Abdul Rahman Diab

Abdul Rahman Diab, Emily E. Karn, Renchin Wu et al.

Despite the promise of computational pathology foundation models, adapting them to specific clinical tasks remains challenging due to the complexity of whole-slide image (WSI) processing, the opacity of learned features, and the wide range of potential adaptation strategies. To address these challenges, we introduce PathFMTools, a lightweight, extensible Python package that enables efficient execution, analysis, and visualization of pathology foundation models. We use this tool to interface with and evaluate two state-of-the-art vision-language foundation models, CONCH and MUSK, on the task of histological grading in cutaneous squamous cell carcinoma (cSCC), a critical criterion that informs cSCC staging and patient management. Using a cohort of 440 cSCC H&E WSIs, we benchmark multiple adaptation strategies, demonstrating trade-offs across prediction approaches and validating the potential of using foundation model embeddings to train small specialist models. These findings underscore the promise of pathology foundation models for real-world clinical applications, with PathFMTools enabling efficient analysis and validation.

William Lotter, Abdul Rahman Diab, Bryan Haslam et al.

Breast cancer remains a global challenge, causing over 1 million deaths globally in 2018. To achieve earlier breast cancer detection, screening x-ray mammography is recommended by health organizations worldwide and has been estimated to decrease breast cancer mortality by 20-40%. Nevertheless, significant false positive and false negative rates, as well as high interpretation costs, leave opportunities for improving quality and access. To address these limitations, there has been much recent interest in applying deep learning to mammography; however, obtaining large amounts of annotated data poses a challenge for training deep learning models for this purpose, as does ensuring generalization beyond the populations represented in the training dataset. Here, we present an annotation-efficient deep learning approach that 1) achieves state-of-the-art performance in mammogram classification, 2) successfully extends to digital breast tomosynthesis (DBT; "3D mammography"), 3) detects cancers in clinically-negative prior mammograms of cancer patients, 4) generalizes well to a population with low screening rates, and 5) outperforms five-out-of-five full-time breast imaging specialists by improving absolute sensitivity by an average of 14%. Our results demonstrate promise towards software that can improve the accuracy of and access to screening mammography worldwide.