Prompt engineering plays a crucial role in optimizing artificial intelligence (AI) and large language model (LLM) outputs by refining input structure, a key factor in medical applications where precision and reliability are paramount. This Clinical Perspective provides an overview of prompt engineering techniques and their relevance to interventional radiology (IR). It explores key strategies, including zero-shot, one- or few-shot, chain-of-thought, tree-of-thought, self-consistency, and directional stimulus prompting, demonstrating their application in IR-specific contexts. Practical examples illustrate how these techniques can be effectively structured for workplace and clinical use. Additionally, the article discusses best practices for designing effective prompts and addresses challenges in the clinical use of generative AI, including data privacy and regulatory concerns. It concludes with an outlook on the future of generative AI in IR, highlighting advances including retrieval-augmented generation, domain-specific LLMs, and multimodal models.

Fast PET imaging is clinically important for reducing motion artifacts and improving patient comfort. While recent diffusion-based deep learning methods have shown promise, they often fail to capture the true PET degradation process, suffer from accumulated inference errors, introduce artifacts, and require extensive reconstruction iterations. To address these challenges, we propose a novel multistage diffusion framework tailored for fast PET imaging. At the coarse level, we design a multistage structure to approximate the temporal non-linear PET degradation process in a data-driven manner, using paired PET images collected under different acquisition duration. A Phase Error Correction Network (PECNet) ensures consistency across stages by correcting accumulated deviations. At the fine level, we introduce a deterministic cold diffusion mechanism, which simulates intra-stage degradation through interpolation between known acquisition durations-significantly reducing reconstruction iterations to as few as 10. Evaluations on [⁶⁸Ga]FAPI and [¹⁸F]FDG PET datasets demonstrate the superiority of our approach, achieving peak PSNRs of 36.2 dB and 39.0 dB, respectively, with average SSIMs over 0.97. Our framework offers high-fidelity PET imaging with fewer iterations, making it practical for accelerated clinical imaging.

Artificial intelligence (AI) has been proposed to assist radiologists in reporting multiparametric magnetic resonance imaging (mpMRI) of the prostate. We evaluate the diagnostic performance of radiologists with different levels of experience when reporting mpMRI with the support of available AI-based software (Quantib Prostate). This is a single-center study (NCT06298305) involving 110 patients. Those with a positive mpMRI (PI-RADS ≥ 3) underwent targeted plus systematic biopsy (TBx plus SBx), while those with a negative mpMRI but a high clinical suspicion of prostate cancer (PCa) underwent SBx. Three readers with different levels of experience, identified as R1, R2, and R3 reviewed all mpMRI. Inter-reader agreement among the three readers with or without the assistance of Quantib Prostate as well as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for the detection of clinically significant PCa (csPCa) were assessed. 102 patients underwent prostate biopsy and the csPCa detection rate was 47%. Using Quantib Prostate resulted in an increased number of lesions identified for R3 (101 vs. 127). Inter-reader agreement slightly increased when using Quantib Prostate from 0.37 to 0.41 without vs. with Quantib Prostate, respectively. PPV, NPV and diagnostic accuracy (measured by the area under the curve [AUC]) of R3 improved (0.51 vs. 0.55, 0.65 vs.0.82 and 0.56 vs. 0.62, respectively). Conversely, no changes were observed for R1 and R2. Using Quantib Prostate did not enhance the detection rate of csPCa for readers with some experience in prostate imaging. However, for an inexperienced reader, this AI-based software is demonstrated to improve the performance. Name of registry: clinicaltrials.gov. NCT06298305. Date of registration: 2022-09.

