Multimodality eye disease screening is crucial in ophthalmology as it integrates information from diverse sources to complement their respective performances. However, the existing methods are weak in assessing the reliability of each unimodality, and directly fusing an unreliable modality may cause screening errors. To address this issue, we introduce a novel multimodality evidential fusion pipeline for eye disease screening, EyeMoSt, which provides a measure of confidence for unimodality and elegantly integrates the multimodality information from a multi-distribution fusion perspective. Specifically, our model estimates both local uncertainty for unimodality and global uncertainty for the fusion modality to produce reliable classification results. More importantly, the proposed mixture of Student's $t$ distributions adaptively integrates different modalities to endow the model with heavy-tailed properties, increasing robustness and reliability. Our experimental findings on both public and in-house datasets show that our model is more reliable than current methods. Additionally, EyeMost has the potential ability to serve as a data quality discriminator, enabling reliable decision-making for multimodality eye disease screening.
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MET protein overexpression is a targetable event in non-small cell lung cancer (NSCLC) and is the subject of active drug development. Challenges in identifying patients for these therapies include lack of access to validated testing, such as standardized immunohistochemistry (IHC) assessment, and consumption of valuable tissue for a single gene/protein assay. Development of pre-screening algorithms using routinely available digitized hematoxylin and eosin (H&E)-stained slides to predict MET overexpression could promote testing for those who will benefit most. While assessment of MET expression using IHC is currently not routinely performed in NSCLC, next-generation sequencing is common and in some cases includes RNA expression panel testing. In this work, we leveraged a large database of matched H&E slides and RNA expression data to train a weakly supervised model to predict MET RNA overexpression directly from H&E images. This model was evaluated on an independent holdout test set of 300 over-expressed and 289 normal patients, demonstrating an ROC-AUC of 0.70 (95th percentile interval: 0.66 - 0.74) with stable performance characteristics across different patient clinical variables and robust to synthetic noise on the test set. These results suggest that H&E-based predictive models could be useful to prioritize patients for confirmatory testing of MET protein or MET gene expression status.
The visual examination of tissue biopsy sections is fundamental for cancer diagnosis, with pathologists analyzing sections at multiple magnifications to discern tumor cells and their subtypes. However, existing attention-based multiple instance learning (MIL) models, used for analyzing Whole Slide Images (WSIs) in cancer diagnostics, often overlook the contextual information of tumor and neighboring tiles, leading to misclassifications. To address this, we propose the Context-Aware Multiple Instance Learning (CAMIL) architecture. CAMIL incorporates neighbor-constrained attention to consider dependencies among tiles within a WSI and integrates contextual constraints as prior knowledge into the MIL model. We evaluated CAMIL on subtyping non-small cell lung cancer (TCGA-NSCLC) and detecting lymph node (CAMELYON16) metastasis, achieving test AUCs of 0.959\% and 0.975\%, respectively, outperforming other state-of-the-art methods. Additionally, CAMIL enhances model interpretability by identifying regions of high diagnostic value.
