BackgroundAdvancements in imaging technology, alongside increasing longevity and co-morbidities, have led to heightened demand for diagnostic radiology services. However, there is a shortfall in radiology and radiography staff to acquire, read and report on such imaging examinations. Artificial intelligence (AI) has been identified, notably by AI developers, as a potential solution to impact positively the workload of radiology services for diagnostics to address this staffing shortfall. MethodsA rapid review complemented with data from interviews with UK radiology service stakeholders was undertaken. ArXiv, Cochrane Library, Embase, Medline and Scopus databases were searched for publications in English published between 2007 and 2022. Following screening 110 full texts were included. Interviews with 15 radiology service managers, clinicians and academics were carried out between May and September 2022. ResultsMost literature was published in 2021 and 2022 with a distinct focus on AI for diagnostics of lung and chest disease (n = 25) notably COVID-19 and respiratory system cancers, closely followed by AI for breast screening (n = 23). AI contribution to streamline the workload of radiology services was categorised as autonomous, augmentative and assistive contributions. However, percentage estimates, of workload reduction, varied considerably with the most significant reduction identified in national screening programmes. AI was also recognised as aiding radiology services through providing second opinion, assisting in prioritisation of images for reading and improved quantification in diagnostics. Stakeholders saw AI as having the potential to remove some of the laborious work and contribute service resilience. ConclusionsThis review has shown there is limited data on real-world experiences from radiology services for the implementation of AI in clinical production. Autonomous, augmentative and assistive AI can, as noted in the article, decrease workload and aid reading and reporting, however the governance surrounding these advancements lags.

Pancreatic cancer carries a poor prognosis and relies on endoscopic ultrasound (EUS) for targeted biopsy and radiotherapy. However, the speckle noise, low contrast, and unintuitive appearance of EUS make segmentation of pancreatic tumors with fully supervised deep learning (DL) models both error-prone and dependent on large, expert-curated annotation datasets. To address these challenges, we present TextSAM-EUS, a novel, lightweight, text-driven adaptation of the Segment Anything Model (SAM) that requires no manual geometric prompts at inference. Our approach leverages text prompt learning (context optimization) through the BiomedCLIP text encoder in conjunction with a LoRA-based adaptation of SAM's architecture to enable automatic pancreatic tumor segmentation in EUS, tuning only 0.86% of the total parameters. On the public Endoscopic Ultrasound Database of the Pancreas, TextSAM-EUS with automatic prompts attains 82.69% Dice and 85.28% normalized surface distance (NSD), and with manual geometric prompts reaches 83.10% Dice and 85.70% NSD, outperforming both existing state-of-the-art (SOTA) supervised DL models and foundation models (e.g., SAM and its variants). As the first attempt to incorporate prompt learning in SAM-based medical image segmentation, TextSAM-EUS offers a practical option for efficient and robust automatic EUS segmentation. Code is available at https://github.com/HealthX-Lab/TextSAM-EUS .

Breast cancer (BC) remains one of the leading causes of cancer-related mortality among women, despite recent advances in Computer-Aided Diagnosis (CAD) systems. Accurate and efficient interpretation of multi-view mammograms is essential for early detection, driving a surge of interest in Artificial Intelligence (AI)-powered CAD models. While state-of-the-art multi-view mammogram classification models are largely based on Transformer architectures, their computational complexity scales quadratically with the number of image patches, highlighting the need for more efficient alternatives. To address this challenge, we propose Mammo-Mamba, a novel framework that integrates Selective State-Space Models (SSMs), transformer-based attention, and expert-driven feature refinement into a unified architecture. Mammo-Mamba extends the MambaVision backbone by introducing the Sequential Mixture of Experts (SeqMoE) mechanism through its customized SecMamba block. The SecMamba is a modified MambaVision block that enhances representation learning in high-resolution mammographic images by enabling content-adaptive feature refinement. These blocks are integrated into the deeper stages of MambaVision, allowing the model to progressively adjust feature emphasis through dynamic expert gating, effectively mitigating the limitations of traditional Transformer models. Evaluated on the CBIS-DDSM benchmark dataset, Mammo-Mamba achieves superior classification performance across all key metrics while maintaining computational efficiency.

