CVAug 29, 2023
RACR-MIL: Rank-aware contextual reasoning for weakly supervised grading of squamous cell carcinoma using whole slide imagesAnirudh Choudhary, Mosbah Aouad, Krishnakant Saboo et al.
Squamous cell carcinoma (SCC) is the most common cancer subtype, with an increasing incidence and a significant impact on cancer-related mortality. SCC grading using whole slide images is inherently challenging due to the lack of a reliable protocol and substantial tissue heterogeneity. We propose RACR-MIL, the first weakly-supervised SCC grading approach achieving robust generalization across multiple anatomies (skin, head and neck, lung). RACR-MIL is an attention-based multiple-instance learning framework that enhances grade-relevant contextual representation learning and addresses tumor heterogeneity through two key innovations: (1) a hybrid WSI graph that captures both local tissue context and non-local phenotypical dependencies between tumor regions, and (2) a rank-ordering constraint in the attention mechanism that consistently prioritizes higher-grade tumor regions, aligning with pathologists diagnostic process. Our model achieves state-of-the-art performance across multiple SCC datasets, achieving 3-9% higher grading accuracy, resilience to class imbalance, and up to 16% improved tumor localization. In a pilot study, pathologists reported that RACR-MIL improved grading efficiency in 60% of cases, underscoring its potential as a clinically viable cancer diagnosis and grading assistant.
LGAug 8, 2025Code
Early Detection of Pancreatic Cancer Using Multimodal Learning on Electronic Health RecordsMosbah Aouad, Anirudh Choudhary, Awais Farooq et al.
Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancers, and early detection remains a major clinical challenge due to the absence of specific symptoms and reliable biomarkers. In this work, we propose a new multimodal approach that integrates longitudinal diagnosis code histories and routinely collected laboratory measurements from electronic health records to detect PDAC up to one year prior to clinical diagnosis. Our method combines neural controlled differential equations to model irregular lab time series, pretrained language models and recurrent networks to learn diagnosis code trajectory representations, and cross-attention mechanisms to capture interactions between the two modalities. We develop and evaluate our approach on a real-world dataset of nearly 4,700 patients and achieve significant improvements in AUC ranging from 6.5% to 15.5% over state-of-the-art methods. Furthermore, our model identifies diagnosis codes and laboratory panels associated with elevated PDAC risk, including both established and new biomarkers. Our code is available at https://github.com/MosbahAouad/EarlyPDAC-MML.