Erik Meijering

Lena Maier-Hein, Annika Reinke, Patrick Godau et al. · utoronto

Increasing evidence shows that flaws in machine learning (ML) algorithm validation are an underestimated global problem. Particularly in automatic biomedical image analysis, chosen performance metrics often do not reflect the domain interest, thus failing to adequately measure scientific progress and hindering translation of ML techniques into practice. To overcome this, our large international expert consortium created Metrics Reloaded, a comprehensive framework guiding researchers in the problem-aware selection of metrics. Following the convergence of ML methodology across application domains, Metrics Reloaded fosters the convergence of validation methodology. The framework was developed in a multi-stage Delphi process and is based on the novel concept of a problem fingerprint - a structured representation of the given problem that captures all aspects that are relevant for metric selection, from the domain interest to the properties of the target structure(s), data set and algorithm output. Based on the problem fingerprint, users are guided through the process of choosing and applying appropriate validation metrics while being made aware of potential pitfalls. Metrics Reloaded targets image analysis problems that can be interpreted as a classification task at image, object or pixel level, namely image-level classification, object detection, semantic segmentation, and instance segmentation tasks. To improve the user experience, we implemented the framework in the Metrics Reloaded online tool, which also provides a point of access to explore weaknesses, strengths and specific recommendations for the most common validation metrics. The broad applicability of our framework across domains is demonstrated by an instantiation for various biological and medical image analysis use cases.

Karim Lekadir, Aasa Feragen, Abdul Joseph Fofanah et al. · eth-zurich

Despite major advances in artificial intelligence (AI) for medicine and healthcare, the deployment and adoption of AI technologies remain limited in real-world clinical practice. In recent years, concerns have been raised about the technical, clinical, ethical and legal risks associated with medical AI. To increase real world adoption, it is essential that medical AI tools are trusted and accepted by patients, clinicians, health organisations and authorities. This work describes the FUTURE-AI guideline as the first international consensus framework for guiding the development and deployment of trustworthy AI tools in healthcare. The FUTURE-AI consortium was founded in 2021 and currently comprises 118 inter-disciplinary experts from 51 countries representing all continents, including AI scientists, clinicians, ethicists, and social scientists. Over a two-year period, the consortium defined guiding principles and best practices for trustworthy AI through an iterative process comprising an in-depth literature review, a modified Delphi survey, and online consensus meetings. The FUTURE-AI framework was established based on 6 guiding principles for trustworthy AI in healthcare, i.e. Fairness, Universality, Traceability, Usability, Robustness and Explainability. Through consensus, a set of 28 best practices were defined, addressing technical, clinical, legal and socio-ethical dimensions. The recommendations cover the entire lifecycle of medical AI, from design, development and validation to regulation, deployment, and monitoring. FUTURE-AI is a risk-informed, assumption-free guideline which provides a structured approach for constructing medical AI tools that will be trusted, deployed and adopted in real-world practice. Researchers are encouraged to take the recommendations into account in proof-of-concept stages to facilitate future translation towards clinical practice of medical AI.

Jiayi Zhu, Bart Bolsterlee, Brian V. Y. Chow et al.

Semi-supervised learning has made significant progress in medical image segmentation. However, existing methods primarily utilize information acquired from a single dimensionality (2D/3D), resulting in sub-optimal performance on challenging data, such as magnetic resonance imaging (MRI) scans with multiple objects and highly anisotropic resolution. To address this issue, we present a Hybrid Dual Mean-Teacher (HD-Teacher) model with hybrid, semi-supervised, and multi-task learning to achieve highly effective semi-supervised segmentation. HD-Teacher employs a 2D and a 3D mean-teacher network to produce segmentation labels and signed distance fields from the hybrid information captured in both dimensionalities. This hybrid learning mechanism allows HD-Teacher to combine the `best of both worlds', utilizing features extracted from either 2D, 3D, or both dimensions to produce outputs as it sees fit. Outputs from 2D and 3D teacher models are also dynamically combined, based on their individual uncertainty scores, into a single hybrid prediction, where the hybrid uncertainty is estimated. We then propose a hybrid regularization module to encourage both student models to produce results close to the uncertainty-weighted hybrid prediction. The hybrid uncertainty suppresses unreliable knowledge in the hybrid prediction, leaving only useful information to improve network performance further. Extensive experiments of binary and multi-class segmentation conducted on three MRI datasets demonstrate the effectiveness of the proposed framework. Code is available at https://github.com/ThisGame42/Hybrid-Teacher.

