Alzheimer's disease (AD) is a progressive neurodegenerative disorder that severely impairs cognitive function and quality of life. Timely intervention in AD relies heavily on early and precise diagnosis, which remains challenging due to the complex and subtle structural changes in the brain. Most existing deep learning methods focus only on a single plane of structural magnetic resonance imaging (sMRI) and struggle to accurately capture the complex and nonlinear relationships among pathological regions of the brain, thus limiting their ability to precisely identify atrophic features. To overcome these limitations, we propose an innovative framework, MPF-KANSC, which integrates multi-plane fusion (MPF) for combining features from the coronal, sagittal, and axial planes, and a Kolmogorov-Arnold Network-guided spatial-channel attention mechanism (KANSC) to more effectively learn and represent sMRI atrophy features. Specifically, the proposed model enables parallel feature extraction from multiple anatomical planes, thus capturing more comprehensive structural information. The KANSC attention mechanism further leverages a more flexible and accurate nonlinear function approximation technique, facilitating precise identification and localization of disease-related abnormalities. Experiments on the ADNI dataset confirm that the proposed MPF-KANSC achieves superior performance in AD diagnosis. Moreover, our findings provide new evidence of right-lateralized asymmetry in subcortical structural changes during AD progression, highlighting the model's promising interpretability.

Segmentation of lesions on CT enables automatic measurement for clinical assessment of chronic diseases (e.g., lymphoma). Integrating large language models (LLMs) into the lesion segmentation workflow offers the potential to combine imaging features with descriptions of lesion characteristics from the radiology reports. In this study, we investigate the feasibility of integrating text into the Swin-UMamba architecture for the task of lesion segmentation. The publicly available ULS23 DeepLesion dataset was used along with short-form descriptions of the findings from the reports. On the test dataset, a high Dice Score of 82% and low Hausdorff distance of 6.58 (pixels) was obtained for lesion segmentation. The proposed Text-Swin-UMamba model outperformed prior approaches: 37% improvement over the LLM-driven LanGuideMedSeg model (p < 0.001),and surpassed the purely image-based xLSTM-UNet and nnUNet models by 1.74% and 0.22%, respectively. The dataset and code can be accessed at https://github.com/ruida/LLM-Swin-UMamba

Magnetic resonance (MR) imaging, including cardiac MR, is prone to domain shift due to variations in imaging devices and acquisition protocols. This challenge limits the deployment of trained AI models in real-world scenarios, where performance degrades on unseen domains. Traditional solutions involve increasing the size of the dataset through ad-hoc image augmentation or additional online training/transfer learning, which have several limitations. Synthetic data offers a promising alternative, but anatomical/structural consistency constraints limit the effectiveness of generative models in creating image-label pairs. To address this, we propose a diffusion model (DM) trained on a source domain that generates synthetic cardiac MR images that resemble a given reference. The synthetic data maintains spatial and structural fidelity, ensuring similarity to the source domain and compatibility with the segmentation mask. We assess the utility of our generative approach in multi-centre cardiac MR segmentation, using the 2D nnU-Net, 3D nnU-Net and vanilla U-Net segmentation networks. We explore domain generalisation, where, domain-invariant segmentation models are trained on synthetic source domain data, and domain adaptation, where, we shift target domain data towards the source domain using the DM. Both strategies significantly improved segmentation performance on data from an unseen target domain, in terms of surface-based metrics (Welch's t-test, p < 0.01), compared to training segmentation models on real data alone. The proposed method ameliorates the need for transfer learning or online training to address domain shift challenges in cardiac MR image analysis, especially useful in data-scarce settings.

Accurate segmentation of femur structures from Magnetic Resonance Imaging (MRI) is critical for orthopedic diagnosis and surgical planning but remains challenging due to the limitations of existing 2D and 3D deep learning-based segmentation approaches. In this study, we propose XAG-Net, a novel 2.5D U-Net-based architecture that incorporates pixel-wise cross-slice attention (CSA) and skip attention gating (AG) mechanisms to enhance inter-slice contextual modeling and intra-slice feature refinement. Unlike previous CSA-based models, XAG-Net applies pixel-wise softmax attention across adjacent slices at each spatial location for fine-grained inter-slice modeling. Extensive evaluations demonstrate that XAG-Net surpasses baseline 2D, 2.5D, and 3D U-Net models in femur segmentation accuracy while maintaining computational efficiency. Ablation studies further validate the critical role of the CSA and AG modules, establishing XAG-Net as a promising framework for efficient and accurate femur MRI segmentation.

