Hernandez C, Combalia M, Puig S, Malvehy J, Vilaplana V. Contrastive and attention-based multiple instance learning for the prediction of sentinel lymph node status from histopathologies of primary melanoma tumours. In Cancer Prevention through early detecTion (Caption) Workshop at 25th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI 2022). 2022.


Sentinel lymph node status is a crucial prognosis factor for melanomas; nonetheless, the invasive surgery required to obtain it always puts the patient at risk. In this study, we develop a Deep Learning-based approach to predict lymph node metastasis from Whole Slide Images of primary tumours. Albeit very informative, these images come with complexities that hamper their use in machine learning applications, namely their large size and limited datasets. We propose a pre-training strategy based on self-supervised contrastive learning to extract better image feature representations and an attention-based Multiple Instance Learning approach to enhance the model's performance. With this work, we quantitatively demonstrate that combining both methods improves various classification metrics and qualitatively show that contrastive learning encourages the network to output higher attention scores to tumour tissue and lower scores to image artifacts.