To construct a pathomics-based machine learning model to enhance the diagnostic efficacy of LungPro navigational bronchoscopy for peripheral pulmonary lesions and to optimize the management strategy for LungPro-diagnosed negative lesions. Clinical data and hematoxylin and eosin (H&E)-stained whole slide images (WSIs) were collected from 144 consecutive patients undergoing LungPro virtual bronchoscopy at a single institution between January 2022 and December 2023. Patients were stratified into diagnosis-positive and diagnosis-negative cohorts based on histopathological or etiological confirmation. An artificial intelligence (AI) model was developed and validated using 94 diagnosis-positive cases. Logistic regression (LR) identified associations between clinical/imaging characteristics and malignant pulmonary lesion risk factors. We implemented a convolutional neural network (CNN) with weakly supervised learning to extract image-level features, followed by multiple instance learning (MIL) for patient-level feature aggregation. Multiple machine learning (ML) algorithms were applied to model the extracted features. A multimodal diagnostic framework integrating clinical, imaging, and pathomics data were subsequently developed and evaluated on 50 LungPro-negative patients to assess the framework's diagnostic performance and predictive validity. Univariable and multivariable logistic regression analyses identified that age, lesion boundary and mean computed tomography (CT) attenuation were independent risk factors for malignant peripheral pulmonary lesions (P < 0.05). A histopathological model using a MIL fusion strategy showed strong diagnostic performance for lung cancer, with area under the curve (AUC) values of 0.792 (95% CI 0.680-0.903) in the training cohort and 0.777 (95% CI 0.531-1.000) in the test cohort. Combining predictive clinical features with pathological characteristics enhanced diagnostic yield for peripheral pulmonary lesions to 0.848 (95% CI 0.6945-1.0000). In patients with initially negative LungPro biopsy results, the model identified 20 of 28 malignant lesions (sensitivity: 71.43%) and 15 of 22 benign lesions (specificity: 68.18%). Class activation mapping (CAM) validated the model by highlighting key malignant features, including conspicuous nucleoli and nuclear atypia. The fusion diagnostic model that incorporates clinical and pathomic features markedly enhances the diagnostic accuracy of LungPro in this retrospective cohort. This model aids in the detection of subtle malignant characteristics, thereby offering evidence to support precise and targeted therapeutic interventions for lesions that LungPro classifies as negative in clinical settings.

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.

Accurate classification of anatomical regions in computed tomography (CT) scans is essential for optimizing downstream diagnostic and analytic workflows in medical imaging. We demonstrate the high performance that deep learning (DL) algorithms can achieve in the classification of whole-body parts in CT images acquired under various protocols. Our model was trained using a dataset consisting of 5485 anonymized neuroimaging informatics technology initiative (NIFTI) CT scans collected from 45 different health centers. The dataset was split into 3290 scans for training, 1097 scans for validation, and 1098 scans for testing. Each body CT scan was classified into six distinct classes covering the whole body: chest, abdomen, pelvis, chest and abdomen, abdomen and pelvis, and chest and abdomen and pelvis. The performance of the DL model stood at an accuracy, precision, recall, and F1-score of 97.53% (95% CI: 96.62%, 98.45%), 97.56% (95% CI: 96.6%, 98.4%), 97.6% (95% CI: 96.7%, 98.5%), and 97.56% (96.6%, 98.4%), respectively, in identifying different body parts. These findings demonstrate the strength of our approach in annotating CT images through a wide variation in both acquisition protocols and patient demographics. This study underlines the potential that DL holds for medical imaging and, in particular, for the automation of body region classification in CT. Our findings confirm that these models could be implemented in clinical routines to improve diagnostic efficiency and harmony.

