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Advancing Limited-Angle CT Reconstruction Through Diffusion-Based Sinogram Completion

Jiaqi Guo, Santiago Lopez-Tapia, Aggelos K. Katsaggelos

arxiv logopreprintMay 26 2025
Limited Angle Computed Tomography (LACT) often faces significant challenges due to missing angular information. Unlike previous methods that operate in the image domain, we propose a new method that focuses on sinogram inpainting. We leverage MR-SDEs, a variant of diffusion models that characterize the diffusion process with mean-reverting stochastic differential equations, to fill in missing angular data at the projection level. Furthermore, by combining distillation with constraining the output of the model using the pseudo-inverse of the inpainting matrix, the diffusion process is accelerated and done in a step, enabling efficient and accurate sinogram completion. A subsequent post-processing module back-projects the inpainted sinogram into the image domain and further refines the reconstruction, effectively suppressing artifacts while preserving critical structural details. Quantitative experimental results demonstrate that the proposed method achieves state-of-the-art performance in both perceptual and fidelity quality, offering a promising solution for LACT reconstruction in scientific and clinical applications.

tUbe net: a generalisable deep learning tool for 3D vessel segmentation

Holroyd, N. A., Li, Z., Walsh, C., Brown, E. E., Shipley, R. J., Walker-Samuel, S.

biorxiv logopreprintMay 26 2025
Deep learning has become an invaluable tool for bioimage analysis but, while open-source cell annotation software such as cellpose are widely used, an equivalent tool for three-dimensional (3D) vascular annotation does not exist. With the vascular system being directly impacted by a broad range of diseases, there is significant medical interest in quantitative analysis for vascular imaging. However, existing deep learning approaches for this task are specialised to particular tissue types or imaging modalities. We present a new deep learning model for segmentation of vasculature that is generalisable across tissues, modalities, scales and pathologies. To create a generalisable model, a 3D convolutional neural network was trained using data from multiple modalities including optical imaging, computational tomography and photoacoustic imaging. Through this varied training set, the model was forced to learn common features of vessels cross-modality and scale. Following this, the general model was fine-tuned to different applications with a minimal amount of manually labelled ground truth data. It was found that the general model could be specialised to segment new datasets, with a high degree of accuracy, using as little as 0.3% of the volume of that dataset for fine-tuning. As such, this model enables users to produce accurate segmentations of 3D vascular networks without the need to label large amounts of training data.

Deep Learning for Pneumonia Diagnosis: A Custom CNN Approach with Superior Performance on Chest Radiographs

Mehta, A., Vyas, M.

medrxiv logopreprintMay 26 2025
A major global health and wellness issue causing major health problems and death, pneumonia underlines the need of quickly and precisely identifying and treating it. Though imaging technology has advanced, radiologists manual reading of chest X-rays still constitutes the basic method for pneumonia detection, which causes delays in both treatment and medical diagnosis. This study proposes a pneumonia detection method to automate the process using deep learning techniques. The concept employs a bespoke convolutional neural network (CNN) trained on different pneumonia-positive and pneumonia-negative cases from several healthcare providers. Various pre-processing steps were done on the chest radiographs to increase integrity and efficiency before teaching the design. Based on the comparison study with VGG19, ResNet50, InceptionV3, DenseNet201, and MobileNetV3, our bespoke CNN model was discovered to be the most efficient in balancing accuracy, recall, and parameter complexity. It shows 96.5% accuracy and 96.6% F1 score. This study contributes to the expansion of an automated, paired with a reliable, pneumonia finding system, which could improve personal outcomes and increase healthcare efficiency. The full project is available at here.

PolyPose: Localizing Deformable Anatomy in 3D from Sparse 2D X-ray Images using Polyrigid Transforms

Vivek Gopalakrishnan, Neel Dey, Polina Golland

arxiv logopreprintMay 25 2025
Determining the 3D pose of a patient from a limited set of 2D X-ray images is a critical task in interventional settings. While preoperative volumetric imaging (e.g., CT and MRI) provides precise 3D localization and visualization of anatomical targets, these modalities cannot be acquired during procedures, where fast 2D imaging (X-ray) is used instead. To integrate volumetric guidance into intraoperative procedures, we present PolyPose, a simple and robust method for deformable 2D/3D registration. PolyPose parameterizes complex 3D deformation fields as a composition of rigid transforms, leveraging the biological constraint that individual bones do not bend in typical motion. Unlike existing methods that either assume no inter-joint movement or fail outright in this under-determined setting, our polyrigid formulation enforces anatomically plausible priors that respect the piecewise rigid nature of human movement. This approach eliminates the need for expensive deformation regularizers that require patient- and procedure-specific hyperparameter optimization. Across extensive experiments on diverse datasets from orthopedic surgery and radiotherapy, we show that this strong inductive bias enables PolyPose to successfully align the patient's preoperative volume to as few as two X-ray images, thereby providing crucial 3D guidance in challenging sparse-view and limited-angle settings where current registration methods fail.

