Cancer Detection

Mycosis fungoides (MF) is a rare form of cutaneous T-cell lymphoma that is often misdiagnosed in early stages due to its visual similarity to benign inflammatory dermatoses. Early and accurate diagnosis is critical for improving patient outcomes. In this paper, we propose a comprehensive diagnostic framework for automated MF detection that combines dual- scale histopathological image analysis with deep learning. To distinguish MF from other lymphoproliferative skin conditions, the proposed approach leverages a late-fusion ensemble of dual- magnification (10x and 20x) convolutional neural networks (CNNs), complemented by a random forest classifier trained on 16 clinical features. Experimental results on an expanded dataset of 6,267 images (4,306 MF; 1,961 Non-MF) across 463 patients demonstrate that strong detection performance is obtained by prioritizing higher-resolution cytological details (20x) within broader architectural context (10x). The image-based late-fusion model achieves an accuracy of 83.58% and a sensitivity of 89.13%, while the clinical random forest model achieves an accuracy of 96.6% and sensitivity of 93.8%, highlighting the po- tential of this multimodal framework as a robust clinical decision support system in dermatology. This framework addresses two distinct clinical objectives: an image-based dual-scale pipeline optimized for the early diagnostic screening of MF versus non- MF dermatoses, and a complementary clinical metadata model designed for the subsequent staging of confirmed MF cases (patch/plaque versus tumor)

Multi-cancer segmentation in computed tomography (CT) is fundamentally limited by the scarcity of tumor masks across different organs. We present Merlin Plus, the first large-scale CT dataset with radiologist-created tumor masks across 9 organs. Merlin Plus extends the Merlin dataset by adding 1,153 per-voxel tumor masks and longitudinal metadata. To create these tumor masks, we developed a report-based active-learning framework in which radiology reports identify tumor cases for annotation and support training of a tumor segmentation model. The model generates initial masks, which radiologists review and correct to produce the final masks, reducing annotation burden while maintaining high-quality annotations. Besides tumor masks, the longitudinal metadata in Merlin Plus enables temporal modeling of cancer progression. By directly addressing the major bottleneck of limited multi-cancer segmentation masks, Merlin Plus supports scalable multi-organ cancer detection, segmentation, and longitudinal analysis in CT. Dataset is available at: https://github.com/MrGiovanni/MerlinPlus

Background & Problem: Thyroid Fine-Needle Aspiration Biopsy (FNAB) cytology based on the Bethesda System plays a pivotal role in early thyroid cancer detection; however, deep learning approaches face substantial challenges regarding high false-negative rates and overconfidence under clinical domain shift. Methods: In this study, we propose TAM-Chain, a multi-scale (10x, 20x, 40x) thyroid cytology classification framework leveraging Absorbing Markov Chain theory combined with Shannon Entropy-based Uncertainty Quantification. The framework dynamically models multi-magnification feature extraction as an absorbing stochastic process, enabling optimal stopping criteria and a human-in-the-loop referral mechanism to strictly suppress critical diagnostic errors. Results: Extensive evaluation on an internal test set (N = 235) demonstrates a Macro F1 score of 0.9741 with an absolute False-Negative Rate (FNR) of 0.00%. On an independent external validation set (N = 1015) presenting severe domain shift, TAM-Chain maintains superior stability and classification performance (Macro F1 = 0.7026) by adaptively adjusting the expected stopping step and triggering specialist referrals, significantly outperforming single-magnification baselines. Conclusion: The TAM-Chain framework proves to be a highly effective, safe, and adaptable solution for digital pathology workflows, successfully harmonizing automated diagnostic efficiency with stringent biological safety.

Background: Clear cell renal cell carcinoma (ccRCC) exhibits substantial clinical heterogeneity, and accurate grade assessment is essential for risk stratification and treatment planning. However, conventional grading requires invasive tissue sampling. We developed RCC-Align, a cross-modal contrastive learning framework that leverages paired histopathology and computed tomography (CT) data during training to improve noninvasive CT-based ccRCC grade prediction. Methods: RCC-Align aligns paired whole-slide histopathology images (WSIs) and CT scans through contrastive cross-modal objectives, transferring grade-discriminative information from microscopic tissue morphology to macroscopic radiologic representations. The framework was trained and evaluated on paired TCGA and CPTAC cohorts using patient-level five-fold cross-validation. Performance for low- versus high-grade ccRCC classification was compared against CT-only baselines (DINOv2-Base and DINOv2-Finetuned) and a WSI-based reference model (GigaPath-Finetuned). Cross-modal alignment was assessed using cosine similarity analysis. Results: RCC-Align achieved an AUC of 0.601 (95% CI, 0.524-0.673) and AUPRC of 0.599 (95% CI, 0.541-0.676), outperforming DINOv2-Finetuned (AUC 0.545; AUPRC 0.543) with significantly improved low-grade prediction (p = 0.004). RCC-Align also demonstrated stronger paired WSI-CT embedding alignment compared with baselines. The WSI-based GigaPath reference achieved an AUC of 0.719. Conclusion: Pathology-guided contrastive learning improves CT-based ccRCC grading while requiring only CT at inference. This approach may complement tissue diagnosis when biopsy is unsafe, infeasible, or limited by intratumoral heterogeneity. Validation in larger, multi-institutional cohorts with external testing is needed before clinical translation.

Radiomics provides quantitative descriptions of tumour appearance that may complement disease-specific foundation models in small labelled cohorts. We investigate this complementarity for computed tomography-based classification of clear cell renal cell carcinoma. Our framework uses radiomics to modulate RenalCLIP features through feature-wise linear modulation (FiLM), while retaining a direct radiomics contribution. Internal testing and external validation compare it with conventional fusion strategies and reference classifiers. The FiLM model achieves an area under the receiver operating characteristic curve (AUC) of 0.804 internally and 0.854 externally, with the highest mean AUC among the evaluated RenalCLIP fusion strategies in both cohorts. Pathway ablations examine the contributions of conditional modulation and the direct radiomics residual, while feature permutation highlights the role of tumour texture. These findings support radiomics as a useful complement to RenalCLIP in a small labelled cohort and identify FiLM as an effective approach to integrating their representations for robust renal tumour classification.

Accurate preoperative subtype classification of renal cell carcinoma (RCC) from contrast-enhanced computed tomography remains clinically challenging. Radiomics provides structured tumour descriptors, whereas foundation representations offer transferable image features. However, it remains unclear whether radiomics still adds value beyond pretrained representations, and how 2D and 3D MedVAE encoders compare in this setting. We compared handcrafted radiomics, 2D MedVAE, 3D MedVAE, and their fusion for binary clear-cell RCC versus non-clear-cell RCC classification on KiTS23 under a unified preprocessing pipeline. Concatenation, cross-attention, and gated fusion were evaluated as representative integration strategies, and radiomics feature importance was analysed to support decision-centric interpretability. Fusion consistently improved discrimination over image-only MedVAE branches. The best overall performance was achieved by 3D gated fusion, with an AUC of 82.7%, outperforming the best 2D fusion model (79.6%), the radiomics baseline (74.4%), and the single-modality MedVAE branches. Ablation analysis further showed clear gains of the full fusion model over both image-only and radiomics-only variants, indicating complementary contributions from radiomics and image representations. These findings suggest that radiomics remains relevant for RCC CT classification in the presence of foundation representations, and that its integration with MedVAE is more effective in the 3D setting. More broadly, the study supports a complementary role for radiomics and foundation representations in clinically meaningful imaging decision support.

Background: Microvascular invasion (MVI) predicts recurrence and survival in hepatocellular carcinoma (HCC) but requires postoperative histopathology for diagnosis. We developed and validated a model integrating multimodal ultrasound and clinical data for preoperative MVI prediction. Methods: This multicenter study included 489 patients with HCC from eight centers. All patients had B-mode ultrasound (BUS), color Doppler flow imaging (CDFI), dynamic contrast-enhanced ultrasound (DCE-US), and clinical information. Data from seven centers (n = 421) were used for model development with five-fold cross-validation; data from the remaining center (n = 68) formed an independent external validation cohort. The proposed multimodal information fusion network used modality-specific encoders, a hemodynamic temporal change module for bidirectional DCE-US perfusion changes, and a representation consistency learning module to align heterogeneous ultrasound representations before Transformer-based fusion. Results: In external validation, DCE-US achieved the highest single-modality area under the receiver operating characteristic curve (AUC; 0.8545+/-0.0198), versus clinical information (0.6715+/-0.0156), CDFI (0.6435+/-0.0344), and BUS (0.6087+/-0.0417). Pixel-difference sampling and the proposed temporal module outperformed alternative sampling and video representation methods. The full model achieved the best performance, with an AUC of 0.8953+/-0.0180, accuracy of 81.18%+/-2.83%, sensitivity of 86.40%+/-6.69%, and specificity of 78.14%+/-6.28. Conclusions: Integrating multimodal ultrasound and clinical information enabled promising preoperative MVI prediction in HCC. DCE-US was the main source of predictive information, while BUS, CDFI, and clinical information provided complementary value. The proposed framework may support preoperative risk stratification and individualized clinical decision-making.

