Oncology

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Overview

Oncology studies how cancers develop and spread, how to detect and classify them, and how to prevent or treat them. AI methods analyze medical images and pathology slides, combine imaging with clinical records and molecular data, and use language models to extract evidence or support clinical decisions. Common approaches include deep learning, foundation models, multimodal fusion, survival analysis, and federated learning across institutions. A central challenge is ensuring models generalize across patients and hospitals and demonstrate safe, useful performance in prospective clinical workflows.

Latest papers

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261 papers7 papers in the last four weeks, down 61% on the four weeks before. 0.0% of all new papers.

Mar 6, 2026

Extracting and analyzing 3D histomorphometric features related to perineural and lymphovascular invasion in prostate cancer

Diagnostic grading of prostate cancer (PCa) relies on the examination of 2D histology sections. However, the limited sampling of specimens afforded by 2D histopathology, and ambiguities when viewing 2D cross-sections, can lead to suboptimal treatment decisions. Recent studies have shown that 3D histomorphometric analysis of glands and nuclei can improve PCa risk assessment compared to analogous 2D features. Here, we expand on these efforts by developing an analytical pipeline to extract 3D features related to perineural invasion (PNI) and lymphovascular invasion (LVI), which correlate with poor prognosis for a variety of cancers. A 3D segmentation model (nnU-Net) was trained to segment nerves and vessels in 3D datasets of archived prostatectomy specimens that were optically cleared, labeled with a fluorescent analog of H&E, and imaged with open-top light-sheet (OTLS) microscopy. PNI- and LVI-related features, including metrics describing cancer-nerve and cancer-vessel proximity, were then extracted based on the 3D nerve/vessel segmentation masks in conjunction with 3D masks of cancer-enriched regions. As a preliminary exploration of the prognostic value of these features, we trained a supervised machine learning classifier to predict 5-year biochemical recurrence (BCR) outcomes, finding that 3D PNI-related features are moderately prognostic and outperform 2D PNI-related features (AUC = 0.71 vs. 0.52). Source code is available at https://github.com/sarahrahsl/SegCIA.git.

Sarah S. L. Chow, Rui Wang, Robert B. Serafin +10

Department of Pathology, Stanford University, Stanford, CA 94305 USA · University of Washington, Seattle, WA 98195 USA · University of Chicago, Chicago, IL 60637 USA +6

OncologyComputational PathologyPerineural Invasion PredictionMicroscopy Image Analysis
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Mar 6, 2026

AI End-to-End Radiation Treatment Planning Under One Second

Artificial intelligence-based radiation therapy (RT) planning has the potential to reduce planning time and inter-planner variability, improving efficiency and consistency in clinical workflows. Most existing automated approaches rely on multiple dose evaluations and corrections, resulting in plan generation times of several minutes. We introduce AIRT (Artificial Intelligence-based Radiotherapy), an end-to-end deep-learning framework that directly infers deliverable treatment plans from CT images and structure contours. AIRT generates single-arc VMAT prostate plans, from imaging and anatomical inputs to leaf sequencing, in under one second on a single Nvidia A100 GPU. The framework includes a differentiable dose feedback, an adversarial fluence map shaping, and a plan generation augmentation to improve plan quality and robustness. The model was trained on more than 10,000 intact prostate cases. Non-inferiority to RapidPlan Eclipse was demonstrated across target coverage and OAR sparing metrics. Target homogeneity (HI = 0.10 ±\pm 0.01) and OAR sparing were similar to reference plans when evaluated using AcurosXB. These results represent a significant step toward ultra-fast standardized RT planning and a streamlined clinical workflow.

Simon Arberet, Riqiang Gao, Martin Kraus +9

Digital Technology and Innovation, Siemens Healthineers, Princeton, NJ, USA. · Digital Technology and Innovation, Siemens Healthineers, Erlangen, Germany. · Varian Medical Affairs, Siemens Healthineers, Palo Alto, CA, USA.

