RAA-MIL: A Novel Framework for Classification of Oral Cytology
This work addresses the slow and subjective manual examination of cytology images for oral cancer detection, establishing the first patient-level weakly supervised benchmark in this domain, though it is incremental as it builds on existing multiple-instance learning methods.
The paper tackled the problem of automating patient-level diagnosis of oral cytology whole slide images for early detection of oral squamous cell carcinoma, achieving an average accuracy of 72.7% and weighted F1-score of 0.69 with a proposed Region-Affinity Attention MIL framework.
Cytology is a valuable tool for early detection of oral squamous cell carcinoma (OSCC). However, manual examination of cytology whole slide images (WSIs) is slow, subjective, and depends heavily on expert pathologists. To address this, we introduce the first weakly supervised deep learning framework for patient-level diagnosis of oral cytology whole slide images, leveraging the newly released Oral Cytology Dataset [1], which provides annotated cytology WSIs from ten medical centres across India. Each patient case is represented as a bag of cytology patches and assigned a diagnosis label (Healthy, Benign, Oral Potentially Malignant Disorders (OPMD), OSCC) by an in-house expert pathologist. These patient-level weak labels form a new extension to the dataset. We evaluate a baseline multiple-instance learning (MIL) model and a proposed Region-Affinity Attention MIL (RAA-MIL) that models spatial relationships between regions within each slide. The RAA-MIL achieves an average accuracy of 72.7%, weighted F1-score of 0.69 on an unseen test set, outperforming the baseline. This study establishes the first patient-level weakly supervised benchmark for oral cytology and moves toward reliable AI-assisted digital pathology.