Lung Cancer
AutoRad-Lung: A Radiomic-Guided Prompting Autoregressive Vision-Language Model for Lung Nodule Malignancy Prediction
Khademi, Sadaf, Shabanpour, Mehran, Taleei, Reza, Oikonomou, Anastasia, Mohammadi, Arash
Lung cancer remains one of the leading causes of cancer-related mortality worldwide. A crucial challenge for early diagnosis is differentiating uncertain cases with similar visual characteristics and closely annotation scores. In clinical practice, radiologists rely on quantitative, hand-crafted Radiomic features extracted from Computed Tomography (CT) images, while recent research has primarily focused on deep learning solutions. More recently, Vision-Language Models (VLMs), particularly Contrastive Language-Image Pre-Training (CLIP)-based models, have gained attention for their ability to integrate textual knowledge into lung cancer diagnosis. While CLIP-Lung models have shown promising results, we identified the following potential limitations: (a) dependence on radiologists' annotated attributes, which are inherently subjective and error-prone, (b) use of textual information only during training, limiting direct applicability at inference, and (c) Convolutional-based vision encoder with randomly initialized weights, which disregards prior knowledge. To address these limitations, we introduce AutoRad-Lung, which couples an autoregressively pre-trained VLM, with prompts generated from hand-crafted Radiomics. AutoRad-Lung uses the vision encoder of the Large-Scale Autoregressive Image Model (AIMv2), pre-trained using a multi-modal autoregressive objective. Given that lung tumors are typically small, irregularly shaped, and visually similar to healthy tissue, AutoRad-Lung offers significant advantages over its CLIP-based counterparts by capturing pixel-level differences. Additionally, we introduce conditional context optimization, which dynamically generates context-specific prompts based on input Radiomics, improving cross-modal alignment.
Dexterous Control of an 11-DOF Redundant Robot for CT-Guided Needle Insertion With Task-Oriented Weighted Policies
Zhang, Peihan, Richter, Florian, Duriseti, Ishan, Yip, Michael
Computed tomography (CT)-guided needle biopsies are critical for diagnosing a range of conditions, including lung cancer, but present challenges such as limited in-bore space, prolonged procedure times, and radiation exposure. Robotic assistance offers a promising solution by improving needle trajectory accuracy, reducing radiation exposure, and enabling real-time adjustments. In our previous work, we introduced a redundant robotic platform designed for dexterous needle insertion within the confined CT bore. However, its limited base mobility restricts flexible deployment in clinical settings. In this study, we present an improved 11-degree-of-freedom (DOF) robotic system that integrates a 6-DOF robotic base with a 5-DOF cable-driven end-effector, significantly enhancing workspace flexibility and precision. With the hyper-redundant degrees of freedom, we introduce a weighted inverse kinematics controller with a two-stage priority scheme for large-scale movement and fine in-bore adjustments, along with a null-space control strategy to optimize dexterity. We validate our system through both simulation and real-world experiments, demonstrating superior tracking accuracy and enhanced manipulability in CT-guided procedures. The study provides a strong case for hyper-redundancy and null-space control formulations for robot-assisted needle biopsy scenarios.
SMILE: a Scale-aware Multiple Instance Learning Method for Multicenter STAS Lung Cancer Histopathology Diagnosis
Pan, Liangrui, Li, Xiaoyu, Dou, Yutao, Song, Qiya, Luo, Jiadi, Liang, Qingchun, Peng, Shaoliang
Spread through air spaces (STAS) represents a newly identified aggressive pattern in lung cancer, which is known to be associated with adverse prognostic factors and complex pathological features. Pathologists currently rely on time consuming manual assessments, which are highly subjective and prone to variation. This highlights the urgent need for automated and precise diag nostic solutions. 2,970 lung cancer tissue slides are comprised from multiple centers, re-diagnosed them, and constructed and publicly released three lung cancer STAS datasets: STAS CSU (hospital), STAS TCGA, and STAS CPTAC. All STAS datasets provide corresponding pathological feature diagnoses and related clinical data. To address the bias, sparse and heterogeneous nature of STAS, we propose an scale-aware multiple instance learning(SMILE) method for STAS diagnosis of lung cancer. By introducing a scale-adaptive attention mechanism, the SMILE can adaptively adjust high attention instances, reducing over-reliance on local regions and promoting consistent detection of STAS lesions. Extensive experiments show that SMILE achieved competitive diagnostic results on STAS CSU, diagnosing 251 and 319 STAS samples in CPTAC andTCGA,respectively, surpassing clinical average AUC. The 11 open baseline results are the first to be established for STAS research, laying the foundation for the future expansion, interpretability, and clinical integration of computational pathology technologies. The datasets and code are available at https://anonymous.4open.science/r/IJCAI25-1DA1.