Oncology
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Mar 6, 2026

TumorChain: Interleaved Multimodal Chain-of-Thought Reasoning for Traceable Clinical Tumor Analysis

Accurate tumor analysis is central to clinical radiology and precision oncology, where early detection, reliable lesion characterization, and pathology-level risk assessment guide diagnosis and treatment planning. Chain-of-Thought (CoT) reasoning is particularly important in this setting because it enables step-by-step interpretation from imaging findings to clinical impressions and pathology conclusions, improving traceability and reducing diagnostic errors. Here, we target the clinical tumor analysis task and build a large-scale benchmark that operationalizes a multimodal reasoning pipeline, spanning findings, impressions, and pathology predictions. We curate TumorCoT, a large-scale dataset of 1.5M CoT-labeled VQA instructions paired with 3D CT scans, with step-aligned rationales and cross-modal alignments along the trajectory from findings to impression to pathology, enabling evaluation of both answer accuracy and reasoning consistency. We further propose TumorChain, a multimodal interleaved reasoning framework that tightly couples 3D imaging encoders, clinical text understanding, and organ-level vision-language alignment. Through cross-modal alignment and iterative interleaved causal reasoning, TumorChain grounds visual evidence, aggregates conclusions, and issues pathology predictions after multiple rounds of self-refinement, improving traceability and reducing hallucination risk. Experiments show consistent improvements over strong baselines in lesion detection, impression generation, and pathology classification, and demonstrate strong generalization on the DeepTumorVQA benchmark. These results highlight the potential of multimodal reasoning for reliable and interpretable tumor analysis in clinical practice. Detailed information about our project can be found on our project homepage at https://github.com/ZJU4HealthCare/TumorChain.

Sijing Li, Zhongwei Qiu, Jiang Liu +22

Zhejiang University · DAMO Academy, Alibaba Group · Hupan Lab +3

Radiology VLMsMultimodal CoT ReasoningMultimodal QAOncology3D Medical Imaging
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Mar 3, 2026

BRIGHT: A Collaborative Generalist-Specialist Foundation Model for Breast Pathology

Generalist pathology foundation models (PFMs), pretrained on large-scale multi-organ datasets, have demonstrated remarkable predictive capabilities across diverse clinical applications. However, their proficiency on the full spectrum of clinically essential tasks within a specific organ system remains an open question due to the lack of large-scale validation cohorts for a single organ as well as the absence of a tailored training paradigm that can effectively translate broad histomorphological knowledge into the organ-specific expertise required for specialist-level interpretation. In this study, we propose BRIGHT, the first PFM specifically designed for breast pathology, trained on over 51,000 breast whole-slide images derived from a cohort of over 40,000 patients across 19 hospitals. BRIGHT employs a collaborative generalist-specialist framework to capture both universal and organ-specific features. To comprehensively evaluate the performance of PFMs on breast oncology, we curate the largest multi-institutional cohorts to date for downstream task development and evaluation, comprising over 25,000 WSIs across 10 hospitals. The validation cohorts cover the full spectrum of breast pathology across 25 distinct clinical tasks spanning diagnosis, biomarker prediction, treatment response and survival prediction. Extensive experiments demonstrate that BRIGHT outperforms five leading generalist PFMs, achieving state-of-the-art (SOTA) performance in 25 of 25 internal validation tasks and in 4 of 11 external validation tasks with excellent heatmap interpretability. By evaluating on large-scale validation cohorts, this study not only demonstrates BRIGHT's clinical utility in breast oncology but also validates a collaborative generalist-specialist paradigm, providing a scalable template for developing PFMs on a specific organ system, accelerating the translation of foundation models into ...

Xiaojing Guo, Jiatai Lin, Yumian Jia +39

Breast CancerHealthcarePathology Foundation ModelsOncologyWhole-Slide Image Analysis
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Mar 3, 2026

Intelligent Pathological Diagnosis of Gestational Trophoblastic Diseases via Visual-Language Deep Learning Model

The pathological diagnosis of gestational trophoblastic disease(GTD) takes a long time, relies heavily on the experience of pathologists, and the consistency of initial diagnosis is low, which seriously threatens maternal health and reproductive outcomes. We developed an expert model for GTD pathological diagnosis, named GTDoctor. GTDoctor can perform pixel-based lesion segmentation on pathological slides, and output diagnostic conclusions and personalized pathological analysis results. We developed a software system, GTDiagnosis, based on this technology and conducted clinical trials. The retrospective results demonstrated that GTDiagnosis achieved a mean precision of over 0.91 for lesion detection in pathological slides (n=679 slides). In prospective studies, pathologists using GTDiagnosis attained a Positive Predictive Value of 95.59% (n=68 patients). The tool reduced average diagnostic time from 56 to 16 seconds per case (n=285 patients). GTDoctor and GTDiagnosis offer a novel solution for GTD pathological diagnosis, enhancing diagnostic performance and efficiency while maintaining clinical interpretability.

