TopoTxR: A topology-guided deep convolutional network for breast parenchyma learning on DCE-MRIs

Characterization of breast parenchyma in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a challenging task owing to the complexity of underlying tissue structures. Existing quantitative approaches, like radiomics and deep learning models, lack explicit quantification of intricate and subtle parenchymal structures, including fibroglandular tissue. To address this, we propose a novel topological approach that explicitly extracts multi-scale topological structures to better approximate breast parenchymal structures, and then incorporates these structures into a deep-learning-based prediction model via an attention mechanism. Our topology-informed deep learning model, \emph{TopoTxR}, leverages topology to provide enhanced insights into tissues critical for disease pathophysiology and treatment response. We empirically validate \emph{TopoTxR} using the VICTRE phantom breast dataset, showing that the topological structures extracted by our model effectively approximate the breast parenchymal structures. We further demonstrate \emph{TopoTxR}'s efficacy in predicting response to neoadjuvant chemotherapy. Our qualitative and quantitative analyses suggest differential topological behavior of breast tissue in treatment-na\"ive imaging, in patients who respond favorably to therapy as achieving pathological complete response (pCR) versus those who do not. In a comparative analysis with several baselines on the publicly available I-SPY 1 dataset (N=161, including 47 patients with pCR and 114 without) and the Rutgers proprietary dataset (N=120, with 69 patients achieving pCR and 51 not), \emph{TopoTxR} demonstrates a notable improvement, achieving a 2.6\% increase in accuracy and a 4.6\% enhancement in AUC compared to the state-of-the-art method.

Hard Negative Sample Mining for Whole Slide Image Classification

Weakly supervised whole slide image (WSI) classification is challenging due to the lack of patch-level labels and high computational costs. State-of-the-art methods use self-supervised patch-wise feature representations for multiple instance learning (MIL). Recently, methods have been proposed to fine-tune the feature representation on the downstream task using pseudo labeling, but mostly focusing on selecting high-quality positive patches. In this paper, we propose to mine hard negative samples during fine-tuning. This allows us to obtain better feature representations and reduce the training cost. Furthermore, we propose a novel patch-wise ranking loss in MIL to better exploit these hard negative samples. Experiments on two public datasets demonstrate the efficacy of these proposed ideas. Our codes are available at https://github.com/winston52/HNM-WSI

Semi-Supervised Contrastive VAE for Disentanglement of Digital Pathology Images

Despite the strong prediction power of deep learning models, their interpretability remains an important concern. Disentanglement models increase interpretability by decomposing the latent space into interpretable subspaces. In this paper, we propose the first disentanglement method for pathology images. We focus on the task of detecting tumor-infiltrating lymphocytes (TIL). We propose different ideas including cascading disentanglement, novel architecture, and reconstruction branches. We achieve superior performance on complex pathology images, thus improving the interpretability and even generalization power of TIL detection deep learning models. Our codes are available at https://github.com/Shauqi/SS-cVAE.

Histo-Diffusion: A Diffusion Super-Resolution Method for Digital Pathology with Comprehensive Quality Assessment

Digital pathology has advanced significantly over the last decade, with Whole Slide Images (WSIs) encompassing vast amounts of data essential for accurate disease diagnosis. High-resolution WSIs are essential for precise diagnosis but technical limitations in scanning equipment and variablity in slide preparation can hinder obtaining these images. Super-resolution techniques can enhance low-resolution images; while Generative Adversarial Networks (GANs) have been effective in natural image super-resolution tasks, they often struggle with histopathology due to overfitting and mode collapse. Traditional evaluation metrics fall short in assessing the complex characteristics of histopathology images, necessitating robust histology-specific evaluation methods. We introduce Histo-Diffusion, a novel diffusion-based method specially designed for generating and evaluating super-resolution images in digital pathology. It includes a restoration module for histopathology prior and a controllable diffusion module for generating high-quality images. We have curated two histopathology datasets and proposed a comprehensive evaluation strategy which incorporates both full-reference and no-reference metrics to thoroughly assess the quality of digital pathology images. Comparative analyses on multiple datasets with state-of-the-art methods reveal that Histo-Diffusion outperforms GANs. Our method offers a versatile solution for histopathology image super-resolution, capable of handling multi-resolution generation from varied input sizes, providing valuable support in diagnostic processes.

SI-MIL: Taming Deep MIL for Self-Interpretability in Gigapixel Histopathology

Introducing interpretability and reasoning into Multiple Instance Learning (MIL) methods for Whole Slide Image (WSI) analysis is challenging, given the complexity of gigapixel slides. Traditionally, MIL interpretability is limited to identifying salient regions deemed pertinent for downstream tasks, offering little insight to the end-user (pathologist) regarding the rationale behind these selections. To address this, we propose Self-Interpretable MIL (SI-MIL), a method intrinsically designed for interpretability from the very outset. SI-MIL employs a deep MIL framework to guide an interpretable branch grounded on handcrafted pathological features, facilitating linear predictions. Beyond identifying salient regions, SI-MIL uniquely provides feature-level interpretations rooted in pathological insights for WSIs. Notably, SI-MIL, with its linear prediction constraints, challenges the prevalent myth of an inevitable trade-off between model interpretability and performance, demonstrating competitive results compared to state-of-the-art methods on WSI-level prediction tasks across three cancer types. In addition, we thoroughly benchmark the local- and global-interpretability of SI-MIL in terms of statistical analysis, a domain expert study, and desiderata of interpretability, namely, user-friendliness and faithfulness.