Annika Reinke, Minu D. Tizabi, Michael Baumgartner et al.

Validation metrics are key for the reliable tracking of scientific progress and for bridging the current chasm between artificial intelligence (AI) research and its translation into practice. However, increasing evidence shows that particularly in image analysis, metrics are often chosen inadequately in relation to the underlying research problem. This could be attributed to a lack of accessibility of metric-related knowledge: While taking into account the individual strengths, weaknesses, and limitations of validation metrics is a critical prerequisite to making educated choices, the relevant knowledge is currently scattered and poorly accessible to individual researchers. Based on a multi-stage Delphi process conducted by a multidisciplinary expert consortium as well as extensive community feedback, the present work provides the first reliable and comprehensive common point of access to information on pitfalls related to validation metrics in image analysis. Focusing on biomedical image analysis but with the potential of transfer to other fields, the addressed pitfalls generalize across application domains and are categorized according to a newly created, domain-agnostic taxonomy. To facilitate comprehension, illustrations and specific examples accompany each pitfall. As a structured body of information accessible to researchers of all levels of expertise, this work enhances global comprehension of a key topic in image analysis validation.

Raktim Kumar Mondol, Ewan K. A. Millar, Peter H Graham et al.

Gene expression can be used to subtype breast cancer with improved prediction of risk of recurrence and treatment responsiveness over that obtained using routine immunohistochemistry (IHC). However, in the clinic, molecular profiling is primarily used for ER+ breast cancer, which is costly, tissue destructive, requires specialized platforms and takes several weeks to obtain a result. Deep learning algorithms can effectively extract morphological patterns in digital histopathology images to predict molecular phenotypes quickly and cost-effectively. We propose a new, computationally efficient approach called hist2RNA inspired by bulk RNA-sequencing techniques to predict the expression of 138 genes (incorporated from six commercially available molecular profiling tests), including luminal PAM50 subtype, from hematoxylin and eosin (H&E) stained whole slide images (WSIs). The training phase involves the aggregation of extracted features for each patient from a pretrained model to predict gene expression at the patient level using annotated H&E images from The Cancer Genome Atlas (TCGA, n=335). We demonstrate successful gene prediction on a held-out test set (n = 160, corr = 0.82 across patients, corr = 0.29 across genes) and perform exploratory analysis on an external tissue microarray (TMA) dataset (n = 498) with known IHC and survival information. Our model is able to predict gene expression and luminal PAM50 subtype (Luminal A versus Luminal B) on the TMA dataset with prognostic significance for overall survival in univariate analysis (c-index = 0.56, hazard ratio = 2.16 (95% CI 1.12-3.06), p < 5 x 10-3), and independent significance in multivariate analysis incorporating standard clinicopathological variables (c-index = 0.65, hazard ratio = 1.85 (95% CI 1.30-2.68), p < 5 x 10-3).

Masoud Fetanat, Michael Stevens, Pankaj Jain et al.

