Tumor detection under cystoscopy with transformer-augmented deep learning algorithm.

Journal: Physics in medicine and biology
Published Date:

Abstract

Accurate tumor detection is critical in cystoscopy to improve bladder cancer resection and decrease recurrence. Advanced deep learning algorithms hold the potential to improve the performance of standard white-light cystoscopy (WLC) in a noninvasive and cost-effective fashion. The purpose of this work is to develop a cost-effective, transformer-augmented deep learning algorithm for accurate detection of bladder tumors in WLC and to assess its performance on archived patient data.'CystoNet-T', a deep learning-based bladder tumor detector, was developed with a transformer-augmented pyramidal CNN architecture to improve automated tumor detection of WLC. CystoNet-T incorporated the self-attention mechanism by attaching transformer encoder modules to the pyramidal layers of the feature pyramid network (FPN), and obtained multi-scale activation maps with global features aggregation. Features resulting from context augmentation served as the input to a region-based detector to produce tumor detection predictions. The training set was constructed by 510 WLC frames that were obtained from cystoscopy video sequences acquired from 54 patients. The test set was constructed based on 101 images obtained from WLC sequences of 13 patients.CystoNet-T was evaluated on the test set with 96.4 F1 and 91.4 AP (Average Precision). This result improved the benchmark of Faster R-CNN and YOLO by 7.3 points in F1 and 3.8 points in AP. The improvement is attributed to the strong ability of global attention of CystoNet-T and better feature learning of the pyramids architecture throughout the training. The model was found to be particularly effective in highlighting the foreground information for precise localization of the true positives while favorably avoiding false alarmsWe have developed a deep learning algorithm that accurately detects bladder tumors in WLC. Transformer-augmented AI framework promises to aid in clinical decision-making for improved bladder cancer diagnosis and therapeutic guidance.

Authors

  • Xiao Jia
    School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong 510515, People's Republic of China. School of Software Engineering, Nanyang Normal University, Nanyang, Henan 473061, People's Republic of China. Guangzhou Key Laboratory of Medical Radiation Imaging and Detection Technology, Southern Medical University, Guangzhou, Guangdong 510515, People's Republic of China.
  • Eugene Shkolyar
    Department of Urology, Stanford University School of Medicine, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
  • Mark A Laurie
    Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Mail Code 5656, Palo Alto, CA 94304, USA; Department of Radiation Oncology, Stanford University School of Medicine, 875 Blake Wilbur Drive Room G204, Stanford, CA 94305-5847, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; Institute for Computational and Mathematical Engineering, Stanford University School of Engineering, Stanford, CA 94305, USA.
  • Okyaz Eminaga
    Okyaz Eminaga, Stanford Medical School, Stanford, CA; University Hospital of Cologne, Cologne, France; Nurettin Eminaga, St Mauritius Therapy Clinic, Meerbusch; Axel Semjonow, University Hospital Muenster; and Bernhard Breil, Niederrhein University of Applied Sciences, Krefeld, Germany.
  • Joseph C Liao
    Department of Urology, Stanford University School of Medicine, Stanford, CA, USA.
  • Lei Xing
    Department of Radiation Oncology, Stanford University, CA, USA.