Swin transformers are robust to distribution and concept drift in endoscopy-based longitudinal rectal cancer assessment Conference Paper


Authors: Gomez, J. T.; Rangnekar, A.; Williams, H.; Thompson, H. M.; Garcia-Aguilar, J.; Smith, J. J.; Veeraraghavan, H.
Title: Swin transformers are robust to distribution and concept drift in endoscopy-based longitudinal rectal cancer assessment
Conference Title: Medical Imaging 2025: Image Processing
Abstract: Endoscopic images are used at various stages of rectal cancer treatment starting from cancer screening and diagnosis, during treatment to assess response and toxicity from treatments such as colitis, and at follow-up to detect new tumor or local regrowth. However, subjective assessment is highly variable and can underestimate the degree of response in some patients, subjecting them to unnecessary surgery, or overestimating response that places patients at risk of disease spread. Advances in deep learning have shown the ability to produce consistent and objective response assessments for endoscopic images. However, methods for detecting cancers, regrowth, and monitoring response during the entire course of patient treatment and follow-up are lacking. This is because automated diagnosis and rectal cancer response assessment require methods that are robust to inherent imaging illumination variations and confounding conditions (blood, scope, blurring) present in endoscopy images as well as changes to the normal lumen and tumor during treatment. Hence, a hierarchical shifted window (Swin) transformer was trained to distinguish rectal cancer from normal lumen using endoscopy images. Swin, as well as two convolutional (ResNet-50, WideResNet-50), and the vision transformer architectures, were trained and evaluated on follow-up longitudinal images to detect LR on in-distribution (ID) private datasets as well as on out-of-distribution (OOD) public colonoscopy datasets to detect pre/non-cancerous polyps. Color shifts were applied using optimal transport to simulate distribution shifts. Swin and ResNet models were similarly accurate in the ID dataset. Swin was more accurate than other methods (follow-up: 0.84, OOD: 0.83), even when subject to color shifts (follow-up: 0.83, OOD: 0.87), indicating the capability to provide robust performance for longitudinal cancer assessment. © 2025 SPIE.
Keywords: chemotherapy; follow up; neurosurgery; cancer diagnosis; cancer screening; endoscopy; arthroplasty; diseases; cryosurgery; rectal cancer; robotic surgery; electrotherapeutics; transplantation (surgical); transplants; noninvasive medical procedures; longitudinal analysis; cardiovascular surgery; medicaments; concept drifts; endoscopy images; robustness to distribution; color shifts; endoscopic image; endoscopy image
Journal Title Progress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume: 13406
Conference Dates: 2025 Feb 17-20
Conference Location: San Diego, CA
ISBN: 1605-7422
Publisher: SPIE  
Date Published: 2025-01-01
Start Page: 134061N
Language: English
DOI: 10.1117/12.3046794
PROVIDER: scopus
DOI/URL:
Notes: Conference paper -- ISBN: 9781510685901 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics