Sushmita Mitra

A Mani, Sushmita Mitra

Rational approximations are introduced and studied in granular graded rough sets and generalizations thereof by the first author in recent research papers. The concept of rationality is determined by related ontologies and coherence between granularity, mereology and approximations in the context. In addition, a framework for rational approximations is introduced by her in the mentioned paper(s). Granular approximations constructed as per the procedures of variable precision rough sets (VPRS) are likely to be more rational than those constructed from a classical perspective under certain conditions. This may continue to hold for some generalizations of the former. However, a formal characterization of such conditions is not available in the previously published literature. In this research, theoretical aspects of the problem are critically examined, uniform generalizations of granular VPRS are introduced, new connections with granular graded rough sets are proved, appropriate concepts of substantial parthood are introduced, their extent of compatibility with the framework is accessed, and the framework is extended. Basic assumptions are explained in detail, and additional examples are constructed for readability. Furthermore, meta applications to cluster validation, image segmentation and dynamic sorting are invented. Extensions to direct generalizations of VPRS such as probabilistic rough sets are a natural consequence of the work.

Surochita Pal Das, Sushmita Mitra, B. Uma Shankar

The devastation caused by the coronavirus pandemic makes it imperative to design automated techniques for a fast and accurate detection. We propose a novel non-invasive tool, using deep learning and imaging, for delineating COVID-19 infection in lungs. The Ensembling Attention-based Multi-scaled Convolution network (EAMC), employing Leave-One-Patient-Out (LOPO) training, exhibits high sensitivity and precision in outlining infected regions along with assessment of severity. The Attention module combines contextual with local information, at multiple scales, for accurate segmentation. Ensemble learning integrates heterogeneity of decision through different base classifiers. The superiority of EAMC, even with severe class imbalance, is established through comparison with existing state-of-the-art learning models over four publicly-available COVID-19 datasets. The results are suggestive of the relevance of deep learning in providing assistive intelligence to medical practitioners, when they are overburdened with patients as in pandemics. Its clinical significance lies in its unprecedented scope in providing low-cost decision-making for patients lacking specialized healthcare at remote locations.

Shramana Dey, Zahir Khan, T. A. PramodKumar et al.

Diabetic Retinopathy (DR) is a serious microvascular complication of diabetes, and one of the leading causes of vision loss worldwide. Although automated detection and grading, with Deep Learning (DL), can reduce the burden on ophthalmologists, it is constrained by the limited availability of high-quality datasets. Existing repositories often remain geographically narrow, contain limited samples, and exhibit inconsistent annotations or variable image quality; thereby, restricting their clinical reliability. This paper presents a comprehensive review and comparative analysis of fundus image datasets used in the management of DR. The study evaluates their usability across key tasks, including binary classification, severity grading, lesion localization, and multi-disease screening. It also categorizes the datasets by size, accessibility, and annotation type (such as image-level, lesion-level, and multi-disease). Finally, a recently published dataset is presented as a case study to illustrate broader challenges in dataset curation and usage. The review consolidates current knowledge while highlighting persistent gaps such as the lack of standardized lesion-level annotations and longitudinal data. It also outlines recommendations for future dataset development to support clinically reliable and explainable solutions in DR screening.

Shramana Dey, Abhirup Banerjee, B. Uma Shankar et al.

Diabetic Retinopathy (DR) requires timely screening to prevent irreversible vision loss. However, its early detection remains a significant challenge since often the subtle pathological manifestations (lesions) get overlooked due to insufficient annotation. Existing literature primarily focuses on image-level supervision, weakly-supervised localization, and clustering-based representation learning, which fail to systematically annotate unlabeled lesion region(s) for refining the dataset. Expert-driven lesion annotation is labor-intensive and often incomplete, limiting the performance of deep learning models. We introduce Similarity-based Annotation via Feature-space Ensemble (SAFE), a two-stage framework that unifies weak supervision, contrastive learning, and patch-wise embedding inference, to systematically expand sparse annotations in the pathology. SAFE preserves fine-grained details of the lesion(s) under partial clinical supervision. In the first stage, a dual-arm Patch Embedding Network learns semantically structured, class-discriminative embeddings from expert annotated patches. Next, an ensemble of independent embedding spaces extrapolates labels to the unannotated regions based on spatial and semantic proximity. An abstention mechanism ensures trade-off between highly reliable annotation and noisy coverage. Experimental results demonstrate reliable separation of healthy and diseased patches, achieving upto 0.9886 accuracy. The annotation generated from SAFE substantially improves downstream tasks such as DR classification, demonstrating a substantial increase in F1-score of the diseased class and a performance gain as high as 0.545 in Area Under the Precision-Recall Curve (AUPRC). Qualitative analysis, with explainability, confirms that SAFE focuses on clinically relevant lesion patterns; and is further validated by ophthalmologists.

