Although deep learning has driven remarkable advancements in medical image registration, deep neural network-based non-rigid deformation field generation methods demonstrate high accuracy in single-modality scenarios. However, multi-modal medical image registration still faces critical challenges. To address the issues of insufficient anatomical consistency and unstable deformation field optimization in cross-modal registration tasks among existing methods, this paper proposes an end-to-end medical image registration method based on a Dynamic Harmonized Registration framework (DHR-Net). DHR-Net employs a cascaded two-stage architecture, comprising a translation network and a registration network that operate in sequential processing phases. Furthermore, we propose a loss function based on the Noise Contrastive Estimation framework, which enhances anatomical consistency in cross-modal translation by maximizing mutual information between input and transformed image patches. This loss function incorporates a dynamic temperature adjustment mechanism that progressively optimizes feature contrast constraints during training to improve high-frequency detail preservation, thereby better constraining the topological structure of target images. Experiments conducted on the M&M Heart Dataset demonstrate that DHR-Net outperforms existing methods in registration accuracy, deformation field smoothness, and cross-modal robustness. The framework significantly enhances the registration quality of cardiac images while demonstrating exceptional performance in preserving anatomical structures, exhibiting promising potential for clinical applications.

Fractional anisotropy (FA) derived from diffusion MRI is a widely used marker of white matter (WM) integrity. However, conventional FA based genetic studies focus on phenotypes representing tract- or atlas-defined averages, which may oversimplify spatial patterns of WM integrity and thus limiting the genetic discovery. Here, we proposed a deep learning-based framework, termed unsupervised deep representation of white matter (UDR-WM), to extract brain-wide FA features-referred to as UDIP-FA, that capture distributed microstructural variation without prior anatomical assumptions. UDIP-FAs exhibit enhanced sensitivity to aging and substantially higher SNP-based heritability compared to traditional FA phenotypes ( <i>P</i> < 2.20e-16, Mann-Whitney U test, mean h ² = 50.81%). Through multivariate GWAS, we identified 939 significant lead SNPs in 586 loci, mapped to 3480 genes, dubbed UDIP-FA related genes (UFAGs). UFAGs are overexpressed in glial cells, particularly in astrocytes and oligodendrocytes (Bonferroni-corrected <i>P <</i> 2e-6, Wald Test), and show strong overlap with risk gene sets for schizophrenia and Parkinson disease (Bonferroni-corrected P < 7.06e-3, Fisher exact test). UDIP-FAs are genetically correlated with multiple brain disorders and cognitive traits, including fluid intelligence and reaction time, and are associated with polygenic risk for bone mineral density. Network analyses reveal that UFAGs form disease-enriched modules across protein-protein interaction and co-expression networks, implicating core pathways in myelination and axonal structure. Notably, several UFAGs, including <i>ACHE</i> and <i>ALDH2</i> , are targets of existing neuropsychiatric drugs. Together, our findings establish UDIP-FA as a biologically and clinically informative brain phenotype, enabling high-resolution dissection of white matter genetic architecture and its genetic links to complex brain traits.

Most current medical image segmentation models employ a unified feature modeling strategy for all target regions. However, they overlook the significant heterogeneity in lesion structure, boundary characteristics, and semantic texture, which frequently restricts their ability to accurately segment morphologically diverse lesions in complex imaging contexts, thereby reducing segmentation accuracy and robustness. To address this issue, we propose a brain-inspired segmentation framework named BrainNet, which adopts a tri-level backbone encoder-Brain Network-decoder architecture. Such an architecture enables globally guided, locally differentiated feature modeling. We further instantiate the framework with an attention-enhanced segmentation model, termed Att-BrainNet. In this model, a Thalamus Gating Module (TGM) dynamically selects and activates structurally identical but functionally diverse Encephalic Region Networks (ERNs) to collaboratively extract lesion-specific features. In addition, an S-F image enhancement module is incorporated to improve sensitivity to boundaries and fine structures. Meanwhile, multi-head self-attention is embedded in the encoder to strengthen global semantic modeling and regional coordination. Experiments conducted on two lung cancer CT segmentation datasets and the Synapse multi-organ dataset demonstrate that Att-BrainNet outperforms existing mainstream segmentation models in terms of both accuracy and generalization. Further ablation studies and mechanism visualizations confirm the effectiveness of the BrainNet architecture and the dynamic scheduling strategy. This research provides a novel structural paradigm for medical image segmentation and holds promise for extension to other complex segmentation scenarios.