Heart failure (HF) is one of the most prevalent life-threatening cardiovascular diseases in which 6.5 million people are suffering in the USA and more than 23 million worldwide. Mechanical circulatory support of HF patients can be achieved by implanting a left ventricular assist device (LVAD) into HF patients as a bridge to transplant, recovery or destination therapy and can be controlled by measurement of normal and abnormal pulmonary arterial wedge pressure (PAWP). While there are no commercial long-term implantable pressure sensors to measure PAWP, real-time non-invasive estimation of abnormal and normal PAWP becomes vital. In this work, first an improved Harris Hawks optimizer algorithm called HHO+ is presented and tested on 24 unimodal and multimodal benchmark functions. Second, a novel fully Elman neural network (FENN) is proposed to improve the classification performance. Finally, four novel 18-layer deep learning methods of convolutional neural networks (CNNs) with multi-layer perceptron (CNN-MLP), CNN with Elman neural networks (CNN-ENN), CNN with fully Elman neural networks (CNN-FENN), and CNN with fully Elman neural networks optimized by HHO+ algorithm (CNN-FENN-HHO+) for classification of abnormal and normal PAWP using estimated HVAD pump flow were developed and compared. The estimated pump flow was derived by a non-invasive method embedded into the commercial HVAD controller. The proposed methods are evaluated on an imbalanced clinical dataset using 5-fold cross-validation. The proposed CNN-FENN-HHO+ method outperforms the proposed CNN-MLP, CNN-ENN and CNN-FENN methods and improved the classification performance metrics across 5-fold cross-validation. The proposed methods can reduce the likelihood of hazardous events like pulmonary congestion and ventricular suction for HF patients and notify identified abnormal cases to the hospital, clinician and cardiologist.

Md Mamunur Rahaman, Ewan K. A. Millar, Erik Meijering

Tumour heterogeneity in breast cancer poses challenges in predicting outcome and response to therapy. Spatial transcriptomics technologies may address these challenges, as they provide a wealth of information about gene expression at the cell level, but they are expensive, hindering their use in large-scale clinical oncology studies. Predicting gene expression from hematoxylin and eosin stained histology images provides a more affordable alternative for such studies. Here we present BrST-Net, a deep learning framework for predicting gene expression from histopathology images using spatial transcriptomics data. Using this framework, we trained and evaluated 10 state-of-the-art deep learning models without utilizing pretrained weights for the prediction of 250 genes. To enhance the generalisation performance of the main network, we introduce an auxiliary network into the framework. Our methodology outperforms previous studies, with 237 genes identified with positive correlation, including 24 genes with a median correlation coefficient greater than 0.50. This is a notable improvement over previous studies, which could predict only 102 genes with positive correlation, with the highest correlation values ranging from 0.29 to 0.34.

Tariq M. Khan, Muhammad Arsalan, Antonio Robles-Kelly et al.

Image segmentation is an important task in medical imaging. It constitutes the backbone of a wide variety of clinical diagnostic methods, treatments, and computer-aided surgeries. In this paper, we propose a multi-kernel image segmentation net (MKIS-Net), which uses multiple kernels to create an efficient receptive field and enhance segmentation performance. As a result of its multi-kernel design, MKIS-Net is a light-weight architecture with a small number of trainable parameters. Moreover, these multi-kernel receptive fields also contribute to better segmentation results. We demonstrate the efficacy of MKIS-Net on several tasks including segmentation of retinal vessels, skin lesion segmentation, and chest X-ray segmentation. The performance of the proposed network is quite competitive, and often superior, in comparison to state-of-the-art methods. Moreover, in some cases MKIS-Net has more than an order of magnitude fewer trainable parameters than existing medical image segmentation alternatives and is at least four times smaller than other light-weight architectures.

Tariq M. Khan, Muhammad Arsalan, Shahzaib Iqbal et al.