Headaches are a nearly universal human experience traditionally diagnosed based solely on symptoms. Recent advances in imaging techniques and artificial intelligence (AI) have enabled the development of automated headache detection systems, which can enhance clinical diagnosis, especially when symptom-based evaluations are insufficient. Current AI models often require extensive data, limiting their clinical applicability where data availability is low. However, deep learning models, particularly pre-trained ones and fine-tuned with smaller, targeted datasets can potentially overcome this limitation. By leveraging BioMedCLIP, a pre-trained foundational model combining a vision transformer (ViT) image encoder with PubMedBERT text encoder, we fine-tuned the pre-trained ViT model for the specific purpose of classifying headaches and detecting biomarkers from brain MRI data. The dataset consisted of 721 individuals: 424 healthy controls (HC) from the IXI dataset and 297 local participants, including migraine sufferers (n = 96), individuals with acute post-traumatic headache (APTH, n = 48), persistent post-traumatic headache (PPTH, n = 49), and additional HC (n = 104). The model achieved high accuracy across multiple balanced test sets, including 89.96% accuracy for migraine versus HC, 88.13% for APTH versus HC, and 83.13% for PPTH versus HC, all validated through five-fold cross-validation for robustness. Brain regions identified by Gradient-weighted Class Activation Mapping analysis as responsible for migraine classification included the postcentral cortex, supramarginal gyrus, superior temporal cortex, and precuneus cortex; for APTH, rostral middle frontal and precentral cortices; and, for PPTH, cerebellar cortex and precentral cortex. To our knowledge, this is the first study to leverage a multimodal biomedical foundation model in the context of headache classification and biomarker detection using structural MRI, offering complementary insights into the causes and brain changes associated with headache disorders.

The COVID-19 pandemic has been the most catastrophic global health emergency of the [Formula: see text] century, resulting in hundreds of millions of reported cases and five million deaths. Chest X-ray (CXR) images are highly valuable for early detection of lung diseases in monitoring and investigating pulmonary disorders such as COVID-19, pneumonia, and tuberculosis. These CXR images offer crucial features about the lung's health condition and can assist in making accurate diagnoses. Manual interpretation of CXR images is challenging even for expert radiologists due to the overlapping radiological features. Therefore, Artificial Intelligence (AI) based image processing took over the charge in healthcare. But still it is uncertain to trust the prediction results by an AI model. However, this can be resolved by implementing explainable artificial intelligence (XAI) tools that transform a black-box AI into a glass-box model. In this research article, we have proposed a novel XAI-TRANS model with inception based transfer learning addressing the challenge of overlapping features in multiclass classification of CXR images. Also, we proposed an improved U-Net Lung segmentation dedicated to obtaining the radiological features for classification. The proposed approach achieved a maximum precision of 98% and accuracy of 97% in multiclass lung disease classification. By leveraging XAI techniques with the evident improvement of 4.75%, specifically LIME and Grad-CAM, to provide detailed and accurate explanations for the model's prediction.

In the evolving field of healthcare, centralized cloud-based medical image retrieval faces challenges related to security, availability, and adversarial threats. Existing deep learning-based solutions improve retrieval but remain vulnerable to adversarial attacks and quantum threats, necessitating a shift to more secure distributed cloud solutions. This article proposes SFMedIR, a secure and fault tolerant medical image retrieval framework that contains an adversarial attack-resistant federated learning for hashcode generation, utilizing a ConvNeXt-based model to improve accuracy and generalizability. The framework integrates quantum-chaos-based encryption for security, dynamic threshold-based shadow storage for fault tolerance, and a distributed cloud architecture to mitigate single points of failure. Unlike conventional methods, this approach significantly improves security and availability in cloud-based medical image retrieval systems, providing a resilient and efficient solution for healthcare applications. The framework is validated on Brain MRI and Kidney CT datasets, achieving a 60-70% improvement in retrieval accuracy for adversarial queries and an overall 90% retrieval accuracy, outperforming existing models by 5-10%. The results demonstrate superior performance in terms of both security and retrieval efficiency, making this framework a valuable contribution to the future of secure medical image management.

