Traditional supervised learning tasks require a label for every instance in the training set, but in many real-world applications, labels are only available for collections (bags) of instances. This problem setting, known as multiple instance learning (MIL), is particularly relevant in the medical domain, where high-resolution images are split into smaller patches, but labels apply to the image as a whole. Recent MIL models are able to capture correspondences between patches by employing self-attention, allowing them to weigh each patch differently based on all other patches in the bag. However, these approaches still do not consider the relative spatial relationships between patches within the larger image, which is especially important in computational pathology. To this end, we introduce a novel MIL model with distance-aware self-attention (DAS-MIL), which explicitly takes into account relative spatial information when modelling the interactions between patches. Unlike existing relative position representations for self-attention which are discrete, our approach introduces continuous distance-dependent terms into the computation of the attention weights, and is the first to apply relative position representations in the context of MIL. We evaluate our model on a custom MNIST-based MIL dataset that requires the consideration of relative spatial information, as well as on CAMELYON16, a publicly available cancer metastasis detection dataset, where we achieve a test AUROC score of 0.91. On both datasets, our model outperforms existing MIL approaches that employ absolute positional encodings, as well as existing relative position representation schemes applied to MIL. Our code is available at https://anonymous.4open.science/r/das-mil.
Recently, large, high-quality public datasets have led to the development of convolutional neural networks that can detect lymph node metastases of breast cancer at the level of expert pathologists. Many cancers, regardless of the site of origin, can metastasize to lymph nodes. However, collecting and annotating high-volume, high-quality datasets for every cancer type is challenging. In this paper we investigate how to leverage existing high-quality datasets most efficiently in multi-task settings for closely related tasks. Specifically, we will explore different training and domain adaptation strategies, including prevention of catastrophic forgetting, for colon and head-and-neck cancer metastasis detection in lymph nodes. Our results show state-of-the-art performance on both cancer metastasis detection tasks. Furthermore, we show the effectiveness of repeated adaptation of networks from one cancer type to another to obtain multi-task metastasis detection networks. Last, we show that leveraging existing high-quality datasets can significantly boost performance on new target tasks and that catastrophic forgetting can be effectively mitigated using regularization.
Breast cancer diagnosis often requires accurate detection of metastasis in lymph nodes through Whole-slide Images (WSIs). Recent advances in deep convolutional neural networks (CNNs) have shown significant successes in medical image analysis and particularly in computational histopathology. Because of the outrageous large size of WSIs, most of the methods divide one slide into lots of small image patches and perform classification on each patch independently. However, neighboring patches often share spatial correlations, and ignoring these spatial correlations may result in inconsistent predictions. In this paper, we propose a neural conditional random field (NCRF) deep learning framework to detect cancer metastasis in WSIs. NCRF considers the spatial correlations between neighboring patches through a fully connected CRF which is directly incorporated on top of a CNN feature extractor. The whole deep network can be trained end-to-end with standard back-propagation algorithm with minor computational overhead from the CRF component. The CNN feature extractor can also benefit from considering spatial correlations via the CRF component. Compared to the baseline method without considering spatial correlations, we show that the proposed NCRF framework obtains probability maps of patch predictions with better visual quality. We also demonstrate that our method outperforms the baseline in cancer metastasis detection on the Camelyon16 dataset and achieves an average FROC score of 0.8096 on the test set. NCRF is open sourced at https://github.com/baidu-research/NCRF.