Diseases such as diabetic retinopathy and age-related macular degeneration pose a significant risk to vision, highlighting the importance of precise segmentation of retinal vessels for the tracking and diagnosis of progression. However, existing vessel segmentation methods that heavily rely on encoder-decoder structures struggle to capture contextual information about retinal vessel configurations, leading to challenges in reconciling semantic disparities between encoder and decoder features. To address this, we propose a novel feature enhancement segmentation network (FES-Net) that achieves accurate pixel-wise segmentation without requiring additional image enhancement steps. FES-Net directly processes the input image and utilizes four prompt convolutional blocks (PCBs) during downsampling, complemented by a shallow upsampling approach to generate a binary mask for each class. We evaluate the performance of FES-Net on four publicly available state-of-the-art datasets: DRIVE, STARE, CHASE, and HRF. The evaluation results clearly demonstrate the superior performance of FES-Net compared to other competitive approaches documented in the existing literature.

Tariq M. Khan, Syed S. Naqvi, Antonio Robles-Kelly et al.

Compression of convolutional neural network models has recently been dominated by pruning approaches. A class of previous works focuses solely on pruning the unimportant filters to achieve network compression. Another important direction is the design of sparsity-inducing constraints which has also been explored in isolation. This paper presents a novel training scheme based on composite constraints that prune redundant filters and minimize their effect on overall network learning via sparsity promotion. Also, as opposed to prior works that employ pseudo-norm-based sparsity-inducing constraints, we propose a sparse scheme based on gradient counting in our framework. Our tests on several pixel-wise segmentation benchmarks show that the number of neurons and the memory footprint of networks in the test phase are significantly reduced without affecting performance. MobileNetV3 and UNet, two well-known architectures, are used to test the proposed scheme. Our network compression method not only results in reduced parameters but also achieves improved performance compared to MobileNetv3, which is an already optimized architecture.

Tariq M Khan, Shahzaib Iqbal, Syed S. Naqvi et al.

Retinal diseases can cause irreversible vision loss in both eyes if not diagnosed and treated early. Since retinal diseases are so complicated, retinal imaging is likely to show two or more abnormalities. Current deep learning techniques for segmenting retinal images with many labels and attributes have poor detection accuracy and generalisability. This paper presents a multipath convolutional neural network for multifeature segmentation. The proposed network is lightweight and spatially sensitive to information. A patch-based implementation is used to extract local image features, and focal modulation attention blocks are incorporated between the encoder and the decoder for improved segmentation. Filter optimisation is used to prevent filter overlaps and speed up model convergence. A combination of convolution operations and group convolution operations is used to reduce computational costs. This is the first robust and generalisable network capable of segmenting multiple features of fundus images (including retinal vessels, microaneurysms, optic discs, haemorrhages, hard exudates, and soft exudates). The results of our experimental evaluation on more than ten publicly available datasets with multiple features show that the proposed network outperforms recent networks despite having a small number of learnable parameters.

Shreyas Bhat Brahmavar, Rohit Rajesh, Tirtharaj Dash et al.

Deep neural network (DNN) models for retinopathy have estimated predictive accuracies in the mid-to-high 90%. However, the following aspects remain unaddressed: State-of-the-art models are complex and require substantial computational infrastructure to train and deploy; The reliability of predictions can vary widely. In this paper, we focus on these aspects and propose a form of iterative knowledge distillation(IKD), called IKD+ that incorporates a tradeoff between size, accuracy and reliability. We investigate the functioning of IKD+ using two widely used techniques for estimating model calibration (Platt-scaling and temperature-scaling), using the best-performing model available, which is an ensemble of EfficientNets with approximately 100M parameters. We demonstrate that IKD+ equipped with temperature-scaling results in models that show up to approximately 500-fold decreases in the number of parameters than the original ensemble without a significant loss in accuracy. In addition, calibration scores (reliability) for the IKD+ models are as good as or better than the base mode

Yao Yao, Ihor Smal, Ilya Grigoriev et al.

