KAYRA: A Microservice Architecture for AI-Assisted Karyotyping with Cloud and On-Premise Deployment

Chromosome analysis is a fundamental step in the diagnosis of genetic diseases, but the manual karyotyping workflow is time-consuming and heavily dependent on expert specialists, often requiring several days per patient. Although Deep Learning models have achieved high performance in chromosome detection, most proposed solutions remain restricted to research prototypes or lack graphical interfaces suitable for clinical use. In this work, we present Aycromo, an open-source desktop platform for AI-assisted cytogenetic analysis. Built on Electron and ONNX Runtime, the tool allows cytogeneticists to load pre-trained models, compare architectures through an integrated benchmarking module, and manually correct detections via an interactive annotation interface, all without command-line interaction. Preliminary experiments on metaphase images from the CRCN-NE dataset demonstrate that YOLOv11 achieves 99.40% mAP@50, while the platform reduces per-slide analysis to seconds

High classification accuracy alone is insufficient for clinical image analysis, where calibrated confidence and reliable uncertainty estimates are essential. This study proposes a reliability-aware Hybrid-K ensemble selection framework for multiclass cervical cytology classification using the SIPaKMeD dataset. Nine deep learning architectures were evaluated using a fixed stratified five-fold partition and three training seeds. After post-hoc temperature scaling, models were assessed using macro-F1, accuracy, AUROC, expected calibration error (ECE), worst-class ECE (WC-ECE), area under the risk-coverage curve (AURC), Brier score, and negative log-likelihood (NLL). Models were ranked using an equal-weight composite score, and Hybrid-K ensembles were formed from the top-ranked models using soft voting. Robustness was examined using 5,000 Dirichlet-sampled metric-weight vectors, leave-one-metric-out analysis, and corrected paired testing across 15 fold-by-seed evaluations. The final Hybrid-2 ensemble, comprising Swin-Tiny and TinyViT-5M, reduced AURC by 43%, NLL by 17%, and WC-ECE by 36% relative to the best individual model. It was selected in 96.8% of random weighting scenarios, remained unchanged across all leave-one-metric-out analyses, and improved the full composite score. However, per-metric gains were not statistically significant after Holm-Bonferroni correction (all adjusted p >= 0.168). Because post-hoc calibration did not use a fully independent calibration set, calibration-dependent results should be interpreted as exploratory internal estimates. Overall, the framework identified a compact ensemble robust to alternative metric weightings and improved reliability point estimates under internal validation on a single dataset.

We present a clinically deployed end-to-end auto-contouring system for cervical cancer radiotherapy planning, anchored by the Boundary-Aware Transformer with Region-Aware Mamba (BAT-RM), a hybrid architecture that integrates Sobel-gated boundary attention, a linear-time, multi-directional Mamba module for long-range context, and a boundary-skeleton-guided fusion gate. This design achieves linear-time complexity for long-range context modeling, avoiding the quadratic cost of full spatial self-attention. The full pipeline spans multi-institutional data collection, rigorous inter-rater quality assurance, external validation in an independent cohort, and a web-based clinical interface natively compatible with Varian, RayStation, and Monaco. Against four baselines, BAT-RM achieves superior performance across seven anatomical classes, with statistically significant improvements in target volumes, including GTV and CTV, and in organs at risk such as the rectum and bladder. A prospective multi-center reader study involving 13 radiation oncologists demonstrated that AI assistance elevates junior oncologists' IoU from 0.899 to 0.965, approaching senior-level accuracy, while reducing contouring time by more than 80%. The system also reduced expert consultation rates and improved inter-reader consistency, reflecting gains in both efficiency and quality assurance. Following clinical deployment at a partner hospital, the system reduced patient wait times from days to hours without additional staffing, enabling same-day or next-day initiation of treatment for routine cases. BAT-RM demonstrates that a rigorous research pipeline, from data curation to clinical deployment, can translate directly into measurable patient benefit in resource-constrained settings where the demand for radiotherapy far exceeds specialist capacity.