In the application of deep learning on optical coherence tomography (OCT) data, it is common to train classification networks using 2D images originating from volumetric data. Given the micrometer resolution of OCT systems, consecutive images are often very similar in both visible structures and noise. Thus, an inappropriate data split can result in overlap between the training and testing sets, with a large portion of the literature overlooking this aspect. In this study, the effect of improper dataset splitting on model evaluation is demonstrated for three classification tasks using three OCT open-access datasets extensively used, Kermany’s and Srinivasan’s ophthalmology datasets, and AIIMS breast tissue dataset. Results show that the classification performance is inflated by 0.07 up to 0.43 in terms of Matthews Correlation Coefficient (accuracy: 5% to 30%) for models tested on datasets with improper splitting, highlighting the considerable effect of dataset handling on model evaluation. This study intends to raise awareness on the importance of dataset splitting given the increased research interest in implementing deep learning on OCT data.

Purpose: To implement and evaluate deep learning-based methods for the classification of pediatric brain tumors (PBT) in magnetic resonance (MR) data. Methods: A subset of the “Children’s Brain Tumor Network” dataset was retrospectively used (n = 178 subjects, female = 72, male = 102, NA = 4, age range [0.01, 36.49] years) with tumor types being low-grade astrocytoma (n = 84), ependymoma (n = 32), and medulloblastoma (n = 62). T1w post-contrast (n = 94 subjects), T2w (n = 160 subjects), and apparent diffusion coefficient (ADC: n = 66 subjects) MR sequences were used separately. Two deep learning models were trained on transversal slices showing tumor. Joint fusion was implemented to combine image and age data, and 2 pre-training paradigms were utilized. Model explainability was investigated using gradient-weighted class-activation mapping (Grad-CAM), and the learned feature space was visualized using principal component analysis (PCA). Results: The highest tumor-type classification performance was achieved when using a vision transformer model pre-trained on ImageNet and fine-tuned on ADC images with age fusion (Matthews correlation coefficient [MCC]: 0.77 ± 0.14, Accuracy: 0.87 ± 0.08), followed by models trained on T2w (MCC: 0.58 ± 0.11, Accuracy: 0.73 ± 0.08) and T1w post-contrast (MCC: 0.41 ± 0.11, Accuracy: 0.62 ± 0.08) data. Age fusion marginally improved the model’s performance. Both model architectures performed similarly across the experiments, with no differences between the pre-training strategies. Grad-CAMs showed that the models’ attention focused on the brain region. PCA of the feature space showed greater separation of the tumor-type clusters when using contrastive pre-training. Conclusion: Classification of PBT on MR images could be accomplished using deep learning, with the top-performing model being trained on ADC data, which radiologists use for the clinical classification of these tumors.

Effective, robust, and automatic tools for brain tumor segmentation are needed for the extraction of information useful in treatment planning. Recently, convolutional neural networks have shown remarkable performance in the identification of tumor regions in magnetic resonance (MR) images. Context-aware artificial intelligence is an emerging concept for the development of deep learning applications for computer-aided medical image analysis. A large portion of the current research is devoted to the development of new network architectures to improve segmentation accuracy by using context-aware mechanisms. In this work, it is investigated whether or not the addition of contextual information from the brain anatomy in the form of white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF) masks and probability maps improves U-Net-based brain tumor segmentation. The BraTS2020 dataset was used to train and test two standard 3D U-Net (nnU-Net) models that, in addition to the conventional MR image modalities, used the anatomical contextual information as extra channels in the form of binary masks (CIM) or probability maps (CIP). For comparison, a baseline model (BLM) that only used the conventional MR image modalities was also trained. The impact of adding contextual information was investigated in terms of overall segmentation accuracy, model training time, domain generalization, and compensation for fewer MR modalities available for each subject. Median (mean) Dice scores of 90.2 (81.9), 90.2 (81.9), and 90.0 (82.1) were obtained on the official BraTS2020 validation dataset (125 subjects) for BLM, CIM, and CIP, respectively. Results show that there is no statistically significant difference when comparing Dice scores between the baseline model and the contextual information models (p > 0.05), even when comparing performances for high and low grade tumors independently. In a few low grade cases where improvement was seen, the number of false positives was reduced. Moreover, no improvements were found when considering model training time or domain generalization. Only in the case of compensation for fewer MR modalities available for each subject did the addition of anatomical contextual information significantly improve (p < 0.05) the segmentation of the whole tumor. In conclusion, there is no overall significant improvement in segmentation performance when using anatomical contextual information in the form of either binary WM, GM, and CSF masks or probability maps as extra channels.

