Researcher profile

Joel Saltz

Joel Saltz contributes to research discovery and scholarly infrastructure.

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Published work

8 published item(s)

preprint2026arXiv

Semantic Context-aware mOdality fUsion Transformer (SCOUT): A Context-Aware Multimodal Transformer for Concept-Grounded Pathology Report Generation

Whole-slide images (WSIs) present a fundamental challenge for computational pathology due to their extreme resolution, multi-scale heterogeneity, and the requirement for clinically reliable interpretation. Although recent pathology foundation models have enabled fluent report generation, they often lack clinical grounding, failing to accurately represent key diagnostic concepts and relationships observed by pathologists. This limitation arises from the difficulty of integrating heterogeneous visual evidence spanning fine-grained cellular patterns, slide-level tissue architecture, and high-level diagnostic concepts, while maintaining interpretability and clinical coherence. Here we present SCOUT: Semantic Context-aware mOdality fUsion Transformer, a context-aware concept-grounded multimodal framework for pathology report generation that enables progressive conditioning of image representations by global slide information and explicit diagnostic concepts. The method integrates local histological patterns, whole-slide context, and expert-curated semantic descriptors within a unified learning paradigm, allowing visual features to be dynamically refined throughout the encoding process. By combining depth-aware contextual modulation with adaptive multimodal fusion during text generation, the framework produces clinically coherent reports while preserving complementarity across representational scales. Using CONCH1.5 features, we evaluate SCOUT against WSI-Caption, HistGen, and BiGen on TCGA-BRCA, MICCAI REG, and HistAI. SCOUT achieves the best BLEU-1 to BLEU-4 and METEOR scores on all datasets, plus the best ROUGE-L on TCGA-BRCA and MICCAI REG. On TCGA-BRCA, it reaches 0.436/0.303/0.202/0.156 BLEU-1/2/3/4 and 0.204 METEOR; on REG 2025, it achieves 0.865/0.834/0.805/0.780 and 0.568. These results support progressive contextual conditioning for grounded pathology report generation.

preprint2022arXiv

AI and Pathology: Steering Treatment and Predicting Outcomes

The combination of data analysis methods, increasing computing capacity, and improved sensors enable quantitative granular, multi-scale, cell-based analyses. We describe the rich set of application challenges related to tissue interpretation and survey AI methods currently used to address these challenges. We focus on a particular class of targeted human tissue analysis - histopathology - aimed at quantitative characterization of disease state, patient outcome prediction and treatment steering.

preprint2022arXiv

ImageBox3: No-Server Tile Serving to Traverse Whole Slide Images on the Web

Whole slide imaging (WSI) has become the primary modality for digital pathology data. However, due to the size and high-resolution nature of these images, they are generally only accessed in smaller sections or tiles via specialized platforms, most of which require extensive setup and/or costly infrastructure. These platforms typically also need a copy of the images to be locally available to them, potentially causing issues with data governance and provenance. To address these concerns, we developed ImageBox3, an in-browser tiling mechanism to enable zero-footprint traversal of remote WSI data. All computation is performed client-side without compromising user governance, operating public and private images alike as long as the storage service supports HTTP range requests (standard in Cloud storage and most web servers). ImageBox3 thus removes significant hurdles to WSI operation and effective collaboration, allowing for the sort of democratized analytical tools needed to establish participative, FAIR digital pathology data commons. Availability: code - https://github.com/episphere/imagebox3; fig1 (live) - https://episphere.github.io/imagebox3/demo/scriptTag ; fig2 (live) - https://episphere.github.io/imagebox3/demo/serviceWorker ; fig 3 (live) - https://observablehq.com/@prafulb/imagebox3-in-observable .