Despite the remarkable results of deep learning in breast cancer image classification, challenges such as data imbalance and interpretability still exist and require cross-domain knowledge and collaboration among medical experts. In this study, we propose a dual-activated lightweight attention ResNet50 module method-based breast cancer classification method that effectively addresses challenges such as data imbalance and interpretability. Our model fuses a pre-trained deep ResNet50 and a lightweight attention mechanism to accomplish classification by embedding an attention module in layer 4 of ResNet50 and adding two fully connected layers. For the fully connected network design, we employ both Leaky ReLU and ReLU activation functions. On medical histopathology datasets, our model outperforms conventional models, visual transformers, and large models in terms of precision, accuracy, recall, F1 score, and GMean. In particular, the model demonstrates significant robustness and broad applicability when dealing with the unbalanced breast cancer dataset. Our model is tested on 40X, 100X, 200X, and 400X images and achieves accuracies of 98.5%, 98.7%, 97.9%, and 94.3%, respectively. Through an in-depth analysis of loss and accuracy, as well as Grad-CAM analysis, we comprehensively assessed the model performance and gained perspective on its training process. In the later stages of training, the validated losses and accuracies change minimally, showing that the model avoids overfitting and exhibits good generalization ability. Overall, this study provides an effective solution for breast cancer image classification with practical applica
Clinical texts, represented in electronic medical records (EMRs), contain rich medical information and are essential for disease prediction, personalised information recommendation, clinical decision support, and medication pattern mining and measurement. Relation extractions between medication mentions and temporal information can further help clinicians better understand the patients' treatment history. To evaluate the performances of deep learning (DL) and large language models (LLMs) in medication extraction and temporal relations classification, we carry out an empirical investigation of \textbf{MedTem} project using several advanced learning structures including BiLSTM-CRF and CNN-BiLSTM for a clinical domain named entity recognition (NER), and BERT-CNN for temporal relation extraction (RE), in addition to the exploration of different word embedding techniques. Furthermore, we also designed a set of post-processing roles to generate structured output on medications and the temporal relation. Our experiments show that CNN-BiLSTM slightly wins the BiLSTM-CRF model on the i2b2-2009 clinical NER task yielding 75.67, 77.83, and 78.17 for precision, recall, and F1 scores using Macro Average. BERT-CNN model also produced reasonable evaluation scores 64.48, 67.17, and 65.03 for P/R/F1 using Macro Avg on the temporal relation extraction test set from i2b2-2012 challenges. Code and Tools from MedTem will be hosted at \url{//github.com/HECTA-UoM/MedTem}
Electrocardiogram (ECG) signals, which capture the heart's electrical activity, are used to diagnose and monitor cardiac problems. The accurate classification of ECG signals, particularly for distinguishing among various types of arrhythmias and myocardial infarctions, is crucial for the early detection and treatment of heart-related diseases. This paper proposes a novel approach based on an improved differential evolution (DE) algorithm for ECG signal classification for enhancing the performance. In the initial stages of our approach, the preprocessing step is followed by the extraction of several significant features from the ECG signals. These extracted features are then provided as inputs to an enhanced multi-layer perceptron (MLP). While MLPs are still widely used for ECG signal classification, using gradient-based training methods, the most widely used algorithm for the training process, has significant disadvantages, such as the possibility of being stuck in local optimums. This paper employs an enhanced differential evolution (DE) algorithm for the training process as one of the most effective population-based algorithms. To this end, we improved DE based on a clustering-based strategy, opposition-based learning, and a local search. Clustering-based strategies can act as crossover operators, while the goal of the opposition operator is to improve the exploration of the DE algorithm. The weights and biases found by the improved DE algorithm are then fed into six gradient-based local search algorithms. In other words, the weights found by the DE are employed as an initialization point. Therefore, we introduced six different algorithms for the training process (in terms of different local search algorithms). In an extensive set of experiments, we showed that our proposed training algorithm could provide better results than the conventional training algorithms.
Human readers or radiologists routinely perform full-body multi-organ multi-disease detection and diagnosis in clinical practice, while most medical AI systems are built to focus on single organs with a narrow list of a few diseases. This might severely limit AI's clinical adoption. A certain number of AI models need to be assembled non-trivially to match the diagnostic process of a human reading a CT scan. In this paper, we construct a Unified Tumor Transformer (CancerUniT) model to jointly detect tumor existence & location and diagnose tumor characteristics for eight major cancers in CT scans. CancerUniT is a query-based Mask Transformer model with the output of multi-tumor prediction. We decouple the object queries into organ queries, tumor detection queries and tumor diagnosis queries, and further establish hierarchical relationships among the three groups. This clinically-inspired architecture effectively assists inter- and intra-organ representation learning of tumors and facilitates the resolution of these complex, anatomically related multi-organ cancer image reading tasks. CancerUniT is trained end-to-end using a curated large-scale CT images of 10,042 patients including eight major types of cancers and occurring non-cancer tumors (all are pathology-confirmed with 3D tumor masks annotated by radiologists). On the test set of 631 patients, CancerUniT has demonstrated strong performance under a set of clinically relevant evaluation metrics, substantially outperforming both multi-disease methods and an assembly of eight single-organ expert models in tumor detection, segmentation, and diagnosis. This moves one step closer towards a universal high performance cancer screening tool.