Optical Coherence Tomography (OCT) is a critical imaging modality for diagnosing ocular and systemic conditions, yet its accessibility is hindered by the need for specialized expertise and high computational demands. To address these challenges, we introduce ChatOCT, an offline-capable, domain-adaptive clinical decision support system (CDSS) that integrates structured expert Q&A generation, OCT-specific knowledge injection, and activation-aware model compression. Unlike existing systems, ChatOCT functions without internet access, making it suitable for low-resource environments. ChatOCT is built upon LLaMA-2-7B, incorporating domain-specific knowledge from PubMed and OCT News through a two-stage training process: (1) knowledge injection for OCT-specific expertise and (2) Q&A instruction tuning for structured, interactive diagnostic reasoning. To ensure feasibility in offline environments, we apply activation-aware weight quantization, reducing GPU memory usage to ~ 4.74 GB, enabling deployment on standard OCT hardware. A novel expert answer generation framework mitigates hallucinations by structuring responses in a multi-step process, ensuring accuracy and interpretability. ChatOCT outperforms state-of-the-art baselines such as LLaMA-2, PMC-LLaMA-13B, and ChatDoctor by 10-15 points in coherence, relevance, and clinical utility, while reducing GPU memory requirements by 79%, while maintaining real-time responsiveness (~ 20 ms inference time). Expert ophthalmologists rated ChatOCT's outputs as clinically actionable and aligned with real-world decision-making needs, confirming its potential to assist frontline healthcare providers. ChatOCT represents an innovative offline clinical decision support system for optical coherence tomography (OCT) that runs entirely on local embedded hardware, enabling real-time analysis in resource-limited settings without internet connectivity. By offering a scalable, generalizable pipeline that integrates knowledge injection, instruction tuning, and model compression, ChatOCT provides a blueprint for next-generation, resource-efficient clinical AI solutions across multiple medical domains.

Thyroid cancer is the most prevalent malignant tumour in the endocrine system, with its incidence steadily rising in recent years. Current central processing units (CPUs) and graphics processing units (GPUs) face significant challenges in terms of processing speed, energy consumption, cost, and scalability in the identification of thyroid nodules, making them inadequate for the demands of future green, efficient, and accessible healthcare. To overcome these limitations, this study proposes an efficient quantized inference method using a field-programmable gate array (FPGA). We employ the YOLOv4-tiny neural network model, enhancing software performance with the K-means + + optimization algorithm and improving hardware performance through techniques such as 8-bit weight quantization, batch normalization, and convolutional layer fusion. The study is based on the ZYNQ7020 FPGA platform. Experimental results demonstrate an average accuracy of 81.44% on the Tn3k dataset and 81.20% on the internal test set from a Chinese tertiary hospital. The power consumption of the FPGA platform, CPU (Intel Core i5-10200 H), and GPU (NVIDIA RTX 4090) were 3.119 watts, 45 watts, and 68 watts, respectively, with energy efficiency ratios of 5.45, 0.31, and 5.56. This indicates that the FPGA's energy efficiency is 17.6 times that of the CPU and 0.98 times that of the GPU. These results show that the FPGA not only significantly outperforms the CPU in speed but also consumes far less power than the GPU. Moreover, using mid-to-low-end FPGAs yields performance comparable to that of commercial-grade GPUs. This technology presents a novel solution for medical imaging diagnostics, with the potential to significantly enhance the speed, accuracy, and environmental sustainability of ultrasound image analysis, thereby supporting the future development of medical care.

Low back pain (LBP) is a prevalent pain condition whose persistence can lead to changes in the brain regions responsible for sensory, cognitive, attentional, and emotional processing. Previous neuroimaging studies have identified various structural and functional abnormalities in patients with LBP; however, how the static and dynamic large-scale functional network connectivity (FNC) of the brain is affected in these patients remains unclear. Forty-one patients with chronic low back pain (cLBP) and 42 healthy controls underwent resting-state functional MRI scanning. The independent component analysis method was employed to extract the resting-state networks. Subsequently, we calculate and compare between groups for static intra- and inter-network functional connectivity. In addition, we investigated the differences between dynamic functional network connectivity and dynamic temporal metrics between cLBP patients and healthy controls. Finally, we tried to distinguish cLBP patients from healthy controls by support vector machine method. The results showed that significant reductions in functional connectivity within the network were found within the DMN,DAN, and ECN in cLBP patients. Significant between-group differences were also found in static FNC and in each state of dynamic FNC. In addition, in terms of dynamic temporal metrics, fraction time and mean dwell time were significantly altered in cLBP patients. In conclusion, our study suggests the existence of static and dynamic large-scale brain network alterations in patients with cLBP. The findings provide insights into the neural mechanisms underlying various brain function abnormalities and altered pain experiences in patients with cLBP.

