Machine Learning Approach for Enumeration of Circulating Cells with Diffuse in vivo Flow Cytometry

Significance Diffuse in vivo flow cytometry (DiFC) is an emerging technique for enumerating rare, fluorescentlylabeled circulating tumor cells (CTCs) in small animals without drawing blood samples. DiFC uses detection of transient fluorescent peaks in time-series data. Previously, we used a simple amplitude threshold-based method for identifying peak candidates, but it ignores potentially useful information in peak shape that could reduce false-positive detections from instrument noise and increase detection efficiency of lower-amplitude peaks. Aim To develop a machine learning (ML)-integrated signal processing approach for improved CTC enumeration using DiFC by distinguishing CTC peaks from artifacts. Approach We developed an ML-integrated approach that incorporates a convolutional neural network (CNN) classifier. The CNN was trained to distinguish CTC peaks from artifacts by analyzing peak amplitude and temporal shape characteristics. Performance was validated on in-silico , control, and CTC-bearing mouse datasets. Results The CNN classifier achieved accuracy, precision, sensitivity, and specificity exceeding 98% on test data. Compared with our previously published threshold-based approach, the ML-integrated method increased the number of correctly identified CTCs and their flow direction while reducing false detections across validation datasets. Conclusions The ML-integrated approach significantly improves DiFC CTC enumeration, enabling robustness against artifacts in noisy conditions.