--This study investigates the application of diffusion models in medical image classification (DiffMIC), focusing on skin and oral lesions. Utilizing the datasets PAD-UFES-20 for skin cancer and P-NDB-UFES for oral cancer, the diffusion model demonstrated competitive performance compared to state-of-the-art deep learning models like Convolutional Neural Networks (CNNs) and Transformers. Specifically, for the PAD-UFES-20 dataset, the model achieved a balanced accuracy of 0.6457 for six-class classification and 0.8357 for binary classification (cancer vs. non-cancer). For the P-NDB-UFES dataset, it attained a balanced accuracy of 0.9050. These results suggest that diffusion models are viable models for classifying medical images of skin and oral lesions. In addition, we investigate the robustness of the model trained on PAD-UFES-20 for skin cancer but tested on the clinical images of the HIBA dataset. Skin cancer, according to studies from the Global Cancer Observatory (GCO), had approximately 1,198,000 new cases worldwide in 2020, with non-melanoma skin cancer being the fifth most common cancer in terms of new cases, accounting for this high number [9]. In the same period, skin melanoma presented around 324,000 new cases.

The growing demand for accurate and equitable AI models in digital dermatology faces a significant challenge: the lack of diverse, high-quality labeled data. In this work, we investigate the potential of domain-specific foundation models for dermatology in addressing this challenge. We utilize self-supervised learning (SSL) techniques to pre-train models on a dataset of over 240,000 dermatological images from public and private collections. Our study considers several SSL methods and compares the resulting foundation models against domain-agnostic models like those pre-trained on ImageNet and state-of-the-art models such as MONET across 12 downstream tasks. Unlike previous research, we emphasize the development of smaller models that are more suitable for resource-limited clinical settings, facilitating easier adaptation to a broad range of use cases. Results show that models pre-trained in this work not only outperform general-purpose models but also approach the performance of models 50 times larger on clinically relevant diagnostic tasks. To promote further research in this direction, we publicly release both the training code and the foundation models, which can benefit clinicians in dermatological applications.

The 7-point checklist (7PCL) is widely used in dermoscopy to identify malignant melanoma lesions needing urgent medical attention. It assigns point values to seven attributes: major attributes are worth two points each, and minor ones are worth one point each. A total score of three or higher prompts further evaluation, often including a biopsy. However, a significant limitation of current methods is the uniform weighting of attributes, which leads to imprecision and neglects their interconnections. Previous deep learning studies have treated the prediction of each attribute with the same importance as predicting melanoma, which fails to recognize the clinical significance of the attributes for melanoma. To address these limitations, we introduce a novel diagnostic method that integrates two innovative elements: a Clinical Knowledge-Based Topological Graph (CKTG) and a Gradient Diagnostic Strategy with Data-Driven Weighting Standards (GD-DDW). The CKTG integrates 7PCL attributes with diagnostic information, revealing both internal and external associations. By employing adaptive receptive domains and weighted edges, we establish connections among melanoma's relevant features. Concurrently, GD-DDW emulates dermatologists' diagnostic processes, who first observe the visual characteristics associated with melanoma and then make predictions. Our model uses two imaging modalities for the same lesion, ensuring comprehensive feature acquisition. Our method shows outstanding performance in predicting malignant melanoma and its features, achieving an average AUC value of 85%. This was validated on the EDRA dataset, the largest publicly available dataset for the 7-point checklist algorithm. Specifically, the integrated weighting system can provide clinicians with valuable data-driven benchmarks for their evaluations.

Existing multi-modal approaches primarily focus on enhancing multi-label skin lesion classification performance through advanced fusion modules, often neglecting the associated rise in parameters. In clinical settings, both clinical and dermoscopy images are captured for diagnosis; however, dermoscopy images exhibit more crucial visual features for multi-label skin lesion classification. Motivated by this observation, we introduce a novel asymmetric multi-modal fusion method in this paper for efficient multi-label skin lesion classification. Our fusion method incorporates two innovative schemes. Firstly, we validate the effectiveness of our asymmetric fusion structure. It employs a light and simple network for clinical images and a heavier, more complex one for dermoscopy images, resulting in significant parameter savings compared to the symmetric fusion structure using two identical networks for both modalities. Secondly, in contrast to previous approaches using mutual attention modules for interaction between image modalities, we propose an asymmetric attention module. This module solely leverages clinical image information to enhance dermoscopy image features, considering clinical images as supplementary information in our pipeline. We conduct the extensive experiments on the seven-point checklist dataset. Results demonstrate the generality of our proposed method for both networks and Transformer structures, showcasing its superiority over existing methods We will make our code publicly available.