Yuhang Liu, Yueyang Cang, Wenge Que +12

Department of Automation, Tsinghua University, Beijing, China · College of Materials Science and Engineering, Donghua University, Shanghai, China · Department of Pathology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China +6

Computational PathologyHistopathology Image ClassificationMedical VLMsHistopathology Image SegmentationOncology
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Mar 2, 2026

PanCanBench: A Comprehensive Benchmark for Evaluating Large Language Models in Pancreatic Oncology

Large language models (LLMs) have achieved expert-level performance on standardized examinations, yet multiple-choice accuracy poorly reflects real-world clinical utility and safety. As patients and clinicians increasingly use LLMs for guidance on complex conditions such as pancreatic cancer, evaluation must extend beyond general medical knowledge. Existing frameworks, such as HealthBench, rely on simulated queries and lack disease-specific depth. Moreover, high rubric-based scores do not ensure factual correctness, underscoring the need to assess hallucinations. We developed a human-in-the-loop pipeline to create expert rubrics for de-identified patient questions from the Pancreatic Cancer Action Network (PanCAN). The resulting benchmark, PanCanBench, includes 3,130 question-specific criteria across 282 authentic patient questions. We evaluated 22 proprietary and open-source LLMs using an LLM-as-a-judge framework, measuring clinical completeness, factual accuracy, and web-search integration. Models showed substantial variation in rubric-based completeness, with scores ranging from 46.5% to 82.3%. Factual errors were common, with hallucination rates (the percentages of responses containing at least one factual error) ranging from 6.0% for Gemini-2.5 Pro and GPT-4o to 53.8% for Llama-3.1-8B. Importantly, newer reasoning-optimized models did not consistently improve factuality: although o3 achieved the highest rubric score, it produced inaccuracies more frequently than other GPT-family models. Web-search integration did not inherently guarantee better responses. The average score changed from 66.8% to 63.9% for Gemini-2.5 Pro and from 73.8% to 72.8% for GPT-5 when web search was enabled. Synthetic AI-generated rubrics inflated absolute scores by 17.9 points on average while generally maintaining similar relative ranking.

Yimin Zhao, Sheela R. Damle, Simone E. Dekker +13

Department of Biostatistics, University of Washington · Clinical Research Division, Fred Hutch Cancer Center · Division of Hematology and Oncology, Department of Medicine, University of Washington +5

Clinical Language Model EvaluationMedical QAOncology
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Feb 28, 2026

From Literature to Hypotheses: An AI Co-Scientist System for Biomarker-Guided Drug Combination Hypothesis Generation

The rapid growth of biomedical evidence makes it difficult to translate biomarker mechanisms into actionable drug combination hypotheses. We present CoDHy, an interactive AI co-scientist for biomarker-guided hypothesis generation in oncology. CoDHy constructs task-specific knowledge graphs from curated databases and biomedical literature, then combines graph embeddings with agent-based reasoning to generate, validate, and rank evidence-grounded drug combinations. Through a web interface, researchers specify the biomarker, cancer context, and literature scope; inspect supporting evidence and intermediate results; and iteratively refine the generated hypotheses. The demonstration presents CoDHy's end-to-end workflow and shows how researchers can interactively explore and compare mechanistically supported drug combinations while remaining in control of hypothesis prioritization.

Raneen Younis, Suvinava Basak, Lukas Chavez +1

Peter L. Reichertz Institute for Medical Informatics (PLRI), Hannover Medical School · Lower Saxony Center for Artificial Intelligence and Causal Methods in Medicine (CAIMed) · Sanford Burnham Prebys (SBP) Medical Discovery Institute

Scientific Hypothesis GenerationOncologyDrug DiscoveryBiomedical KGs
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Feb 26, 2026

Automated Dose-Based Anatomic Region Classification of Radiotherapy Treatment for Big Data Applications

Curation is a significant barrier to using 'big data' radiotherapy planning databases of 100,000+ patients. Anatomic site stratification is essential for downstream analyses, but current methods rely on inconsistent plan labels or target nomenclature, which is unreliable for multi-institutional data. We developed software to automate labeling by inferring anatomic regions directly from dose-volume overlap with deep-learning segmentations, eliminating metadata reliance. The software processes DICOM files in bulk, utilizing deep learning to segment 118 structures (organs, glands, and bones) categorized into six regions: Cranial, Head and Neck, Pelvis, Abdomen, Thorax, Extremity. The 85% and 50% isodose lines are converted to structures to compute organ-specific dose-overlap metrics. Plans are assigned ranked regional labels based on these intersections. The algorithm was refined using 109 expert-labeled cases and validated on 100 consecutive clinical plans. On the 100-plan test dataset, the algorithm achieved 91% Exact Accuracy (matching all expert labels and order), 94% Top-2 Accuracy (matching the top two expert regions regardless of order), and 95% Top-1 Accuracy (matching the primary expert label). The automated workflow demonstrated high accuracy and robustness. The 95% Top-1 Accuracy is particularly significant, as it enables reliable querying of plans based on the primary treatment site. Detailed analysis of the few mismatched cases showed most were treated areas at the border between anatomic regions and were ambiguous between these two regions in a common-sense interpretation. This algorithm provides a scalable, standardized solution for curating the large, multi-institutional datasets required for 'big data' in radiotherapy and provides an important complement to text-based approaches.