Hereditary polyposis syndromes can be precursor lesions to colorectal cancer and are associated with a broad spectrum of extracolonic tumors. Early identification and accurate classification of these syndromes are essential for timely diagnosis, individualized patient management, and targeted surveillance strategies for affected families. However, public endoscopic datasets are largely organized around the individual sporadic polyp, and none links the polyposis phenotype to histopathology and germline findings at the patient level. Here, we present ERCPMP-Gx, an endoscopic, histopathological, and genomic dataset developed to support the application of artificial intelligence (AI) in the recognition, characterization, and classification of colorectal polyposis. Most procedures were performed using the Olympus EVIS X1 system with white-light endoscopy (WLE), narrow-band imaging (NBI), magnifying NBI (M-NBI), and NBI with near focus modes, yielding 160 images and accompanying video clips. Approximately eighty percent of cases represent clinically and/or genetically confirmed hereditary polyposis syndromes (PG), including familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome (PJS), juvenile polyposis syndrome (JPS), and ganglioneuroma syndrome (GNS), while the remaining twenty percent comprise non-hereditary polyps and polyp-mimicking lesions with overlapping morphological features (Non-PG), included to support differential classification. Each released record is linked, where available, to standardized endoscopic annotations, representative histopathology, and clinically reported germline findings, forming an AI-ready, patient-level annotation framework. The dataset is publicly accessible at Mendeley (https://doi.org/10.17632/nzyfc544bx.2). For the latest updates and further information, readers are referred to the DataBioX website: https://databiox.com.

Deep learning models for multi-modal breast cancer diagnosis achieve high predictive accuracy but remain clinically unacceptable without actionable, counterfactual explanations. Attribution-based methods (LIME, SHAP) are categorically inapplicable to this purpose, as they generate no alternative instances and thus cannot be evaluated on counterfactual quality metrics. This investigation provides empirical evidence that FCA-Guided Counterfactual (FCA-CF) framework that uses a Formal Concept Analysis (FCA) concept lattice as a hard structural constraint on counterfactual search, operating over a multi-modal TCGA-BRCA dataset. We benchmark against four genuine counterfactual methods: Wachter-style CF, DiCE, FACE, and NICE, evaluated on 60 benign-predicted TCGA-BRCA instances. The FCA-CF framework achieves Validity = 1.0000 (100% of counterfactuals successfully flip the prediction), Sparsity = 2.37 features changed (best among all valid methods), and Proximity = 0.900 (normalised L2-based, matching NICE as joint best). The classifier achieves Accuracy = 0.980, F1 = 0.976, ROC-AUC = 0.9947. Ablation analysis confirms that the FCA lattice constraint is the primary sparsity driver (removing it increases sparsity by +40%, p < 0.001, Cohen's d = 0.78), while Phase C greedy refinement accounts for the largest individual contribution (+113% sparsity increase when disabled, p < 0.001, d = 5.01). FCA-guided counterfactual generation achieves a clinically important Pareto-dominant outcome; it is simultaneously the sparsest and among the most proximate of all valid methods, with perfect validity. The emergent sparsity property arising from lattice topology rather than numerical penalty terms constitutes a structurally novel contribution to the counterfactual explanation literature.

This study explores the use of deep learning and explainable artificial intelligence to diagnose hepatocellular carcinoma (HCC) and define effective biomarkers across five different stages of disease development using a transcriptomic biomarker HCC dataset constructed via semi-supervised learning from three source datasets. Several deep learning experiments were conducted with different feature extraction techniques and gene sets to identify the most effective features for training high-accuracy models with minimal loss. The best-performing model, using 15 selected genes with the SelectKBest algorithm, achieved 90.74% accuracy, while the model with the lowest recorded loss of 0.3187 was obtained using 20 selected genes. To address the issue of class imbalance in the dataset, a weighted training approach was conducted, and for model transparency and interpretability a SHAP-based XAI analysis provided insights into the model's decision-making, consistently finding DNAJB14 as the most influential gene. Functional validation in this study has provided compelling evidence that DNAJB14 plays an important role in the adverse properties of HCC and that its inhibition effectively reverses tumour cell migration, invasion, colony and sphere formation. The main limitation of this study is the dataset's class imbalance, and while weighted training helped mitigate this, further research and additional data are needed to guarantee model generalizability. Future studies should also explore the influence of genetic variations, environmental factors, and clinical differences on model performance across diverse populations.

Cervical cancer is a major global health challenge, with disease burden falling disproportionately on low- and middle-income countries (LMICs) due to a shortage of trained specialists and the subjective nature of colposcopy-based screening. To address this challenge, we propose a novel deep learning framework for the automated grading of Cervical Intraepithelial Neoplasia (CIN) and the prediction of clinical Swede scores. We also introduce the BUET Multi-Center Colposcopy Dataset, a novel, multi-center cohort designed and annotated for Swede score prediction and CIN grading. Our proposed dual-stream cross-attention architecture mimics the visual reasoning of an expert colposcopist by explicitly fusing paired multimodal cervigrams to evaluate comparative tissue responses. Furthermore, we introduce a custom composite loss function to address severe class imbalances and scoring inconsistencies across the five Swede score components. The proposed framework achieved 71.85% accuracy and an 86.23% AUC-ROC for three-class CIN grading, outperforming existing methods. For Swede score component prediction, the architecture achieved AUC-ROC values ranging from 75.7% to 88.4%, with the composite loss function yielding consistent F1-score improvements. Finally, the total predicted Swede Score, which ranges between 0 and 10, shows a Mean Absolute Error (MAE) of 1.489. The results show that the proposed method can pave the way towards developing AI-assisted colposcopy screening tools to support risk-based triage in resource-limited healthcare settings. The dataset and source code are publicly available(url: https://github.com/mHealthBuet/BUET-colposcopy)

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.

Basal Cell Carcinoma (BCC) is the most common type of skin cancer, accounting for nearly 80% of skin cancer di- agnoses. Its optimal clinical management is guided by the distinct histopathologic subtype, with aggressive variants requiring more drastic measures. In current clinical practice, subtyping relies on skin biopsies, a procedure both costly and invasive. In this paper, we conduct a preliminary investigation into using deep learning for BCC subtyping, solely from a single dermatoscopic image of the lesion. Given the limited data at our disposal, we employ pre-trained vision transformers (ViTs), a state-of-the-art family of models highly effective for challenging downstream tasks with limited labeled data. Through repeated stratified k-fold cross-validation, we demonstrate that ViTs can achieve superior performance (AUC 0.784 on a dataset of 1271 dermatoscopic images of various BCC subtypes) over standard CNN-based baselines as well as previously-reported human reader perfor- mance, on the task of differentiating aggressive BCCs from other subtype families. These initial findings highlight the potential of combining deep learning and dermatoscopy to provide a biopsy- free alternative for BCC subtyping, thus aiding in improving treatment planning and patient outcomes.

Deep learning models for CT scan analysis are often limited by the scarcity of precise pixel-level annotations, which require significant radiologist effort to produce. Training on scan-level labels alone reduces annotation requirements but introduces challenges: low supervision ratios and large input volumes make models prone to overfitting and shortcut learning. In this work, we investigate two complementary methods to address these challenges: multi-instance learning (MIL) and anatomical filtering. MIL divides CT volumes into 2D slice instances, enabling efficient 2D architectures with ImageNet pretraining rather than computationally demanding 3D models. Anatomical filtering uses Compass, our self-supervised body part regression model, to crop scans to pathology-relevant subregions without requiring segmentation masks. We evaluate two MIL frameworks - Attention-based MIL (ABMIL) and FocusMIL - on kidney tumor classification across one internal dataset (TUH) and two external datasets (KiTS23 and TCGA-KiRC). Our best models achieve F1 = 0.83 on the internal test set using only scan-level labels. We further show that anatomical filtering with the Compass model is critical for the out-of-distribution generalization of embedding-based ABMIL, while instance-based FocusMIL demonstrates greater inherent robustness to distribution shift. While evaluated on kidney tumors, we consider this a proof-of-concept for a broader weakly supervised CT classification pipeline applicable to other organs and pathologies.

Clear cell renal cell carcinoma (CCRCC) grading is essential for treatment planning, yet existing approaches either analyze patch-level images directly or focus solely on nuclei-level classification, without linking to final tumor grading. We propose a semantic-guided multimodal preprocessing method that integrates nuclei classification maps from existing pre-trained models with RGB histopathology images for Vision Transformer (ViT)-based CCRCC grading. Our approach employs classification map channel concatenation and multiplicative modulation, with optimized overlays to leverage nuclei grading information, while preserving RGB textural features. Evaluation of multiple preprocessing strategies demonstrates that semantic-guided enhancement achieves 0.916 balanced accuracy, outperforming RGB-only baseline (0.707) and max-voting aggregation from prior studies (0.427). Sensitivity analysis reveals that this 21 percentage point improvement over baseline persists even under simulated perturbation at rates matching current state-of-the-art nuclei classification model error thresholds, suggesting both effective semantic utilization and practical robustness. These findings show that preprocessing-based multimodal fusion can leverage the diagnostic potential of existing imperfect nuclei classifiers, effectively bridging previously isolated fine-grained nuclear-level analysis with coarse-grained ViT-based patch classification. Per-class recall was consistent across grades (0.93, 0.91, 0.91), indicating that gains are not concentrated in the majority class. Because the sensitivity analysis perturbs ground-truth maps rather than predictions from an actual nuclei model, this result characterizes robustness under simulated error rather than deployment with a real upstream model, which remains for future work.