Learned representation-guided diffusion models for large-image generation

To synthesize high-fidelity samples, diffusion models typically require auxiliary data to guide the generation process. However, it is impractical to procure the painstaking patch-level annotation effort required in specialized domains like histopathology and satellite imagery; it is often performed by domain experts and involves hundreds of millions of patches. Modern-day self-supervised learning (SSL) representations encode rich semantic and visual information. In this paper, we posit that such representations are expressive enough to act as proxies to fine-grained human labels. We introduce a novel approach that trains diffusion models conditioned on embeddings from SSL. Our diffusion models successfully project these features back to high-quality histopathology and remote sensing images. In addition, we construct larger images by assembling spatially consistent patches inferred from SSL embeddings, preserving long-range dependencies. Augmenting real data by generating variations of real images improves downstream classifier accuracy for patch-level and larger, image-scale classification tasks. Our models are effective even on datasets not encountered during training, demonstrating their robustness and generalizability. Generating images from learned embeddings is agnostic to the source of the embeddings. The SSL embeddings used to generate a large image can either be extracted from a reference image, or sampled from an auxiliary model conditioned on any related modality (e.g. class labels, text, genomic data). As proof of concept, we introduce the text-to-large image synthesis paradigm where we successfully synthesize large pathology and satellite images out of text descriptions.

Automated Assessment of Critical View of Safety in Laparoscopic Cholecystectomy

Cholecystectomy (gallbladder removal) is one of the most common procedures in the US, with more than 1.2M procedures annually. Compared with classical open cholecystectomy, laparoscopic cholecystectomy (LC) is associated with significantly shorter recovery period, and hence is the preferred method. However, LC is also associated with an increase in bile duct injuries (BDIs), resulting in significant morbidity and mortality. The primary cause of BDIs from LCs is misidentification of the cystic duct with the bile duct. Critical view of safety (CVS) is the most effective of safety protocols, which is said to be achieved during the surgery if certain criteria are met. However, due to suboptimal understanding and implementation of CVS, the BDI rates have remained stable over the last three decades. In this paper, we develop deep-learning techniques to automate the assessment of CVS in LCs. An innovative aspect of our research is on developing specialized learning techniques by incorporating domain knowledge to compensate for the limited training data available in practice. In particular, our CVS assessment process involves a fusion of two segmentation maps followed by an estimation of a certain region of interest based on anatomical structures close to the gallbladder, and then finally determination of each of the three CVS criteria via rule-based assessment of structural information. We achieved a gain of over 11.8% in mIoU on relevant classes with our two-stream semantic segmentation approach when compared to a single-model baseline, and 1.84% in mIoU with our proposed Sobel loss function when compared to a Transformer-based baseline model. For CVS criteria, we achieved up to 16% improvement and, for the overall CVS assessment, we achieved 5% improvement in balanced accuracy compared to DeepCVS under the same experiment settings.

Attention De-sparsification Matters: Inducing Diversity in Digital Pathology Representation Learning

We propose DiRL, a Diversity-inducing Representation Learning technique for histopathology imaging. Self-supervised learning techniques, such as contrastive and non-contrastive approaches, have been shown to learn rich and effective representations of digitized tissue samples with limited pathologist supervision. Our analysis of vanilla SSL-pretrained models' attention distribution reveals an insightful observation: sparsity in attention, i.e, models tends to localize most of their attention to some prominent patterns in the image. Although attention sparsity can be beneficial in natural images due to these prominent patterns being the object of interest itself, this can be sub-optimal in digital pathology; this is because, unlike natural images, digital pathology scans are not object-centric, but rather a complex phenotype of various spatially intermixed biological components. Inadequate diversification of attention in these complex images could result in crucial information loss. To address this, we leverage cell segmentation to densely extract multiple histopathology-specific representations, and then propose a prior-guided dense pretext task for SSL, designed to match the multiple corresponding representations between the views. Through this, the model learns to attend to various components more closely and evenly, thus inducing adequate diversification in attention for capturing context rich representations. Through quantitative and qualitative analysis on multiple tasks across cancer types, we demonstrate the efficacy of our method and observe that the attention is more globally distributed.

PathLDM: Text conditioned Latent Diffusion Model for Histopathology

To achieve high-quality results, diffusion models must be trained on large datasets. This can be notably prohibitive for models in specialized domains, such as computational pathology. Conditioning on labeled data is known to help in data-efficient model training. Therefore, histopathology reports, which are rich in valuable clinical information, are an ideal choice as guidance for a histopathology generative model. In this paper, we introduce PathLDM, the first text-conditioned Latent Diffusion Model tailored for generating high-quality histopathology images. Leveraging the rich contextual information provided by pathology text reports, our approach fuses image and textual data to enhance the generation process. By utilizing GPT's capabilities to distill and summarize complex text reports, we establish an effective conditioning mechanism. Through strategic conditioning and necessary architectural enhancements, we achieved a SoTA FID score of 7.64 for text-to-image generation on the TCGA-BRCA dataset, significantly outperforming the closest text-conditioned competitor with FID 30.1.

Learning to Segment from Noisy Annotations: A Spatial Correction Approach

Noisy labels can significantly affect the performance of deep neural networks (DNNs). In medical image segmentation tasks, annotations are error-prone due to the high demand in annotation time and in the annotators' expertise. Existing methods mostly assume noisy labels in different pixels are \textit{i.i.d}. However, segmentation label noise usually has strong spatial correlation and has prominent bias in distribution. In this paper, we propose a novel Markov model for segmentation noisy annotations that encodes both spatial correlation and bias. Further, to mitigate such label noise, we propose a label correction method to recover true label progressively. We provide theoretical guarantees of the correctness of the proposed method. Experiments show that our approach outperforms current state-of-the-art methods on both synthetic and real-world noisy annotations.