Knowledge-Driven Vision-Language Model for Plexus Detection in Hirschsprung's Disease
Bibliographic record
Abstract
Hirschsprung’s disease is defined as the congenital absence of ganglion cells in some segment(s) of the colon. The muscle cannot make coordinated movements to propel stool in that section, most commonly leading to obstruction. The diagnosis and treatment for this disease require a clear identification of different region(s) of the myenteric plexus, where ganglion cells should be present, on the microscopic view of the tissue slide. While deep learning approaches, such as Convolutional Neural Networks, have performed very well in this task, they are often treated as black boxes, with minimal understanding gained from them, and may not conform to how a physician makes decisions. In this study, we propose a novel framework that integrates expert-derived textual concepts into a Contrastive Language-Image Pre-training-based vision-language model to guide plexus classification. Using prompts derived from expert sources (e.g., medical textbooks and papers) generated by large language models and reviewed by our team before being encoded with QuiltNet, our approach aligns clinically relevant semantic cues with visual features. Experimental results show that the proposed model demonstrated superior discriminative capability across different classification metrics as it outperformed CNN-based models, including VGG-19, ResNet-18, and ResNet-50; achieving an accuracy of 83.9%, a precision of 86.6%, and a specificity of 87.6%. These findings highlight the potential of multi-modal learning in histopathology and underscore the value of incorporating expert knowledge for more clinically relevant model outputs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".