Deep learning-based histopathology image classification is a key technique to help physicians in improving the accuracy and promptness of cancer diagnosis. However, the noisy labels are often inevitable in the complex manual annotation process, and thus mislead the training of the classification model. In this work, we introduce a novel hard sample aware noise robust learning method for histopathology image classification. To distinguish the informative hard samples from the harmful noisy ones, we build an easy/hard/noisy (EHN) detection model by using the sample training history. Then we integrate the EHN into a self-training architecture to lower the noise rate through gradually label correction. With the obtained almost clean dataset, we further propose a noise suppressing and hard enhancing (NSHE) scheme to train the noise robust model. Compared with the previous works, our method can save more clean samples and can be directly applied to the real-world noisy dataset scenario without using a clean subset. Experimental results demonstrate that the proposed scheme outperforms the current state-of-the-art methods in both the synthetic and real-world noisy datasets. The source code and data are available at https://github.com/bupt-ai-cz/HSA-NRL/ .

Background: Breast cancer causes hundreds of thousands of deaths each year worldwide. The early stage diagnosis and treatment can significantly reduce the mortality rate. However, the traditional manual diagnosis needs intense workload, and diagnostic errors are prone to happen with the prolonged work of pathologists. Automatic histopathology image recognition plays a key role in speeding up diagnosis and improving the quality of diagnosis. Methods: In this work, we propose a breast cancer histopathology image classification by assembling multiple compact Convolutional Neural Networks (CNNs). First, a hybrid CNN architecture is designed, which contains a global model branch and a local model branch. By local voting and two-branch information merging, our hybrid model obtains stronger representation ability. Second, by embedding the proposed Squeeze-Excitation-Pruning (SEP) block into our hybrid model, the channel importance can be learned and the redundant channels are thus removed. The proposed channel pruning scheme can decrease the risk of overfitting and produce higher accuracy with the same model size. At last, with different data partition and composition, we build multiple models and assemble them together to further enhance the model generalization ability. Results: Experimental results show that in public BreaKHis dataset, our proposed hybrid model achieves comparable performance with the state-of-the-art. By adopting the multi-model assembling scheme, our method outperforms the state-of-the-art in both patient level and image level accuracy for BACH dataset. Conclusions: We propose a novel compact breast cancer histopathology image classification scheme by assembling multiple compact hybrid CNNs. The proposed scheme achieves promising results for the breast cancer image classification task. Our method can be used in breast cancer auxiliary diagnostic scenario, and it can reduce the workload of pathologists as well as improve the quality of diagnosis.

Objectives: To develop and validate a deep learning (DL)-based primary tumor biopsy signature for predicting axillary lymph node (ALN) metastasis preoperatively in early breast cancer (EBC) patients with clinically negative ALN.Methods: A total of 1,058 EBC patients with pathologically confirmed ALN status were enrolled from May 2010 to August 2020. A DL core-needle biopsy (DL-CNB) model was built on the attention-based multiple instance-learning (AMIL) framework to predict ALN status utilizing the DL features, which were extracted from the cancer areas of digitized whole-slide images (WSIs) of breast CNB specimens annotated by two pathologists. Accuracy, sensitivity, specificity, receiver operating characteristic (ROC) curves, and areas under the ROC curve (AUCs) were analyzed to evaluate our model.Results: The best-performing DL-CNB model with VGG16_BN as the feature extractor achieved an AUC of 0.816 (95% confidence interval (CI): 0.758, 0.865) in predicting positive ALN metastasis in the independent test cohort. Furthermore, our model incorporating the clinical data, which was called DL-CNB+C, yielded the best accuracy of 0.831 (95%CI: 0.775, 0.878), especially for patients younger than 50 years (AUC: 0.918, 95%CI: 0.825, 0.971). The interpretation of DL-CNB model showed that the top signatures most predictive of ALN metastasis were characterized by the nucleus features including density (p= 0.015), circumference (p= 0.009), circularity (p= 0.010), and orientation (p= 0.012).Conclusion: Our study provides a novel DL-based biomarker on primary tumor CNB slides to predict the metastatic status of ALN preoperatively for patients with EBC.

Adolescent idiopathic scoliosis (AIS) manifests as a 3-dimensional spinal malformation.¹ It is reported to occur in up to 2.2% of boys and 4.8% of girls,² with a high prevalence of progression during puberty leading to reduced quality of life and mobility in adulthood, as well as cardiopulmonary impairment and back pain. Thus, early detection, close follow-up, and proper interventions are critical. Hong Kong has initiated a school screening program³ beginning in 1995 as a part of the territory-wide annual comprehensive health assessment scheme for AIS. However, this type of screening practice can be interrupted (such as during the COVID-19 pandemic), which underpins an increased need for out-of-hospital, accessible assessment.⁴