Justin Hink, Yasin Abdulkadir, Jack Neylon +1

Department of Radiation Oncology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, California, USA

Oncology
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Feb 23, 2026

Efficient endometrial carcinoma screening via cross-modal synthesis and gradient distillation

Early detection of myometrial invasion is critical for the staging and life-saving management of endometrial carcinoma (EC), a prevalent global malignancy. Transvaginal ultrasound serves as the primary, accessible screening modality in resource-constrained primary care settings; however, its diagnostic reliability is severely hindered by low tissue contrast, high operator dependence, and a pronounced scarcity of positive pathological samples. Existing artificial intelligence solutions struggle to overcome this severe class imbalance and the subtle imaging features of invasion, particularly under the strict computational limits of primary care clinics. Here we present an automated, highly efficient two-stage deep learning framework that resolves both data and computational bottlenecks in EC screening. To mitigate pathological data scarcity, we develop a structure-guided cross-modal generation network that synthesizes diverse, high-fidelity ultrasound images from unpaired magnetic resonance imaging (MRI) data, strictly preserving clinically essential anatomical junctions. Furthermore, we introduce a lightweight screening network utilizing gradient distillation, which transfers discriminative knowledge from a high-capacity teacher model to dynamically guide sparse attention towards task-critical regions. Evaluated on a large, multicenter cohort of 7,951 participants, our model achieves a sensitivity of 99.5%, a specificity of 97.2%, and an area under the curve of 0.987 at a minimal computational cost (0.289 GFLOPs), substantially outperforming the average diagnostic accuracy of expert sonographers. Our approach demonstrates that combining cross-modal synthetic augmentation with knowledge-driven efficient modeling can democratize expert-level, real-time cancer screening for resource-constrained primary care settings.

Dongjing Shan, Yamei Luo, Jiqing Xuan +7

School of Medical Information and Engineering, Southwest Medical University, Luzhou 646000, Sichuan, China · School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu 611731, China · Department of Ultrasound, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China +8

Medical Image AnalysisOncologyUltrasound ImagingMedical Image Synthesis
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Feb 20, 2026

From Global Radiomics to Parametric Maps: A Unified Workflow Fusing Radiomics and Deep Learning for PDAC Detection

Radiomics and deep learning both offer powerful tools for quantitative medical imaging, but most existing fusion approaches only leverage global radiomic features and overlook the complementary value of spatially resolved radiomic parametric maps. We propose a unified framework that first selects discriminative radiomic features and then injects them into a radiomics-enhanced nnUNet at both the global and voxel levels for pancreatic ductal adenocarcinoma (PDAC) detection. On the PANORAMA dataset, our method achieved AUC = 0.96 and AP = 0.84 in cross-validation. On an external in-house cohort, it achieved AUC = 0.95 and AP = 0.78, outperforming the baseline nnUNet; it also ranked second in the PANORAMA Grand Challenge. This demonstrates that handcrafted radiomics, when injected at both global and voxel levels, provide complementary signals to deep learning models for PDAC detection. Our code can be found at https://github.com/briandzt/dl-pdac-radiomics-global-n-paramaps

Zengtian Deng, Yimeng He, Yu Shi +4

Cedars-Sinai Medical Center, Los Angeles, CA, USA · University of California, Los Angeles, Los Angeles, CA, USA

Medical Image AnalysisRadiomicsOncologyConvolutional Neural Networks
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Feb 18, 2026

End-user validation of BRIGHT with custom-developed graphical user interface applied to cervical cancer brachytherapy