Automated X-ray inspection is crucial for efficient and unobtrusive security screening in various public settings. However, challenges such as object occlusion, variations in the physical properties of items, diversity in X-ray scanning devices, and limited training data hinder accurate and reliable detection of illicit items. Despite the large body of research in the field, reported experimental evaluations are often incomplete, with frequently conflicting outcomes. To shed light on the research landscape and facilitate further research, a systematic, detailed, and thorough comparative evaluation of recent Deep Learning (DL)-based methods for X-ray object detection is conducted. For this, a comprehensive evaluation framework is developed, composed of: a) Six recent, large-scale, and widely used public datasets for X-ray illicit item detection (OPIXray, CLCXray, SIXray, EDS, HiXray, and PIDray), b) Ten different state-of-the-art object detection schemes covering all main categories in the literature, including generic Convolutional Neural Network (CNN), custom CNN, generic transformer, and hybrid CNN-transformer architectures, and c) Various detection (mAP50 and mAP50:95) and time/computational-complexity (inference time (ms), parameter size (M), and computational load (GFLOPS)) metrics. A thorough analysis of the results leads to critical observations and insights, emphasizing key aspects such as: a) Overall behavior of the object detection schemes, b) Object-level detection performance, c) Dataset-specific observations, and d) Time efficiency and computational complexity analysis. To support reproducibility of the reported experimental results, the evaluation code and model weights are made publicly available at https://github.com/jgenc/xray-comparative-evaluation.

Unsupervised anomaly detection (UAD) plays a crucial role in neuroimaging for identifying deviations from healthy subject data and thus facilitating the diagnosis of neurological disorders. In this work, we focus on Bayesian flow networks (BFNs), a novel class of generative models, which have not yet been applied to medical imaging or anomaly detection. BFNs combine the strength of diffusion frameworks and Bayesian inference. We introduce AnoBFN, an extension of BFNs for UAD, designed to: i) perform conditional image generation under high levels of spatially correlated noise, and ii) preserve subject specificity by incorporating a recursive feedback from the input image throughout the generative process. We evaluate AnoBFN on the challenging task of Alzheimer's disease-related anomaly detection in FDG PET images. Our approach outperforms other state-of-the-art methods based on VAEs (beta-VAE), GANs (f-AnoGAN), and diffusion models (AnoDDPM), demonstrating its effectiveness at detecting anomalies while reducing false positive rates.

In computed tomography (CT), achieving high image quality while minimizing radiation exposure remains a key clinical challenge. This paper presents CAPRI-CT, a novel causal-aware deep learning framework for Causal Analysis and Predictive Reasoning for Image Quality Optimization in CT imaging. CAPRI-CT integrates image data with acquisition metadata (such as tube voltage, tube current, and contrast agent types) to model the underlying causal relationships that influence image quality. An ensemble of Variational Autoencoders (VAEs) is employed to extract meaningful features and generate causal representations from observational data, including CT images and associated imaging parameters. These input features are fused to predict the Signal-to-Noise Ratio (SNR) and support counterfactual inference, enabling what-if simulations, such as changes in contrast agents (types and concentrations) or scan parameters. CAPRI-CT is trained and validated using an ensemble learning approach, achieving strong predictive performance. By facilitating both prediction and interpretability, CAPRI-CT provides actionable insights that could help radiologists and technicians design more efficient CT protocols without repeated physical scans. The source code and dataset are publicly available at https://github.com/SnehaGeorge22/capri-ct.

Foundation models have recently gained tremendous popularity in medical image analysis. State-of-the-art methods leverage either paired image-text data via vision-language pre-training or unpaired image data via self-supervised pre-training to learn foundation models with generalizable image features to boost downstream task performance. However, learning foundation models exclusively on either paired or unpaired image data limits their ability to learn richer and more comprehensive image features. In this paper, we investigate a novel task termed semi-supervised vision-language pre-training, aiming to fully harness the potential of both paired and unpaired image data for foundation model learning. To this end, we propose MaskedCLIP, a synergistic masked image modeling and contrastive language-image pre-training framework for semi-supervised vision-language pre-training. The key challenge in combining paired and unpaired image data for learning a foundation model lies in the incompatible feature spaces derived from these two types of data. To address this issue, we propose to connect the masked feature space with the CLIP feature space with a bridge transformer. In this way, the more semantic specific CLIP features can benefit from the more general masked features for semantic feature extraction. We further propose a masked knowledge distillation loss to distill semantic knowledge of original image features in CLIP feature space back to the predicted masked image features in masked feature space. With this mutually interactive design, our framework effectively leverages both paired and unpaired image data to learn more generalizable image features for downstream tasks. Extensive experiments on retinal image analysis demonstrate the effectiveness and data efficiency of our method.