We present a novel approach to variational volume reconstruction from sparse, noisy slice data using the Deep Ritz method. Motivated by biomedical imaging applications such as MRI-based slice-to-volume reconstruction (SVR), our approach addresses three key challenges: (i) the reliance on image segmentation to extract boundaries from noisy grayscale slice images, (ii) the need to reconstruct volumes from a limited number of slice planes, and (iii) the computational expense of traditional mesh-based methods. We formulate a variational objective that combines a regression loss designed to avoid image segmentation by operating on noisy slice data directly with a modified Cahn-Hilliard energy incorporating anisotropic diffusion to regularize the reconstructed geometry. We discretize the phase field with a neural network, approximate the objective at each optimization step with Monte Carlo integration, and use ADAM to find the minimum of the approximated variational objective. While the stochastic integration may not yield the true solution to the variational problem, we demonstrate that our method reliably produces high-quality reconstructed volumes in a matter of seconds, even when the slice data is sparse and noisy.

The use of diverse modalities, such as omics, medical images, and clinical data can not only improve the performance of prognostic models but also deepen an understanding of disease mechanisms and facilitate the development of novel treatment approaches. However, medical data are complex, often incomplete, and contains missing modalities, making effective handling its crucial for training multimodal models. We introduce impuTMAE, a novel transformer-based end-to-end approach with an efficient multimodal pre-training strategy. It learns inter- and intra-modal interactions while simultaneously imputing missing modalities by reconstructing masked patches. Our model is pre-trained on heterogeneous, incomplete data and fine-tuned for glioma survival prediction using TCGA-GBM/LGG and BraTS datasets, integrating five modalities: genetic (DNAm, RNA-seq), imaging (MRI, WSI), and clinical data. By addressing missing data during pre-training and enabling efficient resource utilization, impuTMAE surpasses prior multimodal approaches, achieving state-of-the-art performance in glioma patient survival prediction. Our code is available at https://github.com/maryjis/mtcp

BackgroundInterstitial lung disease (ILD) encompasses diverse pulmonary disorders with varied prognoses. Current pathological diagnoses suffer from inter-observer variability,necessitating more standardized approaches. We developed an ensemble model AI for cryobiopsy, CRAI, an artificial intelligence model to analyze transbronchial lung cryobiopsy (TBLC) specimens and predict patient outcomes. MethodsWe developed an explainable AI model, CRAI, to analyze TBLC. CRAI comprises seven modules for detecting histological features, generating 19 pathologically significant findings. A downstream XGBoost classifier was developed to predict disease progression using these findings. The models performance was evaluated using respiratory function changes and survival analysis in cross-validation and external test cohorts. FindingsIn the internal cross-validation (135 cases), the model predicted 105 cases without disease progression and 30 with disease progression. The annual {Delta}%FVC was -1.293 in the non-progressive group versus -5.198 in the progressive group, outperforming most pathologists diagnoses. In the external test cohort (48 cases), the model predicted 38 non-progressive and 10 progressive cases. Survival analysis demonstrated significantly shorter survival times in the progressive group (p=0.034). InterpretationCRAI provides a comprehensive, interpretable approach to analyzing TBLC specimens, offering potential for standardizing ILD diagnosis and predicting disease progression. The model could facilitate early identification of progressive cases and guide personalized therapeutic interventions. FundingNew Energy and Industrial Technology Development Organization (NEDO) and Japanese Ministry of Health, Labor, and Welfare.