Pallabi Dutta, Sushmita Mitra

Automated delineation of COVID-19 lesions from lung CT scans aids the diagnosis and prognosis for patients. The asymmetric shapes and positioning of the infected regions make the task extremely difficult. Capturing information at multiple scales will assist in deciphering features, at global and local levels, to encompass lesions of variable size and texture. We introduce the Full-scale Deeply Supervised Attention Network (FuDSA-Net), for efficient segmentation of corona-infected lung areas in CT images. The model considers activation responses from all levels of the encoding path, encompassing multi-scalar features acquired at different levels of the network. This helps segment target regions (lesions) of varying shape, size and contrast. Incorporation of the entire gamut of multi-scalar characteristics into the novel attention mechanism helps prioritize the selection of activation responses and locations containing useful information. Determining robust and discriminatory features along the decoder path is facilitated with deep supervision. Connections in the decoder arm are remodeled to handle the issue of vanishing gradient. As observed from the experimental results, FuDSA-Net surpasses other state-of-the-art architectures; especially, when it comes to characterizing complicated geometries of the lesions.

Pallabi Dutta, Soham Bose, Swalpa Kumar Roy et al.

The development of efficient segmentation strategies for medical images has evolved from its initial dependence on Convolutional Neural Networks (CNNs) to the current investigation of hybrid models that combine CNNs with Vision Transformers (ViTs). There is an increasing focus on creating architectures that are both high-performing and computationally efficient, capable of being deployed on remote systems with limited resources. Although transformers can capture global dependencies in the input space, they face challenges from the corresponding high computational and storage expenses involved. This research investigates the integration of CNNs with Vision Extended Long Short-Term Memory (Vision-xLSTM)s by introducing the novel U-VixLSTM. The Vision-xLSTM blocks capture the temporal and global relationships within the patches extracted from the CNN feature maps. The convolutional feature reconstruction path upsamples the output volume from the Vision-xLSTM blocks to produce the segmentation output. Our primary objective is to propose that Vision-xLSTM forms an appropriate backbone for medical image segmentation, offering excellent performance with reduced computational costs. The U-VixLSTM exhibits superior performance compared to the state-of-the-art networks in the publicly available Synapse, ISIC and ACDC datasets. Code provided: https://github.com/duttapallabi2907/U-VixLSTM

Pallabi Dutta, Sushmita Mitra

An early effective screening and grading of COVID-19 has become imperative towards optimizing the limited available resources of the medical facilities. An automated segmentation of the infected volumes in lung CT is expected to significantly aid in the diagnosis and care of patients. However, an accurate demarcation of lesions remains problematic due to their irregular structure and location(s) within the lung. A novel deep learning architecture, Composite Deep network with Feature Weighting (CDNetFW), is proposed for efficient delineation of infected regions from lung CT images. Initially a coarser-segmentation is performed directly at shallower levels, thereby facilitating discovery of robust and discriminatory characteristics in the hidden layers. The novel feature weighting module helps prioritise relevant feature maps to be probed, along with those regions containing crucial information within these maps. This is followed by estimating the severity of the disease.The deep network CDNetFW has been shown to outperform several state-of-the-art architectures in the COVID-19 lesion segmentation task, as measured by experimental results on CT slices from publicly available datasets, especially when it comes to defining structures involving complex geometries.

Shramana Dey, Varun Ajith, Abhirup Banerjee et al.

Domain generalization in fundus imaging is challenging due to variations in acquisition conditions across devices and clinical settings. The inability to adapt to these variations causes performance degradation on unseen domains for deep learning models. Besides, obtaining annotated data across domains is often expensive and privacy constraints restricts their availability. Although single-source domain generalization (SDG) offers a realistic solution to this problem, the existing approaches frequently fail to capture anatomical topology or decouple appearance from anatomical features. This research introduces WaveSDG, a new wavelet-guided segmentation network for SDG. It decouples anatomical structure from domain-specific appearance through a wavelet sub-band decomposition. A novel Wavelet-based Invariant Structure Extraction and Refinement (WISER) module is proposed to process encoder features by leveraging distinct semantic roles of each wavelet sub-band. The module refines low-frequency components to anchor global anatomy, while selectively enhancing directional edges and suppressing noise within the high-frequency sub-bands. Extensive ablation studies validate the effectiveness of the WISER module and its decoupling strategy. Our evaluations on optic cup and optic disc segmentation across one source and five unseen target datasets show that WaveSDG consistently outperforms seven state-of-the-art methods. Notably, it achieves the best balanced Dice score and lowest 95th percentile Hausdorff distance with reduced variance, indicating improved accuracy, robustness, and cross-domain stability.

