This study aimed to develop a fully automated semantic placenta segmentation model that integrates the U-Net and SegNeXt architectures through ensemble learning. A total of 218 pregnant women with suspected placental abnormalities who underwent magnetic resonance imaging (MRI) were enrolled, yielding 1090 annotated images for developing a deep learning model for placental segmentation. The images were standardized and divided into training and test sets. The performance of Placental Segmentation Network (PlaNet-S), which integrates U-Net and SegNeXt within an ensemble framework, was assessed using Intersection over Union (IoU) and counting connected components (CCC) against the U-Net, U-Net + + , and DS-transUNet. PlaNet-S had significantly higher IoU (0.78, SD = 0.10) than that of U-Net (0.73, SD = 0.13) (p < 0.005) and DS-transUNet (0.64, SD = 0.16) (p < 0.005), while the difference with U-Net + + (0.77, SD = 0.12) was not statistically significant. The CCC for PlaNet-S was significantly higher than that for U-Net (p < 0.005), U-Net + + (p < 0.005), and DS-transUNet (p < 0.005), matching the ground truth in 86.0%, 56.7%, 67.9%, and 20.9% of the cases, respectively. PlaNet-S achieved higher IoU than U-Net and DS-transUNet, and comparable IoU to U-Net + + . Moreover, PlaNet-S significantly outperformed all three models in CCC, indicating better agreement with the ground truth. This model addresses the challenges of time-consuming physician-assisted manual segmentation and offers the potential for diverse applications in placental imaging analyses.

Alzheimer's disease (AD) is the most prevalent type of dementia. It is linked with a gradual decline in various brain functions, such as memory. Many research efforts are now directed toward non-invasive procedures for early diagnosis because early detection greatly benefits the patient care and treatment outcome. Additional to an accurate diagnosis and reduction of the rate of misdiagnosis; Computer-Aided Design (CAD) systems are built to give definitive diagnosis. This paper presents a novel CAD system to determine stages of AD. Initially, deep learning techniques are utilized to extract features from the AD brain MRIs. Then, the extracted features are reduced using a proposed feature reduction technique named Deep Downsized Kernel Partial Least Squares (DDKPLS). The proposed approach selects a reduced number of samples from the initial information matrix. The samples chosen give rise to a new data matrix further processed by KPLS to deal with the high dimensionality. The reduced feature space is finally classified using ELM. The implementation is named DDKPLS-ELM. Reference tests have been performed on the Kaggle MRI dataset, which exhibit the efficacy of the DDKPLS-based classifier; it achieves accuracy up to 95.4% and an F1 score of 95.1%.

One possible adverse effect of breast irradiation is the development of pulmonary fibrosis. The aim of this study was to determine whether planning CT scans can predict which patients are more likely to develop lung lesions after treatment. A retrospective analysis of 242 patient records was performed using different machine learning models. These models showed a remarkable correlation between the occurrence of fibrosis and the hounsfield units of lungs in CT data. Three different classification methods (Tree, Kernel-based, k-Nearest Neighbors) showed predictive values above 60%. The human predictive factor (HPF), a mathematical predictive model, further strengthened the association between lung hounsfield unit (HU) metrics and radiation-induced lung injury (RILI). These approaches optimize radiation treatment plans to preserve lung health. Machine learning models and HPF can also provide effective diagnostic and therapeutic support for other diseases.

Early screening, diagnosis, and treatment of lung cancer are pivotal in clinical practice since the tumor stage remains the most dominant factor that affects patient survival. Previous initiatives have tried to develop new tools for decision-making of lung cancer. In this study, we proposed the China Protocol, a complete workflow of lung cancer tailored to the Chinese population, which is implemented by steps including early screening by evaluation of risk factors and three-dimensional thin-layer image reconstruction technique for low-dose computed tomography (Tre-LDCT), accurate diagnosis via artificial intelligence (AI) and novel biomarkers, and individualized treatment through non-invasive molecule visualization strategies. The application of this protocol has improved the early diagnosis and 5-year survival rates of lung cancer in China. The proportion of early-stage (stage I) lung cancer has increased from 46.3% to 65.6%, along with a 5-year survival rate of 90.4%. Moreover, especially for stage IA1 lung cancer, the diagnosis rate has improved from 16% to 27.9%; meanwhile, the 5-year survival rate of this group achieved 97.5%. Thus, here we defined stage IA1 lung cancer, which cohort benefits significantly from early diagnosis and treatment, as the "ultra-early stage lung cancer", aiming to provide an intuitive description for more precise management and survival improvement. In the future, we will promote our findings to multicenter remote areas through medical alliances and mobile health services with the desire to move forward the diagnosis and treatment of lung cancer.