Improving Medical Reasoning with Curriculum-Aware Reinforcement Learning

Shaohao Rui, Kaitao Chen, Weijie Ma, Xiaosong Wang

arxiv logopreprintMay 25 2025
Recent advances in reinforcement learning with verifiable, rule-based rewards have greatly enhanced the reasoning capabilities and out-of-distribution generalization of VLMs/LLMs, obviating the need for manually crafted reasoning chains. Despite these promising developments in the general domain, their translation to medical imaging remains limited. Current medical reinforcement fine-tuning (RFT) methods predominantly focus on close-ended VQA, thereby restricting the model's ability to engage in world knowledge retrieval and flexible task adaptation. More critically, these methods fall short of addressing the critical clinical demand for open-ended, reasoning-intensive decision-making. To bridge this gap, we introduce \textbf{MedCCO}, the first multimodal reinforcement learning framework tailored for medical VQA that unifies close-ended and open-ended data within a curriculum-driven RFT paradigm. Specifically, MedCCO is initially fine-tuned on a diverse set of close-ended medical VQA tasks to establish domain-grounded reasoning capabilities, and is then progressively adapted to open-ended tasks to foster deeper knowledge enhancement and clinical interpretability. We validate MedCCO across eight challenging medical VQA benchmarks, spanning both close-ended and open-ended settings. Experimental results show that MedCCO consistently enhances performance and generalization, achieving a 11.4\% accuracy gain across three in-domain tasks, and a 5.7\% improvement on five out-of-domain benchmarks. These findings highlight the promise of curriculum-guided RL in advancing robust, clinically-relevant reasoning in medical multimodal language models.

SPARS: Self-Play Adversarial Reinforcement Learning for Segmentation of Liver Tumours

Catalina Tan, Yipeng Hu, Shaheer U. Saeed

arxiv logopreprintMay 25 2025
Accurate tumour segmentation is vital for various targeted diagnostic and therapeutic procedures for cancer, e.g., planning biopsies or tumour ablations. Manual delineation is extremely labour-intensive, requiring substantial expert time. Fully-supervised machine learning models aim to automate such localisation tasks, but require a large number of costly and often subjective 3D voxel-level labels for training. The high-variance and subjectivity in such labels impacts model generalisability, even when large datasets are available. Histopathology labels may offer more objective labels but the infeasibility of acquiring pixel-level annotations to develop tumour localisation methods based on histology remains challenging in-vivo. In this work, we propose a novel weakly-supervised semantic segmentation framework called SPARS (Self-Play Adversarial Reinforcement Learning for Segmentation), which utilises an object presence classifier, trained on a small number of image-level binary cancer presence labels, to localise cancerous regions on CT scans. Such binary labels of patient-level cancer presence can be sourced more feasibly from biopsies and histopathology reports, enabling a more objective cancer localisation on medical images. Evaluating with real patient data, we observed that SPARS yielded a mean dice score of $77.3 \pm 9.4$, which outperformed other weakly-supervised methods by large margins. This performance was comparable with recent fully-supervised methods that require voxel-level annotations. Our results demonstrate the potential of using SPARS to reduce the need for extensive human-annotated labels to detect cancer in real-world healthcare settings.

MedITok: A Unified Tokenizer for Medical Image Synthesis and Interpretation

Chenglong Ma, Yuanfeng Ji, Jin Ye, Zilong Li, Chenhui Wang, Junzhi Ning, Wei Li, Lihao Liu, Qiushan Guo, Tianbin Li, Junjun He, Hongming Shan

arxiv logopreprintMay 25 2025
Advanced autoregressive models have reshaped multimodal AI. However, their transformative potential in medical imaging remains largely untapped due to the absence of a unified visual tokenizer -- one capable of capturing fine-grained visual structures for faithful image reconstruction and realistic image synthesis, as well as rich semantics for accurate diagnosis and image interpretation. To this end, we present MedITok, the first unified tokenizer tailored for medical images, encoding both low-level structural details and high-level clinical semantics within a unified latent space. To balance these competing objectives, we introduce a novel two-stage training framework: a visual representation alignment stage that cold-starts the tokenizer reconstruction learning with a visual semantic constraint, followed by a textual semantic representation alignment stage that infuses detailed clinical semantics into the latent space. Trained on the meticulously collected large-scale dataset with over 30 million medical images and 2 million image-caption pairs, MedITok achieves state-of-the-art performance on more than 30 datasets across 9 imaging modalities and 4 different tasks. By providing a unified token space for autoregressive modeling, MedITok supports a wide range of tasks in clinical diagnostics and generative healthcare applications. Model and code will be made publicly available at: https://github.com/Masaaki-75/meditok.

