Vision Language Models versus Machine Learning Models Performance on Polyp Detection and Classification in Colonoscopy Images

Introduction: This study provides a comprehensive performance assessment of vision-language models (VLMs) against established convolutional neural networks (CNNs) and classic machine learning models (CMLs) for computer-aided detection (CADe) and computer-aided diagnosis (CADx) of colonoscopy polyp images. Method: We analyzed 2,258 colonoscopy images with corresponding pathology reports from 428 patients. We preprocessed all images using standardized techniques (resizing, normalization, and augmentation) and implemented a rigorous comparative framework evaluating 11 distinct models: ResNet50, 4 CMLs (random forest, support vector machine, logistic regression, decision tree), two specialized contrastive vision language encoders (CLIP, BiomedCLIP), and three general-purpose VLMs ( GPT-4 Gemini-1.5-Pro, Claude-3-Opus). Our performance assessment focused on two clinical tasks: polyp detection (CADe) and classification (CADx). Result: In polyp detection, ResNet50 achieved the best performance (F1: 91.35%, AUROC: 0.98), followed by BiomedCLIP (F1: 88.68%, AUROC: [AS1] ). GPT-4 demonstrated comparable effectiveness to traditional machine learning approaches (F1: 81.02%, AUROC: [AS2] ), outperforming other general-purpose VLMs. For polyp classification, performance rankings remained consistent but with lower overall metrics. ResNet50 maintained the highest efficacy (weighted F1: 74.94%), while GPT-4 demonstrated moderate capability (weighted F1: 41.18%), significantly exceeding other VLMs (Claude-3-Opus weighted F1: 25.54%, Gemini 1.5 Pro weighted F1: 6.17%). Conclusion: CNNs remain superior for both CADx and CADe tasks. However, VLMs like BioMedCLIP and GPT-4 may be useful for polyp detection tasks where training CNNs is not feasible.

BreastRegNet: A Deep Learning Framework for Registration of Breast Faxitron and Histopathology Images

A standard treatment protocol for breast cancer entails administering neoadjuvant therapy followed by surgical removal of the tumor and surrounding tissue. Pathologists typically rely on cabinet X-ray radiographs, known as Faxitron, to examine the excised breast tissue and diagnose the extent of residual disease. However, accurately determining the location, size, and focality of residual cancer can be challenging, and incorrect assessments can lead to clinical consequences. The utilization of automated methods can improve the histopathology process, allowing pathologists to choose regions for sampling more effectively and precisely. Despite the recognized necessity, there are currently no such methods available. Training such automated detection models require accurate ground truth labels on ex-vivo radiology images, which can be acquired through registering Faxitron and histopathology images and mapping the extent of cancer from histopathology to x-ray images. This study introduces a deep learning-based image registration approach trained on mono-modal synthetic image pairs. The models were trained using data from 50 women who received neoadjuvant chemotherapy and underwent surgery. The results demonstrate that our method is faster and yields significantly lower average landmark error ($2.1\pm1.96$ mm) over the state-of-the-art iterative ($4.43\pm4.1$ mm) and deep learning ($4.02\pm3.15$ mm) approaches. Improved performance of our approach in integrating radiology and pathology information facilitates generating large datasets, which allows training models for more accurate breast cancer detection.