Outbreaks of hand-foot-and-mouth disease(HFMD) have been associated with significant morbidity and, in severe cases, mortality. Accurate forecasting of daily admissions of pediatric HFMD patients is therefore crucial for aiding the hospital in preparing for potential outbreaks and mitigating nosocomial transmissions. To address this pressing need, we propose a novel transformer-based model with a U-net shape, utilizing the patching strategy and the joint prediction strategy that capitalizes on insights from herpangina, a disease closely correlated with HFMD. This model also integrates representation learning by introducing reconstruction loss as an auxiliary loss. The results show that our U-net Patching Time Series Transformer (UPTST) model outperforms existing approaches in both long- and short-arm prediction accuracy of HFMD at hospital-level. Furthermore, the exploratory extension experiments show that the model's capabilities extend beyond prediction of infectious disease, suggesting broader applicability in various domains.
Nuclei detection and segmentation in hematoxylin and eosin-stained (H&E) tissue images are important clinical tasks and crucial for a wide range of applications. However, it is a challenging task due to nuclei variances in staining and size, overlapping boundaries, and nuclei clustering. While convolutional neural networks have been extensively used for this task, we explore the potential of Transformer-based networks in this domain. Therefore, we introduce a new method for automated instance segmentation of cell nuclei in digitized tissue samples using a deep learning architecture based on Vision Transformer called CellViT. CellViT is trained and evaluated on the PanNuke dataset, which is one of the most challenging nuclei instance segmentation datasets, consisting of nearly 200,000 annotated Nuclei into 5 clinically important classes in 19 tissue types. We demonstrate the superiority of large-scale in-domain and out-of-domain pre-trained Vision Transformers by leveraging the recently published Segment Anything Model and a ViT-encoder pre-trained on 104 million histological image patches - achieving state-of-the-art nuclei detection and instance segmentation performance on the PanNuke dataset with a mean panoptic quality of 0.50 and an F1-detection score of 0.83. The code is publicly available at //github.com/TIO-IKIM/CellViT
Breast cancer is a major concern for women's health globally, with axillary lymph node (ALN) metastasis identification being critical for prognosis evaluation and treatment guidance. This paper presents a deep learning (DL) classification pipeline for quantifying clinical information from digital core-needle biopsy (CNB) images, with one step less than existing methods. A publicly available dataset of 1058 patients was used to evaluate the performance of different baseline state-of-the-art (SOTA) DL models in classifying ALN metastatic status based on CNB images. An extensive ablation study of various data augmentation techniques was also conducted. Finally, the manual tumor segmentation and annotation step performed by the pathologists was assessed.
Understanding causality helps to structure interventions to achieve specific goals and enables predictions under interventions. With the growing importance of learning causal relationships, causal discovery tasks have transitioned from using traditional methods to infer potential causal structures from observational data to the field of pattern recognition involved in deep learning. The rapid accumulation of massive data promotes the emergence of causal search methods with brilliant scalability. Existing summaries of causal discovery methods mainly focus on traditional methods based on constraints, scores and FCMs, there is a lack of perfect sorting and elaboration for deep learning-based methods, also lacking some considers and exploration of causal discovery methods from the perspective of variable paradigms. Therefore, we divide the possible causal discovery tasks into three types according to the variable paradigm and give the definitions of the three tasks respectively, define and instantiate the relevant datasets for each task and the final causal model constructed at the same time, then reviews the main existing causal discovery methods for different tasks. Finally, we propose some roadmaps from different perspectives for the current research gaps in the field of causal discovery and point out future research directions.
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