In recent years, scientists have been trying to convert magnetic resonance imaging (MRI) images into computed tomography (CT) images for dose calculations while taking advantage of the benefits of MRI images. The main approaches for image conversion are bulk density, Atlas registration, and machine learning. These methods have limitations in accuracy and time consumption and require large datasets to convert images. In this study, the novel 'voxels spawn voxels' technique combined with the 'orthonormalize' feature in Carimas software was developed to build a conversion dataset from MRI intensity to Hounsfield unit value for some structural regions including gluteus maximus, liver, kidneys, spleen, pancreas, and colon. The original CT images and the converted MRI images were imported into the Geant4/Gamos software for dose calculation. It gives good results (<5%) in most organs except the intestine (18%).

Ultrasound imaging is pivotal in clinical diagnostics due to its affordability, portability, safety, real-time capability, and non-invasive nature. It is widely utilized for examining various organs, such as the breast, thyroid, ovary, cardiac, and more. However, the manual interpretation and annotation of ultrasound images are time-consuming and prone to variability among physicians. While single-task artificial intelligence (AI) solutions have been explored, they are not ideal for scaling AI applications in medical imaging. Foundation models, although a trending solution, often struggle with real-world medical datasets due to factors such as noise, variability, and the incapability of flexibly aligning prior knowledge with task adaptation. To address these limitations, we propose an orchestration learning framework named PerceptGuide for general-purpose ultrasound classification and segmentation. Our framework incorporates a novel orchestration mechanism based on prompted hyper-perception, which adapts to the diverse inductive biases required by different ultrasound datasets. Unlike self-supervised pre-trained models, which require extensive fine-tuning, our approach leverages supervised pre-training to directly capture task-relevant features, providing a stronger foundation for multi-task and multi-organ ultrasound imaging. To support this research, we compiled a large-scale Multi-task, Multi-organ public ultrasound dataset (M²-US), featuring images from 9 organs and 16 datasets, encompassing both classification and segmentation tasks. Our approach employs four specific prompts-Object, Task, Input, and Position-to guide the model, ensuring task-specific adaptability. Additionally, a downstream synchronization training stage is introduced to fine-tune the model for new data, significantly improving generalization capabilities and enabling real-world applications. Experimental results demonstrate the robustness and versatility of our framework in handling multi-task and multi-organ ultrasound image processing, outperforming both specialist models and existing general AI solutions. Compared to specialist models, our method improves segmentation from 82.26% to 86.45%, classification from 71.30% to 79.08%, while also significantly reducing model parameters.

The radiology specialty examination assesses clinical decision-making, image interpretation, and diagnostic reasoning. With the expansion of medical knowledge, traditional test design faces challenges in maintaining accuracy and relevance. Large language models (LLMs) demonstrate potential in medical education. This study evaluates LLM performance in radiology specialty exams, explores their role in assessing question difficulty, and investigates their reasoning processes, aiming to develop a more objective and efficient framework for exam design. This study compared the performance of LLMs and human examinees in a radiology specialty examination. Three LLMs (GPT-4o, o1-preview, and GPT-3.5-turbo-1106) were evaluated under zero-shot conditions. Exam accuracy, examinee accuracy, discrimination index, and point-biserial correlation were used to assess LLMs' ability to predict question difficulty and reasoning processes. The data provided by the Taiwan Radiological Society ensures comparability between AI and human performance. As for accuracy, GPT-4o (88.0%) and o1-preview (90.9%) outperformed human examinees (76.3%), whereas GPT-3.5-turbo-1106 showed significantly lower accuracy (50.2%). Question difficulty analysis revealed that newer LLMs excel in solving complex questions, while GPT-3.5-turbo-1106 exhibited greater performance variability. Discrimination index and point-biserial Correlation analyses demonstrated that GPT-4o and o1-preview accurately identified key differentiating questions, closely mirroring human reasoning patterns. These findings suggest that advanced LLMs can assess medical examination difficulty, offering potential applications in exam standardization and question evaluation. This study evaluated the problem-solving capabilities of GPT-3.5-turbo-1106, GPT-4o, and o1-preview in a radiology specialty examination. LLMs should be utilized as tools for assessing exam question difficulty and assisting in the standardized development of medical examinations.

