OraRefer：面向口腔癌筛查的分割引导多照片融合方法，具备患者级灵敏度保证
OraRefer: Segmentation-Guided Multi-Photograph Fusion for Oral Cancer Screening with Guaranteed Patient-Level Sensitivity
Rupam Mukherjee, Mehakdeep Singh, Shirin Dasgupta, Subhamoy Mandal
AI 速览：OraRefer 是一个患者级口腔癌筛查模型：它用分割引导的基础模型读取每张照片，融合同一患者的多张照片与风险因素，并通过带有限样本灵敏度保证的阈值做出转诊判断。
Oral cancer and the oral potentially malignant disorders (OPMD) that can precede it are visible on the oral mucosa, which makes smartphone photographs a promising tool for screening. Deep learning models for this task classify individual photographs. However, screening refers patients, not photographs: a patient is usually photographed several times, and the referral decision must miss no more than a set share of patients with disease. We propose OraRefer, a patient-level screening model that reads each photograph with a segmentation-guided foundation model that conditions its class decision on the predicted lesion, combines all photographs of a patient with risk factors, and refers through a threshold with a finite-sample sensitivity guarantee. The model localizes the mouth itself, so inference needs no annotation. On 3000 photographs of 714 patients, patient-level fusion reaches an AUROC of 0.919 and outperforms attention-based multiple-instance learning. At a 90% sensitivity target, OraRefer detects 95% of patients with OPMD or cancer and misses 3 of 61 patients with cancer, at a specificity of 0.610. Because the threshold is calibrated without retraining, each clinic can set its own guaranteed operating point on a local calibration sample.