arXiv:2502.21109eess.IVcs.CV2025-02被引 1

用肿瘤占比回归替代分类,实现无需正常样本的病理切片肿瘤检测。

"No negatives needed": weakly-supervised regression for interpretable tumor detection in whole-slide histopathology images

  • 将肿瘤检测转为回归任务,直接预测肿瘤占比,无需负样本。
  • 在多器官多场景下验证,对小肿瘤区域敏感性提升显著。
  • 通过注意力图提供可解释性,适合临床医生理解模型决策。

数字病理全切片图像(WSIs)中的精准肿瘤检测对癌症诊断与治疗至关重要。多实例学习(MIL)作为弱监督方法,广泛应用于大规模数据中无需人工标注的肿瘤检测。然而,传统MIL依赖分类任务,需肿瘤阴性样本,这在真实临床中(尤其是手术切除标本)难以获取。本文提出将肿瘤检测重构为回归任务,直接估计WSI中的肿瘤占比,该目标在多种癌症类型中均可获得。我们分析了该弱监督回归框架在多器官、多标本类型及不同临床场景下的表现,评估了肿瘤占比作为噪声回归目标的鲁棒性,并引入一种新型增强技术,提升小肿瘤区域的检测灵敏度。最后,通过可视化注意力图与逻辑值图,提供模型预测的可解释性洞察。代码已开源:https://github.com/DIAGNijmegen/tumor-percentage-mil-regression。

原文摘要 · Abstract (English)

Accurate tumor detection in digital pathology whole-slide images (WSIs) is crucial for cancer diagnosis and treatment planning. Multiple Instance Learning (MIL) has emerged as a widely used approach for weakly-supervised tumor detection with large-scale data without the need for manual annotations. However, traditional MIL methods often depend on classification tasks that require tumor-free cases as negative examples, which are challenging to obtain in real-world clinical workflows, especially for surgical resection specimens. We address this limitation by reformulating tumor detection as a regression task, estimating tumor percentages from WSIs, a clinically available target across multiple cancer types. In this paper, we provide an analysis of the proposed weakly-supervised regression framework by applying it to multiple organs, specimen types and clinical scenarios. We characterize the robustness of our framework to tumor percentage as a noisy regression target, and introduce a novel concept of amplification technique to improve tumor detection sensitivity when learning from small tumor regions. Finally, we provide interpretable insights into the model's predictions by analyzing visual attention and logit maps. Our code is available at https://github.com/DIAGNijmegen/tumor-percentage-mil-regression.

弱监督病理图像回归检测可解释性

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