Riddhasree Bhattacharyya, Pallabi Dutta, Sushmita Mitra

Prostate cancer being one of the frequently diagnosed malignancy in men, the rising demand for biopsies places a severe workload on pathologists. The grading procedure is tedious and subjective, motivating the development of automated systems. Although deep learning has made inroads in terms of performance, its limited interpretability poses challenges for widespread adoption in high-stake applications like medicine. Existing interpretability techniques for prostate cancer classifiers provide a coarse explanation but do not reveal why the highlighted regions matter. In this scenario, we propose a novel prototype-based weakly-supervised framework for an interpretable grading of prostate cancer from histopathology images. These networks can prove to be more trustworthy since their explicit reasoning procedure mirrors the workflow of a pathologist in comparing suspicious regions with clinically validated examples. The network is initially pre-trained at patch-level to learn robust prototypical features associated with each grade. In order to adapt it to a weakly-supervised setup for prostate cancer grading, the network is fine-tuned with a new prototype-aware loss function. Finally, a new attention-based dynamic pruning mechanism is introduced to handle inter-sample heterogeneity, while selectively emphasizing relevant prototypes for optimal performance. Extensive validation on the benchmark PANDA and SICAP datasets confirms that the framework can serve as a reliable assistive tool for pathologists in their routine diagnostic workflows.

Pallabi Dutta, Anubhab Maity, Sushmita Mitra

The high computational demands of Vision Transformers (ViTs) in processing a large number of tokens often constrain their practical application in analyzing medical images. This research proposes a Prompt-driven Adaptive Token ({\it PrATo}) pruning method to selectively reduce the processing of irrelevant tokens in the segmentation pipeline. The prompt-based spatial prior helps to rank the tokens according to their relevance. Tokens with low-relevance scores are down-weighted, ensuring that only the relevant ones are propagated for processing across subsequent stages. This data-driven pruning strategy improves segmentation accuracy and inference speed by allocating computational resources to essential regions. The proposed framework is integrated with several state-of-the-art models to facilitate the elimination of irrelevant tokens, thereby enhancing computational efficiency while preserving segmentation accuracy. The experimental results show a reduction of $\sim$ 35-55% tokens; thus reducing the computational costs relative to baselines. Cost-effective medical image processing, using our framework, facilitates real-time diagnosis by expanding its applicability in resource-constrained environments.

Surochita Pal, Sushmita Mitra

This study focuses on the classification of cancerous and healthy slices from multimodal lung images. The data used in the research comprises Computed Tomography (CT) and Positron Emission Tomography (PET) images. The proposed strategy achieves the fusion of PET and CT images by utilizing Principal Component Analysis (PCA) and an Autoencoder. Subsequently, a new ensemble-based classifier developed, Deep Ensembled Multimodal Fusion (DEMF), employing majority voting to classify the sample images under examination. Gradient-weighted Class Activation Mapping (Grad-CAM) employed to visualize the classification accuracy of cancer-affected images. Given the limited sample size, a random image augmentation strategy employed during the training phase. The DEMF network helps mitigate the challenges of scarce data in computer-aided medical image analysis. The proposed network compared with state-of-the-art networks across three publicly available datasets. The network outperforms others based on the metrics - Accuracy, F1-Score, Precision, and Recall. The investigation results highlight the effectiveness of the proposed network.