Deep learning has significantly advanced the field of computer vision; however, developing models that generalize effectively across diverse image domains remains a major research challenge. In this study, we introduce DeepFreqNet, a novel deep neural architecture specifically designed for high-performance multi-domain image classification. The innovative aspect of DeepFreqNet lies in its combination of three powerful components: multi-scale feature extraction for capturing patterns at different resolutions, depthwise separable convolutions for enhanced computational efficiency, and residual connections to maintain gradient flow and accelerate convergence. This hybrid design improves the architecture's ability to learn discriminative features and ensures scalability across domains with varying data complexities. Unlike traditional transfer learning models, DeepFreqNet adapts seamlessly to diverse datasets without requiring extensive reconfiguration. Experimental results from nine benchmark datasets, including MRI tumor classification, blood cell classification, and sign language recognition, demonstrate superior performance, achieving classification accuracies between 98.96% and 99.97%. These results highlight the effectiveness and versatility of DeepFreqNet, showcasing a significant improvement over existing state-of-the-art methods and establishing it as a robust solution for real-world image classification challenges.

To develop a hybrid fusion model-deep learning radiomics nomograms (DLRN), integrating radiomics and transfer learning for assisting sonographers differentiate benign and malignant parotid gland tumors. This study retrospectively analyzed a total of 328 patients with pathologically confirmed parotid gland tumors from two centers. Radiomics features extracted from ultrasound images were input into eight machine learning classifiers to construct Radiomics (Rad) model. Additionally, images were also input into seven transfer learning networks to construct deep transfer learning (DTL) model. The prediction probabilities from these two models were combined through decision fusion to construct a DLR model. Clinical features were further integrated with the prediction probabilities of the DLR model to develop the DLRN model. The performance of these models was evaluated using receiver operating characteristic curve analysis, calibration curve, decision curve analysis and the Hosmer-Lemeshow test. In the internal and external validation cohorts, compared with Clinic (AUC = 0.891 and 0.734), Rad (AUC = 0.809 and 0.860), DTL (AUC = 0.905 and 0.782) and DLR (AUC = 0.932 and 0.828), the DLRN model demonstrated the greatest discriminative ability (AUC = 0.931 and 0.934), showing the best discriminative power. With the assistance of DLR, the diagnostic accuracy of resident, attending and chief physician increased by 6.6%, 6.5% and 1.2%, respectively. The hybrid fusion model DLRN significantly enhances the diagnostic performance for benign and malignant tumors of the parotid gland. It can effectively assist sonographers in making more accurate diagnoses.

Recent advances in vision-language models (VLMs) have achieved remarkable performance on standard medical benchmarks, yet their true clinical reasoning ability remains unclear. Existing datasets predominantly emphasize classification accuracy, creating an evaluation illusion in which models appear proficient while still failing at high-stakes diagnostic reasoning. We introduce Neural-MedBench, a compact yet reasoning-intensive benchmark specifically designed to probe the limits of multimodal clinical reasoning in neurology. Neural-MedBench integrates multi-sequence MRI scans, structured electronic health records, and clinical notes, and encompasses three core task families: differential diagnosis, lesion recognition, and rationale generation. To ensure reliable evaluation, we develop a hybrid scoring pipeline that combines LLM-based graders, clinician validation, and semantic similarity metrics. Through systematic evaluation of state-of-the-art VLMs, including GPT-4o, Claude-4, and MedGemma, we observe a sharp performance drop compared to conventional datasets. Error analysis shows that reasoning failures, rather than perceptual errors, dominate model shortcomings. Our findings highlight the necessity of a Two-Axis Evaluation Framework: breadth-oriented large datasets for statistical generalization, and depth-oriented, compact benchmarks such as Neural-MedBench for reasoning fidelity. We release Neural-MedBench at https://neuromedbench.github.io/ as an open and extensible diagnostic testbed, which guides the expansion of future benchmarks and enables rigorous yet cost-effective assessment of clinically trustworthy AI.