Hamed Hooshangnejad

Yi Luo, Yike Guo, Hamed Hooshangnejad et al.

Lung nodule detection in chest CT is crucial for early lung cancer diagnosis, yet existing deep learning approaches face challenges when deployed in clinical settings with limited annotated data. While curriculum learning has shown promise in improving model training, traditional static curriculum strategies fail in data-scarce scenarios. We propose Scale Adaptive Curriculum Learning (SACL), a novel training strategy that dynamically adjusts curriculum design based on available data scale. SACL introduces three key mechanisms:(1) adaptive epoch scheduling, (2) hard sample injection, and (3) scale-aware optimization. We evaluate SACL on the LUNA25 dataset using YOLOv11 as the base detector. Experimental results demonstrate that while SACL achieves comparable performance to static curriculum learning on the full dataset in mAP50, it shows significant advantages under data-limited conditions with 4.6%, 3.5%, and 2.0% improvements over baseline at 10%, 20%, and 50% of training data respectively. By enabling robust training across varying data scales without architectural modifications, SACL provides a practical solution for healthcare institutions to develop effective lung nodule detection systems despite limited annotation resources.

Hamed Hooshangnejad, Xue Feng, Gaofeng Huang et al.

Lung cancer is a devastating disease with the highest mortality rate among cancer types. Over 60% of non-small cell lung cancer (NSCLC) patients, which accounts for 87% of diagnoses, require radiation therapy. Rapid treatment initiation significantly increases the patient's survival rate and reduces the mortality rate. Accurate tumor segmentation is a critical step in the diagnosis and treatment of NSCLC. Manual segmentation is time and labor-consuming and causes delays in treatment initiation. Although many lung nodule detection methods, including deep learning-based models, have been proposed, there is still a long-standing problem of high false positives (FPs) with most of these methods. Here, we developed an electronic health record (EHR) guided lung tumor auto-segmentation called EXACT-Net (EHR-enhanced eXACtitude in Tumor segmentation), where the extracted information from EHRs using a pre-trained large language model (LLM), was used to remove the FPs and keep the TP nodules only. The auto-segmentation model was trained on NSCLC patients' computed tomography (CT), and the pre-trained LLM was used with the zero-shot learning approach. Our approach resulted in a 250% boost in successful nodule detection using the data from ten NSCLC patients treated in our institution.

Yi Luo, Hamed Hooshangnejad, Xue Feng et al.

Background: Lung cancer ranks as the leading cause of cancer-related mortality worldwide. The complexity of tumor delineation, crucial for radiation therapy, requires expertise often unavailable in resource-limited settings. Artificial Intelligence(AI), particularly with advancements in deep learning (DL) and natural language processing (NLP), offers potential solutions yet is challenged by high false positive rates. Purpose: The Oncology Contouring Copilot (OCC) system is developed to leverage oncologist expertise for precise tumor contouring using textual descriptions, aiming to increase the efficiency of oncological workflows by combining the strengths of AI with human oversight. Methods: Our OCC system initially identifies nodule candidates from CT scans. Employing Language Vision Models (LVMs) like GPT-4V, OCC then effectively reduces false positives with clinical descriptive texts, merging textual and visual data to automate tumor delineation, designed to elevate the quality of oncology care by incorporating knowledge from experienced domain experts. Results: Deployments of the OCC system resulted in a significant reduction in the false discovery rate by 35.0%, a 72.4% decrease in false positives per scan, and an F1-score of 0.652 across our dataset for unbiased evaluation. Conclusions: OCC represents a significant advance in oncology care, particularly through the use of the latest LVMs to improve contouring results by (1) streamlining oncology treatment workflows by optimizing tumor delineation, reducing manual processes; (2) offering a scalable and intuitive framework to reduce false positives in radiotherapy planning using LVMs; (3) introducing novel medical language vision prompt techniques to minimize LVMs hallucinations with ablation study, and (4) conducting a comparative analysis of LVMs, highlighting their potential in addressing medical language vision challenges.

Yi Luo, Yike Guo, Hamed Hooshangnejad et al.

Lung cancer remains the leading cause of cancerrelated deaths globally. Accurate delineation of internal gross tumor volume (IGTV) in PET/CT imaging is pivotal for optimal radiation therapy in mobile tumors such as lung cancer to account for tumor motion, yet is hindered by the limited availability of annotated IGTV datasets and attenuated PET signal intensity at tumor boundaries. In this study, we present a transfer learningbased methodology utilizing a multimodal interactive perception network with MAMBA, pre-trained on extensive gross tumor volume (GTV) datasets and subsequently fine-tuned on a private IGTV cohort. This cohort constitutes the PET/CT subset of the Lung-cancer Unified Cross-modal Imaging Dataset (LUCID). To further address the challenge of weak PET intensities in IGTV peripheral slices, we introduce a slice interaction module (SIM) within a 2.5D segmentation framework to effectively model inter-slice relationships. Our proposed module integrates channel and spatial attention branches with depthwise convolutions, enabling more robust learning of slice-to-slice dependencies and thereby improving overall segmentation performance. A comprehensive experimental evaluation demonstrates that our approach achieves a Dice of 0.609 on the private IGTV dataset, substantially surpassing the conventional baseline score of 0.385. This work highlights the potential of transfer learning, coupled with advanced multimodal techniques and a SIM to enhance the reliability and clinical relevance of IGTV segmentation for lung cancer radiation therapy planning.