IEEE Journal of Biomedical and Health Informatics

Cervical Cancer Diagnostics Healthcare System Using Hybrid Object Detection Adversarial Networks

Cervical cancer is one of the common cancers among women and it causes significant mortality in many developing countries. Diagnosis of cervical lesions is done using pap smear test or visual inspection using acetic acid (staining). Digital colposcopy, an inexpensive methodology, provides painless and efficient screening results. Therefore, automating cervical cancer screening using colposcopy images will be highly useful in saving many lives. Nowadays, many automation techniques using computer vision and machine learning in cervical screening gained attention, paving the way for diagnosing cervical cancer. However, most of the methods rely entirely on the annotation of cervical spotting and segmentation. This paper aims to introduce the Faster Small-Object Detection Neural Networks (FSOD-GAN) to address the cervical screening and diagnosis of cervical cancer and the type of cancer using digital colposcopy images. The proposed approach automatically detects the cervical spot using Faster Region-Based Convolutional Neural Network (FR-CNN) and performs the hierarchical multiclass classification of three types of cervical cancer lesions. Experimentation was done with colposcopy data collected from available open sources consisting of 1,993 patients with three cervical categories, and the proposed approach shows 99% accuracy in diagnosing the stages of cervical cancer.

SCAC: A Semi-Supervised Learning Approach for Cervical Abnormal Cell Detection

Cervical abnormal cell detection plays a crucial role in the early screening of cervical cancer. In recent years, some deep learning-based methods have been proposed. However, these methods rely heavily on large amounts of annotated images, which are time-consuming and labor-intensive to acquire, thus limiting the detection performance. In this paper, we present a novel Semi-supervised Cervical Abnormal Cell detector (SCAC), which effectively utilizes the abundant unlabeled data. We utilize Transformer as the backbone of SCAC to capture long-range dependencies to mimic the diagnostic process of pathologists. In addition, in SCAC, we design a Unified Strong and Weak Augment strategy (USWA) that unifies two data augmentation pipelines, implementing consistent regularization in semi-supervised learning and enhancing the diversity of the training data. We also develop a Global Attention Feature Pyramid Network (GAFPN), which utilizes the attention mechanism to better extract multi-scale features from cervical cytology images. Notably, we have created an unlabeled cervical cytology image dataset, which can be leveraged by semi-supervised learning to enhance detection accuracy. To the best of our knowledge, this is the first publicly available large unlabeled cervical cytology image dataset. By combining this dataset with two publicly available annotated datasets, we demonstrate that SCAC outperforms other existing methods, achieving state-of-the-art performance. Additionally, comprehensive ablation studies are conducted to validate the effectiveness of USWA and GAFPN. These promising results highlight the capability of SCAC to achieve high diagnostic accuracy and extensive clinical applications.

Discriminative Cervical Lesion Detection in Colposcopic Images With Global Class Activation and Local Bin Excitation

Accurate cervical lesion detection (CLD) methods using colposcopic images are highly demanded in computer-aided diagnosis (CAD) for automatic diagnosis of High-grade Squamous Intraepithelial Lesions (HSIL). However, compared to natural scene images, the specific characteristics of colposcopic images, such as low contrast, visual similarity, and ambiguous lesion boundaries, pose difficulties to accurately locating HSIL regions and also significantly impede the performance improvement of existing CLD approaches. To tackle these difficulties and better capture cervical lesions, we develop novel feature enhancing mechanisms from both global and local perspectives, and propose a new discriminative CLD framework, called CervixNet, with a Global Class Activation (GCA) module and a Local Bin Excitation (LBE) module. Specifically, the GCA module learns discriminative features by introducing an auxiliary classifier, and guides our model to focus on HSIL regions while ignoring noisy regions. It globally facilitates the feature extraction process and helps boost feature discriminability. Further, our LBE module excites lesion features in a local manner, and allows the lesion regions to be more fine-grained enhanced by explicitly modelling the inter-dependencies among bins of proposal feature. Extensive experiments on a number of 9888 clinical colposcopic images verify the superiority of our method (AP

Multi-Task Collaborative Assisted Training Method for Grouping Fuzzy Categories Classification of Cervical Cancer Cells

