Federated learning (FL) allows collaborative model training across healthcare sites without sharing sensitive patient data. However, real-world FL deployment is often hindered by complex operational challenges that demand substantial human efforts. This includes: (a) selecting appropriate clients (hospitals), (b) coordinating between the central server and clients, (c) client-level data pre-processing, (d) harmonizing non-standardized data and labels across clients, and (e) selecting FL algorithms based on user instructions and cross-client data characteristics. However, the existing FL works overlook these practical orchestration challenges. These operational bottlenecks motivate the need for autonomous, agent-driven FL systems, where intelligent agents at each hospital client and the central server agent collaboratively manage FL setup and model training with minimal human intervention. To this end, we first introduce an agent-driven FL framework that captures key phases of real-world FL workflows from client selection to training completion and a benchmark dubbed FedAgentBench that evaluates the ability of LLM agents to autonomously coordinate healthcare FL. Our framework incorporates 40 FL algorithms, each tailored to address diverse task-specific requirements and cross-client characteristics. Furthermore, we introduce a diverse set of complex tasks across 201 carefully curated datasets, simulating 6 modality-specific real-world healthcare environments, viz., Dermatoscopy, Ultrasound, Fundus, Histopathology, MRI, and X-Ray. We assess the agentic performance of 14 open-source and 10 proprietary LLMs spanning small, medium, and large model scales. While some agent cores such as GPT-4.1 and DeepSeek V3 can automate various stages of the FL pipeline, our results reveal that more complex, interdependent tasks based on implicit goals remain challenging for even the strongest models.

To evaluate the predictive performance of a clinical-CT-radiomics nomogram based on radiomics signature and independent clinical-CT predictors for predicting endoscopic red color sign (RC) in cirrhotic patients with esophageal varices (EV). We retrospectively evaluated 215 cirrhotic patients. Among them, 108 and 107 cases were positive and negative for endoscopic RC, respectively. Patients were assigned to a training cohort (n = 150) and a validation cohort (n = 65) at a 7:3 ratio. In the training cohort, univariate and multivariate logistic regression analyses were performed on clinical and CT features to develop a clinical-CT model. Radiomic features were extracted from portal venous phase CT images to generate a Radiomic score (Rad-score) and to construct five machine learning models. A combined model was built using clinical-CT predictors and Rad-score through logistic regression. The performance of different models was evaluated using the receiver operating characteristic (ROC) curves and the area under the curve (AUC). The spleen-to-platelet ratio, liver volume, splenic vein diameter, and superior mesenteric vein diameter were independent predictors. Six radiomics features were selected to construct five machine learning models. The adaptive boosting model showed excellent predictive performance, achieving an AUC of 0.964 in the validation cohort, while the combined model achieved the highest predictive accuracy with an AUC of 0.985 in the validation cohort. The clinical-CT-radiomics nomogram demonstrates high predictive accuracy for endoscopic RC in cirrhotic patients with EV, which provides a novel tool for non-invasive prediction of esophageal varices bleeding.

Interstitial lung disease (ILD) is a leading cause of morbidity and mortality in systemic sclerosis (SSc). Chest computed tomography (CT) is the primary imaging modality for diagnosing and monitoring lung complications in SSc patients. However, its role in disease progression and mortality prediction has not yet been fully clarified. This study introduces a novel, large-scale longitudinal chest CT analysis framework that utilizes radiomics and deep learning to predict mortality associated with lung complications of SSc. We collected and analyzed 2,125 CT scans from SSc patients enrolled in the Northwestern Scleroderma Registry, conducting mortality analyses at one, three, and five years using advanced imaging analysis techniques. Death labels were assigned based on recorded deaths over the one-, three-, and five-year intervals, confirmed by expert physicians. In our dataset, 181, 326, and 428 of the 2,125 CT scans were from patients who died within one, three, and five years, respectively. Using ResNet-18, DenseNet-121, and Swin Transformer we use pre-trained models, and fine-tuned on 2,125 images of SSc patients. Models achieved an AUC of 0.769, 0.801, 0.709 for predicting mortality within one-, three-, and five-years, respectively. Our findings highlight the potential of both radiomics and deep learning computational methods to improve early detection and risk assessment of SSc-related interstitial lung disease, marking a significant advancement in the literature.