To develop and validate interpretable machine learning models for differentiating glioblastoma (GB) from solitary brain metastasis (SBM) using radiomics features from contrast-enhanced T1-weighted MRI (CE-T1WI), and to compare the impact of low-order and high-order features on model performance. A cohort of 434 patients with histopathologically confirmed GB (226 patients) and SBM (208 patients) was retrospectively analyzed. Radiomic features were derived from CE-T1WI, with feature selection conducted through minimum redundancy maximum relevance and least absolute shrinkage and selection operator regression. Machine learning models, including GradientBoost and lightGBM (LGBM), were trained using low-order and high-order features. The performance of the models was assessed through receiver operating characteristic analysis and computation of the area under the curve, along with other indicators, including accuracy, specificity, and sensitivity. SHapley Additive Explanations (SHAP) analysis is used to measure the influence of each feature on the model's predictions. The performances of various machine learning models on both the training and validation datasets were notably different. For the training group, the LGBM, CatBoost, multilayer perceptron (MLP), and GradientBoost models achieved the highest AUC scores, all exceeding 0.9, demonstrating strong discriminative power. The LGBM model exhibited the best stability, with a minimal AUC difference of only 0.005 between the training and test sets, suggesting strong generalizability. Among the validation group results, the GradientBoost classifier achieved the maximum AUC of 0.927, closely followed by random forest at 0.925. GradientBoost also demonstrated high sensitivity (0.911) and negative predictive value (NPV, 0.889), effectively identifying true positives. The LGBM model showed the highest test accuracy (86.2%) and performed excellently in terms of sensitivity (0.911), NPV (0.895), and positive predictive value (PPV, 0.837). The models utilizing high-order features outperformed those based on low-order features in all the metrics. SHAP analysis further enhances model interpretability, providing insights into feature importance and contributions to classification decisions. Machine learning techniques based on radiomics can effectively distinguish GB from SBM, with gradient boosting tree-based models such as LGBMs demonstrating superior performance. High-order features significantly improve model accuracy and robustness. SHAP technology enhances the interpretability and transparency of models for distinguishing brain tumors, providing intuitive visualization of the contribution of radiomic features to classification.

Early detection of malignant lesions in ultrasound images is crucial for effective cancer diagnosis and treatment. While traditional methods rely on radiologists, deep learning models can improve accuracy, reduce errors, and enhance efficiency. This study explores the application of a deep learning model for classifying benign and malignant lesions, focusing on its performance and interpretability. In this study, we proposed a feature fusion-based deep learning model for classifying benign and malignant lesions in ultrasound images. The model leverages advanced architectures such as MobileNetV2 and DenseNet121, enhanced with feature fusion and attention mechanisms to boost classification accuracy. The clinical dataset comprises 2171 images collected from 1758 patients between December 2020 and May 2024. Additionally, we utilized the publicly available BUSI dataset, consisting of 780 images from female patients aged 25 to 75, collected in 2018. To enhance interpretability, we applied Grad-CAM, Saliency Maps, and shapley additive explanations (SHAP) techniques to explain the model's decision-making. A comparative analysis with radiologists of varying expertise levels is also conducted. The proposed model exhibited the highest performance, achieving an AUC of 0.9320 on our private dataset and an area under the curve (AUC) of 0.9834 on the public dataset, significantly outperforming traditional deep convolutional neural network models. It also exceeded the diagnostic performance of radiologists, showcasing its potential as a reliable tool for medical image classification. The model's success can be attributed to its incorporation of advanced architectures, feature fusion, and attention mechanisms. The model's decision-making process was further clarified using interpretability techniques like Grad-CAM, Saliency Maps, and SHAP, offering insights into its ability to focus on relevant image features for accurate classification. The proposed deep learning model offers superior accuracy in classifying benign and malignant lesions in ultrasound images, outperforming traditional models and radiologists. Its strong performance, coupled with interpretability techniques, demonstrates its potential as a reliable and efficient tool for medical diagnostics. The datasets generated and analyzed during the current study are not publicly available due to the nature of this research and participants of this study, but may be available from the corresponding author on reasonable request.

Valid non-invasive biomarkers for Parkinson's disease (PD) and Parkinson-plus syndrome (PPS) are urgently needed. Based on our recent self-supervised vision foundation model the Shift Window UNET TRansformer (Swin UNETR), which uses clinical multi-contrast whole brain MRI, we aimed to develop an efficient and practical model ('SwinClassifier') for the discrimination of PD vs PPS using routine clinical MRI scans. We used 75,861 clinical head MRI scans including T1-weighted, T2-weighted and fluid attenuated inversion recovery imaging as a pre-training dataset to develop a foundation model, using self-supervised learning with a cross-contrast context recovery task. Then clinical head MRI scans from n = 1992 participants with PD and n = 1989 participants with PPS were used as a downstream PD vs PPS classification dataset. We then assessed SwinClassifier's performance in confusion matrices compared to a comparative self-supervised vanilla Vision Transformer (ViT) autoencoder ('ViTClassifier'), and to two convolutional neural networks (DenseNet121 and ResNet50) trained from scratch. SwinClassifier showed very good performance (F1 score 0.83, 95% confidence interval [CI] [0.79-0.87], AUC 0.89) in PD vs PPS discrimination in independent test datasets (n = 173 participants with PD and n = 165 participants with PPS). This self-supervised classifier with pretrained weights outperformed the ViTClassifier and convolutional classifiers trained from scratch (F1 score 0.77-0.82, AUC 0.83-0.85). Occlusion sensitivity mapping in the correctly-classified cases (n = 160 PD and n = 114 PPS) highlighted the brain regions guiding discrimination mainly in sensorimotor and midline structures including cerebellum, brain stem, ventricle and basal ganglia. Our self-supervised digital model based on routine clinical head MRI discriminated PD vs PPS with good accuracy and sensitivity. With incremental improvements the approach may be diagnostically useful in early disease. National Key Research and Development Program of China.