Accurate adult age estimation represents a critical component of forensic individual identification. However, traditional methods relying on skeletal developmental characteristics are susceptible to preservation status and developmental variation. Teeth, owing to their exceptional taphonomic resistance and minimal postmortem alteration, emerge as premier biological samples. Utilizing the high-resolution capabilities of Cone Beam Computed Tomography (CBCT), this study retrospectively analyzed 1,857 right first molars obtained from Han Chinese adults in Sichuan Province (883 males, 974 females; aged 18-65 years). Pulp chamber volume (PCV) was measured using semi-automatic segmentation in Mimics software (v21.0). Statistically significant differences in PCV were observed based on sex and tooth position (maxillary vs. mandibular). Significant negative correlations existed between PCV and age (r = -0.86 to -0.81). The strongest correlation (r = -0.88) was identified in female maxillary first molars. Eleven curvilinear regression models and six machine learning models (Linear Regression, Lasso Regression, Neural Network, Random Forest, Gradient Boosting, and XGBoost) were developed. Among the curvilinear regression models, the cubic model demonstrated the best performance, with the female maxillary-specific model achieving a mean absolute error (MAE) of 4.95 years. Machine learning models demonstrated superior accuracy. Specifically, the sex- and tooth position-specific XGBoost model for female maxillary first molars achieved an MAE of 3.14 years (R{superscript 2} = 0.87). This represents a significant 36.5% reduction in error compared to the optimal cubic regression model. These findings demonstrate that PCV measurements in first molars, combined with machine learning algorithms (specifically XGBoost), effectively overcome the limitations of traditional methods, providing a highly precise and reproducible approach for forensic age estimation.

White matter hyperintensities (WMH) are frequently observed on MRI in aging and Alzheimers disease (AD), yet their microstructural pathology remains poorly characterized. Conventional MRI sequences provide limited information to describe the tissue abnormalities underlying WMH, while histopathology--the gold standard--can only be applied postmortem. Quantitative MRI (qMRI) offers promising non-invasive alternatives to postmortem histopathology, but lacks histological validation of these metrics in AD. In this study, we examined the relationship between MRI metrics and histopathology in postmortem brain scans from eight donors with AD from the South Texas Alzheimers Disease Research Center. Regions of interest are delineated by aligning MRI-identified WMH in the brain donor scans with postmortem histological sections. Histopathological features, including myelin integrity, tissue vacuolation, and gliosis, are quantified within these regions using machine learning. We report the correlations between these histopathological measures and two qMRI metrics: T2 and absolute myelin water signal (aMWS) maps, as well as conventional T1w/T2w MRI. The results derived from aMWS and T2 mapping indicate a strong association between WMH, myelin loss, and increased tissue vacuolation. Bland-Altman analyses indicated that T2 mapping showed more consistent agreement with histopathology, whereas the derived aMWS demonstrated signs of systematic bias. T1w/T2w values exhibited weaker associations with histological alterations. Additionally, we observed distinct patterns of gliosis in periventricular and subcortical WMH. Our study presents one of the first histopathological validations of qMRI in AD, confirming that aMWS and T2 mapping are robust, non-invasive biomarkers that offer promising ways to monitor white matter pathology in neurodegenerative disorders.

Machine learning using transformers has shown great potential in medical imaging, but its real-world applicability remains limited due to the scarcity of annotated data. In this study, we propose a practical framework for the few-shot deployment of pretrained MRI transformers in diverse brain imaging tasks. By utilizing the Masked Autoencoder (MAE) pretraining strategy on a large-scale, multi-cohort brain MRI dataset comprising over 31 million slices, we obtain highly transferable latent representations that generalize well across tasks and datasets. For high-level tasks such as classification, a frozen MAE encoder combined with a lightweight linear head achieves state-of-the-art accuracy in MRI sequence identification with minimal supervision. For low-level tasks such as segmentation, we propose MAE-FUnet, a hybrid architecture that fuses multiscale CNN features with pretrained MAE embeddings. This model consistently outperforms other strong baselines in both skull stripping and multi-class anatomical segmentation under data-limited conditions. With extensive quantitative and qualitative evaluations, our framework demonstrates efficiency, stability, and scalability, suggesting its suitability for low-resource clinical environments and broader neuroimaging applications.