A novel rotation and scale-invariant deep learning framework leveraging conical transformers for precise...

Meningiomas, the most prevalent tumors of the central nervous system, can have overlapping histopathological features with solitary fibrous tumors (SFT), presenting a significant diagnostic challenge. Accurate differentiation between these two diagnoses is crucial for optimal medical management. Currently, immunohistochemistry and molecular techniques are the methods of choice for distinguishing between them; however, these techniques are expensive and not universally available. In this article, we propose a rotational and scale-invariant deep learning framework to enable accurate discrimination between these two tumor types. The proposed framework employs a novel architecture of conical transformers to capture both global and local imaging markers from whole-slide images, accommodating variations across different magnification scales. A weighted majority voting schema is utilized to combine individual scale decisions, ultimately producing a complementary and more accurate diagnostic outcome. A dataset comprising 92 patients (46 with meningioma and 46 with SFT) was used for evaluation. The experimental results demonstrate robust performance across different validation methods. In train-test evaluation, the model achieved 92.27% accuracy, 87.77% sensitivity, 97.55% specificity, and 92.46% F1-score. Performance further improved in 4-fold cross-validation, achieving 94.68% accuracy, 96.05% sensitivity, 93.11% specificity, and 95.07% F1-score. These findings highlight the potential of AI-based diagnostic approaches for precise differentiation between meningioma and SFT, paving the way for innovative diagnostic tools in pathology.