Concept bottleneck models (CBMs) can improve the transparency of cancer image diagnostic prediction by expressing predictions through radiological concepts. However, their dependence on instance-level concept annotations limits practical applicability. We propose a prior-guided hybrid CBM that integrates limited concept annotations, class-conditional concept distribution matching on unannotated patients, and prior initialization of the concept-to-diagnosis head. We evaluate the method on CBIS-DDSM mammographic masses and calcifications and LIDC-IDRI pulmonary nodules across 0-100% concept annotation. In the clinically relevant 0-20% annotation regime, the hybrid CBM consistently improves mean concept AUC over a matched standard CBM, while maintaining diagnostic performance close to black-box models. At 10% annotation specifically, concept AUC increases from 0.619 to 0.741 for masses, from 0.650 to 0.787 for calcifications, and from 0.597 to 0.642 for pulmonary nodules. Ablation experiments identify prior initialization as the main component contributing to improved concept detection, likely by stabilizing the concept-to-diagnosis head. Zero-shot VLMs remain insufficient for reliable fine-grained tumor-level concept prediction. These findings suggest that structured priors can substantially reduce the annotation burden of interpretable cancer imaging models.

Background and Study Aims: Accurate optical diagnosis of colorectal polyps guides resection strategy and surveillance, with multimodal large language models (MLLMs) showing potential for image-based diagnosis. We aimed to evaluate the diagnostic accuracy of MLLMs in classifying colorectal polyps and predicting histology. Methods: We conducted a retrospective diagnostic performance study using the PRIME dataset, a curated set of white light and narrow-band imaging (NBI) images. We evaluated Claude Opus 4, Google Gemini 2.5 Pro, GPT-o3, GPT-4o, and GPT-5. For Paris, Narrow-band Imaging Colorectal Endoscopic (NICE), and predicted histology, we calculated F1 scores, percent correct scores, and accuracy of each MLLM compared to expert responses for 132 cases. Cochran's Q and McNemar's Test were used to determine differences between predicted values of each MLLM. Results: The F1 scores among MLLMs were >0.9 for all models for neoplastic vs. non-neoplastic polyps. Gemini 2.5 Pro demonstrated the highest F1 scores for invasive vs. non-invasive polyps and low- vs. high-grade adenoma, at 0.560 and 0.492 respectively. Claude Opus 4 and GPT-5 had statistically significantly higher percent correct scores than other MLLMs at 41.7%, using Paris classification. Conclusions: Claude Opus 4 and Gemini 2.5 Pro showed the highest accuracy in differentiating polyp subtypes, performing closest to expert consensus. Sensitivity and specificity, however, did not meet ESGE standards, highlighting the need for prospective multicenter trials and the design of human-in-the-loop workflows before clinical deployment.

Enhancing classification performance in mammography remains a persistent challenge across both small curated datasets and large-scale clinical cohorts. Conventional transfer learning approaches often neglect dataset-specific characteristics, while recent neighborhood-informed methods have been restricted to narrow tasks with rigid formulations, limiting their scalability to population-level datasets. To address these challenges, we propose the Dataset-Informed Transfer Learning (DITL) framework, which integrates dataset-derived difficulty signals with neighborhood-based triplet supervision in a unified objective. DITL introduces two adaptive components: (i) Adaptive Difficulty-Weighted Cross-Entropy (A-DWCE), which assigns per-sample weights based on k-nearest neighbor label purity in a self-supervised feature space, and (ii) Adaptive Neighborhood Representation Triplet (A-NR-Triplet), which enforces intra-class compactness and inter-class separation using a learnable margin. Unlike focal loss, DITL requires no hyperparameter tuning, removes heuristic weighting and fixed margins, and incurs negligible computational overhead, yielding a robust and scalable optimization strategy. On the large-scale VinDR-Mammo dataset, DITL achieves state-of-the-art performance for whole-image breast density classification, with significant improvements across accuracy, F1-score, and AUC (p < 0.0001). Beyond large cohorts, DITL also delivers consistent, statistically significant gains on small ROI datasets (p < 0.0001). By bridging small-scale lesion analysis with large-scale density estimation, DITL establishes a clinically relevant, scalable, and generalizable framework for mammography classification, spanning the full breast cancer screening-to-diagnosis spectrum.

ThinPrep Cytologic Test (TCT) enables early cervical cancer screening, but manual reading is time-consuming and yields inconsistent diagnostic results among cytopathologists. Existing AI detection models perform poorly under real clinical conditions, primarily restricted by two key constraints: unbalanced spatial distribution of cell populations in TCT slides, and limited high-quality annotated cytology data relying on professional pathologist labeling. To address these limitations, we propose a Cell-Distribution Normalization (C-Norm) method. By decoupling abnormal and normal cells from the original TCT images and re-synthesizing them, this method ensures a uniform distribution of cell populations, thereby mitigating generalization degradation caused by distribution bias. Building upon this, we integrate the YOLOv12 framework with a DINOv3 module. This hybrid architecture leverages the advanced detection capability of YOLO models and the superior feature representations of DINOv3 to capture subtle morphological nuances essential for precise recognition of TCT images. Extensive experiments demonstrate that our proposed method achieves state-of-the-art performance, significantly outperforming mainstream detection algorithms. The complete implementation is available at: https://github.com/ddw2AIGROUP2CQUPT/Cell-Norm

Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer-related deaths globally, with approximately 1,926,425 new cases and 904,019 deaths reported in 2022. Accurate histologic grading plays a critical role in prognosis and treatment planning for colorectal adenocarcinoma. In recent years, artificial intelligence and its subcategories, including machine learning and deep learning, have been increasingly employed for automated cancer detection and classification. An appropriate and well-organized dataset is the essential first step to achieve this goal. This paper introduces CRC-HGD, a histopathological microscopy image dataset of 1,914 images obtained from 214 colorectal adenocarcinoma patients (Grade I: 106, Grade II: 75, Grade III: 33). The specimens are H&E-stained colorectal tissue sections acquired at the Poursina Hakim Research Center of Isfahan University of Medical Sciences, Iran, diagnosed between 2014 and 2019, and graded according to the World Health Organization (WHO) criteria into three grades: well-differentiated (Grade I), moderately differentiated (Grade II), and poorly differentiated (Grade III). For each specimen, four magnification levels are provided: 4x, 10x, 20x, and 40x. The dataset is accessible via Mendeley Data (https://doi.org/10.17632/yfp5sfj47m.4) and at http://databiox.com, where the latest version is also available. The distinctive feature of this dataset is the provision of labeled specimens across all three differentiation grades at multiple magnification levels, enabling comprehensive computational analysis of colorectal cancer grading.

Accurate cervical cytology image classification is a key component of automated cervical cancer screening, where reliable recognition of normal, precancerous, and cancer-associated cellular patterns from Pap smear images can improve screening efficiency and diagnostic consistency. However, this task remains challenging because cervical cells exhibit complex morphology, subtle intra-class variations, and strong inter-class similarities. Existing convolution-based models capture local texture well but have limited ability to model long-range relationships, whereas attention-based models provide broader context but often lack explicit structural guidance. To address these limitations, we propose a geometry-aware classification framework for cervical cancer screening-oriented cytology image analysis, incorporating semantic abstraction and structural priors learned from pre-trained vision-language features. The method uses Gaussian expert modules to generate axis-wise priors from global semantic information, capturing structural regularities such as nuclear alignment and cellular spatial organization. These priors are embedded into an axial self-attention module to modulate similarity computation along horizontal and vertical directions, improving long-range dependency modeling and structure-sensitive feature interaction. Experiments on the Mendeley liquid-based cytology and SIPaKMeD datasets show that the proposed method achieves 99.48% accuracy on the former and 96.08% on the latter, with balanced gains in recall, precision, and overall classification performance. Visual analysis further shows that the learned priors highlight diagnostically relevant cellular regions, demonstrating the potential of the proposed framework as a screening-oriented decision-support tool for cervical cytology.

Breast cancer remains the most commonly diagnosed malignancy among women worldwide, yet accurate detection and characterization of breast masses in mammography remain challenging due to subtle intensity variations, heterogeneous tissue densities, and indistinct lesion boundaries that complicate radiological interpretation. To address these limitations, we propose BiLoG-Net, a deep learning framework that jointly performs breast mass segmentation and malignancy classification through bi-context location-aware feature modeling and segmentation-guided attention mechanisms. Our architecture integrates a novel encoder-decoder paradigm with Fire-based feature extraction, lightweight global and local feature enhancement modules, and adaptive location-aware gating to simultaneously capture long-range contextual dependencies and fine-grained boundary-sensitive details. Unlike conventional multi-stage pipelines, our tightly coupled multi-task design enables mutual reinforcement between pixel-level localization and image-level diagnosis, reducing error propagation while producing spatially grounded malignancy predictions. Evaluated on CBIS-DDSM and INBreast benchmarks, BiLoG-Net achieves state-of-the-art performance with Dice scores of 94.20% and 93.10%, classification accuracies of 95.20% and 93.60%, and AUC values of 97.10% and 96.00%, respectively, substantially outperforming existing CNN and transformer-based baselines. By combining precise boundary delineation with reliable malignancy assessment in a single end-to-end model, this work holds strong potential for clinical computer-aided detection systems, helping radiologists prioritize suspicious cases and improve screening efficiency in busy clinical settings.