Multi-objective optimisation using BRIGHT has proven insightful and effective in prostate cancer brachytherapy treatment planning. BRachytherapy via artificially Intelligent GOMEA-Heuristic based Treatment planning (BRIGHT) generates multiple treatment plans, each with a different trade-off between tumour coverage and organs-at-risk sparing. BRIGHT was recently extended to cervical cancer brachytherapy. In this study, we present a novel, custom-developed graphical user interface (GUI) that enables plan navigation, pairwise comparisons, dose distribution visualisation, and possibility for adjustments - essential for efficient clinical use of BRIGHT. End-user validation of BRIGHT with the dedicated GUI was conducted for cervical cancer brachytherapy by emulating clinical practice in ten previously treated patients. A multidisciplinary brachytherapy team used BRIGHT to create new treatment plans. GUI usability was assessed using the System Usability Scale (SUS). BRIGHT plan quality was compared to clinical practice via blinded one-on-one comparisons. The GUI offered helpful features for plan navigation and evaluation, giving users quick insight into whether planning aims are achievable and what treatment options are available. The overall SUS score was 83.3, indicating an 'excellent' system. BRIGHT outperformed clinical practice in five out of ten patients regarding the coverage-sparing trade-off and performed equally well in the remaining five. The BRIGHT plan was preferred over the clinical plan in eight out of ten patients, four of which showed clinically relevant differences. The clinical plan was preferred in two patients, neither with clinically relevant differences. In conclusion, BRIGHT, with its dedicated GUI, is a clinically viable and user-friendly tool for treatment planning in cervical cancer brachytherapy.

Leah R. M. Dickhoff, Ellen M. Kerkhof, Heloisa H. Deuzeman +12

OncologyClinical Decision SupportMulti-Objective Optimization
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Feb 17, 2026

Context-aware Skin Cancer Epithelial Cell Classification with Scalable Graph Transformers

Whole-slide images (WSIs) from cancer patients contain rich information that can be used for medical diagnosis or to follow treatment progress. To automate their analysis, numerous deep learning methods based on convolutional neural networks and Vision Transformers have been developed and have achieved strong performance in segmentation and classification tasks. However, due to the large size and complex cellular organization of WSIs, these models rely on patch-based representations, losing vital tissue-level context. We propose using scalable Graph Transformers on a full-WSI cell graph for classification. We evaluate this methodology on a challenging task: the classification of healthy versus tumor epithelial cells in cutaneous squamous cell carcinoma (cSCC), where both cell types exhibit very similar morphologies and are therefore difficult to differentiate for image-based approaches. We first compared image-based and graph-based methods on a single WSI. Graph Transformer models SGFormer and DIFFormer achieved balanced accuracies of 85.2±1.585.2 \pm 1.5 (±\pm standard error) and 85.1±2.585.1 \pm 2.5 in 3-fold cross-validation, respectively, whereas the best image-based method reached 81.2±3.081.2 \pm 3.0. By evaluating several node feature configurations, we found that the most informative representation combined morphological and texture features as well as the cell classes of non-epithelial cells, highlighting the importance of the surrounding cellular context. We then extended our work to train on several WSIs from several patients. To address the computational constraints of image-based models, we extracted four 2560×25602560 \times 2560 pixel patches from each image and converted them into graphs. In this setting, DIFFormer achieved a balanced accuracy of 83.6±1.983.6 \pm 1.9 (3-fold cross-validation), while the state-of-the-art image-based model CellViT256 reached 78.1±0.578.1 \pm 0.5.

Lucas Sancéré, Noémie Moreau, Katarzyna Bozek

Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, North Rhine-Westphalia, Germany · Institute for Biomedical Informatics, Faculty of Medicine and University Hospital Cologne, University of Cologne, North Rhine-Westphalia, Germany · Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, North Rhine-Westphalia, Germany +1

Computational PathologyOncologyHistopathology Image ClassificationGraph TransformerWhole-Slide Image Analysis
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Jan 17, 2026

Mapping the maturation of TCM as an adjuvant to radiotherapy

The integration of complementary medicine into oncology represents a paradigm shift that has seen to increasing adoption of Traditional Chinese Medicine (TCM) as an adjuvant to radiotherapy. About twenty-five years since the formal institutionalization of integrated oncology, it is opportune to synthesize the trajectory of evidence for TCM as an adjuvant to radiotherapy. Here we conduct a large-scale analysis of 69,745 publications (2000 - 2025), emerging a cyclical evolution defined by coordinated expansion and contraction in publication output, international collaboration, and funding commitments that mirrors a define-ideate-test pattern. Using a theme modeling workflow designed to determine a stable thematic structure of the field, we identify five dominant thematic axes - cancer types, supportive care, clinical endpoints, mechanisms, and methodology - that signal a focus on patient well-being, scientific rigor and mechanistic exploration. Cross-theme integration of TCM is patient-centered and systems-oriented. Together with the emergent cycles of evolution, the thematic structure demonstrates progressive specialization and potential defragmentation of the field or saturation of existing research agenda. The analysis points to a field that has matured its current research agenda and is likely at the cusp of something new. Additionally, the field exhibits positive reporting of findings that is homogeneous across publication types, thematic areas, and the cycles of evolution suggesting a system-wide positive reporting bias agnostic to structural drivers.

