Pathologic diagnosis is a critical phase in deciding the optimal treatment procedure for dealing with colorectal cancer (CRC). Colonic polyps, precursors to CRC, can pathologically be classified into two major types: adenomatous and hyperplastic. For precise classification and early diagnosis of such polyps, the medical procedure of colonoscopy has been widely adopted paired with various imaging techniques, including narrow band imaging and white light imaging. However, the existing classification techniques mainly rely on a single imaging modality and show limited performance due to data scarcity. Recently, generative artificial intelligence has been gaining prominence in overcoming such issues. Additionally, various generation-controlling mechanisms using text prompts and images have been introduced to obtain visually appealing and desired outcomes. However, such mechanisms require class labels to make the model respond efficiently to the provided control input. In the colonoscopy domain, such controlling mechanisms are rarely explored; specifically, the text prompt is a completely uninvestigated area. Moreover, the unavailability of expensive class-wise labels for diverse sets of images limits such explorations. Therefore, we develop a novel model, PathoPolyp-Diff, that generates text-controlled synthetic images with diverse characteristics in terms of pathology, imaging modalities, and quality. We introduce cross-class label learning to make the model learn features from other classes, reducing the burdensome task of data annotation. The experimental results report an improvement of up to 7.91% in balanced accuracy using a publicly available dataset. Moreover, cross-class label learning achieves a statistically significant improvement of up to 18.33% in balanced accuracy during video-level analysis. The code is available at https://github.com/Vanshali/PathoPolyp-Diff.
Uncertainty quantification in medical images has become an essential addition to segmentation models for practical application in the real world. Although there are valuable developments in accurate uncertainty quantification methods using 2D images and slices of 3D volumes, in clinical practice, the complete 3D volumes (such as CT and MRI scans) are used to evaluate and plan the medical procedure. As a result, the existing 2D methods miss the rich 3D spatial information when resolving the uncertainty. A popular approach for quantifying the ambiguity in the data is to learn a distribution over the possible hypotheses. In recent work, this ambiguity has been modeled to be strictly Gaussian. Normalizing Flows (NFs) are capable of modelling more complex distributions and thus, better fit the embedding space of the data. To this end, we have developed a 3D probabilistic segmentation framework augmented with NFs, to enable capturing the distributions of various complexity. To test the proposed approach, we evaluate the model on the LIDC-IDRI dataset for lung nodule segmentation and quantify the aleatoric uncertainty introduced by the multi-annotator setting and inherent ambiguity in the CT data. Following this approach, we are the first to present a 3D Squared Generalized Energy Distance (GED) of 0.401 and a high 0.468 Hungarian-matched 3D IoU. The obtained results reveal the value in capturing the 3D uncertainty, using a flexible posterior distribution augmented with a Normalizing Flow. Finally, we present the aleatoric uncertainty in a visual manner with the aim to provide clinicians with additional insight into data ambiguity and facilitating more informed decision-making.
Outcome prediction from clinical text can prevent doctors from overlooking possible risks and help hospitals to plan capacities. We simulate patients at admission time, when decision support can be especially valuable, and contribute a novel admission to discharge task with four common outcome prediction targets: Diagnoses at discharge, procedures performed, in-hospital mortality and length-of-stay prediction. The ideal system should infer outcomes based on symptoms, pre-conditions and risk factors of a patient. We evaluate the effectiveness of language models to handle this scenario and propose clinical outcome pre-training to integrate knowledge about patient outcomes from multiple public sources. We further present a simple method to incorporate ICD code hierarchy into the models. We show that our approach improves performance on the outcome tasks against several baselines. A detailed analysis reveals further strengths of the model, including transferability, but also weaknesses such as handling of vital values and inconsistencies in the underlying data.