XtraLight-MedMamba for Classification of Neoplastic Tubular Adenomas

arXiv:2602.04819v4 Announce Type: replace Abstract: Accurate risk stratification of precancerous polyps during routine colonoscopy screening is a key strategy to reduce the incidence of colorectal cancer (CRC). However, assessment of low-grade dysplasia remains limited by subjective histopathologic interpretation. Advances in computational pathology and deep learning offer new opportunities to identify subtle, fine morphologic patterns associated with malignant progression that may be imperceptible to the human eye. In this work, we propose XtraLight-MedMamba, an ultra-lightweight state-space-based deep learning framework to classify neoplastic tubular adenomas from whole-slide images (WSIs). The architecture is a blend of a ConvNeXt-based shallow feature extractor with parallel vision mamba blocks to efficiently model local texture cues within global contextual structure. An integration of the Spatial and Channel Attention Bridge (SCAB) module enhances multiscale feature extraction, while the Fixed Non-Negative Orthogonal Classifier (FNOClassifier) enables substantial parameter reduction and improved generalization. The model was evaluated on a curated dataset acquired from patients with low-grade tubular adenomas, stratified into case and control cohorts based on subsequent CRC development. XtraLight-MedMamba achieved an accuracy of 97.18\% and an F1-score of 0.9767 using approximately 32,000 parameters, outperforming transformer-based and conventional Mamba architectures, which have significantly higher model complexity and computational burden, making it suitable for resource-constrained areas.