Reliable analysis of intracellular dynamic processes in time-lapse fluorescence microscopy images requires complete and accurate tracking of all small particles in all time frames of the image sequences. A fundamental first step towards this goal is particle detection. Given the small size of the particles, their detection is greatly affected by image noise. Recent studies have shown that applying image denoising as a preprocessing step indeed improves particle detection and their subsequent tracking. Deep learning based particle detection methods have shown superior results compared to traditional detection methods. However, they do not explicitly aim to remove noise from the images to facilitate detection. Thus we hypothesize that their performance could be further improved. In this paper, we propose a new deep neural network, called DENODET (denoising-detection network), which performs image denoising and particle detection simultaneously. We show that integrative denoising and detection yields more accurate detection results. Our method achieves superior results compared to state-of-the-art particle detection methods on the particle tracking challenge dataset and our own real fluorescence microscopy image data.

Shahzaib Iqbal, Tariq M. Khan, Syed S. Naqvi et al.

Deep learning has shown great potential for automated medical image segmentation to improve the precision and speed of disease diagnostics. However, the task presents significant difficulties due to variations in the scale, shape, texture, and contrast of the pathologies. Traditional convolutional neural network (CNN) models have certain limitations when it comes to effectively modelling multiscale context information and facilitating information interaction between skip connections across levels. To overcome these limitations, a novel deep learning architecture is introduced for medical image segmentation, taking advantage of CNNs and vision transformers. Our proposed model, named TBConvL-Net, involves a hybrid network that combines the local features of a CNN encoder-decoder architecture with long-range and temporal dependencies using biconvolutional long-short-term memory (LSTM) networks and vision transformers (ViT). This enables the model to capture contextual channel relationships in the data and account for the uncertainty of segmentation over time. Additionally, we introduce a novel composite loss function that considers both the segmentation robustness and the boundary agreement of the predicted output with the gold standard. Our proposed model shows consistent improvement over the state of the art on ten publicly available datasets of seven different medical imaging modalities.

Ari Tchetchenian, Leo Zekelman, Yuqian Chen et al.

Parcellation of human cerebellar pathways is essential for advancing our understanding of the human brain. Existing diffusion MRI tractography parcellation methods have been successful in defining major cerebellar fibre tracts, while relying solely on fibre tract structure. However, each fibre tract may relay information related to multiple cognitive and motor functions of the cerebellum. Hence, it may be beneficial for parcellation to consider the potential importance of the fibre tracts for individual motor and cognitive functional performance measures. In this work, we propose a multimodal data-driven method for cerebellar pathway parcellation, which incorporates both measures of microstructure and connectivity, and measures of individual functional performance. Our method involves first training a multitask deep network to predict various cognitive and motor measures from a set of fibre tract structural features. The importance of each structural feature for predicting each functional measure is then computed, resulting in a set of structure-function saliency values that are clustered to parcellate cerebellar pathways. We refer to our method as Deep Multimodal Saliency Parcellation (DeepMSP), as it computes the saliency of structural measures for predicting cognitive and motor functional performance, with these saliencies being applied to the task of parcellation. Applying DeepMSP we found that it was feasible to identify multiple cerebellar pathway parcels with unique structure-function saliency patterns that were stable across training folds.

Yiwen Xu, Tariq M. Khan, Yang Song et al.

Edge deep learning, a paradigm change reconciling edge computing and deep learning, facilitates real-time decision making attuned to environmental factors through the close integration of computational resources and data sources. Here we provide a comprehensive review of the current state of the art in edge deep learning, focusing on computer vision applications, in particular medical diagnostics. An overview of the foundational principles and technical advantages of edge deep learning is presented, emphasising the capacity of this technology to revolutionise a wide range of domains. Furthermore, we present a novel categorisation of edge hardware platforms based on performance and usage scenarios, facilitating platform selection and operational effectiveness. Following this, we dive into approaches to effectively implement deep neural networks on edge devices, encompassing methods such as lightweight design and model compression. Reviewing practical applications in the fields of computer vision in general and medical diagnostics in particular, we demonstrate the profound impact edge-deployed deep learning models can have in real-life situations. Finally, we provide an analysis of potential future directions and obstacles to the adoption of edge deep learning, with the intention to stimulate further investigations and advancements of intelligent edge deep learning solutions. This survey provides researchers and practitioners with a comprehensive reference shedding light on the critical role deep learning plays in the advancement of edge computing applications.