Artificial intelligence (AI) utilization is growing, but patient perceptions of AI are unclear. Our objective was to understand patient perceptions of AI through a multi-site survey of breast imaging patients. A 36-question survey was distributed to eight US practices (6 academic, 2 non-academic) from October 2023 through October 2024. This manuscript analyzes a subset of questions from the survey addressing digital health literacy and attitudes towards AI in medicine and breast imaging specifically. Multivariable analysis compared responses by respondent demographics. A total of 3,532 surveys were collected (response rate: 69.9%, 3,532/5053). Median respondent age was 55 years (IQR 20). Most respondents were White (73.0%, 2579/3532) and had completed college (77.3%, 2732/3532). Overall, respondents were undecided (range: 43.2%-50.8%) regarding questions about general perceptions of AI in healthcare. Respondents with higher electronic health literacy, more education, and younger age were significantly more likely to consider it useful to use utilize AI for aiding medical tasks (all p<0.001). In contrast, respondents with lower electronic health literacy and less education were significantly more likely to indicate it was a bad idea for AI to perform medical tasks (p<0.001). Non-White patients were more likely to express concerns that AI will not work as well for some groups compared to others (p<0.05). Overall, favorable opinions of AI use for medical tasks were associated with younger age, more education, and higher electronic health literacy. As AI is increasingly implemented into clinical workflows, it is important to educate patients and provide transparency to build patient understanding and trust.

Deep learning techniques have demonstrated potential in various fields, including segmentation, and have recently been applied to medical image processing. This study aims to develop and evaluate computer-based diagnostic software designed to assess the segmentation of the mandibular condyle in ultrasound images. A total of 668 retrospective ultrasound images of anonymous adult mandibular condyles were analyzed. The CranioCatch labeling program (CranioCatch, Eskişehir, Turkey) was utilized to annotate the mandibular condyle using a polygonal labeling method. These annotations were subsequently reviewed and validated by experts in oral and maxillofacial radiology. In this study, all test images were detected and segmented using the YOLOv8 deep learning artificial intelligence (AI) model. When evaluating the model's performance in image estimation, it achieved an F1 score of 0.93, a sensitivity of 0.90, and a precision of 0.96. The automatic segmentation of the mandibular condyle from ultrasound images presents a promising application of artificial intelligence. This approach can help surgeons, radiologists, and other specialists save time in the diagnostic process.

Nuclear medicine is rapidly evolving with new molecular imaging targets and advanced computational tools that promise to enhance diagnostic precision and personalized therapy. Recent years have seen a surge in novel PET and SPECT tracers, such as those targeting prostate-specific membrane antigen (PSMA) in prostate cancer, fibroblast activation protein (FAP) in tumor stroma, and tau protein in neurodegenerative disease. These tracers enable more specific visualization of disease processes compared to traditional agents, fitting into a broader shift toward precision imaging in oncology and neurology. In parallel, artificial intelligence (AI) and machine learning techniques are being integrated into tracer development and image analysis. AI-driven methods can accelerate radiopharmaceutical discovery, optimize pharmacokinetic properties, and assist in interpreting complex imaging datasets. This editorial provides an expanded overview of emerging imaging targets and techniques, including theranostic applications that pair diagnosis with radionuclide therapy, and examines how AI is augmenting nuclear medicine. We discuss the implications of these advancements within the field's historical trajectory and address the regulatory, manufacturing, and clinical challenges that must be navigated. Innovations in molecular targeting and AI are poised to transform nuclear medicine practice, enabling more personalized diagnostics and radiotheranostic strategies in the era of precision healthcare.

Achieving efficient analysis of multiple pathological indicators has great significance for breast cancer prognosis and therapeutic decision-making. In this study, we aim to explore a deep multi-task learning (MTL) framework for collaborative prediction of histological grade and proliferation marker (Ki-67) status in breast cancer using multi-phase dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). In the novel design of hybrid multi-task architecture (HMT-Net), co-representative features are explicitly distilled using a feature extraction backbone. A customized prediction network is then introduced to perform soft-parameter sharing between two correlated tasks. Specifically, task-common and task-specific knowledge is transmitted into tower layers for informative interactions. Furthermore, low-level feature maps containing tumor edges and texture details are recaptured by a hard-parameter sharing branch, which are then incorporated into the tower layer for each subtask. Finally, the probabilities of two histological indicators, predicted in the multi-phase DCE-MRI, are separately fused using a decision-level fusion strategy. Experimental results demonstrate that the proposed HMT-Net achieves optimal discriminative performance over other recent MTL architectures and deep models based on single image series, with the area under the receiver operating characteristic curve of 0.908 for tumor grade and 0.694 for Ki-67 status. Benefiting from the innovative HMT-Net, our proposed method elucidates its strong robustness and flexibility in the collaborative prediction task of breast biomarkers. Multi-phase DCE-MRI is expected to contribute valuable dynamic information for breast cancer pathological assessment in a non-invasive manner.