Abstract

Esophageal cancer has become one of the important cancers that seriously threaten human life and health, and its incidence and mortality rate are still among the top malignant tumors. Histopathological image analysis is the gold standard for diagnosing different differentiation types of esophageal cancer. The grading accuracy and interpretability of the auxiliary diagnostic model for esophageal cancer are seriously affected by small interclass differences, imbalanced data distribution, and poor model interpretability. Therefore, we focused on developing the category imbalance attention block network (CIABNet) model to try to solve the previous problems. First, the quantitative metrics and model visualization results are integrated to transfer knowledge from the source domain images to better identify the regions of interest (ROI) in the target domain of esophageal cancer. Second, in order to pay attention to the subtle interclass differences, we propose the concatenate fusion attention block, which can focus on the contextual local feature relationships and the changes of channel attention weights among different regions simultaneously. Third, we proposed a category imbalance attention module, which treats each esophageal cancer differentiation class fairly based on aggregating different intensity information at multiple scales and explores more representative regional features for each class, which effectively mitigates the negative impact of category imbalance. Finally, we use feature map visualization to focus on interpreting whether the ROIs are the same or similar between the model and pathologists, thus better improving the interpretability of the model. The experimental results show that the CIABNet model outperforms other state-of-the-art models, which achieves the most advanced results in classifying the differentiation types of esophageal cancer with an average classification accuracy of 92.24%, an average precision of 93.52%, an average recall of 90.31%, an average F1 value of 91.73%, and an average AUC value of 97.43%. In addition, the CIABNet model has essentially similar or identical to the ROI of pathologists in identifying histopathological images of esophageal cancer. Our experimental results prove that our proposed computer-aided diagnostic algorithm shows great potential in histopathological images of multi-differentiated types of esophageal cancer.

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