Pseudo-healthy image inpainting is an essential preprocessing step for analyzing pathological brain MRI scans. Most current inpainting methods favor slice-wise 2D models for their high in-plane fidelity, but their independence across slices produces discontinuities in the volume. Fully 3D models alleviate this issue, but their high model capacity demands extensive training data for reliable, high-fidelity synthesis -- often impractical in medical settings. We address these limitations with a hierarchical diffusion framework by replacing direct 3D modeling with two perpendicular coarse-to-fine 2D stages. An axial diffusion model first yields a coarse, globally consistent inpainting; a coronal diffusion model then refines anatomical details. By combining perpendicular spatial views with adaptive resampling, our method balances data efficiency and volumetric consistency. Our experiments show our approach outperforms state-of-the-art baselines in both realism and volumetric consistency, making it a promising solution for pseudo-healthy image inpainting. Code is available at https://github.com/dou0000/3dMRI-Consistent-Inpaint.

Recent advances in deep learning have led to robust automated tools for segmentation of abdominal computed tomography (CT). Meanwhile, segmentation of magnetic resonance imaging (MRI) is substantially more challenging due to the inherent signal variability and the increased effort required for annotating training datasets. Hence, existing approaches are trained on limited sets of MRI sequences, which might limit their generalizability. To characterize the landscape of MRI abdominal segmentation tools, we present here a comprehensive benchmarking of the three state-of-the-art and open-source models: MRSegmentator, MRISegmentator-Abdomen, and TotalSegmentator MRI. Since these models are trained using labor-intensive manual annotation cycles, we also introduce and evaluate ABDSynth, a SynthSeg-based model purely trained on widely available CT segmentations (no real images). More generally, we assess accuracy and generalizability by leveraging three public datasets (not seen by any of the evaluated methods during their training), which span all major manufacturers, five MRI sequences, as well as a variety of subject conditions, voxel resolutions, and fields-of-view. Our results reveal that MRSegmentator achieves the best performance and is most generalizable. In contrast, ABDSynth yields slightly less accurate results, but its relaxed requirements in training data make it an alternative when the annotation budget is limited. The evaluation code and datasets are given for future benchmarking at https://github.com/deepakri201/AbdoBench, along with inference code and weights for ABDSynth.

Recent advances in deep learning have led to robust automated tools for segmentation of abdominal computed tomography (CT). Meanwhile, segmentation of magnetic resonance imaging (MRI) is substantially more challenging due to the inherent signal variability and the increased effort required for annotating training datasets. Hence, existing approaches are trained on limited sets of MRI sequences, which might limit their generalizability. To characterize the landscape of MRI abdominal segmentation tools, we present here a comprehensive benchmarking of the three state-of-the-art and open-source models: MRSegmentator, MRISegmentator-Abdomen, and TotalSegmentator MRI. Since these models are trained using labor-intensive manual annotation cycles, we also introduce and evaluate ABDSynth, a SynthSeg-based model purely trained on widely available CT segmentations (no real images). More generally, we assess accuracy and generalizability by leveraging three public datasets (not seen by any of the evaluated methods during their training), which span all major manufacturers, five MRI sequences, as well as a variety of subject conditions, voxel resolutions, and fields-of-view. Our results reveal that MRSegmentator achieves the best performance and is most generalizable. In contrast, ABDSynth yields slightly less accurate results, but its relaxed requirements in training data make it an alternative when the annotation budget is limited. The evaluation code and datasets are given for future benchmarking at https://github.com/deepakri201/AbdoBench, along with inference code and weights for ABDSynth.