Carlo Sansone

Alice Natalina Caragliano, Valerio Guarrasi, Michela Gravina et al.

Pathological complete response (pCR) is a key prognostic factor in breast cancer patients undergoing neoadjuvant therapy, strongly associated with long-term survival and treatment personalization. However, accurate pre-treatment pCR prediction remains challenging due to severe class imbalance and limited generalizability across diverse clinical settings. In this work, we propose a multimodal stepwise clinically-guided attention learning framework for pCR prediction from breast magnetic resonance imaging (MRI), designed to address these limitations through medically grounded spatial guidance and multimodal integration. The approach follows a stepwise training strategy inspired by physician reasoning: the model first learns global discriminative imaging patterns, then attention mechanisms are introduced to constrain the network toward tumor regions, and finally clinical variables are integrated to refine decision-making. This guidance strategy encourages prioritization of task-relevant features, improving identification of responders despite their limited representation in the dataset. Moreover, grounding attention in anatomically consistent tumor regions reduces reliance on dataset-specific patterns, thereby enhancing cross-institutional generalization. The framework is evaluated through external validation across heterogeneous MRI cohorts. Compared to non-guided single-stage baselines, the proposed approach improves sensitivity while maintaining competitive specificity, and produces anatomically coherent attention maps that support interpretation of the model's predictions. These findings highlight the potential of clinically-guided multimodal attention learning for robust and generalizable pCR prediction in breast cancer.

Michela Gravina, Diego Gragnaniello, Luisa Verdoliva et al.

Lung ultrasound imaging is reaching growing interest from the scientific community. On one side, thanks to its harmlessness and high descriptive power, this kind of diagnostic imaging has been largely adopted in sensitive applications, like the diagnosis and follow-up of preterm newborns in neonatal intensive care units. On the other side, state-of-the-art image analysis and pattern recognition approaches have recently proven their ability to fully exploit the rich information contained in these data, making them attractive for the research community. In this work, we present a thorough analysis of recent deep learning networks and training strategies carried out on a vast and challenging multicenter dataset comprising 87 patients with different diseases and gestational ages. These approaches are employed to assess the lung respiratory status from ultrasound images and are evaluated against a reference marker. The conducted analysis sheds some light on this problem by showing the critical points that can mislead the training procedure and proposes some adaptations to the specific data and task. The achieved results sensibly outperform those obtained by a previous work, which is based on textural features, and narrow the gap with the visual score predicted by the human experts.

Marco Castelluccio, Giovanni Poggi, Carlo Sansone et al.

We explore the use of convolutional neural networks for the semantic classification of remote sensing scenes. Two recently proposed architectures, CaffeNet and GoogLeNet, are adopted, with three different learning modalities. Besides conventional training from scratch, we resort to pre-trained networks that are only fine-tuned on the target data, so as to avoid overfitting problems and reduce design time. Experiments on two remote sensing datasets, with markedly different characteristics, testify on the effectiveness and wide applicability of the proposed solution, which guarantees a significant performance improvement over all state-of-the-art references.