Yiyi Liang

Liangrui Pan, Jiadi Luo, Yuxuan Xiao et al.

Accurate intraoperative and postoperative diagnosis of spread through air spaces (STAS) is essential for guiding surgical decisions and postoperative management in lung cancer. However, histopathological assessment is labor-intensive and is prone to missed or incorrect diagnoses. We propose a Diffusion Attention Expert Model (DAEM) to detect STAS in frozen sections (FSs) and paraffin sections (PSs). Its diffusion attention expert module leverages full attention aggregation to learn multi-scale features from histopathological images, while a dual-branch architecture strengthens multi-scale feature representation. On an internal dataset, DAEM achieves AUCs of 0.8946 for FSs and 0.9112 for PSs. Validation on external multi-center datasets from eight institutions demonstrates strong generalizability and interpretability. Using tumor microenvironment (TME) features in PSs, we further enable semi-automatic measurement of STAS location and its distance from the primary tumor. Several quantitative TME metrics are identified as potential biomarkers for STAS, including micropapillary-type STAS. Overall, DAEM offers a clinically actionable framework for STAS assessment by enabling accurate and interpretable detection on FSs and PSs, supporting postoperative risk stratification through quantitative TME-based analysis.

Liangrui Pan, Qingchun Liang, Wenwu Zeng et al.

Spread through air spaces (STAS) is a distinct invasion pattern in lung cancer, crucial for prognosis assessment and guiding surgical decisions. Histopathology is the gold standard for STAS detection, yet traditional methods are subjective, time-consuming, and prone to misdiagnosis, limiting large-scale applications. We present VERN, an image analysis model utilizing a feature-interactive Siamese graph encoder to predict STAS from lung cancer histopathological images. VERN captures spatial topological features with feature sharing and skip connections to enhance model training. Using 1,546 histopathology slides, we built a large single-cohort STAS lung cancer dataset. VERN achieved an AUC of 0.9215 in internal validation and AUCs of 0.8275 and 0.8829 in frozen and paraffin-embedded test sections, respectively, demonstrating clinical-grade performance. Validated on a single-cohort and three external datasets, VERN showed robust predictive performance and generalizability, providing an open platform (http://plr.20210706.xyz:5000/) to enhance STAS diagnosis efficiency and accuracy.

Liangrui Pan, Yijun Peng, Yan Li et al.

Integrating the different data modalities of cancer patients can significantly improve the predictive performance of patient survival. However, most existing methods ignore the simultaneous utilization of rich semantic features at different scales in pathology images. When collecting multimodal data and extracting features, there is a likelihood of encountering intra-modality missing data, introducing noise into the multimodal data. To address these challenges, this paper proposes a new end-to-end framework, FORESEE, for robustly predicting patient survival by mining multimodal information. Specifically, the cross-fusion transformer effectively utilizes features at the cellular level, tissue level, and tumor heterogeneity level to correlate prognosis through a cross-scale feature cross-fusion method. This enhances the ability of pathological image feature representation. Secondly, the hybrid attention encoder (HAE) uses the denoising contextual attention module to obtain the contextual relationship features and local detail features of the molecular data. HAE's channel attention module obtains global features of molecular data. Furthermore, to address the issue of missing information within modalities, we propose an asymmetrically masked triplet masked autoencoder to reconstruct lost information within modalities. Extensive experiments demonstrate the superiority of our method over state-of-the-art methods on four benchmark datasets in both complete and missing settings.