preprint2022arXiv

Learning Topological Interactions for Multi-Class Medical Image Segmentation

Deep learning methods have achieved impressive performance for multi-class medical image segmentation. However, they are limited in their ability to encode topological interactions among different classes (e.g., containment and exclusion). These constraints naturally arise in biomedical images and can be crucial in improving segmentation quality. In this paper, we introduce a novel topological interaction module to encode the topological interactions into a deep neural network. The implementation is completely convolution-based and thus can be very efficient. This empowers us to incorporate the constraints into end-to-end training and enrich the feature representation of neural networks. The efficacy of the proposed method is validated on different types of interactions. We also demonstrate the generalizability of the method on both proprietary and public challenge datasets, in both 2D and 3D settings, as well as across different modalities such as CT and Ultrasound. Code is available at: https://github.com/TopoXLab/TopoInteraction

preprint2022arXiv

Multi-Class Cell Detection Using Spatial Context Representation

In digital pathology, both detection and classification of cells are important for automatic diagnostic and prognostic tasks. Classifying cells into subtypes, such as tumor cells, lymphocytes or stromal cells is particularly challenging. Existing methods focus on morphological appearance of individual cells, whereas in practice pathologists often infer cell classes through their spatial context. In this paper, we propose a novel method for both detection and classification that explicitly incorporates spatial contextual information. We use the spatial statistical function to describe local density in both a multi-class and a multi-scale manner. Through representation learning and deep clustering techniques, we learn advanced cell representation with both appearance and spatial context. On various benchmarks, our method achieves better performance than state-of-the-arts, especially on the classification task. We also create a new dataset for multi-class cell detection and classification in breast cancer and we make both our code and data publicly available.

preprint2020arXiv

Label Super Resolution with Inter-Instance Loss

For the task of semantic segmentation, high-resolution (pixel-level) ground truth is very expensive to collect, especially for high resolution images such as gigapixel pathology images. On the other hand, collecting low resolution labels (labels for a block of pixels) for these high resolution images is much more cost efficient. Conventional methods trained on these low-resolution labels are only capable of giving low-resolution predictions. The existing state-of-the-art label super resolution (LSR) method is capable of predicting high resolution labels, using only low-resolution supervision, given the joint distribution between low resolution and high resolution labels. However, it does not consider the inter-instance variance which is crucial in the ideal mathematical formulation. In this work, we propose a novel loss function modeling the inter-instance variance. We test our method on a real world application: infiltrating breast cancer region segmentation in histopathology slides. Experimental results show the effectiveness of our method.

preprint2020arXiv

Representing Whole Slide Cancer Image Features with Hilbert Curves

Regions of Interest (ROI) contain morphological features in pathology whole slide images (WSI) are delimited with polygons[1]. These polygons are often represented in either a textual notation (with the array of edges) or in a binary mask form. Textual notations have an advantage of human readability and portability, whereas, binary mask representations are more useful as the input and output of feature-extraction pipelines that employ deep learning methodologies. For any given whole slide image, more than a million cellular features can be segmented generating a corresponding number of polygons. The corpus of these segmentations for all processed whole slide images creates various challenges for filtering specific areas of data for use in interactive real-time and multi-scale displays and analysis. Simple range queries of image locations do not scale and, instead, spatial indexing schemes are required. In this paper we propose using Hilbert Curves simultaneously for spatial indexing and as a polygonal ROI representation. This is achieved by using a series of Hilbert Curves[2] creating an efficient and inherently spatially-indexed machine-usable form. The distinctive property of Hilbert curves that enables both mask and polygon delimitation of ROIs is that the elements of the vector extracted ro describe morphological features maintain their relative positions for different scales of the same image.

preprint2020arXiv

Utilizing Automated Breast Cancer Detection to Identify Spatial Distributions of Tumor Infiltrating Lymphocytes in Invasive Breast Cancer

Quantitative assessment of Tumor-TIL spatial relationships is increasingly important in both basic science and clinical aspects of breast cancer research. We have developed and evaluated convolutional neural network (CNN) analysis pipelines to generate combined maps of cancer regions and tumor infiltrating lymphocytes (TILs) in routine diagnostic breast cancer whole slide tissue images (WSIs). We produce interactive whole slide maps that provide 1) insight about the structural patterns and spatial distribution of lymphocytic infiltrates and 2) facilitate improved quantification of TILs. We evaluated both tumor and TIL analyses using three CNN networks - Resnet-34, VGG16 and Inception v4, and demonstrated that the results compared favorably to those obtained by what believe are the best published methods. We have produced open-source tools and generated a public dataset consisting of tumor/TIL maps for 1,015 TCGA breast cancer images. We also present a customized web-based interface that enables easy visualization and interactive exploration of high-resolution combined Tumor-TIL maps for 1,015TCGA invasive breast cancer cases that can be downloaded for further downstream analyses.