Bjørkeli Erin Beate, Esmaeili Morteza
Department of Diagnostic Imaging, Akershus University Hospital, Lørenskog, Norway.
Institute of Clinical Medicine, University of Oslo, Norway.
Biomed Eng Comput Biol. 2025 Jul 17;16:11795972251351815. doi: 10.1177/11795972251351815. eCollection 2025.
Early detection through routine screening methods, such as the Papanicolaou (Pap) test, is crucial for reducing cervical cancer mortality. However, the Pap smear method faces challenges including subjective interpretation, significant variability in diagnostic confidence, and high susceptibility to human errors-leading to both false negatives (missed abnormalities) and false positives (unnecessary follow-up procedures). Providing a first opinion could improve the screening examination pipeline and greatly aid the specialist's confidence in reporting. Artificial intelligence (AI)-based approaches have shown promise in automating cell classification, reducing human error, and identifying subtle abnormalities that may be missed by experts.
In this study, we present RunicNet, a CNN-based architecture with attention mechanisms designed to classify Pap smear cell images. RunicNet integrates attention mechanisms such as High-Frequency Attention Blocks-enhanced Residual Blocks for improved feature extraction, Pixel Attention for computational efficiency, and a Gated-Dconv Feed-Forward Network to refine image representation. The model was trained on a dataset of 85 080 cell images, employing data augmentation and class balancing techniques to address dataset imbalances.
Evaluated on a separate testing dataset, RunicNet achieved a weighted F1-score of 0.78, significantly outperforming baseline models such as ResNet-18 (F1-score of 0.53) and a fully connected CNN (F1-score of 0.66).
The findings support the potential of attention-based CNN models like RunicNet to significantly improve the accuracy and efficiency of cervical cancer screening. Integrating such AI systems into clinical workflows may enhance early detection and reduce diagnostic variability in Pap smear analysis.
通过常规筛查方法(如巴氏试验)进行早期检测对于降低宫颈癌死亡率至关重要。然而,巴氏涂片法面临诸多挑战,包括主观解读、诊断置信度存在显著差异以及极易出现人为错误,从而导致假阴性(遗漏异常情况)和假阳性(不必要的后续程序)。提供初步诊断意见可以优化筛查流程,并极大地增强专家报告时的信心。基于人工智能(AI)的方法在细胞分类自动化、减少人为错误以及识别专家可能遗漏的细微异常方面已显示出前景。
在本研究中,我们提出了RunicNet,这是一种基于卷积神经网络(CNN)并带有注意力机制的架构,用于对巴氏涂片细胞图像进行分类。RunicNet集成了多种注意力机制,如用于改进特征提取的高频注意力块增强残差块、用于计算效率的像素注意力以及用于细化图像表示的门控深度卷积前馈网络。该模型在一个包含85080张细胞图像的数据集上进行训练,采用数据增强和类别平衡技术来解决数据集不平衡问题。
在一个单独的测试数据集上进行评估时,RunicNet的加权F1分数达到了0.78,显著优于诸如ResNet - 18(F1分数为0.53)和全连接CNN(F1分数为0.66)等基线模型。
研究结果支持了像RunicNet这样基于注意力的CNN模型在显著提高宫颈癌筛查的准确性和效率方面的潜力。将此类人工智能系统整合到临床工作流程中可能会加强早期检测,并减少巴氏涂片分析中的诊断差异。