P. Bilha Githinji, Aikaterini Melliou, Xi Yuan +8

Guangdong Provincial Laboratory of Traditional Chinese Medicine, Hengqin, Guangdong, China · Affiliated Fifth Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China

Traditional Chinese MedicineOncologyBibliometric Analysis
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Dec 8, 2025

CLARITY: Medical World Model for Guiding Treatment Decisions by Modeling Context-Aware Disease Trajectories in Latent Space

Clinical decision-making in oncology requires predicting dynamic disease evolution, a task current static AI predictors cannot perform. While world models (WMs) offer a paradigm for generative prediction, existing medical applications remain limited. Existing methods often rely on stochastic diffusion models, focusing on visual reconstruction rather than causal, physiological transitions. Furthermore, in medical domain, models like MeWM typically ignore patient-specific temporal and clinical contexts and lack a feedback mechanism to link predictions to treatment decisions. To address these gaps, we introduce CLARITY, a medical world model that forecasts disease evolution directly within a structured latent space. It explicitly integrates time intervals (temporal context) and patient-specific data (clinical context) to model treatment-conditioned progression as a smooth, interpretable trajectory, and thus generate physiologically faithful, individualized treatment plans. Finally, CLARITY introduces a novel prediction-to-decision framework, translating latent rollouts into transparent, actionable recommendations. CLARITY demonstrates state-of-the-art performance in treatment planning. On the MU-Glioma-Post dataset, our approach outperforms recent MeWM by 12%, and significantly surpasses all other medical-specific large language models.

Tianxingjian Ding, Yuanhao Zou, Chen Chen +2

Institute of Artificial Intelligence, University of Central Florida

Disease Progression ModelingHealthcareClinical Decision SupportClinical Decision-MakingOncologyLatent World Models
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Nov 24, 2025

OncoVision: Integrating Mammography and Clinical Data through Attention-Driven Multimodal AI for Enhanced Breast Cancer Diagnosis

OncoVision is a privileged-information training framework that uses mammography images and clinical features during training and performs inference from mammographic images alone. Employing an attention-based encoder-decoder backbone, it jointly segments four regions of interest (masses, calcifications, axillary findings, and breast tissue) with accuracy exceeding the nnU-Net baseline and predicts ten structured clinical features, including BI-RADS category. We developed two late-fusion strategies, Independent and Dependent, that integrate imaging, radiomic, and clinical information during training to improve diagnostic precision and potentially reduce inter-observer variability. Radiomic features extracted from predicted masks provide shape, intensity, and texture descriptors that complement the learned CNN representations. We evaluated OncoVision in a retrospective multi-reader study with six board-certified radiologists, assessing diagnostic confidence, reading time, and segmentation accuracy with and without AI assistance. In a paired reader-assistance evaluation, OncoVision was associated with higher diagnostic confidence for junior and senior radiologists, reduced reading time by up to 61%, and achieved segmentation accuracy comparable to or exceeding that of radiologists for mass lesions. We operationalized OncoVision as a secure web application, now deployed at a partner hospital, that generates structured reports with dual-confidence scoring and attention-weighted visualizations for real-time diagnostic support. The platform is designed for integration into clinical workflows, with the goal of supporting screening access in underprivileged regions. By combining accurate segmentation with clinical intuition, OncoVision advances AI-assisted mammographic interpretation, offering a scalable and accessible approach to earlier and more consistent image interpretation.

Istiak Ahmed, Galib Ahmed, K. Shahriar Sanjid +10

Department Electrical and Computer Engineering, North South University, Dhaka, 1229, Bangladesh. · Big-Matrix Lab, North South University, Dhaka, 1229, Bangladesh. · Department of Mathematics and Physics, North South University, Dhaka, 1229, Bangladesh. +7

Breast CancerMedical Image SegmentationMammographyOncologyLearning Using Privileged Information
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Nov 22, 2025

Together, Then Apart: Balancing Alignment and Distinctiveness for Multimodal Survival Analysis