Tariq M Khan, Syed S. Naqvi, Erik Meijering

Segmentation is an important task in a wide range of computer vision applications, including medical image analysis. Recent years have seen an increase in the complexity of medical image segmentation approaches based on sophisticated convolutional neural network architectures. This progress has led to incremental enhancements in performance on widely recognised benchmark datasets. However, most of the existing approaches are computationally demanding, which limits their practical applicability. This paper presents an expand-squeeze dual multiscale residual network (ESDMR-Net), which is a fully convolutional network that is particularly well-suited for resource-constrained computing hardware such as mobile devices. ESDMR-Net focuses on extracting multiscale features, enabling the learning of contextual dependencies among semantically distinct features. The ESDMR-Net architecture allows dual-stream information flow within encoder-decoder pairs. The expansion operation (depthwise separable convolution) makes all of the rich features with multiscale information available to the squeeze operation (bottleneck layer), which then extracts the necessary information for the segmentation task. The Expand-Squeeze (ES) block helps the network pay more attention to under-represented classes, which contributes to improved segmentation accuracy. To enhance the flow of information across multiple resolutions or scales, we integrated dual multiscale residual (DMR) blocks into the skip connection. This integration enables the decoder to access features from various levels of abstraction, ultimately resulting in more comprehensive feature representations. We present experiments on seven datasets from five distinct examples of applications. Our model achieved the best results despite having significantly fewer trainable parameters, with a reduction of two or even three orders of magnitude.

Raktim Kumar Mondol, Ewan K. A. Millar, Arcot Sowmya et al.

Breast cancer is a significant health concern affecting millions of women worldwide. Accurate survival risk stratification plays a crucial role in guiding personalised treatment decisions and improving patient outcomes. Here we present BioFusionNet, a deep learning framework that fuses image-derived features with genetic and clinical data to obtain a holistic profile and achieve survival risk stratification of ER+ breast cancer patients. We employ multiple self-supervised feature extractors (DINO and MoCoV3) pretrained on histopathological patches to capture detailed image features. These features are then fused by a variational autoencoder and fed to a self-attention network generating patient-level features. A co-dual-cross-attention mechanism combines the histopathological features with genetic data, enabling the model to capture the interplay between them. Additionally, clinical data is incorporated using a feed-forward network, further enhancing predictive performance and achieving comprehensive multimodal feature integration. Furthermore, we introduce a weighted Cox loss function, specifically designed to handle imbalanced survival data, which is a common challenge. Our model achieves a mean concordance index of 0.77 and a time-dependent area under the curve of 0.84, outperforming state-of-the-art methods. It predicts risk (high versus low) with prognostic significance for overall survival in univariate analysis (HR=2.99, 95% CI: 1.88--4.78, p<0.005), and maintains independent significance in multivariate analysis incorporating standard clinicopathological variables (HR=2.91, 95\% CI: 1.80--4.68, p<0.005).

Raktim Kumar Mondol, Ewan K. A. Millar, Arcot Sowmya et al.

Survival risk stratification is an important step in clinical decision making for breast cancer management. We propose a novel deep learning approach for this purpose by integrating histopathological imaging, genetic and clinical data. It employs vision transformers, specifically the MaxViT model, for image feature extraction, and self-attention to capture intricate image relationships at the patient level. A dual cross-attention mechanism fuses these features with genetic data, while clinical data is incorporated at the final layer to enhance predictive accuracy. Experiments on the public TCGA-BRCA dataset show that our model, trained using the negative log likelihood loss function, can achieve superior performance with a mean C-index of 0.64, surpassing existing methods. This advancement facilitates tailored treatment strategies, potentially leading to improved patient outcomes.