Cervical cytology classification models are typically evaluated on curated, class-balanced benchmarks, but real-world liquid-based cytology (LBC) collections are often small and class-imbalanced. This paper presents a class-imbalance-aware and calibration-aware ensemble classification study on the Mendeley LBC dataset, using its native four-class Bethesda taxonomy (NILM, LSIL, HSIL, SCC) rather than a collapsed binary formulation. Three lightweight architectures (Swin-Tiny, TinyViT-5M, DenseNet121) are trained directly on Mendeley LBC using weighted random sampling to counteract class imbalance, and compared against two soft-voting ensembles (Hybrid-2, Hybrid-3). Post-hoc temperature scaling is fit on a held-out calibration subset carved out of the training portion of each cross-validation fold, distinct from both the training data used to fit model weights and the evaluation fold used for final metrics, avoiding the optimistic calibration estimates that result when the same data is used for both purposes. Calibration substantially reduces expected calibration error, Brier score, and negative log-likelihood for every model and ensemble configuration tested, while discrimination metrics (accuracy, macro-F1, macro-AUROC) remain essentially unchanged. Ensemble size shows no consistent additional reliability benefit over the best individual model once all configurations are properly calibrated. Confusion matrices show that all classification errors, across every configuration, are confined to the boundary between high-grade lesions (HSIL) and carcinoma (SCC); no errors involve the negative (NILM) or low-grade (LSIL) categories. These results suggest that, for this dataset, calibration is the dominant lever for reliability, not ensemble size, though this conclusion should be read in light of the dataset's modest size.

Sparse feature selection is critical for high-dimensional machine learning, yet traditional $\ell_1$-regularized methods are often brittle under observational noise and spurious correlations, leading to unstable feature supports and degraded generalization. Although adversarial training has been widely used to improve model robustness, its interaction with hierarchical sparse feature selection remains underexplored. In this work, we propose Adversarial LassoNet (AdLNet), a stability-driven sparse feature selection framework that integrates input-space adversarial perturbations with the hierarchical sparsity mechanism of LassoNet. We derive a tractable first-order adversarial approximation under local smoothness assumptions and provide an NTK-inspired spectral analysis to characterize how perturbation-driven training can reduce gradient concentration. Experiments on high-dimensional SERS data, six public benchmark datasets, and ColoredMNIST show that AdLNet maintains competitive sparse-selection performance while improving out-of-distribution robustness by 4.4% and feature support reproducibility by 6.3% under nearly matched support sparsity on ColoredMNIST. On the high-dimensional lung cancer screening dataset, AdLNet achieves a 5.3% test accuracy gain and a 6.0% AUC improvement over vanilla LassoNet. Code and dataset are available at https://github.com/719573/Adversarial-LassoNet.

Modernizing cancer registries with deep learning is opening new opportunities to automate labor-intensive tasks such as the coding of pathology reports. However, progress is constrained by the scarcity of report-level human-annotated training data. Cancer registries generate substantial volumes of expert-assigned labels as a routine product of their operations, but these exist at the patient level and are not linked to the individual pathology reports that informed them, limiting their direct use for training models. We develop an efficient framework for training deep learning classifiers by leveraging these operationally-generated labels without requiring per-report human annotation, demonstrated for tumor group classification at the BC Cancer Registry. We use Attention-Based Multiple Instance Learning (ABMIL) to recover the lost link between patient-level labels and the reports that informed them, leveraging the attention the model places on each report to distil a large, noisily-labeled corpus into a compact, high-quality per-report training dataset. A classifier fine-tuned on a distilled dataset achieved a macro F1 of 0.83, outperforming established baselines across most tumor groups. By turning routine operational labels into high-quality training data without additional annotation or large-scale computing infrastructure, ABMIL offers a practical and accessible route to automating cancer registry workflows.

NA methylation profiling has become a powerful approach for central nervous system (CNS) tumor classification, yet important challenges remain regarding cross-cohort transferability, methodological correctness, and robust multiclass evaluation. In this work, we propose a novel and methodologically rigorous machine-learning approach for methylation-based CNS tumor classification that combines Sparse Random Projection for dimensionality reduction with multinomial logistic regression for classification. We evaluate the proposed approach in the same general experimental setting established by a widely used reference classifier. On the 2,801-sample reference cohort, our method achieves a mean accuracy of 96% under stratified 3-fold cross-validation. On the independent 1,104-sample clinical evaluation cohort, it reaches 86% accuracy at the 91-class level and 93% when predictions are evaluated at the methylation class family level. These results improve upon the corresponding state-of-the-art reference figures of 82% class-level concordance and 88% family-level concordance, yielding absolute gains of approximately 4 and 5 percentage points, respectively. This improvement is clinically relevant: in a diagnostic setting, a 5-point increase in correct tumor classification can directly affect cancer subtype assignment and, in turn, influence treatment selection and downstream clinical decision-making. Our results show that the proposed model, grounded in stronger methodological practice in machine learning, consistently outperforms the previous state of the art across evaluation settings and can materially improve the reliability of CNS tumor classification.

We present a multi center breast fine needle aspiration cytology (FNAC) dataset designed for patch wise classification using C1 to C5 reporting labels. The prospective dataset includes 321 patients and 470 whole-slide images (WSIs) collected from participating tertiary medical centers in India between May 2023 and March 2026. Slides were stained using Papanicolaou (190 WSIs) or MayGrunwald Giemsa (280 WSIs), scanned on a Hamamatsu NanoZoomer S360 at 40X magnification and 0.25 microns per pixel, and stored directly in NDPI format. Across the 470 WSIs, 446 WSIs contain annotated patch regions, yielding 7,398 PNG image patches with expert-verified C1 to C5 labels. The release includes NDPI WSIs, WSI-level GeoJSON annotation files, extracted patch images, deidentified metadata, a data dictionary, a validation summary, a manifest linking WSIs to Zenodo records, and code for dataset inspection and reuse. The complete dataset is approximately 950 GB and is available through Zenodo.

Multimodal Large Models have significantly advanced automated breast ultrasound diagnosis. However, most existing frameworks utilize opaque, end-to-end paradigms prioritizing global statistical correlations over structured clinical reasoning. Consequently, these models remain susceptible to shortcut learning amid extreme real-world epidemiological imbalances, often bypassing rare but decisive malignant indicators for dominant benign patterns. To address this disconnect, we propose Latent-CURE, a novel diagnostic framework driven by asymmetric weighted chain-of-thought methodology grounded in latent space reasoning. Unlike traditional approaches, our framework constructs an implicit reasoning trajectory forcing the model to sequentially infer standardized BI-RADS morphological descriptors before converging on a final diagnosis. Furthermore, to combat the extreme scarcity of critical malignant features, we couple this architecture with a dual-asymmetric optimization strategy. By dynamically adjusting margins and weights, this strategy safeguards high-specificity malignant descriptors from being overshadowed by common benign priors. Comprehensive evaluations demonstrate that our knowledge-injected approach provides transparent clinical evidence while achieving robust, accurate diagnostic performance in imbalanced medical cohorts.

Cross-domain diagnosis remains a major challenge in cervical cell pathology due to pronounced domain shifts across institutions and the subtle visual differences among disease stages, which jointly impair model generalization. To address these issues, this paper proposes a two-stage framework for cross-domain cervical cell detection. In the first stage, we propose the Spatially-Continuous Unpaired Neural Schrödinger Bridge (SC-UNSB), which constructs a synthetic intermediate domain to mitigate cross-domain distribution shifts by modeling image translation as an entropy-regularized optimal transport process. In the second stage, we propose a dual-level feature alignment strategy within a knowledge distillation, which progressively aligns shallow structural features and deep semantic representations to facilitate the transfer of domain-invariant knowledge from the source to the target model. Experimental results demonstrate that the proposed method effectively mitigates domain shift and category ambiguity, improving the cross-domain detection performance.