Riddhasree Bhattacharyya, Surochita Pal Das, Sushmita Mitra

Prostate cancer grading using the ISUP system (International Society of Urological Pathology) for treatment decisions is highly subjective and requires considerable expertise. Despite advances in computer-aided diagnosis systems, few have handled efficient ISUP grading on Whole Slide Images (WSIs) of prostate biopsies based only on slide-level labels. Some of the general challenges include managing gigapixel WSIs, obtaining patch-level annotations, and dealing with stain variability across centers. One of the main task-specific challenges faced by deep learning in ISUP grading, is the learning of patch-level features of Gleason patterns (GPs) based only on their slide labels. In this scenario, an efficient framework for ISUP grading is developed. The proposed TSOR is based on a novel Task-specific Self-supervised learning (SSL) model, which is fine-tuned using Ordinal Regression. Since the diversity of training samples plays a crucial role in SSL, a patch-level dataset is created to be relatively balanced w.r.t. the Gleason grades (GGs). This balanced dataset is used for pre-training, so that the model can effectively learn stain-agnostic features of the GP for better generalization. In medical image grading, it is desirable that misclassifications be as close as possible to the actual grade. From this perspective, the model is then fine-tuned for the task of ISUP grading using an ordinal regression-based approach. Experimental results on the most extensive multicenter prostate biopsies dataset (PANDA challenge), as well as the SICAP dataset, demonstrate the effectiveness of this novel framework compared to state-of-the-art methods.

Shramana Dey, Pallabi Dutta, Riddhasree Bhattacharyya et al.

The prevalence of ocular illnesses is growing globally, presenting a substantial public health challenge. Early detection and timely intervention are crucial for averting visual impairment and enhancing patient prognosis. This research introduces a new framework called Class Extension with Limited Data (CELD) to train a classifier to categorize retinal fundus images. The classifier is initially trained to identify relevant features concerning Healthy and Diabetic Retinopathy (DR) classes and later fine-tuned to adapt to the task of classifying the input images into three classes: Healthy, DR, and Glaucoma. This strategy allows the model to gradually enhance its classification capabilities, which is beneficial in situations where there are only a limited number of labeled datasets available. Perturbation methods are also used to identify the input image characteristics responsible for influencing the models decision-making process. We achieve an overall accuracy of 91% on publicly available datasets.

Subhashis Banerjee, Sushmita Mitra, Lawrence O. Hall

Prediction of Overall Survival (OS) of brain cancer patients from multi-modal MRI is a challenging field of research. Most of the existing literature on survival prediction is based on Radiomic features, which does not consider either non-biological factors or the functional neurological status of the patient(s). Besides, the selection of an appropriate cut-off for survival and the presence of censored data create further problems. Application of deep learning models for OS prediction is also limited due to the lack of large annotated publicly available datasets. In this scenario we analyse the potential of two novel neuroimaging feature families, extracted from brain parcellation atlases and spatial habitats, along with classical radiomic and geometric features; to study their combined predictive power for analysing overall survival. A cross validation strategy with grid search is proposed to simultaneously select and evaluate the most predictive feature subset based on its predictive power. A Cox Proportional Hazard (CoxPH) model is employed for univariate feature selection, followed by the prediction of patient-specific survival functions by three multivariate parsimonious models viz. Coxnet, Random survival forests (RSF) and Survival SVM (SSVM). The brain cancer MRI data used for this research was taken from two open-access collections TCGA-GBM and TCGA-LGG available from The Cancer Imaging Archive (TCIA). Corresponding survival data for each patient was downloaded from The Cancer Genome Atlas (TCGA). A high cross validation $C-index$ score of $0.82\pm.10$ was achieved using RSF with the best $24$ selected features. Age was found to be the most important biological predictor. There were $9$, $6$, $6$ and $2$ features selected from the parcellation, habitat, radiomic and region-based feature groups respectively.

Sanhita Basu, Sushmita Mitra, Nilanjan Saha

With the ever increasing demand for screening millions of prospective "novel coronavirus" or COVID-19 cases, and due to the emergence of high false negatives in the commonly used PCR tests, the necessity for probing an alternative simple screening mechanism of COVID-19 using radiological images (like chest X-Rays) assumes importance. In this scenario, machine learning (ML) and deep learning (DL) offer fast, automated, effective strategies to detect abnormalities and extract key features of the altered lung parenchyma, which may be related to specific signatures of the COVID-19 virus. However, the available COVID-19 datasets are inadequate to train deep neural networks. Therefore, we propose a new concept called domain extension transfer learning (DETL). We employ DETL, with pre-trained deep convolutional neural network, on a related large chest X-Ray dataset that is tuned for classifying between four classes \textit{viz.} $normal$, $pneumonia$, $other\_disease$, and $Covid-19$. A 5-fold cross validation is performed to estimate the feasibility of using chest X-Rays to diagnose COVID-19. The initial results show promise, with the possibility of replication on bigger and more diverse data sets. The overall accuracy was measured as $90.13\% \pm 0.14$. In order to get an idea about the COVID-19 detection transparency, we employed the concept of Gradient Class Activation Map (Grad-CAM) for detecting the regions where the model paid more attention during the classification. This was found to strongly correlate with clinical findings, as validated by experts.

