Transformer-based personalized attention mechanism for medical images with clinical records

J Pathol Inform. 2023 Jan 2:14:100185. doi: 10.1016/j.jpi.2022.100185. eCollection 2023.

Abstract

In medical image diagnosis, identifying the attention region, i.e., the region of interest for which the diagnosis is made, is an important task. Various methods have been developed to automatically identify target regions from given medical images. However, in actual medical practice, the diagnosis is made based on both the images and various clinical records. Consequently, pathologists examine medical images with prior knowledge of the patients and the attention regions may change depending on the clinical records. In this study, we propose a method, called the Personalized Attention Mechanism (PersAM) method, by which the attention regions in medical images according to the clinical records. The primary idea underlying the PersAM method is the encoding of the relationships between medical images and clinical records using a variant of the Transformer architecture. To demonstrate the effectiveness of the PersAM method, we applied it to a large-scale digital pathology problem involving identifying the subtypes of 842 malignant lymphoma patients based on their gigapixel whole-slide images and clinical records.

Keywords: Digital pathology; Multimodal analysis; Personalized attention; Transformer; Whole slide image.