Artificial intelligence (AI) has achieved remarkable success in medical imaging, but it is widely recognized that these models often perform inconsistently across real-world clinical settings. Such inconsistencies occur when patient demographics and imaging protocols vary, for example, in detecting small tumors, analyzing scans from different contrast phases, or evaluating patients of different ages or sexes. To quantify these inconsistencies, we develop a large-scale, open benchmark of 85,355 CT scans that systematically evaluates 12 tumor-detection AI models across tumor size, location, patient subgroup, and imaging protocol. We leverage large language models (LLMs) to extract and organize subgroup information from clinical data, which makes the analysis both scalable and reproducible. Our benchmark reveals that current state-of-the-art AI models, optimized for average accuracy, perform poorly in rare or underrepresented subgroups, such as young, female African Americans. However, collecting sufficient annotated data for these rare cases is often impractical. The benchmark provides a foundation for building more reliable and robust AI models for tumor detection and highlighting the need for rigorous, subgroup-level evaluation in medical imaging and computer vision. Datasets, code

Automated classification of acute lymphoblastic leukemia (ALL) from peripheral blood smear images has often reported near-perfect performance on the C-NMC 2019 dataset. We show that such results can be inflated by patient-level data leakage caused by random image-level partitioning, where cells from the same subject may appear in both training and test folds. We establish a leakage-aware benchmark under a strict subject-disjoint protocol, comparing LightGBM, RBF-SVM, EfficientNet-B0, EfficientNet-B1, and ViT-Tiny. Models are developed using three subject-disjoint folds from 73 subjects and evaluated on an external preliminary-phase test set of 1,867 images from 28 unseen subjects with zero patient overlap. Beyond discrimination, we assess calibration using expected calibration error, Brier score, and temperature scaling. Under honest evaluation, EfficientNet-B1 achieves the best performance, with AUROC 0.913, sensitivity 0.87, specificity 0.80, and calibrated ECE 0.024. Frozen-feature classifiers and ViT-Tiny show high sensitivity but poor specificity, indicating a tendency to over-predict the malignant class. A random-versus-subject-disjoint ablation shows that random splitting inflates AUROC by about 0.04 even in the conservative frozen-feature setting. These findings caution against image-level evaluation on C-NMC 2019 and provide a reproducible, calibration-aware benchmark for future work.

This study introduces a computationally efficient convolutional neural network (CNN) architecture enhanced with transfer learning for multi-cancer detection using biomedical images. The proposed lightweight CNN model is designed to reduce computational complexity while maintaining high classification performance, making it suitable for deployment in resource-constrained environments. We evaluate this approach on three distinct tumor datasets comprising brain magnetic resonance imaging (MRI) and lung and kidney computed tomography (CT) scans. The model achieves test accuracy of 90.85 +- 2.22%, 98.64 +- 2.43% and 99.92 +- 0.08% for brain, lung, and kidney cancer classification, respectively, using 5-fold stratified cross-validation (CV). Transfer learning is employed by pretraining the model on one cancer type and fine-tuning it on the others, requiring only 20 additional epochs to achieve performance comparable to models trained from scratch. The fine-tuning process involves updating the classification part of the CNN and requires approximately 0.014 seconds per image per epoch using an NVIDIA GeForce GTX 960. Comparative evaluations show that the proposed model outperforms several state-of-the-art pretrained architectures, such as Xception, VGG16, VGG19, MobileNetV2 and DenseNet121. Overall, the model's effectiveness is evaluated across three types of cancer with distinct morphological characteristics, assessing its performance on both MRI and CT imaging modalities and demonstrating robust performance across diverse tasks and data types. These findings underscore the potential of streamlined deep learning (DL) frameworks in accelerating cancer diagnosis without sacrificing accuracy, especially in settings with limited computational resources.

Gastrointestinal cancers represent a growing health burden in the South Asian region, driven largely by rapid changes in socio-economic conditions & lifestyle habits. However, early diagnosis of such malignancies remains a significant challenge, largely due to a lack of modern equipment, lack of financial support, and a scarcity of GI experts. AI-assisted diagnosis & report generation, show great promise in alleviating this problem by providing low-skill manpower the technical expertise to perform diagnosis. However, almost all open-source, publicly available datasets are predominantly collected from the European region, with no representation from the South Asian region. The lack of open-source GI datasets from diverse geographic regions has made it difficult to assess whether population bias is present in existing models, and to develop geographically inclusive AI tools for automated GI diagnosis. To address this gap, we introduce SAGE: An Expert-Annotated South Asian GI Endoscopy dataset for image captioning, multi-label classification, and visual question answering (VQA) tasks. It consists of 1,300 images, their captions along with hallucination tag, 18 labels and 14,726 question-answer pairs making it well-suited for diverse range of tasks including classification, benchmarking, and fine-tuning large multimodal models (LMMs). We further conducted benchmarking of multi-class classifiers on the effect of population shift in GI imaging AI tasks, and contemporary LMMs on their performance. Our study reveals that task-specific models, such as multi-class classification models, suffer the most, with an average performance drop of 58% when evaluated on the South Asian dataset. For contemporary LMMs, benchmarking reveals a substantial drop in the average GREEN score for anatomical landmark detection (0.308) and abnormality detection (0.410).

Matched multi-omics can improve WSI-based biomarker and prognosis prediction, but most existing pipelines use omics as a paral lel feature stream or textual context rather than as an explicit retrieval constraint. HERO asks whether observed omics can be a testable mor phology hypothesis: a sparse pathway-to-morphology prior maps DNA methylation and miRNA into a K-dimensional intent vector m (K=16), TF-IDF retrieval over structured 10 captions selects endpoint-relevant regions, and a cosine gate c=cos(m,v) triggers deterministic deficit driven repair when c<τc. This closed-loop design bounds VLM calls, reduces reliance on embedding-based semantic matching, and makes every retrieval and verification step lexically auditable. On TCGA-BRCA (930WSIs, patient-level 5-fold CV), HERO sets new state-of-the-art across ER, PR, HER2, subtype, and risk prediction, outperforming both multimodal fusion and VLM-based baselines.

Cell-free DNA (cfDNA) is a promising avenue for non-invasive multicancer early detection (MCED), in that, it can enable multiple cancer detection simultaneously from a single blood draw, with particular sensitivity to cancers that currently lack established screening programs. Here we review the computational methods developed between 2022 and 2025 for cfDNA-based MCED. We focus on how fragmentomics and epigenetic features are extracted and analyzed to detect cancer at early stages. We first briefly outline the biological basis of cfDNA signals, then review classical statistical and machine learning approaches alongside deep learning frameworks including autoencoder-based models. For each method we discuss biological interpretability, validation strategy, and readiness for clinical integration. Furthermore, we categorize the current challenges into technical, computational, and methodological while outlining open problems in the field. This review shows that multimodal ensemble approaches have the strongest promise for clinical integration and the highest readiness. However, for better assessment of future work and side-by-side comparison, standardization of evaluation protocols and reporting results will be crucial.

This article presents a complementary approach for integrating multimodal medical data in cancer classification, based on state space models represented by the Mamba architecture. To this end, a mixed multimodal fusion architecture, called Mixed Fusion, was employed and developed to enhance the interpretability of the decision-making process. The proposed approach explores two variants of Mamba: one dedicated to visual processing, responsible for classifying the lesion image and generating probabilities associated with the target classes, and another focused on tabular processing, which uses these probabilities together with clinical and/or sociodemographic data to produce the final diagnosis. The experiments were conducted on two medical datasets: PAD-UFES-20, composed of clinical images and information associated with skin lesions, and NDB-UFES, consisting of histopathological images and sociodemographic data related to oral cancer. The results indicate slightly lower performance in balanced accuracy, compared with Transformer-based approaches, on PAD-UFES-20, and superior performance on NDB-UFES. Additionally, substantial gains were observed in the recall metric. Furthermore, the adoption of the Mixed Fusion architecture enables the application of the Shapley Additive Explanations (SHAP) method, increasing the interpretability of the results. These findings indicate that Mamba-based models constitute a suitable alternative for multimodal classification in medical data, especially in scenarios in which sensitivity is a relevant requirement.

Lung cancer is the leading cause of cancer-related mortality, with approximately 2.5 million new cases and 1.8 million deaths annually, making reliable diagnosis a clinical priority. Although deep learning models have achieved strong performance in lung cancer classification, evaluation has largely focused on predictive accuracy, leaving their decision-making processes insufficiently examined. This study compares three architecturally distinct models: a Convolutional Neural Network (CNN), a pretrained ResNet50, and a Vision Transformer (ViT), trained on the IQ-OTH/NCCD lung cancer CT dataset. Local Interpretable Model-Agnostic Explanations (LIME) were applied to investigate model reasoning. In addition to standard performance metrics, a dual-correlation framework was introduced to measure both prediction agreement and explanation agreement across model pairs. All three models achieved strong classification performance, with ResNet50 attaining 98.61% accuracy, CNN 97.91%, and ViT 93.75%, while all achieved ROC-AUC scores of 0.99. Prediction correlations exceeded 0.99 across all model pairs, indicating highly consistent outputs. However, LIME explanation correlations remained below 0.26, revealing substantial differences in the image regions used to reach those predictions. Analysis of misclassified samples further identified a consistent spatial pattern: incorrect predictions were associated with attention outside the lung parenchyma, whereas correct predictions focused primarily within lung regions. These findings demonstrate that prediction agreement is a poor proxy for reasoning consistency, and that interpretability evaluation must be treated as an independent validation criterion alongside predictive performance in clinical AI systems.

The global elimination of cervical cancer is a key public health goal set by the World Health Organization (WHO), with screening programs reducing mortality by up to 80%. However, access to experts and biopsy services is limited in low- to middle-income countries (LMICs). Deep learning (DL)-based algorithms offer promising support for screening, but most existing approaches have been developed and validated on private datasets from single countries. We present the first DL-based approach to cervical cancer screening validated on data from multiple countries. Technically, we phrase the problem of detecting and classifying lesions in colposcopy images as a multi-task learning problem, in which we simultaneously perform image-level classification and lesion segmentation. Our model was trained on a private data set of acid stain colposcopy images with manually generated lesion segmentation masks and corresponding histopathological results, employing extensive data augmentation to address image variability. In an in-distribution validation with pathology results serving as ground truth, our algorithm outperformed medical experts (Balanced Accuracy: 0.68 vs 0.64) in CIN1- (Cervical intraepithelial neoplasia grade 1 or lower) versus CIN2+ (grade 2 or higher) classification. External validation on four colposcopy data sets from four countries featuring radical differences in prevalence and patient characteristics yielded superior performance of our method compared to baseline methods. Performance variability across countries was high with AUC values ranging from 0.54 - 0.80. Overall, algorithm performance varied with age, transformation zone (cervical area most prone to lesion development), presence of comorbidities and pathognomonic signs, with comorbidities having by far the largest negative effect. Future work should focus on improving model robustness and generalizability.

Early and highly accurate prediction of colorectal polyps, as an important sign of one of the most dangerous types of cancer, will result in saving more lives. Despite the advancements in colorectal polyp classification, many challenges remain in obtaining an automated polyp prediction system that is able to diagnose the difficult-to-predict polyps accompanied by different features in real scenarios, where the model can handle imbalanced data, label distribution shift, and cross-modality generalization successfully. In this study, we propose Polyp-D2ATL, a novel framework accompanied by a specific training strategy, which mitigates these limitations and effectively predicts the different classes of polyps belonging to the NICE classification. Our extensive experiments on the PICCOLO validation and test sets demonstrate that the proposed Polyp-D2ATL significantly outperforms existing state-of-the-art models across various reliable metrics, achieving an accuracy of 82.38%, a Macro-F1 of 77.49%, and a specificity of 87.47% on the validation set, alongside consistent improvements on the held-out test set which demonstrates the generalization capacity and clinical applicability of the proposed approach.

Melanoma is the most dangerous form of skin cancer with five-year survival rates exceeding 99% when detected early but falling sharply once the disease spreads. This paper proposes and evaluates a two-stage fine-tuning approach for ResNet50 applied to binary melanoma classification on dermoscopic images. The core challenges addressed are class imbalance and suboptimal transfer learning from single-stage fine-tuning. After stratified train/validation/test splitting, random oversampling was applied exclusively to the training set to achieve a 1:1 class balance. Stage 1 trained only the classification head with the ResNet50 base frozen, while Stage 2 fine-tuned all layers jointly at a low learning rate of 1e-5 to prevent catastrophic forgetting of learned visual features. On an independent test set of 3,826 images, the model achieved an AUC-ROC of 0.9559, accuracy of 88.34%, sensitivity of 87.56%, specificity of 89.13%, and F1-score of 88.29%. An ablation study confirms the two-stage protocol significantly outperforms single-stage fine-tuning, with sensitivity gains of over 4%. Grad-CAM visualizations demonstrate correct lesion localization. A fully deployable Streamlit detection application is provided alongside all training code.

Purpose. To compare deep learning architectures and classification schemes for dermoscopic images of skin neoplasms and assess their generalization on transfer from open international datasets to independent clinical datasets of Russian practice. Methods. Four architectures (ViT-B/16, Swin-S, ConvNeXt-S, EfficientNetV2-S) were compared in three schemes: binary (malignant/benign), single-stage four-class (benign, MEL, SCC, BCC), and a two-stage cascade (binary triage, then three-class differentiation MEL/SCC/BCC). All models used ImageNet-pretrained weights and a single augmentation protocol on aggregated open ISIC Archive data, and were evaluated on an internal held-out sample and two clinical datasets (Melanoscope AI mobile system; Sechenov University). Results. Internally the binary stage attains ROC-AUC 0.952-0.966; on Sechenov University it drops to 0.797-0.893, sensitivity to 0.53-0.67, and ECE rises from 0.02 to 0.27-0.39 with underestimation of malignancy, quantifying a generalization gap in ranking and calibration. Paired tests confirm one inter-architecture result on clinical data: the deficit of ViT-B/16 at the binary stage (p<0.05); at the differentiation stage no architecture has a proven advantage. The cascade raises macro F1 over single-stage four-class classification for most architectures, but significantly only for ViT-B/16, by recovering malignant lesions assigned to the dominant benign class. On ISIC MILK10k, direct 11-class classification yields mean-class sensitivity 0.525. Conclusion. A tunable triage threshold gives sensitivity control not attainable in standard single-stage (argmax) classification and better reproduces clinical differential-diagnosis logic. The persistent generalization gap mandates external clinical validation and recalibration before deployment.

Skin cancer is among the most prevalent malignancies worldwiAdbe satnradcitts early detection is essential for improving patient survival and reducing treatment costs Conventional dermoscopic and visual imaging techniques are primarily limited to the visible spectrum and often fail to capture subtle spectral signatures associated with early stage malignancies This study proposes an innovative framework that integrates a multispectral metasurface for imaging with a hybrid deep learning architecture based on Convolutional Neural Networks and Vision Transformers The designed metasurface enables noninvasive acquisition of rich spectral information highly sensitive to tissue alterations while the hybrid CNN ViT model simultaneously extracts local and global features to robustly classify skin lesions Simulation-based evaluations demonstrate that the proposed method achieves approximately 98 accuracy 95 percentages sensitivity and 99 perentage specificity surpassing conventional RGB-based and single-architecture approaches Qualitative analyses using attention maps reveal that the model focuses on clinically relevant lesion regions improving interpretability Overall the results indicate that combining metasurface based multispectral imaging with hybrid deep learning can introduce a new generation of diagnostic tools in dermatology and pave the way for portable fast and highly accurate clinical systems

Bone marrow smear review remains important for acute myeloid leukemia (AML) assessment, but manual single-cell interpretation is labor-intensive and patient-level diagnosis requires aggregation of many cellular observations. We present a cell-to-patient deep learning pipeline for AML-assisted diagnosis from bone marrow smear images. The study included 258 patients from six anonymized centers, including a main cohort of 169 patients from Centers 1-3 and an external validation cohort of 89 patients from Centers 4-6. A 16-category cell annotation vocabulary was used to describe the global cellular composition, including granulocytic, monocytic, erythroid, lymphoid, eosinophilic, and other cells. Rather than identifying strict AML blasts or leukemic blasts, the model targets an expert-defined composite category termed Composite Blast-like Cells (CBLC), comprising N, N1, M, M1, R, R1, J, and J1 according to the project-wide morphological standard. A fixed YOLO-based segmentation module detected cells, predicted contours were matched to expert polygon annotations by contour IoU, and standardized single-cell crops were generated. An EfficientNet-B0 classifier was trained through a two-stage GT-to-YOLO and YOLO-to-YOLO strategy with class-imbalance correction, center-border regularization, and morphology-assisted supervision. Cell-level predictions were aggregated into patient-level CBLC ratios for AML-oriented diagnostic support. The pipeline achieved stable internal validation and maintained external generalization, with ensemble weighted F1-scores of 0.9076, 0.8696, and 0.9124 on Centers 4, 5, and 6, respectively.

Modern medicine relies on heterogeneous data sources spanning radiology, pathology, text reports, and structured clinical information. However, real-world patient data are frequently incomplete, with missing or sparsely acquired modalities, limiting the effectiveness of standard multimodal fusion approaches. To this end, we propose the Multimodal Flexible Redundancy-aware decomposed GAted Learning (Multi-FRuGaL) framework, a decomposition-aware, adaptive gated intermediate-fusion framework that performs modality-level representation learning under missing data. Multi-FRuGaL integrates per-modality encoders with a signal decomposition layer, an input-conditioned gating network, and an information-aware fusion objective to separate redundant from modality-specific complementary signals, selectively upweighting informative modalities and suppressing redundant or noisy inputs, and remaining well-defined even when multiple modalities are absent. We evaluate Multi-FRuGaL on two multimodal head and neck cancer cohorts: the HANCOCK challenge dataset (N = 763) comprising five modalities and two prognostic endpoints (5-year survival and 2-year recurrence), and the HECKTOR challenge dataset (N = 588) comprising three modalities for human papillomavirus (HPV) status classification. Multi-FRuGaL consistently achieves higher mean performance than the evaluated baselines across multiple tasks, improving AUC from 0.601 to 0.8496 for survival, from 0.672 to 0.8102 for recurrence, and achieving 0.975 AUC for HPV prediction on HECKTOR. For survival analysis, it further achieves a concordance index of 0.6814 for overall survival, 0.7421 for recurrence-free survival, and 0.7143 for progression-free survival on HANCOCK, and 0.7203 for recurrence-free survival on HECKTOR. Qualitative analyses further show that Multi-FRuGaL learns discriminative and robust multimodal representations, even under severe missing-modality conditions.