Subhashis Banerjee, Sushmita Mitra, Francesco Masulli et al.

Glioma constitutes 80% of malignant primary brain tumors and is usually classified as HGG and LGG. The LGG tumors are less aggressive, with slower growth rate as compared to HGG, and are responsive to therapy. Tumor biopsy being challenging for brain tumor patients, noninvasive imaging techniques like Magnetic Resonance Imaging (MRI) have been extensively employed in diagnosing brain tumors. Therefore automated systems for the detection and prediction of the grade of tumors based on MRI data becomes necessary for assisting doctors in the framework of augmented intelligence. In this paper, we thoroughly investigate the power of Deep ConvNets for classification of brain tumors using multi-sequence MR images. We propose novel ConvNet models, which are trained from scratch, on MRI patches, slices, and multi-planar volumetric slices. The suitability of transfer learning for the task is next studied by applying two existing ConvNets models (VGGNet and ResNet) trained on ImageNet dataset, through fine-tuning of the last few layers. LOPO testing, and testing on the holdout dataset are used to evaluate the performance of the ConvNets. Results demonstrate that the proposed ConvNets achieve better accuracy in all cases where the model is trained on the multi-planar volumetric dataset. Unlike conventional models, it obtains a testing accuracy of 95% for the low/high grade glioma classification problem. A score of 97% is generated for classification of LGG with/without 1p/19q codeletion, without any additional effort towards extraction and selection of features. We study the properties of self-learned kernels/ filters in different layers, through visualization of the intermediate layer outputs. We also compare the results with that of state-of-the-art methods, demonstrating a maximum improvement of 7% on the grading performance of ConvNets and 9% on the prediction of 1p/19q codeletion status.

Spyridon Bakas, Mauricio Reyes, Andras Jakab et al.

Gliomas are the most common primary brain malignancies, with different degrees of aggressiveness, variable prognosis and various heterogeneous histologic sub-regions, i.e., peritumoral edematous/invaded tissue, necrotic core, active and non-enhancing core. This intrinsic heterogeneity is also portrayed in their radio-phenotype, as their sub-regions are depicted by varying intensity profiles disseminated across multi-parametric magnetic resonance imaging (mpMRI) scans, reflecting varying biological properties. Their heterogeneous shape, extent, and location are some of the factors that make these tumors difficult to resect, and in some cases inoperable. The amount of resected tumor is a factor also considered in longitudinal scans, when evaluating the apparent tumor for potential diagnosis of progression. Furthermore, there is mounting evidence that accurate segmentation of the various tumor sub-regions can offer the basis for quantitative image analysis towards prediction of patient overall survival. This study assesses the state-of-the-art machine learning (ML) methods used for brain tumor image analysis in mpMRI scans, during the last seven instances of the International Brain Tumor Segmentation (BraTS) challenge, i.e., 2012-2018. Specifically, we focus on i) evaluating segmentations of the various glioma sub-regions in pre-operative mpMRI scans, ii) assessing potential tumor progression by virtue of longitudinal growth of tumor sub-regions, beyond use of the RECIST/RANO criteria, and iii) predicting the overall survival from pre-operative mpMRI scans of patients that underwent gross total resection. Finally, we investigate the challenge of identifying the best ML algorithms for each of these tasks, considering that apart from being diverse on each instance of the challenge, the multi-institutional mpMRI BraTS dataset has also been a continuously evolving/growing dataset.

Subhasis Banerjee, Sushmita Mitra, Anmol Sharma et al.

Inspired by the success of Convolutional Neural Networks (CNN), we develop a novel Computer Aided Detection (CADe) system using CNN for Glioblastoma Multiforme (GBM) detection and segmentation from multi channel MRI data. A two-stage approach first identifies the presence of GBM. This is followed by a GBM localization in each "abnormal" MR slice. As part of the CADe system, two CNN architectures viz. Classification CNN (C-CNN) and Detection CNN (D-CNN) are employed. The CADe system considers MRI data consisting of four sequences ($T_1$, $T_{1c},$ $T_2$, and $T_{2FLAIR}$) as input, and automatically generates the bounding boxes encompassing the tumor regions in each slice which is deemed abnormal. Experimental results demonstrate that the proposed CADe system, when used as a preliminary step before segmentation, can allow improved delineation of tumor region while reducing false positives arising in normal areas of the brain. The GrowCut method, employed for tumor segmentation, typically requires a foreground and background seed region for initialization. Here the algorithm is initialized with seeds automatically generated from the output of the proposed CADe system, thereby resulting in improved performance as compared to that using random seeds.