Multimodal survival analysis aims to improve cancer prognosis using heterogeneous biomedical data, such as histopathology images and genomic profiles. A common strategy is to align representations across modalities so that shared signals can be captured. However, strong cross-modal alignment can also remove modality-specific evidence that is critical for survival prediction. In this paper, we revisit multimodal survival learning from a simple observation: effective models should first discover shared patterns across modalities, and then preserve modality-specific signals. This motivates a representation learning principle that we refer to as Together Then Apart. Based on this idea, we propose TTA, a framework that balances cross-modal alignment and representation distinctiveness. TTA first performs prototype-based alignment to capture shared survival-related structures between modalities. It then encourages modality-specific distinctiveness through an anchor-guided contrastive objective. To further account for modality imbalance and noisy correspondences, we model cross-modal interactions using unbalanced optimal transport. We evaluate the proposed approach on multiple TCGA cancer cohorts with paired histopathology and genomic data. TTA consistently improves survival prediction over recent multimodal survival models. Moreover, the learned prototype structures reveal interpretable cross-modal patterns associated with clinical outcomes.

Wenjing Liu, Qin Ren, Wen Zhang +2

Stony Brook University, Stony Brook, NY, USA · Johns Hopkins University, Baltimore, MD, USA · Brookhaven National Laboratory, Upton, NY, USA

Cancer Survival PredictionSurvival AnalysisCross-Modal AlignmentOncologyMultimodal Survival AnalysisMultimodal Contrastive Learning
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Oct 13, 2025

Benchmarking Deep Learning Models for Laryngeal Cancer Staging Using the LaryngealCT Dataset

Laryngeal cancer imaging research lacks standardised public datasets to enable reproducible deep learning (DL) model development. We present LaryngealCT, a curated benchmark of 1,029 computed tomography (CT) scans aggregated from six collections from The Cancer Imaging Archive (TCIA). Uniform 1 mm isotropic volumes of interest encompassing the larynx were extracted using a weakly supervised parameter search framework validated by clinical experts. Six 3D DL architectures (custom 3D CNN, ResNet18,50,101, DenseNet121 and MedicalNet-pretrained ResNet50) were benchmarked on (i) early (Tis,T1,T2) vs. advanced (T3,T4) and (ii) T4 vs. non-T4 classification tasks. On the independent test set, the 3D CNN achieved the strongest overall performance across global and per-class metrics (Accuracy 0.854, F1-macro 0.841) in early vs. advanced classification. In the T4 task, AU-ROC values exceeded 0.82 for most models, but sensitivity for T4 disease remained limited (less than or equal to 0.412), with ResNet101 showing the most promising calibrated T4 recall (0.706. Model explainability assessed using GradCAMpp with thyroid cartilage overlays for T4 classification task revealed anatomically plausible peri-cartilage activations, although spatial overlap was modest. Through open-source data, pretrained models, and integrated explainability tools, LaryngealCT offers a reproducible foundation for AI-driven research to support future clinical decision-making in laryngeal oncology.

Nivea Roy, Son Tran, Atul Sajjanhar +4

School of Information Technology, Deakin University, Burwood, Australia · Department of Head and Neck Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India · Department of Radiodiagnosis and Imaging, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India +1

Medical Image ClassificationOncologyMedical Image Benchmarks
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May 6, 2025

Synergistic Vision-Language Reinforcement Enables Scalable On-Demand Analysis across Diverse Clinical Tasks

Accurate segmentation of tumors and organs-at-risk is essential for oncology but remains time-consuming and expertise-intensive. Existing AI systems often require manual spatial prompts or task-specific retraining, while generic class labels provide limited guidance for heterogeneous disease targets. Here we present SyRe, a text-prompted segmentation foundation model based on Synergistic vision-language Reinforcement, which strengthens bidirectional interaction between visual and linguistic representations. We introduce Color Region Description (CRD) to generate region-level semantic supervision and construct SyReData, comprising 20 million image-mask-description triplets across 9 modalities and 229 segmentation tasks. Training with diversified prompt formats enables single-target, multi-target and open-ended segmentation, together with invalid-prompt rejection. SyRe achieves accurate segmentation across diverse clinical scenarios, with strong gains on disease-related targets. Evaluation on 28 unseen external datasets, including 17 cancer types, 3 non-cancer diseases and multinational in-house cohorts, demonstrates generalization under distribution shift. Beyond spatial overlap, SyRe-generated masks preserve quantitative pathology information. Across five retrospective tumor imaging cohorts spanning CT and MRI, radiomics derived from these masks stratify survival and improve prognostic modeling over clinical baselines. Clinician-in-the-loop refinement further supports case-level correction. These results establish SyRe as a generalizable framework for scalable quantitative oncology analysis and clinician-guided segmentation.