Modeling patient trajectories from longitudinal electronic health records (EHRs) requires reasoning over sparse, noisy, and long-context multimodal sequences. Existing LLM-based multi-agent systems address context length but process patients in isolation, failing to mirror how clinicians leverage accumulated experience from similar prior cases. We present Traj-Evolve, a self-evolving multi-agent system with two complementary evolving mechanisms. First, an Experience Pool (ExPool) acts as a non-parametric memory, indexing rejection-sampled reasoning traces to retrieve similar patients as few-shot contexts. Second, multi-agent reinforcement learning (MARL) via reward-ranked fine-tuning parametrically optimizes inter-agent and agent-memory collaboration. A leave-one-out cross-retrieval strategy unifies the two, aligning training- and inference-time behavior under retrieval augmentation. On a lung cancer prediction task utilizing up to five years of multimodal EHRs, Traj-Evolve outperforms 9 strong baselines on the overall population and a challenging never-smoker population. Analysis of the evolving dynamics highlights three key findings: (1) expanding the ExPool shifts optimal retrieval from diverse to specific samples; (2) under MARL, the manager agent's prediction loss converges quickly while the worker agents' temporal reasoning continues to benefit from more verified patients; and (3) the two mechanisms are complementary on the predicted risk, where ExPool improves specificity while MARL improves sensitivity.

Brain cancer's severity necessitates precise brain tumor segmentation, which is crucial for effective brain tumor diagnosis. Manual identification, burdened by high costs, labor, and error risks, highlights the need for automated methods. In this study, we introduce the Global Context-aware Squeeze and Excite Residual UNet (GCSER-UNet), which facilitates a fusion of spatial and channel-wise attention and thus enhances the model's capacity to capture intricate spatial dependencies and contextual information. GCSER-UNet efficiently extracts tumor segments from multimodal MRI slices, delivering exceptional performance. Evaluations on benchmark databases exhibit its superiority, achieving a notable 94 percent dice score on the TCGA LGG dataset, surpassing the state-of-the-art dice score of 91.8 percent. In the BraTS 2020 dataset, the proposed GCSER-UNet ensemble approach yielded dice scores of 95 percent, 92 percent, and 90 percent for the tumor regions - Whole Tumor (W), Tumor Core (T), and Enhancing Tumor (E), respectively. The current state-of-the-art dice scores were 94 percent, 93 percent, and 88 percent. These compelling outcomes highlight the efficacy of GCSER-UNet in precise brain tumor segmentation and thus can aid neurologists in effective brain cancer management and treatment planning.

Introduction. Early detection of malignant skin lesions is critical for prognosis, yet dermatologist shortages in Russian regions limit screening coverage. Mobile dermoscopy clinical decision support systems (CDSS) offer a promising approach, with model interpretability and standardised patient routing remaining key barriers to adoption. Aim. To develop a quantitative interpretability assessment method for cascade deep learning models and a three-zone patient routing algorithm, and to conduct a preliminary single-centre prospective clinical validation of the Melanoscope AI CDSS in Russian outpatient practice. Material and methods. Two-stage cascade classification of dermoscopic images; attention map visualisation (attention rollout for ViT and Swin; Grad-CAM for ConvNeXt and EfficientNetV2); quantitative IoU-based agreement assessment between activation maps and expert annotations; prospective single-centre validation across four "Melanoma Day" sessions (Orel, Russia, June 2025 - April 2026). Results. On 176 patients: agreement with expert assessment 88.6%; no false negatives among 5 malignant lesions (95% CI: 47.8-100.0%); specificity 88.3%. Three melanomas and two basal cell carcinomas were histologically confirmed; six dysplastic naevi placed under follow-up. Mean IoU (n=180): ViT - 0.69; Swin - 0.64; ConvNeXt - 0.53; EfficientNetV2 - 0.51. Routing thresholds: P<0.15 / 0.15-0.50 / >=0.50. Conclusion. No false negatives were observed; specificity was 88.3%, supporting screening use. The integrated cascade classification, attention map visualisation with IoU assessment, and three-zone routing provide reproducible, interpretable clinical decision support adaptable to varying resource levels.

Skin cancer is a common and fast rising malignancy worldwide. Early detection is critical for improving outcomes. Deep learning models trained on dermoscopic and clinical images can support automated and fast triage. However, many studies evaluate only a limited set of architectures. Experimental setups also vary across studies. In this paper, we present a unified evaluation of twelve deep learning models for binary skin cancer detection on the PAD-UFES-20 dataset. The models span four families: convolutional neural networks (CNN), vision transformers (ViT), hybrid convolution transformer backbones, and vision language models (VLM). Performance is assessed using AUC, the maximum F1 score with its precision and recall, and sensitivity at 80% specificity, reflecting screening oriented requirements. Our results show that well tuned CNNs already provide strong baselines, but transformer based families consistently improve discrimination. Hybrid models (MaxViT Tiny, CoAtNet0) and a SigLIP based VLM achieve the best overall trade off between ranking performance and clinically relevant operating points, while CLIP based model offers high precision. The full codebase for all experiments is publicly released. Together, these findings offer practical guidance on which model families are most suitable for real world deployment in skin cancer screening and establish a reproducible reference point for future work on PAD-UFES-20.

Urgent suspected colorectal cancer (CRC) referrals create operational bottlenecks because semi-structured clinical documents often require manual review and transcription. The original RAPTOR system used Large Language Models for structured extraction but relied on a separate OCR stage, making it vulnerable to handwriting, layout variation, and loss of visual evidence linkage. We present RAPTOR+, a multimodal extension that uses Vision-Language Models (VLMs) for end-to-end referral understanding. We evaluate fine-tuned VLMs, commercial and open-source zero-shot VLMs, and the original OCR-based pipeline on 223 clinically curated CRC urgent referral forms. We also introduce a grounding-aware evaluation framework that measures both extraction accuracy and evidence localisation. Results show a clear grounding gap in zero-shot models. Gemini 2.5 Flash achieved 92.6% Reading Accuracy but only 1.2% Strict Safety. In contrast, fine-tuned Qwen3-VL-8B achieved 96.1% Reading Accuracy and 60.6% Strict Safety, substantially improving verifiable evidence grounding. These findings show that task-specific fine-tuning is essential for reliable, auditable clinical document understanding. RAPTOR+ enables extracted referral decisions to be linked to visual evidence, supporting safer and more efficient cancer referral triage.

Synthesizing high fidelity contrast enhanced MRI is clinically valuable for safer and more efficient breast cancer screening, yet remains challenging due to complex lesion textures and heterogeneous enhancement patterns.

Generative augmentation is often proposed as a remedy for small medical-image datasets, but synthetic images are only useful when they improve downstream task performance. "Augmentation" here means synthetic supplementation: GAN-generated samples added to the real training pool, not geometric or photometric transforms of existing images. Twelve class-plane StyleGAN2-ADA generators were trained on constrained BRISC 2025 partitions to test whether their output, with or without InceptionV3 feature-space filtering, improves held-out tumour classification across three classifier families: a random forest (RF) on InceptionV3 features, a compact two-headed convolutional neural network (CNN), and MobileViTV2, a mobile hybrid convolutional-transformer. Each was evaluated at 1:1 and 1:2 real-to-synthetic ratios. An independent GPT-5.5 blind test placed gated real-versus-synthetic discrimination at 57.73% (95% CI: 54.48--60.92%) on the model-legible subset -- modestly above chance. The RF classifier did not benefit from the synthetic MRIs. The CNN showed consistent mean gains that did not survive Holm correction. MobileViTV2 showed the clearest benefit: filtered 1:1 augmentation improved tumour classification accuracy by 1.02% absolute (95% CI: 0.54--1.54%; Holm-corrected p = 0.0104). A secondary efficiency analysis found that every augmented CNN condition selected its checkpoint 42--64% earlier than baseline, while compute-matched MobileViTV2 runs reached selection after 50--67% fewer real-data epochs. Overall, augmentation utility was found to be architecture- and ratio-dependent, not guaranteed by visual fidelity alone.

In histopathology, human experts primarily rely on color as a means of enhancing contrast to interpret tissue morphology, whereas machine vision models process color as raw statistical information. This distinction raises a fundamental question: to what extent can pixel intensity alone, independent of structural and morphological cues, support cancer classification? To address this question, we systematically evaluated the standalone discriminative power of global color features while deliberately excluding all morphological information. Specifically, we extracted statistical color moments and discretized RGB and HSV color histograms, and assessed their performance across ten diverse experimental settings using classical machine learning classifiers. Our results demonstrate that color features alone can achieve strong performance in binary diagnostic tasks (e.g., benign versus malignant), with classification accuracies reaching up to 89%. This performance is likely attributable to global chromatic shifts associated with malignancy. Importantly, these simple color-based representations consistently outperformed random baselines by a substantial margin, indicating that raw color distributions encode a non-random and diagnostically relevant signal for cancer detection. Consequently, this study suggests that simple, computationally efficient color features can serve as an effective pre-screening tool. By identifying samples with strong chromatic indicators of malignancy, these lightweight models could function as a first-pass triage system, reducing the computational burden on complex deep learning architectures.