Md Mamunur Rahaman, Ewan K. A. Millar, Erik Meijering

Zero-shot learning holds tremendous potential for histopathology image analysis by enabling models to generalize to unseen classes without extensive labeled data. Recent advancements in vision-language models (VLMs) have expanded the capabilities of ZSL, allowing models to perform tasks without task-specific fine-tuning. However, applying VLMs to histopathology presents considerable challenges due to the complexity of histopathological imagery and the nuanced nature of diagnostic tasks. In this paper, we propose a novel framework called Multi-Resolution Prompt-guided Hybrid Embedding (MR-PHE) to address these challenges in zero-shot histopathology image classification. MR-PHE leverages multiresolution patch extraction to mimic the diagnostic workflow of pathologists, capturing both fine-grained cellular details and broader tissue structures critical for accurate diagnosis. We introduce a hybrid embedding strategy that integrates global image embeddings with weighted patch embeddings, effectively combining local and global contextual information. Additionally, we develop a comprehensive prompt generation and selection framework, enriching class descriptions with domain-specific synonyms and clinically relevant features to enhance semantic understanding. A similarity-based patch weighting mechanism assigns attention-like weights to patches based on their relevance to class embeddings, emphasizing diagnostically important regions during classification. Our approach utilizes pretrained VLM, CONCH for ZSL without requiring domain-specific fine-tuning, offering scalability and reducing dependence on large annotated datasets. Experimental results demonstrate that MR-PHE not only significantly improves zero-shot classification performance on histopathology datasets but also often surpasses fully supervised models.

Raktim Kumar Mondol, Ewan K. A. Millar, Peter H. Graham et al.

Explainable AI (XAI) in medical histopathology is essential for enhancing the interpretability and clinical trustworthiness of deep learning models in cancer diagnosis. However, the black-box nature of these models often limits their clinical adoption. We introduce GRAPHITE (Graph-based Interpretable Tissue Examination), a post-hoc explainable framework designed for breast cancer tissue microarray (TMA) analysis. GRAPHITE employs a multiscale approach, extracting patches at various magnification levels, constructing an hierarchical graph, and utilising graph attention networks (GAT) with scalewise attention (SAN) to capture scale-dependent features. We trained the model on 140 tumour TMA cores and four benign whole slide images from which 140 benign samples were created, and tested it on 53 pathologist-annotated TMA samples. GRAPHITE outperformed traditional XAI methods, achieving a mean average precision (mAP) of 0.56, an area under the receiver operating characteristic curve (AUROC) of 0.94, and a threshold robustness (ThR) of 0.70, indicating that the model maintains high performance across a wide range of thresholds. In clinical utility, GRAPHITE achieved the highest area under the decision curve (AUDC) of 4.17e+5, indicating reliable decision support across thresholds. These results highlight GRAPHITE's potential as a clinically valuable tool in computational pathology, providing interpretable visualisations that align with the pathologists' diagnostic reasoning and support precision medicine.

Marsha Mariya Kappan, Eduardo Benitez Sandoval, Erik Meijering et al.

Pose estimation is a critical task in computer vision with a wide range of applications from activity monitoring to human-robot interaction. However,most of the existing methods are computationally expensive or have complex architecture. Here we propose a lightweight attention based pose estimation network that utilizes depthwise separable convolution and Convolutional Block Attention Module on an hourglass backbone. The network significantly reduces the computational complexity (floating point operations) and the model size (number of parameters) containing only about 10% of parameters of original eight stack Hourglass network. Experiments were conducted on COCO and MPII datasets using a two stack hourglass backbone. The results showed that our model performs well in comparison to six other lightweight pose estimation models with an average precision of 72.07. The model achieves this performance with only 2.3M parameters and 3.7G FLOPs.

Tariq M Khan, Dawn Lin, Shahzaib Iqbal et al.