CardioCoT: Hierarchical Reasoning for Multimodal Survival Analysis

Shaohao Rui, Haoyang Su, Jinyi Xiang, Lian-Ming Wu, Xiaosong Wang

arxiv logopreprintMay 25 2025
Accurate prediction of major adverse cardiovascular events recurrence risk in acute myocardial infarction patients based on postoperative cardiac MRI and associated clinical notes is crucial for precision treatment and personalized intervention. Existing methods primarily focus on risk stratification capability while overlooking the need for intermediate robust reasoning and model interpretability in clinical practice. Moreover, end-to-end risk prediction using LLM/VLM faces significant challenges due to data limitations and modeling complexity. To bridge this gap, we propose CardioCoT, a novel two-stage hierarchical reasoning-enhanced survival analysis framework designed to enhance both model interpretability and predictive performance. In the first stage, we employ an evidence-augmented self-refinement mechanism to guide LLM/VLMs in generating robust hierarchical reasoning trajectories based on associated radiological findings. In the second stage, we integrate the reasoning trajectories with imaging data for risk model training and prediction. CardioCoT demonstrates superior performance in MACE recurrence risk prediction while providing interpretable reasoning processes, offering valuable insights for clinical decision-making.

CDPDNet: Integrating Text Guidance with Hybrid Vision Encoders for Medical Image Segmentation

Jiong Wu, Yang Xing, Boxiao Yu, Wei Shao, Kuang Gong

arxiv logopreprintMay 25 2025
Most publicly available medical segmentation datasets are only partially labeled, with annotations provided for a subset of anatomical structures. When multiple datasets are combined for training, this incomplete annotation poses challenges, as it limits the model's ability to learn shared anatomical representations among datasets. Furthermore, vision-only frameworks often fail to capture complex anatomical relationships and task-specific distinctions, leading to reduced segmentation accuracy and poor generalizability to unseen datasets. In this study, we proposed a novel CLIP-DINO Prompt-Driven Segmentation Network (CDPDNet), which combined a self-supervised vision transformer with CLIP-based text embedding and introduced task-specific text prompts to tackle these challenges. Specifically, the framework was constructed upon a convolutional neural network (CNN) and incorporated DINOv2 to extract both fine-grained and global visual features, which were then fused using a multi-head cross-attention module to overcome the limited long-range modeling capability of CNNs. In addition, CLIP-derived text embeddings were projected into the visual space to help model complex relationships among organs and tumors. To further address the partial label challenge and enhance inter-task discriminative capability, a Text-based Task Prompt Generation (TTPG) module that generated task-specific prompts was designed to guide the segmentation. Extensive experiments on multiple medical imaging datasets demonstrated that CDPDNet consistently outperformed existing state-of-the-art segmentation methods. Code and pretrained model are available at: https://github.com/wujiong-hub/CDPDNet.git.

CDPDNet: Integrating Text Guidance with Hybrid Vision Encoders for Medical Image Segmentation

Jiong Wu, Yang Xing, Boxiao Yu, Wei Shao, Kuang Gong

arxiv logopreprintMay 25 2025
Most publicly available medical segmentation datasets are only partially labeled, with annotations provided for a subset of anatomical structures. When multiple datasets are combined for training, this incomplete annotation poses challenges, as it limits the model's ability to learn shared anatomical representations among datasets. Furthermore, vision-only frameworks often fail to capture complex anatomical relationships and task-specific distinctions, leading to reduced segmentation accuracy and poor generalizability to unseen datasets. In this study, we proposed a novel CLIP-DINO Prompt-Driven Segmentation Network (CDPDNet), which combined a self-supervised vision transformer with CLIP-based text embedding and introduced task-specific text prompts to tackle these challenges. Specifically, the framework was constructed upon a convolutional neural network (CNN) and incorporated DINOv2 to extract both fine-grained and global visual features, which were then fused using a multi-head cross-attention module to overcome the limited long-range modeling capability of CNNs. In addition, CLIP-derived text embeddings were projected into the visual space to help model complex relationships among organs and tumors. To further address the partial label challenge and enhance inter-task discriminative capability, a Text-based Task Prompt Generation (TTPG) module that generated task-specific prompts was designed to guide the segmentation. Extensive experiments on multiple medical imaging datasets demonstrated that CDPDNet consistently outperformed existing state-of-the-art segmentation methods. Code and pretrained model are available at: https://github.com/wujiong-hub/CDPDNet.git.
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