To evaluate the effects of super-resolution deep learning-based reconstruction (SR-DLR) on thin-slice T2-weighted hippocampal MR image quality using 3 T MRI, in both human volunteers and phantoms. Thirteen healthy volunteers underwent hippocampal MRI at standard and high resolutions. Original (standard-resolution; StR) images were reconstructed with and without deep learning-based reconstruction (DLR) (Matrix = 320 × 320), and with SR-DLR (Matrix = 960 × 960). High-resolution (HR) images were also reconstructed with/without DLR (Matrix = 960 × 960). Contrast, contrast-to-noise ratio (CNR), and septum slope were analyzed. Two radiologists evaluated the images for noise, contrast, artifacts, sharpness, and overall quality. Quantitative and qualitative results are reported as medians and interquartile ranges (IQR). Comparisons used the Wilcoxon signed-rank test with Holm correction. We also scanned an American College of Radiology (ACR) phantom to evaluate the ability of our SR-DLR approach to reduce artifacts induced by zero-padding interpolation (ZIP). SR-DLR exhibited contrast comparable to original images and significantly higher than HR-images. Its slope was comparable to that of HR images but was significantly steeper than that of StR images (p < 0.01). Furthermore, the CNR of SR-DLR (10.53; IQR: 10.08, 11.69) was significantly superior to the StR-images without DLR (7.5; IQR: 6.4, 8.37), StR-images with DLR (8.73; IQR: 7.68, 9.0), HR-images without DLR (2.24; IQR: 1.43, 2.38), and HR-images with DLR (4.84; IQR: 2.99, 5.43) (p < 0.05). In the phantom study, artifacts induced by ZIP were scarcely observed when using SR-DLR. SR-DLR for hippocampal MRI potentially improves image quality beyond that of actual HR-images while reducing acquisition time.

Large Language Models (LLMs) show promise for generating patient-friendly radiology reports, but the performance of open-source versus proprietary LLMs needs assessment. To compare open-source and proprietary LLMs in generating patient-friendly radiology reports from chest CTs using quantitative readability metrics and qualitative assessments by radiologists. Fifty chest CT reports were processed by seven LLMs: three open-source models (Llama-3-70b, Mistral-7b, Mixtral-8x7b) and four proprietary models (GPT-4, GPT-3.5-Turbo, Claude-3-Opus, Gemini-Ultra). Simplification was evaluated using five quantitative readability metrics. Three radiologists rated patient-friendliness on a five-point Likert scale across five criteria. Content and coherence errors were counted. Inter-rater reliability and differences among models were statistically assessed. Inter-rater reliability was substantial to near perfect (κ = 0.76-0.86). Qualitatively, Llama-3-70b was non-inferior to leading proprietary models in 4/5 categories. GPT-3.5-Turbo showed the best overall readability, outperforming GPT-4 in two metrics. Llama-3-70b outperformed GPT-3.5-Turbo on the CLI (p = 0.006). Claude-3-Opus and Gemini-Ultra scored lower on readability but were rated highly in qualitative assessments. Claude-3-Opus maintained perfect factual accuracy. Claude-3-Opus and GPT-4 outperformed Llama-3-70b in emotional sensitivity (90.0 % vs 46.0 %, p < 0.001). Llama-3-70b shows strong potential in generating quality, patient-friendly radiology reports, challenging proprietary models. With further adaptation, open-source LLMs could advance patient-friendly reporting technology.

Harmonic Motion Imaging (HMI) is an ultrasound elasticity imaging method that measures the mechanical properties of tissue using amplitude-modulated acoustic radiation force (AM-ARF). Multi-frequency HMI (MF-HMI) excites tissue at various AM frequencies simultaneously, allowing for image optimization without prior knowledge of inclusion size and stiffness. However, challenges remain in size estimation as inconsistent boundary effects result in different perceived sizes across AM frequencies. Herein, we developed an automated assessment method for tumor and focused ultrasound surgery (FUS) induced lesions using a transformer-based multi-modality neural network, HMINet, and further automated neoadjuvant chemotherapy (NACT) response prediction. HMINet was trained on 380 pairs of MF-HMI and B-mode images of phantoms and in vivo orthotopic breast cancer mice (4T1). Test datasets included phantoms (n = 32), in vivo 4T1 mice (n = 24), breast cancer patients (n = 20), FUS-induced lesions in ex vivo animal tissue and in vivo clinical settings with real-time inference, with average segmentation accuracy (Dice) of 0.91, 0.83, 0.80, and 0.81, respectively. HMINet outperformed state-of-the-art models; we also demonstrated the enhanced robustness of the multi-modality strategy over B-mode-only, both quantitatively through Dice scores and in terms of interpretation using saliency analysis. The contribution of AM frequency based on the number of salient pixels showed that the most significant AM frequencies are 800 and 200 Hz across clinical cases. We developed an automated, multimodality ultrasound-based tumor and FUS lesion assessment method, which facilitates the clinical translation of stiffness-based breast cancer treatment response prediction and real-time image-guided FUS therapy.

