module. Our results empirically demonstrate that histological tumor subtyping of renal cell carcinoma is an easy task in which all approaches achieve an area under the receiver operating curve (AUROC) of above 0.9. In contrast, we report significant performance differences for clinically relevant tasks of mutation prediction in colorectal, gastric, and bladder cancer. In these mutation prediction tasks, classical weakly-supervised workflows outperformed MIL-based weakly-supervised methods for mutation prediction, which is surprising given their simplicity. This shows that new end-to-end image analysis pipelines in computational pathology should be compared to classical weakly-supervised methods. Also, these findings motivate the development of new methods which combine the elegant assumptions of MIL with the empirically observed higher performance of classical weakly-supervised approaches. We make all source codes publicly available at https://github.com/KatherLab/HIA, allowing easy application of all methods to any similar task

A Review on Data Fusion of Multidimensional Medical and Biomedical Data

Data fusion aims to provide a more accurate description of a sample than any one source of data alone. At the same time, data fusion minimizes the uncertainty of the results by combining data from multiple sources. Both aim to improve the characterization of samples and might improve clinical diagnosis and prognosis. In this paper, we present an overview of the advances achieved over the last decades in data fusion approaches in the context of the medical and biomedical fields. We collected approaches for interpreting multiple sources of data in different combinations: image to image, image to biomarker, spectra to image, spectra to spectra, spectra to biomarker, and others. We found that the most prevalent combination is the image-to-image fusion and that most data fusion approaches were applied together with deep learning or machine learning methods

Rotation-Agnostic Image Representation Learning for Digital Pathology

This paper addresses complex challenges in histopathological image analysis through three key contributions. Firstly, it introduces a fast patch selection method, FPS, for whole-slide image (WSI) analysis, significantly reducing computational cost while maintaining accuracy. Secondly, it presents PathDino, a lightweight histopathology feature extractor with a minimal configuration of five Transformer blocks and only 9 million parameters, markedly fewer than alternatives. Thirdly, it introduces a rotation-agnostic representation learning paradigm using self-supervised learning, effectively mitigating overfitting. We also show that our compact model outperforms existing state-of-the-art histopathology-specific vision transformers on 12 diverse datasets, including both internal datasets spanning four sites (breast, liver, skin, and colorectal) and seven public datasets (PANDA, CAMELYON16, BRACS, DigestPath, Kather, PanNuke, and WSSS4LUAD). Notably, even with a training dataset of 6 million histopathology patches from The Cancer Genome Atlas (TCGA), our approach demonstrates an average 8.5% improvement in patch-level majority vote performance. These contributions provide a robust framework for enhancing image analysis in digital pathology, rigorously validated through extensive evaluation. Project Page: https://rhazeslab.github.io/PathDino-Page/Comment: 23 pages, 10 figures, 18 tables. Histopathological Image Analysi

A survey on artificial intelligence in histopathology image analysis

The increasing adoption of the whole slide image (WSI) technology in histopathology has dramatically transformed pathologists' workflow and allowed the use of computer systems in histopathology analysis. Extensive research in Artificial Intelligence (AI) with a huge progress has been conducted resulting in efficient, effective, and robust algorithms for several applications including cancer diagnosis, prognosis, and treatment. These algorithms offer highly accurate predictions but lack transparency, understandability, and actionability. Thus, explainable artificial intelligence (XAI) techniques are needed not only to understand the mechanism behind the decisions made by AI methods and increase user trust but also to broaden the use of AI algorithms in the clinical setting. From the survey of over 150 papers, we explore different AI algorithms that have been applied and contributed to the histopathology image analysis workflow. We first address the workflow of the histopathological process. We present an overview of various learning-based, XAI, and actionable techniques relevant to deep learning methods in histopathological imaging. We also address the evaluation of XAI methods and the need to ensure their reliability on the field