Intraoperative guidance tools for thyroid surgery based on optical coherence tomography (OCT) could aid distinguish between normal and diseased tissue. However, OCT images are difficult to interpret, thus, real‐time automatic analysis could support the clinical decision‐making. In this study, several deep learning models were investigated for thyroid disease classification on 2D and 3D OCT data obtained from ex vivo specimens of 22 patients undergoing surgery and diagnosed with several thyroid pathologies. Additionally, two open‐access datasets were used to evaluate the custom models. On the thyroid dataset, the best performance was achieved by the 3D vision transformer model with a Matthew's correlation coefficient (MCC) of 0.79 (accuracy = 0.90) for the normal‐versus‐abnormal classification. On the open‐access datasets, the custom models achieved the best performance (MCC > 0.88, accuracy > 0.96). Results obtained for the normal‐versus‐abnormal classification suggest OCT, complemented with deep learning‐based analysis, as a tool for real‐time automatic diseased tissue identification in thyroid surgery.

Background and purpose: Brain tumors are among the leading causes of cancer deaths in children. Initial diagnosis based on MR images can be a challenging task for radiologists, depending on the tumor type and location. Deep learning methods could support the diagnosis by predicting the tumor type. Materials and methods: A subset (181 subjects) of the data from “Children’s Brain Tumor Network” (CBTN) was used, including infratentorial and supratentorial tumors, with the main tumor types being low-grade astrocytomas, ependymomas, and medulloblastomas. T1w-Gd, T2-w, and ADC MR sequences were used separately. Classification was performed on 2D MR images using four different off-the-shelf deep learning models and a custom-designed shallow network all pre-trained on adult MR images. Joint fusion was implemented to combine image and age data, and tumor type prediction was computed volume-wise. Matthew’s correlation coefficient (MCC), accuracy, and F1 scores were used to assess the models’ performance. Model explainability, using gradient-weighted class activation mapping (Grad-CAM), was implemented and the network’s attention on the tumor region was quantified. Results: The shallow custom network resulted in the highest classification performance when trained on T2-w or ADC MR images fused with age information, when considering infratentorial tumors only (MCC: 0.71 for ADC and 0.64 for T2-w), and both infra- and supratentorial tumors (MCC: 0.70 for ADC and 0.57 for T2-w). Conclusion: Classification of pediatric brain tumors on MR images could be accomplished using deep learning, and the fusion of age information improved model performance.

Brain tumors are the most common solid tumors in children and young adults, but the scarcity of large histopathology datasets has limited the application of computational pathology in this group. This study implements two weakly supervised multiple‐instance learning (MIL) approaches on patch features obtained from state‐of‐the‐art histology‐specific foundation models to classify pediatric brain tumors in hematoxylin and eosin whole slide images (WSIs) from a multi‐center Swedish cohort. WSIs from 540 subjects (age 8.5 ± 4.9 years) diagnosed with brain tumors were gathered from the six Swedish university hospitals. Instance (patch)‐level features were obtained from WSIs using three pre‐trained feature extractors: ResNet50, UNI, and CONCH. Instances were aggregated using attention‐based MIL (ABMIL) or clustering‐constrained attention MIL (CLAM) for patient‐level classification. Models were evaluated on three classification tasks based on the hierarchical classification of pediatric brain tumors: tumor category, family, and type. Model generalization was assessed by training on data from two of the centers and testing on data from four other centers. Model interpretability was evaluated through attention mapping. The highest classification performance was achieved using UNI features and ABMIL aggregation, with Matthew's correlation coefficient of 0.76 ± 0.04, 0.63 ± 0.04, and 0.60 ± 0.05 for tumor category, family, and type classification, respectively. When evaluating generalization, models utilizing UNI and CONCH features outperformed those using ResNet50. However, the drop in performance from the in‐site to out‐of‐site testing was similar across feature extractors. These results show the potential of state‐of‐the‐art computational pathology methods in diagnosing pediatric brain tumors at different hierarchical levels with fair generalizability on a multi‐center national dataset.