Incorporating modern computer vision techniques into clinical protocols shows promise in improving skin lesion segmentation. The U-Net architecture has been a key model in this area, iteratively improved to address challenges arising from the heterogeneity of dermatologic images due to varying clinical settings, lighting, patient attributes, and hair density. To further improve skin lesion segmentation, we developed TAFM-Net, an innovative model leveraging self-adaptive transformer attention (TA) coupled with focal modulation (FM). Our model integrates an EfficientNetV2B1 encoder, which employs TA to enhance spatial and channel-related saliency, while a densely connected decoder integrates FM within skip connections, enhancing feature emphasis, segmentation performance, and interpretability crucial for medical image analysis. A novel dynamic loss function amalgamates region and boundary information, guiding effective model training. Our model achieves competitive performance, with Jaccard coefficients of 93.64\%, 86.88\% and 92.88\% in the ISIC2016, ISIC2017 and ISIC2018 datasets, respectively, demonstrating its potential in real-world scenarios.

Piumi Sandarenu, Julia Chen, Iveta Slapetova et al.

Advancements in digital imaging technologies have sparked increased interest in using multiplexed immunofluorescence (mIF) images to visualise and identify the interactions between specific immunophenotypes with the tumour microenvironment at the cellular level. Current state-of-the-art multiplexed immunofluorescence image analysis pipelines depend on cell feature representations characterised by morphological and stain intensity-based metrics generated using simple statistical and machine learning-based tools. However, these methods are not capable of generating complex representations of cells. We propose a deep learning-based cell feature extraction model using a variational autoencoder with supervision using a latent subspace to extract cell features in mIF images. We perform cell phenotype classification using a cohort of more than 44,000 multiplexed immunofluorescence cell image patches extracted across 1,093 tissue microarray cores of breast cancer patients, to demonstrate the success of our model against current and alternative methods.

Tariq M. Khan, Syed S. Naqvi, Erik Meijering

Recent progress in encoder-decoder neural network architecture design has led to significant performance improvements in a wide range of medical image segmentation tasks. However, state-of-the-art networks for a given task may be too computationally demanding to run on affordable hardware, and thus users often resort to practical workarounds by modifying various macro-level design aspects. Two common examples are downsampling of the input images and reducing the network depth to meet computer memory constraints. In this paper we investigate the effects of these changes on segmentation performance and show that image complexity can be used as a guideline in choosing what is best for a given dataset. We consider four statistical measures to quantify image complexity and evaluate their suitability on ten different public datasets. For the purpose of our experiments we also propose two new encoder-decoder architectures representing shallow and deep networks that are more memory efficient than currently popular networks. Our results suggest that median frequency is the best complexity measure in deciding about an acceptable input downsampling factor and network depth. For high-complexity datasets, a shallow network running on the original images may yield better segmentation results than a deep network running on downsampled images, whereas the opposite may be the case for low-complexity images.

Annika Reinke, Minu D. Tizabi, Carole H. Sudre et al.

While the importance of automatic image analysis is continuously increasing, recent meta-research revealed major flaws with respect to algorithm validation. Performance metrics are particularly key for meaningful, objective, and transparent performance assessment and validation of the used automatic algorithms, but relatively little attention has been given to the practical pitfalls when using specific metrics for a given image analysis task. These are typically related to (1) the disregard of inherent metric properties, such as the behaviour in the presence of class imbalance or small target structures, (2) the disregard of inherent data set properties, such as the non-independence of the test cases, and (3) the disregard of the actual biomedical domain interest that the metrics should reflect. This living dynamically document has the purpose to illustrate important limitations of performance metrics commonly applied in the field of image analysis. In this context, it focuses on biomedical image analysis problems that can be phrased as image-level classification, semantic segmentation, instance segmentation, or object detection task. The current version is based on a Delphi process on metrics conducted by an international consortium of image analysis experts from more than 60 institutions worldwide.