Features of new bleeding on conventional imaging in cerebral cavernous malformations (CCMs) often disappear after several weeks, yet the risk of rebleeding persists long thereafter. Increases in mean lesional quantitative susceptibility mapping (QSM) ≥ 6% on MRI during 1 year of prospective surveillance have been associated with new symptomatic hemorrhage (SH) during that period. The authors hypothesized that QSM at a single time point reflects features of hemorrhage in the prior year or potential bleeding in the subsequent year. Twenty-eight features were extracted from 265 QSM acquisitions in 120 patients enrolled in a prospective trial readiness project, and machine learning methods examined associations with SH and biomarker bleed (QSM increase ≥ 6%) in prior and subsequent years. QSM features including sum variance, variance, and correlation had lower average values in lesions with SH in the prior year (p < 0.05, false discovery rate corrected). A support-vector machine classifier recurrently selected sum average, mean lesional QSM, sphericity, and margin sharpness features to distinguish biomarker bleeds in the prior year (area under the curve = 0.61, 95% CI 0.52-0.70; p = 0.02). No QSM features were associated with a subsequent bleed. These results provide proof of concept that machine learning may derive features of QSM reflecting prior hemorrhagic activity, meriting further investigation. Clinical trial registration no.: NCT03652181 (ClinicalTrials.gov).

Targeted muscle reinnervation (TMR) was initially developed as a technique for bionic prosthetic control but has since become a widely adopted strategy for managing pain and preventing neuroma formation after amputation. This shift in TMR's motivation has influenced surgical approaches, in ways that may challenge conventional electromyography (EMG)-based prosthetic control. The primary goal is often to simply reinnervate nerves to accessible muscles. This contrasts the earlier, more complex TMR surgeries that optimize EMG signal detection by carefully selecting target muscles near the skin's surface and manipulate residual anatomy to electrically isolate muscle activity. Consequently, modern TMR surgeries can involve less consideration for factors such as the depth of the reinnervated muscles or electrical crosstalk between closely located reinnervated muscles, all of which can impair the effectiveness of conventional prosthetic control systems. We recruited 4 participants with TMR, varying levels of upper limb loss, and diverse sets of reinnervated muscles. Participants attempted performing movements with their missing hands and we used a muscle activity measurement technique that employs ultrasound imaging and machine learning (sonomyography) to classify the resulting muscle movements. We found that attempted missing hand movements resulted in unique patterns of deformation in the reinnervated muscles and applying a K-nearest neighbors machine learning algorithm, we could predict 4-10 hand movements for each participant with 83.3-99.4% accuracy. Our findings suggest that despite the shifting motivations for performing TMR surgery this new generation of the surgical procedure not only offers prophylactic benefits but also retains promising opportunities for bionic prosthetic control.

Deep learning (DL) reconstruction shows potential in reducing MRI acquisition times while preserving image quality, but the impact of varying acceleration factors on knee MRI diagnostic accuracy remains undefined. Evaluate diagnostic performance of twofold, fourfold, and sixfold DL-accelerated knee MRI protocols versus standard protocols. In this prospective study, 71 consecutive patients underwent knee MRI with standard, DL2, DL4, and DL6 accelerated protocols. Four radiologists assessed ligament tears, meniscal lesions, bone marrow edema, chondropathy, and extensor abnormalities. Sensitivity, specificity, and interobserver agreement were calculated. DL2 and DL4 demonstrated high diagnostic accuracy. For ACL tears, DL2/DL4 achieved 98-100% sensitivity/specificity, while DL6 showed reduced sensitivity (91-96%). In meniscal evaluation, DL2 maintained 96-100% sensitivity and 98-100% specificity; DL4 showed 94-98% sensitivity and 97-99% specificity. DL6 exhibited decreased sensitivity (82-92%) for subtle lesions. Bone marrow edema detection remained excellent across acceleration factors. Interobserver agreement was excellent for DL2/DL4 (W = 0.91-0.97) and good for DL6 (W = 0.78-0.89). DL2 protocols demonstrate performance nearly identical to standard protocols, while DL4 maintains acceptable diagnostic accuracy for most pathologies. DL6 shows reduced sensitivity for subtle abnormalities, particularly among less experienced readers. DL2 and DL4 protocols represent optimal balance between acquisition time reduction (50-75%) and diagnostic confidence.