Traditional brain connectivity studies have focused mainly on structural connectivity, often relying on tractography with diffusion MRI (dMRI) to reconstruct white matter pathways. In parallel, studies of functional connectivity have examined correlations in brain activity using fMRI. However, emerging methodologies are advancing our understanding of brain networks. Here we explore advanced connectivity approaches beyond conventional tractography, focusing on dMRI morphometry and the integration of structural and functional connectivity analysis. dMRI morphometry enables quantitative assessment of white matter pathway volumes through statistical comparison with normative populations, while functional connectivity reveals network organization that is not restricted to direct anatomical connections. More recently, approaches that combine diffusion tensor imaging (DTI) with functional correlation tensor (FCT) analysis have been introduced, and these complementary methods provide new perspectives into brain structure-function relationships. Together, such approaches have important implications for neurodevelopmental and neurological disorders as well as brain plasticity. The integration of these methods with artificial intelligence techniques have the potential to support both basic neuroscience research and clinical applications.

Inferior alveolar nerve (IAN) injury is a critical complication of mandibular third molar extraction. This study aimed to construct and evaluate a deep learning framework that integrates contrastive learning and Bayesian optimization to enhance predictive performance on cone-beam computed tomography (CBCT) and panoramic radiographs. A retrospective dataset of 902 panoramic radiographs and 1,500 CBCT images was used. Five deep learning architectures (MobileNetV2, ResNet101D, Vision Transformer, Twins-SVT, and SSL-ResNet50) were trained with and without contrastive learning and Bayesian optimization. Model performance was evaluated using accuracy, F1-score, and comparison with oral and maxillofacial surgeons (OMFSs). Contrastive learning significantly improved the F1-scores across all models (e.g., MobileNetV2: 0.302 to 0.740; ResNet101D: 0.188 to 0.689; Vision Transformer: 0.275 to 0.704; Twins-SVT: 0.370 to 0.719; SSL-ResNet50: 0.109 to 0.576). Bayesian optimization further enhanced the F1-scores for MobileNetV2 (from 0.740 to 0.923), ResNet101D (from 0.689 to 0.857), Vision Transformer (from 0.704 to 0.871), Twins-SVT (from 0.719 to 0.857), and SSL-ResNet50 (from 0.576 to 0.875). The AI model outperformed OMFSs on CBCT cross-sectional images (F1-score: 0.923 vs. 0.667) but underperformed on panoramic radiographs (0.666 vs. 0.730). The proposed single-step deep learning approach effectively predicts IAN injury, with contrastive learning addressing data imbalance and Bayesian optimization optimizing model performance. While artificial intelligence surpasses human performance in CBCT images, panoramic radiographs analysis still benefits from expert interpretation. Future work should focus on multi-center validation and explainable artificial intelligence for broader clinical adoption.

Early and accurate diagnosis of Alzheimer Disease is critical for effective clinical intervention, particularly in distinguishing it from Mild Cognitive Impairment, a prodromal stage marked by subtle structural changes. In this study, we propose a hybrid deep learning ensemble framework for Alzheimer Disease classification using structural magnetic resonance imaging. Gray and white matter slices are used as inputs to three pretrained convolutional neural networks such as ResNet50, NASNet, and MobileNet, each fine tuned through an end to end process. To further enhance performance, we incorporate a stacked ensemble learning strategy with a meta learner and weighted averaging to optimally combine the base models. Evaluated on the Alzheimer Disease Neuroimaging Initiative dataset, the proposed method achieves state of the art accuracy of 99.21% for Alzheimer Disease vs. Mild Cognitive Impairment and 91.0% for Mild Cognitive Impairment vs. Normal Controls, outperforming conventional transfer learning and baseline ensemble methods. To improve interpretability in image based diagnostics, we integrate Explainable AI techniques by Gradient weighted Class Activation, which generates heatmaps and attribution maps that highlight critical regions in gray and white matter slices, revealing structural biomarkers that influence model decisions. These results highlight the frameworks potential for robust and scalable clinical decision support in neurodegenerative disease diagnostics.

Convolutional Neural Networks have become a cornerstone of medical image analysis due to their proficiency in learning hierarchical spatial features. However, this focus on a single domain is inefficient at capturing global, holistic patterns and fails to explicitly model an image's frequency-domain characteristics. To address these challenges, we propose the Spatial-Spectral Summarizer Fusion Network (S$^3$F-Net), a dual-branch framework that learns from both spatial and spectral representations simultaneously. The S$^3$F-Net performs a fusion of a deep spatial CNN with our proposed shallow spectral encoder, SpectraNet. SpectraNet features the proposed SpectralFilter layer, which leverages the Convolution Theorem by applying a bank of learnable filters directly to an image's full Fourier spectrum via a computation-efficient element-wise multiplication. This allows the SpectralFilter layer to attain a global receptive field instantaneously, with its output being distilled by a lightweight summarizer network. We evaluate S$^3$F-Net across four medical imaging datasets spanning different modalities to validate its efficacy and generalizability. Our framework consistently and significantly outperforms its strong spatial-only baseline in all cases, with accuracy improvements of up to 5.13%. With a powerful Bilinear Fusion, S$^3$F-Net achieves a SOTA competitive accuracy of 98.76% on the BRISC2025 dataset. Concatenation Fusion performs better on the texture-dominant Chest X-Ray Pneumonia dataset, achieving 93.11% accuracy, surpassing many top-performing, much deeper models. Our explainability analysis also reveals that the S$^3$F-Net learns to dynamically adjust its reliance on each branch based on the input pathology. These results verify that our dual-domain approach is a powerful and generalizable paradigm for medical image analysis.