Machine-learning algorithms can facilitate low-cost, user-guided visual diagnostic platforms for addressing disparities in access to sexual health services. We developed a clinical image dataset using original and augmented images for five penile diseases: herpes eruption, syphilitic chancres, penile candidiasis, penile cancer, and genital warts. We used a U-net architecture model for semantic pixel segmentation into background or subject image, the Inception-ResNet version 2 neural architecture to classify each pixel as diseased or non-diseased, and a salience map using GradCAM++. We trained the model on a random 91% sample of the image database using 150 epochs per image, and evaluated the model on the remaining 9% of images, assessing recall (or sensitivity), precision, specificity, and F1-score (accuracy). Of the 239 images in the validation dataset, 45 (18.8%) were of genital warts, 43 (18.0%) were of HSV infection, 29 (12.1%) were of penile cancer, 40 (16.7%) were of penile candidiasis, 37 (15.5%) were of syphilitic chancres, and 45 (18.8%) were of non-diseased penises. The overall accuracy of the model for correctly classifying the diseased image was 0.944. Between July 1st and October 1st 2023, there were 2,640 unique users of the mobile platform. Among a random sample of submissions (n=437), 271 (62.0%) were from the United States, 64 (14.6%) from Singapore, 41 (9.4%) from Candia, 40 (9.2%) from the United Kingdom, and 21 (4.8%) from Vietnam. The majority (n=277 [63.4%]) were between 18 and 30 years old. We report on the development of a machine-learning model for classifying five penile diseases, which demonstrated excellent performance on a validation dataset. That model is currently in use globally and has the potential to improve access to diagnostic services for penile diseases.

Skin cancer is a major public health problem that could benefit from computer-aided diagnosis to reduce the burden of this common disease. Skin lesion segmentation from images is an important step toward achieving this goal. However, the presence of natural and artificial artifacts (e.g., hair and air bubbles), intrinsic factors (e.g., lesion shape and contrast), and variations in image acquisition conditions make skin lesion segmentation a challenging task. Recently, various researchers have explored the applicability of deep learning models to skin lesion segmentation. In this survey, we cross-examine 177 research papers that deal with deep learning-based segmentation of skin lesions. We analyze these works along several dimensions, including input data (datasets, preprocessing, and synthetic data generation), model design (architecture, modules, and losses), and evaluation aspects (data annotation requirements and segmentation performance). We discuss these dimensions both from the viewpoint of select seminal works, and from a systematic viewpoint, examining how those choices have influenced current trends, and how their limitations should be addressed. To facilitate comparisons, we summarize all examined works in a comprehensive table as well as an interactive table available online at https://github.com/sfu-mial/skin-lesion-segmentation-survey.

In recent years, deep learning (DL) has shown great potential in the field of dermatological image analysis. However, existing datasets in this domain have significant limitations, including a small number of image samples, limited disease conditions, insufficient annotations, and non-standardized image acquisitions. To address these shortcomings, we propose a novel framework called DermSynth3D. DermSynth3D blends skin disease patterns onto 3D textured meshes of human subjects using a differentiable renderer and generates 2D images from various camera viewpoints under chosen lighting conditions in diverse background scenes. Our method adheres to top-down rules that constrain the blending and rendering process to create 2D images with skin conditions that mimic in-the-wild acquisitions, ensuring more meaningful results. The framework generates photo-realistic 2D dermoscopy images and the corresponding dense annotations for semantic segmentation of the skin, skin conditions, body parts, bounding boxes around lesions, depth maps, and other 3D scene parameters, such as camera position and lighting conditions. DermSynth3D allows for the creation of custom datasets for various dermatology tasks. We demonstrate the effectiveness of data generated using DermSynth3D by training DL models on synthetic data and evaluating them on various dermatology tasks using real 2D dermatological images. We make our code publicly available at https://github.com/sfu-mial/DermSynth3D.

A new study published in the Journal of Investigative Dermatology (JID) found that VisualDx's artificial intelligence solution, DermExpert, analyzed skin conditions with the same degree of accuracy as primary care physicians (PCPs) referencing a visual aid. The researchers also found that DermExpert was equally effective when identifying diseases in light and dark skin types, suggesting that clinical decision support tools built on diverse data sets can augment physician decision-making and help to reduce medical errors and improve patient outcomes, particularly for patients of color. Diagnosing the skin remains challenging as dermatologic disease presentation varies widely, and most medical schools offer 10 hours or less of dermatology-specific instruction. To contextualize general practitioners' ability to diagnose skin conditions, the research team compared the accuracy of board-certified internal medicine physicians to DermExpert. When presented with a series of clinical images, PCPs accurately diagnosed skin conditions 36% of the time; with the assistance of a visual aid, their diagnostic accuracy increased to 68%.

What are the practical applications of AI in healthcare? Dr Christoph Zindel, member of the Managing Board at Siemens Healthineers, responsible for the Imaging and Advanced Therapies business segments, has a clear vision. Healthcare IT News (HITN): Dr Zindel, you joined the Managing Board of Siemens Healthineers at the beginning of October. One of your stated goals is to champion digitisation and the use of AI in healthcare. From buzzword to applied technology?

Deformable registration of clinical scans is a fundamental task for many applications, such as population studies or the monitoring of long-term disease progression in individual patients. This task is challenging because, in contrast to high-resolution research-quality scans, clinical images are often sparse, missing up to 85% of the slices in comparison. Furthermore, the anatomy in the acquired slices is not consistent across scans because of variations in patient orientation with respect to the scanner. In this work, we introduce Sparse VoxelMorph (SparseVM), which adapts a state-of-the-art learning-based registration method to improve the registration of sparse clinical images. SparseVM is a fast, unsupervised method that weights voxel contributions to registration in proportion to confidence in the voxels. This leads to improved registration performance on volumes with voxels of varying reliability, such as interpolated clinical scans. SparseVM registers 3D scans in under a second on the GPU, which is orders of magnitudes faster than the best performing clinical registration methods, while still achieving comparable accuracy. Because of its short runtimes and accurate behavior, SparseVM can enable clinical analyses not previously possible. The code is publicly available at voxelmorph.mit.edu.