A Retrospective Systematic Study on Hierarchical Sparse Query Transformer-assisted Ultrasound Screening for Early Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) ranks as the third leading cause of cancer-related mortality worldwide, with early detection being crucial for improving patient survival rates. However, early screening for HCC using ultrasound suffers from insufficient sensitivity and is highly dependent on the expertise of radiologists for interpretation. Leveraging the latest advancements in artificial intelligence (AI) in medical imaging, this study proposes an innovative Hierarchical Sparse Query Transformer (HSQformer) model that combines the strengths of Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs) to enhance the accuracy of HCC diagnosis in ultrasound screening. The HSQformer leverages sparse latent space representations to capture hierarchical details at various granularities without the need for complex adjustments, and adopts a modular, plug-and-play design philosophy, ensuring the model's versatility and ease of use. The HSQformer's performance was rigorously tested across three distinct clinical scenarios: single-center, multi-center, and high-risk patient testing. In each of these settings, it consistently outperformed existing state-of-the-art models, such as ConvNext and SwinTransformer. Notably, the HSQformer even matched the diagnostic capabilities of senior radiologists and comprehensively surpassed those of junior radiologists. The experimental results from this study strongly demonstrate the effectiveness and clinical potential of AI-assisted tools in HCC screening. The full code is available at https://github.com/Asunatan/HSQformer.