The anatomical relationship between the maxillary sinus and maxillary molars is critical for planning dental procedures such as tooth extraction, implant placement and periodontal surgery. This study presents a novel artificial intelligence-based approach for the detection and classification of these anatomical relationships in cone beam computed tomography (CBCT) images. The model, developed using advanced image recognition technology, can automatically detect the relationship between the maxillary sinus and adjacent molars with high accuracy. The artificial intelligence algorithm used in our study provided faster and more consistent results compared to traditional manual evaluations, reaching 89% accuracy in the classification of anatomical structures. With this technology, clinicians will be able to more accurately assess the risks of sinus perforation, oroantral fistula and other surgical complications in the maxillary posterior region preoperatively. By reducing the workload associated with CBCT analysis, the system accelerates clinicians' diagnostic process, improves treatment planning and increases patient safety. It also has the potential to assist in the early detection of maxillary sinus pathologies and the planning of sinus floor elevation procedures. These findings suggest that the integration of AI-powered image analysis solutions into daily dental practice can improve clinical decision-making in oral and maxillofacial surgery by providing accurate, efficient and reliable diagnostic support.

Tuberculosis (TB) is a serious infectious disease that remains a global health challenge. While chest X-rays (CXRs) are widely used for TB detection, manual interpretation can be subjective and time-consuming. Automated classification of CXRs into TB and non-TB cases can significantly support healthcare professionals in timely and accurate diagnosis. This paper introduces a hybrid deep learning approach for classifying CXR images. The solution is based on the CoAtNet framework, which combines the strengths of Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs). The model is pre-trained on the large-scale ImageNet dataset to ensure robust generalization across diverse images. The evaluation is conducted on the IN-CXR tuberculosis dataset from ICMR-NIRT, which contains a comprehensive collection of CXR images of both normal and abnormal categories. The hybrid model achieves a binary classification accuracy of 86.39% and an ROC-AUC score of 93.79%, outperforming tested baseline models that rely exclusively on either CNNs or ViTs when trained on this dataset. Furthermore, the integration of Local Interpretable Model-agnostic Explanations (LIME) enhances the interpretability of the model's predictions. This combination of reliable performance and transparent, interpretable results strengthens the model's role in AI-driven medical imaging research. Code will be made available upon request.

The preoperative differentiation of adenocarcinomas in situ, minimally invasive adenocarcinoma, and invasive adenocarcinoma using computed tomography (CT) is crucial for guiding clinical management decisions. However, accurately classifying ground-glass nodules poses a significant challenge. Incorporating quantitative intratumoral heterogeneity scores may improve the accuracy of this ternary classification. In this multicenter retrospective study, we developed ternary classification models by leveraging insights from both base and stacking ensemble machine learning models, incorporating intratumoral heterogeneity scores along with clinical-radiological features to distinguish adenocarcinomas in situ, minimally invasive adenocarcinoma, and invasive adenocarcinoma. The machine learning models were trained, and final model selection depended on maximizing the macro-average area under the curve (macro-AUC) in both the internal and external validation sets. Data from 802 patients from three centers were divided into a training set (n = 477) and an internal test set (n = 205), in a 7:3 ratio, with an additional external validation set comprising 120 patients. The stacking classifier exhibited superior performance relative to the other models, achieving macro-AUC values of 0.7850 and 0.7717 for the internal and external validation sets, respectively. Moreover, an interpretability analysis utilizing the Shapley Additive Explanation identified four key features of this ternary classification: intratumoral heterogeneity score, nodule size, nodule type, and age. The stacking classifier, recognized as the optimal algorithm for integrating the intratumoral heterogeneity score and clinical-radiological features, effectively served as a ternary classification model for assessing the invasiveness of lung adenocarcinoma in chest CT images. Our stacking classifier integrated intratumoral heterogeneity scores and clinical-radiological features to improve the ternary classification of lung adenocarcinoma invasiveness (adenocarcinomas in situ/minimally invasive adenocarcinoma/invasive adenocarcinoma), aiding in precise diagnosis and clinical decision-making for ground-glass nodules. The intratumoral heterogeneity score effectively assessed the invasiveness of lung adenocarcinoma. The stacking classifier outperformed other methods for this ternary classification task. Intratumoral heterogeneity score, nodule size, nodule type, and age predict invasiveness.