An Integrated Deep Learning Framework Leveraging NASNet and Vision Transformer with MixProcessing for Accurate and Precise Diagnosis of Lung Diseases
Saleem, Sajjad, Sharif, Muhammad Imran
The lungs are the essential organs of respiration, and this system is significant in the carbon dioxide and exchange between oxygen that occurs in human life. However, several lung diseases, which include pneumonia, tuberculosis, COVID-19, and lung cancer, are serious healthiness challenges and demand early and precise diagnostics. The methodological study has proposed a new deep learning framework called NASNet-ViT, which effectively incorporates the convolution capability of NASNet with the global attention mechanism capability of Vision Transformer ViT. The proposed model will classify the lung conditions into five classes: Lung cancer, COVID-19, pneumonia, TB, and normal. A sophisticated multi-faceted preprocessing strategy called MixProcessing has been used to improve diagnostic accuracy. This preprocessing combines wavelet transform, adaptive histogram equalization, and morphological filtering techniques. The NASNet-ViT model performs at state of the art, achieving an accuracy of 98.9%, sensitivity of 0.99, an F1-score of 0.989, and specificity of 0.987, outperforming other state of the art architectures such as MixNet-LD, D-ResNet, MobileNet, and ResNet50. The model's efficiency is further emphasized by its compact size, 25.6 MB, and a low computational time of 12.4 seconds, hence suitable for real-time, clinically constrained environments. These results reflect the high-quality capability of NASNet-ViT in extracting meaningful features and recognizing various types of lung diseases with very high accuracy. This work contributes to medical image analysis by providing a robust and scalable solution for diagnostics in lung diseases.
Requirements for Quality Assurance of AI Models for Early Detection of Lung Cancer
Hahn, Horst K., May, Matthias S., Dicken, Volker, Walz, Michael, Eรeling, Rainer, Lassen-Schmidt, Bianca, Rischen, Robert, Vogel-Claussen, Jens, Nikolaou, Konstantin, Barkhausen, Jรถrg
Lung cancer is the second most common cancer and the leading cause of cancer-related deaths worldwide. Survival largely depends on tumor stage at diagnosis, and early detection with low-dose CT can significantly reduce mortality in high-risk patients. AI can improve the detection, measurement, and characterization of pulmonary nodules while reducing assessment time. However, the training data, functionality, and performance of available AI systems vary considerably, complicating software selection and regulatory evaluation. Manufacturers must specify intended use and provide test statistics, but they can choose their training and test data, limiting standardization and comparability. Under the EU AI Act, consistent quality assurance is required for AI-based nodule detection, measurement, and characterization. This position paper proposes systematic quality assurance grounded in a validated reference dataset, including real screening cases plus phantom data to verify volume and growth rate measurements. Regular updates shall reflect demographic shifts and technological advances, ensuring ongoing relevance. Consequently, ongoing AI quality assurance is vital. Regulatory challenges are also adressed. While the MDR and the EU AI Act set baseline requirements, they do not adequately address self-learning algorithms or their updates. A standardized, transparent quality assessment - based on sensitivity, specificity, and volumetric accuracy - enables an objective evaluation of each AI solution's strengths and weaknesses. Establishing clear testing criteria and systematically using updated reference data lay the groundwork for comparable performance metrics, informing tenders, guidelines, and recommendations.
Doctor-in-the-Loop: An Explainable, Multi-View Deep Learning Framework for Predicting Pathological Response in Non-Small Cell Lung Cancer
Caragliano, Alice Natalina, Ruffini, Filippo, Greco, Carlo, Ippolito, Edy, Fiore, Michele, Tacconi, Claudia, Nibid, Lorenzo, Perrone, Giuseppe, Ramella, Sara, Soda, Paolo, Guarrasi, Valerio
Non-small cell lung cancer (NSCLC) remains a major global health challenge, with high post-surgical recurrence rates underscoring the need for accurate pathological response predictions to guide personalized treatments. Although artificial intelligence models show promise in this domain, their clinical adoption is limited by the lack of medically grounded guidance during training, often resulting in non-explainable intrinsic predictions. To address this, we propose Doctor-in-the-Loop, a novel framework that integrates expert-driven domain knowledge with explainable artificial intelligence techniques, directing the model toward clinically relevant anatomical regions and improving both interpretability and trustworthiness. Our approach employs a gradual multi-view strategy, progressively refining the model's focus from broad contextual features to finer, lesion-specific details. By incorporating domain insights at every stage, we enhance predictive accuracy while ensuring that the model's decision-making process aligns more closely with clinical reasoning. Evaluated on a dataset of NSCLC patients, Doctor-in-the-Loop delivers promising predictive performance and provides transparent, justifiable outputs, representing a significant step toward clinically explainable artificial intelligence in oncology.
Lung cancer rising among non-smokers -- here's why
U.S. Navy veteran John Ryan shares how he beat lung cancer, which he believes is due to an immunotherapy clinical trial he underwent at Johns Hopkins. Cigarette smoking is by far the biggest risk factor for lung cancer, data shows -- but in a surprising turn of events, the most common form of the disease is primarily found in non-smokers. Researchers at the International Agency for Research on Cancer (IARC) analyzed global trends in four main lung cancer subtypes: adenocarcinoma, squamous cell carcinoma, small-cell carcinoma and large-cell carcinoma. They found that adenocarcinoma has been the most "predominant subtype" in recent years, according to a press release summarizing the study. Younger females were found to be at a particularly high risk.