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Methods for unsupervised domain adaptation (UDA) help to improve the performance of deep neural networks on unseen domains without any labeled data. Especially in medical disciplines such as histopathology, this is crucial since large datasets with detailed annotations are scarce. While the majority of existing UDA methods focus on the adaptation from a labeled source to a single unlabeled target domain, many real-world applications with a long life cycle involve more than one target domain. Thus, the ability to sequentially adapt to multiple target domains becomes essential. In settings where the data from previously seen domains cannot be stored, e.g., due to data protection regulations, the above becomes a challenging continual learning problem. To this end, we propose to use generative feature-driven image replay in conjunction with a dual-purpose discriminator that not only enables the generation of images with realistic features for replay, but also promotes feature alignment during domain adaptation. We evaluate our approach extensively on a sequence of three histopathological datasets for tissue-type classification, achieving state-of-the-art results. We present detailed ablation experiments studying our proposed method components and demonstrate a possible use-case of our continual UDA method for an unsupervised patch-based segmentation task given high-resolution tissue images.

The segmentation and automatic identification of histological regions of diagnostic interest offer a valuable aid to pathologists. However, segmentation methods are hampered by the difficulty of obtaining pixel-level annotations, which are tedious and expensive to obtain for Whole-Slide images (WSI). To remedy this, weakly supervised methods have been developed to exploit the annotations directly available at the image level. However, to our knowledge, none of these techniques is adapted to deal with WSIs. In this paper, we propose WholeSIGHT, a weakly-supervised method, to simultaneously segment and classify WSIs of arbitrary shapes and sizes. Formally, WholeSIGHT first constructs a tissue-graph representation of the WSI, where the nodes and edges depict tissue regions and their interactions, respectively. During training, a graph classification head classifies the WSI and produces node-level pseudo labels via post-hoc feature attribution. These pseudo labels are then used to train a node classification head for WSI segmentation. During testing, both heads simultaneously render class prediction and segmentation for an input WSI. We evaluated WholeSIGHT on three public prostate cancer WSI datasets. Our method achieved state-of-the-art weakly-supervised segmentation performance on all datasets while resulting in better or comparable classification with respect to state-of-the-art weakly-supervised WSI classification methods. Additionally, we quantify the generalization capability of our method in terms of segmentation and classification performance, uncertainty estimation, and model calibration.

Deep learning models can achieve high accuracy when trained on large amounts of labeled data. However, real-world scenarios often involve several challenges: Training data may become available in installments, may originate from multiple different domains, and may not contain labels for training. Certain settings, for instance medical applications, often involve further restrictions that prohibit retention of previously seen data due to privacy regulations. In this work, to address such challenges, we study unsupervised segmentation in continual learning scenarios that involve domain shift. To that end, we introduce GarDA (Generative Appearance Replay for continual Domain Adaptation), a generative-replay based approach that can adapt a segmentation model sequentially to new domains with unlabeled data. In contrast to single-step unsupervised domain adaptation (UDA), continual adaptation to a sequence of domains enables leveraging and consolidation of information from multiple domains. Unlike previous approaches in incremental UDA, our method does not require access to previously seen data, making it applicable in many practical scenarios. We evaluate GarDA on two datasets with different organs and modalities, where it substantially outperforms existing techniques., Comment: Fixed typos

Multiple Instance Learning (MIL) methods have become increasingly popular for classifying giga-pixel sized Whole-Slide Images (WSIs) in digital pathology. Most MIL methods operate at a single WSI magnification, by processing all the tissue patches. Such a formulation induces high computational requirements, and constrains the contextualization of the WSI-level representation to a single scale. A few MIL methods extend to multiple scales, but are computationally more demanding. In this paper, inspired by the pathological diagnostic process, we propose ZoomMIL, a method that learns to perform multi-level zooming in an end-to-end manner. ZoomMIL builds WSI representations by aggregating tissue-context information from multiple magnifications. The proposed method outperforms the state-of-the-art MIL methods in WSI classification on two large datasets, while significantly reducing the computational demands with regard to Floating-Point Operations (FLOPs) and processing time by up to 40x., Comment: Typos corrected; Changed dataset name from INSEC to CRC upon dataset creators' request; Update affiliation and fix typos

Neural networks are prone to catastrophic forgetting when trained incrementally on different tasks. Popular incremental learning methods mitigate such forgetting by retaining a subset of previously seen samples and replaying them during the training on subsequent tasks. However, this is not always possible, e.g., due to data protection regulations. In such restricted scenarios, one can employ generative models to replay either artificial images or hidden features to a classifier. In this work, we propose Genifer (GENeratIve FEature-driven image Replay), where a generative model is trained to replay images that must induce the same hidden features as real samples when they are passed through the classifier. Our technique therefore incorporates the benefits of both image and feature replay, i.e.: (1) unlike conventional image replay, our generative model explicitly learns the distribution of features that are relevant for classification; (2) in contrast to feature replay, our entire classifier remains trainable; and (3) we can leverage image-space augmentations, which increase distillation performance while also mitigating overfitting during the training of the generative model. We show that Genifer substantially outperforms the previous state of the art for various settings on the CIFAR-100 and CUB-200 datasets., Comment: Revised method, evaluation, and discussion

Applying state-of-the-art machine learning and natural language processing on approximately one million of teleconsultation records, we developed a triage system, now certified and in use at the largest European telemedicine provider. The system evaluates care alternatives through interactions with patients via a mobile application. Reasoning on an initial set of provided symptoms, the triage application generates AI-powered, personalized questions to better characterize the problem and recommends the most appropriate point of care and time frame for a consultation. The underlying technology was developed to meet the needs for performance, transparency, user acceptance and ease of use, central aspects to the adoption of AI-based decision support systems. Providing such remote guidance at the beginning of the chain of care has significant potential for improving cost efficiency, patient experience and outcomes. Being remote, always available and highly scalable, this service is fundamental in high demand situations, such as the current COVID-19 outbreak., Comment: 10 pages, 5 figures, accepted to AMIA 2020