Haonan Wang, Jiaji Mao, Lehan Wang +11

Department of Electronic and Computer Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR · Department of Radiology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China · Department of Computer Science and Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR

Image SegmentationMedical Imaging Foundation ModelsText-Guided Image SegmentationMedical VLMsMedical Image SegmentationOncology+1
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Apr 18, 2025

Towards Accurate and Lightweight Peripheral Neuroblastic Tumor Diagnosis via Contrastive Multi-scale Pathological Image Analysis

Peripheral neuroblastic tumors (pNTs) are among the most common extracranial solid tumors in children, and accurate pathological subtyping is important for risk stratification and treatment planning. However, pNT subtyping on hematoxylin-eosin whole-slide images (WSIs) remains challenging because of limited pediatric tumor cohorts, marked histological heterogeneity, inter-observer variability, and the computational burden of existing WSI classifiers. To address these challenges, we propose CoPath, a framework consisting of CoHisNet and PathVote. CoHisNet is a lightweight multi-scale feature-fusion network for patch-level histopathological classification. By replacing the multilayer perceptron components in Swin Transformer blocks and the classification head with Kolmogorov-Arnold Network layers, CoHisNet improves nonlinear feature modeling under a compact architecture. Its multi-scale interaction and contrast-driven feature-enhancement design enables the model to capture both tissue-level structures and fine-grained cellular morphology. PathVote further incorporates pathology-informed tissue-component priors to aggregate patch-level predictions into WSI-level decisions. We validated CoPath on a private two-branch PpNTs cohort and the public BreakHis breast cancer histopathology dataset. Experimental results show that CoPath achieves competitive or superior performance compared with general image classifiers, pathology foundation models under linear probing, and pathology-specific classification models, while maintaining substantially lower computational complexity. The source code is available at https://github.com/JSLiam94/CoPath.

Zhu Zhu, Shuo Jiang, Jingyuan Zheng +7

Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China · Hangzhou Dianzi University, Hangzhou 310018, China · Chinese University of Hong Kong, Hong Kong SAR, China +1

Computational PathologyOncologyHistopathology Image ClassificationWhole-Slide Image Analysis
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Mar 3, 2025

CrossFusion: A Multi-Scale Cross-Attention Convolutional Fusion Model for Cancer Survival Prediction

Cancer survival prediction from whole slide images (WSIs) is a challenging task in computational pathology due to the large size, irregular shape, and high granularity of the WSIs. These characteristics make it difficult to capture the full spectrum of patterns, from subtle cellular abnormalities to complex tissue interactions, which are crucial for accurate prognosis. To address this, we propose CrossFusion, a novel multi-scale feature integration framework that extracts and fuses information from patches across different magnification levels. By effectively modeling both scale-specific patterns and their interactions, CrossFusion generates a rich feature set that enhances survival prediction accuracy. We validate our approach across six cancer types from public datasets, demonstrating significant improvements over existing state-of-the-art methods. Moreover, when coupled with domain-specific feature extraction backbones, our method shows further gains in prognostic performance compared to general-purpose backbones. The source code is available at: https://github.com/RustinS/CrossFusion

Rustin Soraki, Huayu Wang, Sitong Liu +2

University of Washington, Seattle, WA · University of California, Los Angeles, CA

Computational PathologyCancer Survival PredictionCross-AttentionMulti-Scale Feature FusionOncologyWhole-Slide Image Analysis
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Mar 18, 2024

Narrative Feature or Structured Feature? A Study of Large Language Models to Identify Cancer Patients at Risk of Heart Failure

Cancer treatments are known to introduce cardiotoxicity, negatively impacting outcomes and survivorship. Identifying cancer patients at risk of heart failure (HF) is critical to improving cancer treatment outcomes and safety. This study examined machine learning (ML) models to identify cancer patients at risk of HF using electronic health records (EHRs), including traditional ML, Time-Aware long short-term memory (T-LSTM), and large language models (LLMs) using novel narrative features derived from the structured medical codes. We identified a cancer cohort of 12,806 patients from the University of Florida Health, diagnosed with lung, breast, and colorectal cancers, among which 1,602 individuals developed HF after cancer. The LLM, GatorTron-3.9B, achieved the best F1 scores, outperforming the traditional support vector machines by 39%, the T-LSTM deep learning model by 7%, and a widely used transformer model, BERT, by 5.6%. The analysis shows that the proposed narrative features remarkably increased feature density and improved performance.

Ziyi Chen, Mengyuan Zhang, Mustafa Mohammed Ahmed +4

Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA · Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA · Division of Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA

HealthcareOncologyLongitudinal EHR ModelingMedical LLMsClinical Risk Prediction
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