John Whittle

Thomas Boucher, Nicholas Tetlow, Annie Fung et al.

Purpose: The distribution of visceral adipose tissue (VAT) in cystectomy patients is indicative of the incidence of post-operative complications. Existing VAT segmentation methods for computed tomography (CT) employing intensity thresholding have limitations relating to inter-observer variability. Moreover, the difficulty in creating ground-truth masks limits the development of deep learning (DL) models for this task. This paper introduces a novel method for VAT prediction in pre-cystectomy CT, which is fully automated and does not require ground-truth VAT masks for training, overcoming aforementioned limitations. Methods: We introduce the Kernel density Enhanced VAT Segmentator ( KEVS), combining a DL semantic segmentation model, for multi-body feature prediction, with Gaussian kernel density estimation analysis of predicted subcutaneous adipose tissue to achieve accurate scan-specific predictions of VAT in the abdominal cavity. Uniquely for a DL pipeline, KEVS does not require ground-truth VAT masks. Results: We verify the ability of KEVS to accurately segment abdominal organs in unseen CT data and compare KEVS VAT segmentation predictions to existing state-of-the-art (SOTA) approaches in a dataset of 20 pre-cystectomy CT scans, collected from University College London Hospital (UCLH-Cyst), with expert ground-truth annotations. KEVS presents a 4.80% and 6.02% improvement in Dice Coefficient over the second best DL and thresholding-based VAT segmentation techniques respectively when evaluated on UCLH-Cyst. Conclusion: This research introduces KEVS; an automated, SOTA method for the prediction of VAT in pre-cystectomy CT which eliminates inter-observer variability and is trained entirely on open-source CT datasets which do not contain ground-truth VAT masks.

Thomas Boucher, John Whittle, Evangelos B. Mazomenos

We demonstrate that quantum vision transformers (QViTs), vision transformers (ViTs) with self-attention (SA) mechanisms replaced by quantum self-attention (QSA) mechanisms, can match state-of-the-art (SOTA) biomedical image classifiers while using 99.99% fewer parameters. QSAs are produced by replacing linear SA layers with parameterised quantum neural networks (QNNs), producing a QSA mechanism and reducing parameter scaling from $\mathcal{O}(n^2)$ to $\mathcal{O}(n)$. On RetinaMNIST, our ultra parameter-efficient QViT outperforms 13/14 SOTA methods including CNNs and ViTs, achieving 56.5% accuracy, just 0.88% below the top MedMamba model while using 99.99% fewer parameters (1K vs 14.5M) and 89% fewer GFLOPs. We present the first investigation of knowledge distillation (KD) from classical to quantum vision transformers in biomedical image classification, showing that QViTs maintain comparable performance to classical ViTs across eight diverse datasets spanning multiple modalities, with improved QSA parameter-efficiency. Our higher-qubit architecture benefitted more from KD pre-training, suggesting a scaling relationship between QSA parameters and KD effectiveness. These findings establish QSA as a practical architectural choice toward parameter-efficient biomedical image analysis.