# REN: Anatomically-Informed Mixture-of-Experts for Interstitial Lung Disease Diagnosis

arXiv: https://arxiv.org/abs/2510.04923 · HTML: https://mlsanity.com/paper/2510.04923/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Placed in Medical and biomedical MoE, one of 12 directions in Mixture-of-experts.
- Builds on 20 of its 38 references that are in the map.
- First posted on arXiv 6 Oct 2025.

## Placed in

- Mixture-of-experts / [Medical and biomedical MoE](https://mlsanity.com/moe/medical-and-biomedical-moe/)

## Builds on (most cited first, 20 of 20)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [XGBoost: A Scalable Tree Boosting System](https://mlsanity.com/paper/1603.02754/) (2016)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [DeepSeekMoE: Towards Ultimate Expert Specialization in Mixture-of-Experts Language Models](https://mlsanity.com/paper/2401.06066/) (2024)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [An Introduction to Convolutional Neural Networks](https://mlsanity.com/paper/1511.08458/) (2015)
- [MoE-LLaVA: Mixture of Experts for Large Vision-Language Models](https://mlsanity.com/paper/2401.15947/) (2024)
- [A Comprehensive Survey of Mixture-of-Experts: Algorithms, Theory, and Applications](https://mlsanity.com/paper/2503.07137/) (2025)
- [Graph Mixture of Experts: Learning on Large-Scale Graphs with Explicit Diversity Modeling](https://mlsanity.com/paper/2304.02806/) (2023)
- [MoE++: Accelerating Mixture-of-Experts Methods with Zero-Computation Experts](https://mlsanity.com/paper/2410.07348/) (2024)
- [Anatomical Priors in Convolutional Networks for Unsupervised Biomedical Segmentation](https://mlsanity.com/paper/1903.03148/) (2019)
- [M4oE: A Foundation Model for Medical Multimodal Image Segmentation with Mixture of Experts](https://mlsanity.com/paper/2405.09446/) (2024)
- [DiffBoost: Enhancing Medical Image Segmentation via Text-Guided Diffusion Model](https://mlsanity.com/paper/2310.12868/) (2023)
- [Anatomical Priors for Image Segmentation via Post-Processing with Denoising Autoencoders](https://mlsanity.com/paper/1906.02343/) (2019)
- [Laplacian-Former: Overcoming the Limitations of Vision Transformers in Local Texture Detection](https://mlsanity.com/paper/2309.00108/) (2023)
- [MedMoE: Modality-Specialized Mixture of Experts for Medical Vision-Language Understanding](https://mlsanity.com/paper/2506.08356/) (2025)
- [PAN: Projective Adversarial Network for Medical Image Segmentation](https://mlsanity.com/paper/1906.04378/) (2019)
- [Anatomy-guided Pathology Segmentation](https://mlsanity.com/paper/2407.05844/) (2024)
- [Deep Learning with Anatomical Priors: Imitating Enhanced Autoencoders in Latent Space for Improved Pelvic Bone Segmentation in MRI](https://mlsanity.com/paper/1903.09263/) (2019)

## Built on by (most cited first, 2 of 2)

- [M-IDoL: Information Decomposition for Modality-Specific and Diverse Representation Learning in Medical Foundation Model](https://mlsanity.com/paper/2604.08936/) (2026)
- [Hierarchical MoE for Multi-Modal ILD Diagnosis](https://mlsanity.com/paper/2608.25261/) (2026)

## Abstract (arXiv)

Mixture-of-Experts (MoE) architectures achieve scalable learning by routing inputs to specialized subnetworks through conditional computation. However, conventional MoE designs assume homogeneous expert capability and domain-agnostic routing-assumptions that are fundamentally misaligned with medical imaging, where anatomical structure and regional disease heterogeneity govern pathological patterns. We introduce Regional Expert Networks (REN), the first anatomically-informed MoE framework for medical image classification. REN encodes anatomical priors by training seven specialized experts, each dedicated to a distinct lung lobe or bilateral lung combination, enabling precise modeling of region-specific pathological variation. Multi-modal gating mechanisms dynamically integrate radiomics biomarkers with deep learning (DL) features extracted by convolutional (CNN), Transformer (ViT), and state-space (Mamba) architectures to weight expert contributions at inference. Applied to interstitial lung disease (ILD) classification on a 597-patient, 1,898-scan longitudinal cohort, REN achieves consistently superior performance: the radiomics-guided ensemble attains an average AUC of 0.8646 +- 0.0467, a +12.5 % improvement over the SwinUNETR single-model baseline (AUC 0.7685, p=0.031). Lower-lobe experts reach AUCs of 0.88-0.90, outperforming DL baselines (CNN: 0.76-0.79) and mirroring known patterns of basal ILD progression. Evaluated under rigorous patient-level cross-validation, REN demonstrates strong generalizability and clinical interpretability, establishing a scalable, anatomically-guided framework potentially extensible to other structured medical imaging tasks. Code is available on our GitHub https://github.com/NUBagciLab/MoE-REN.