Cervical cancer is a malignant tumor that endangers women's life and health. While deep learning has enhanced the accuracy of cervical cell classification, there remain obstacles impeding further performance enhancement, including the similarities between different categories, variability between single cells and cell clusters, as well as the accuracy of annotations. To address these issues, a novel multi-task collaborative framework for cervical cell classification is proposed. Specifically, to solve the similarity between different categories, we propose a grouping cell contrast auxiliary branch, which divides cervical cells into different groups and utilizes supervised contrastive learning to learn representative feature between different categories. And we introduce a multi-level cell classification auxiliary branch that simultaneously performs 5-class, 3-class, and 2-class classification tasks, and explicitly constrains the inter-class relationship learning of cervical cells. Furthermore, to solve the variations within the same category of single cells and cell clusters, we propose an image reconstruction auxiliary branch, which encourages the model to learn more contextual features. Finally, to solve subjectivity and accuracy of annotations, we introduce a soft label distillation auxiliary branch, which constrains the consistency of probability distributions between the encoder and the momentum encoder. It is worth noting that these auxiliary branches only work during training and will not add additional computational consumption during inference. We validate on the HSJCC, DSCC and SIPaKMeD datasets. Compared to existing methods, our approach has achieved outstanding performance and effectively mitigates the issues raised, demonstrating its effectiveness in automated cervical cell classification.

Multi-Omics Deep-Learning Prediction of Homologous Recombination Deficiency-Like Phenotype Improved Risk Stratification and Guided Therapeutic Decisions in Gynecological Cancers

Homologous recombination deficiency (HRD) is a well-recognized important biomarker in determining the clinical benefits of platinum-based chemotherapy and PARP inhibitor therapy for patients diagnosed with gynecologic cancers. Accurate prediction of HRD phenotype remains challenging. Here, we proposed a novel Multi-Omics integrative Deep-learning framework named MODeepHRD for detecting HRD-positive phenotype. MODeepHRD utilizes a convolutional attention autoencoder that effectively leverages omics-specific and cross-omics complementary knowledge learning. We trained MODeepHRD on 351 ovarian cancer (OV) patients using transcriptomic, DNA methylation and mutation data, and validated it in 2133 OV samples of 22 datasets. The predicted HRD-positive tumors were significantly associated with improved survival (HR = 0.68; 95% CI, 0.60-0.77; log-rank p < 0.001 for meta-cohort; HR = 0.5; 95% CI, 0.29-0.86; log-rank p = 0.01 for ICGC-OV cohort) and higher response to platinum-based chemotherapy compared to predicted HRD-negative tumors. The translational potential of MODeepHRDs was further validated in multicenter breast and endometrial cancer cohorts. Furthermore, MODeepHRD outperforms conventional machine-learning methods and other similar task approaches. In conclusion, our study demonstrates the promising value of deep learning as a solution for HRD testing in the clinical setting. MODeepHRD holds potential clinical applicability in guiding patient risk stratification and therapeutic decisions, providing valuable insights for precision oncology and personalized treatment strategies.

Negative Instance Guided Self-Distillation Framework for Whole Slide Image Analysis

Histopathology image classification is an important clinical task, and current deep learning-based whole-slide image (WSI) classification methods typically cut WSIs into small patches and cast the problem as multi-instance learning. The mainstream approach is to train a bag-level classifier, but their performance on both slide classification and positive patch localization is limited because the instance-level information is not fully explored. In this article, we propose a negative instance-guided, self-distillation framework to directly train an instance-level classifier end-to-end. Instead of depending only on the self-supervised training of the teacher and the student classifiers in a typical self-distillation framework, we input the true negative instances into the student classifier to guide the classifier to better distinguish positive and negative instances. In addition, we propose a prediction bank to constrain the distribution of pseudo instance labels generated by the teacher classifier to prevent the self-distillation from falling into the degeneration of classifying all instances as negative. We conduct extensive experiments and analysis on three publicly available pathological datasets: CAMELYON16, PANDA, and TCGA, as well as an in-house pathological dataset for cervical cancer lymph node metastasis prediction. The results show that our method outperforms existing methods by a large margin. Code will be publicly available.