Manual Pap smear analysis for cervical cancer screening is limited by inter-observer variability, time constraints, and restricted expert availability. Although convolutional neural networks (CNNs) have automated cervical cell classification, they remain limited in modeling long-range spatial dependencies and often lack clinical interpretability. In this study, Vision Transformer (ViT) architectures were systematically optimized to enhance automated cervical cancer screening, which resulted in improved interpretability. The Herlev dataset (917 images: 242 normal, 675 abnormal) was utilized to optimize ViT-Tiny, a lightweight Vision Transformer architecture designed for reduced computational complexity, through a comprehensive evaluation of augmentation strategies, class weighting, and hyperparameters. The optimal configuration achieved 94.9%-95.2% cross-validation accuracy, in which random horizontal flipping and class weighting (0.7 x 1.3) were identified as most effective. Gradient-weighted Class Activation Mapping (Grad-CAM) analysis confirmed that model attention corresponded to clinically relevant morphological features, which include nuclear regions, cell boundaries, and chromatin texture, which align with cytopathological criteria. These findings indicate that Vision Transformers can deliver accurate and interpretable decision support for cervical cancer screening, which fulfills both clinical performance and transparency requirements essential for medical AI deployment.

Brain tumors exhibit high heterogeneity in morphology and multimodal contrast, making manual slice-by-slice de lineation time-consuming and experience-dependent, thus necessitating efficient and stable automated segmentation methods. To address the limitations of CNNs in modeling long-range dependencies, and the heavy computational and memory overhead and inter-block contextual in coherence of Transformers in 3D MRI, this paper proposes Multi-Head Mamba (MHMamba). This method combines a U-shaped architecture with a multi-head state-space model (Mamba), splitting the channel dimension into parallel SSM heads and aggregating them with residuals. This enhances long-range representation and improves the stability of multimodal training while maintaining linear complexity. To further align statistics and enhance lesion response, we designed a channel-space calibration module for multi-head outputs and introduced an adaptive fusion mechanism at skip connections to dynamically connect global semantics with local details, thereby improving boundary consistency and the detection of small-volume lesions. We conducted experiments and ablations on BraTS2021 and BraTS2023. The results showed that MHMamba achieved stable and significant improvements in overall accuracy, boundary smoothness, and sensitivity to tumor core and small-volume enhancement areas, while preserving the linear-complexity advantage of Mamba-based modeling, thus verifying the effectiveness and versatility of the method.

Cancer is one of the leading causes of death worldwide, making the development of rapid, minimally invasive, label-free and scalable diagnostic strategies a major challenge in modern oncology. In this context, spectroscopic liquid biopsy has emerged as a promising alternative, as it enables the holistic characterization of biochemical alterations in biological fluids. In this work, we propose a multimodal spectroscopic liquid biopsy framework for multicancer detection based on the combination of Fourier Transform Infrared (FTIR) spectroscopy, Raman spectroscopy, and Excitation-Emission Matrix (EEM) fluorescence spectroscopy together with Machine Learning (ML) methodologies. Serum samples from breast cancer patients, colorectal cancer patients, and healthy controls were analyzed through the three spectroscopic modalities. After modality-specific preprocessing, low-level data fusion (LLDF) was employed to integrate the complementary biochemical information encoded within the different spectroscopic measurements, and classification was performed using XGBoost models. Seven experimental configurations were evaluated, including the three unimodal approaches, all pairwise bimodal configurations, and the full multimodal approach of FTIR, Raman, and EEM fluorescence. The results show that although several individual modalities achieved high discrimination performance, the multimodal fusion provided the most balanced overall results, reaching a ROC-AUC of 0.997 for breast cancer and 0.994 for colorectal cancer, together with highly balanced sensitivity and specificity values.

Donor-level disease classification from single-cell RNA sequencing (scRNA-seq) requires strict donor-aware cross-validation: naive pipelines that split cells randomly conflate training and test donors, inflating reported performance through pseudoreplication. We present a donor-aware benchmark evaluating three feature representations across two independent IBD cohorts: centered log-ratio (CLR) transformed cell-type composition, GatedStructuralCFN dependency embeddings, and scVI variational autoencoder latent embeddings. The cohorts are the SCP259 ulcerative colitis atlas (UC vs. Healthy, n=30 donors, 51 cell types) and the Kong 2023 Crohn's disease atlas (CD vs. Healthy, n=71 donors, 55-68 cell types across three intestinal regions). Compartment-stratified CLR composition achieves AUROC 0.956 +/- 0.061 on SCP259; GatedStructuralCFN on the same features achieves 0.978 +/- 0.050. In the Kong cohort, CFN achieves its best performance in the colon region (0.960 +/- 0.055 after feature filtering), exceeding linear CLR (0.900 +/- 0.100), while terminal ileum classification is dominated by linear models (CatBoost CLR 0.967 +/- 0.075 vs. CFN 0.811 +/- 0.164). Cross-dataset transfer (CD->UC, four shared cell types) achieves AUC 0.833 with XGBoost CLR; the reverse direction performs at chance. CFN edge stability analysis shows that compartment-wise composition eliminates spurious unit-sum-induced instability present in global composition (Jaccard 0.026 vs. top-20 recurrence 1.0). CFN shows a consistent numerical advantage over linear models in the colon region of CD (AUROC 0.960 vs. 0.900), though no inter-method comparison reached statistical significance at n<=34 donors per region. Compartment-aware feature construction is critical for both classification performance and structural interpretability. Code: https://github.com/Jonathan-321/sfn-scrna-study

Motivation: Multi-omics integration can improve cancer subtyping, but modality informativeness and noise vary across cancer types and patients. Existing graph-based methods optimize modality weights jointly with the classification objective and therefore lack independent reliability estimates, so low-quality omics distort patient similarity graphs and amplify noise through message passing. Results: We propose CMGL, a two-stage framework that estimates per-sample modality reliability through evidential deep learning and uses the frozen confidence scores to guide cross-omics fusion and graph construction. On four MLOmics cancer-subtype tasks and the 32-class pan-cancer task, CMGL consistently improves over the strongest baseline, surpassing it by 4.03% in average accuracy on the four single-cancer tasks. Its representations recover the PAM50 intrinsic subtypes of breast invasive carcinoma (BRCA), and the BRCA-trained model transfers without fine-tuning to kidney renal clear cell carcinoma (KIRC), stratifying patients into prognostically distinct groups.

Vision Transformers $(\texttt{ViT})$ have become the architecture of choice for many computer vision tasks, yet their performance in computer-aided diagnostics remains limited. Focusing on breast cancer detection from mammograms, we identify two main causes for this shortfall. First, medical images are high-resolution with small abnormalities, leading to an excessive number of tokens and making it difficult for the softmax-based attention to localize and attend to relevant regions. Second, medical image classification is inherently fine-grained, with low inter-class and high intra-class variability, where standard cross-entropy training is insufficient. To overcome these challenges, we propose a framework with three key components: (1) Region of interest $(\texttt{RoI})$ based token reduction using an object detection model to guide attention; (2) contrastive learning between selected $\texttt{RoI}$ to enhance fine-grained discrimination through hard-negative based training; and (3) a $\texttt{DINOv2}$ pretrained $\texttt{ViT}$ that captures localization-aware, fine-grained features instead of global $\texttt{CLIP}$ representations. Experiments on public mammography datasets demonstrate that our method achieves superior performance over existing baselines, establishing its effectiveness and potential clinical utility for large-scale breast cancer screening. Our code is available for reproducibility here: https://aih-iitd.github.io/publications/attend-what-matters

Lung cancer remains one of the leading causes of cancer-related mortality worldwide. Conventional computed tomography (CT) imaging, while essential for detection and staging, has limitations in distinguishing benign from malignant lesions and providing interpretable diagnostic insights. To address this challenge, this study proposes a dual-modal artificial intelligence framework that integrates CT radiology with hematoxylin and eosin (H&E) histopathology for lung cancer diagnosis and subtype classification. The system employs convolutional neural networks to extract radiologic and histopathologic features and incorporates clinical metadata to improve robustness. Predictions from both modalities are fused using a weighted decision-level integration mechanism to classify adenocarcinoma, squamous cell carcinoma, large cell carcinoma, small cell lung cancer, and normal tissue. Explainable AI techniques including Grad-CAM, Grad-CAM++, Integrated Gradients, Occlusion, Saliency Maps, and SmoothGrad are applied to provide visual interpretability. Experimental results show strong performance with accuracy up to 0.87, AUROC above 0.97, and macro F1-score of 0.88. Grad-CAM++ achieved the highest faithfulness and localization accuracy, demonstrating strong correspondence with expert-annotated tumor regions. These results indicate that multimodal fusion of radiology and histopathology can improve diagnostic performance while maintaining model transparency, suggesting potential for future clinical decision support systems in precision oncology.

Acute Myeloid Leukemia (AML) is one of the most life-threatening type of blood cancers, and its accurate classification is considered and remains a challenging task due to the visual similarity between various cell types. This study addresses the classification of the multiclasses of AML cells Utilizing YOLOv12 deep learning model. We applied two segmentation approaches based on cell and nucleus features, using Hue channel and Otsu thresholding techniques to preprocess the images prior to classification. Our experiments demonstrate that YOLOv12 with Otsu thresholding on cell-based segmentation achieved the highest level of validation and test accuracy, both reaching 99.3%.