Detection of tumors in metastatic colorectal cancer (mCRC) plays an essential role in the early diagnosis and treatment of liver cancer. Deep learning models backboned by fully convolutional neural networks (FCNNs) have become the dominant model for segmenting 3D computerized tomography (CT) scans. However, since their convolution layers suffer from limited kernel size, they are not able to capture long-range dependencies and global context. To tackle this restriction, vision transformers have been introduced to solve FCNN's locality of receptive fields. Although transformers can capture long-range features, their segmentation performance decreases with various tumor sizes due to the model sensitivity to the input patch size. While finding an optimal patch size improves the performance of vision transformer-based models on segmentation tasks, it is a time-consuming and challenging procedure. This paper proposes a technique to select the vision transformer's optimal input multi-resolution image patch size based on the average volume size of metastasis lesions. We further validated our suggested framework using a transfer-learning technique, demonstrating that the highest Dice similarity coefficient (DSC) performance was obtained by pre-training on training data with a larger tumour volume using the suggested ideal patch size and then training with a smaller one. We experimentally evaluate this idea through pre-training our model on a multi-resolution public dataset. Our model showed consistent and improved results when applied to our private multi-resolution mCRC dataset with a smaller average tumor volume. This study lays the groundwork for optimizing semantic segmentation of small objects using vision transformers. The implementation source code is available at:https://github.com/Ramtin-Mojtahedi/OVTPS.

Although machine learning (ML) has shown promise in numerous domains, there are concerns about generalizability to out-of-sample data. This is currently addressed by centrally sharing ample, and importantly diverse, data from multiple sites. However, such centralization is challenging to scale (or even not feasible) due to various limitations. Federated ML (FL) provides an alternative to train accurate and generalizable ML models, by only sharing numerical model updates. Here we present findings from the largest FL study to-date, involving data from 71 healthcare institutions across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, utilizing the largest dataset of such patients ever used in the literature (25, 256 MRI scans from 6, 314 patients). We demonstrate a 33% improvement over a publicly trained model to delineate the surgically targetable tumor, and 23% improvement over the tumor's entire extent. We anticipate our study to: 1) enable more studies in healthcare informed by large and diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further quantitative analyses for glioblastoma via performance optimization of our consensus model for eventual public release, and 3) demonstrate the effectiveness of FL at such scale and task complexity as a paradigm shift for multi-site collaborations, alleviating the need for data sharing.