Testis size is known to be one of the main predictors of male fertility, usually assessed in clinical workup via palpation or imaging. Despite its potential, population-level evaluation of testicular volume using imaging remains underexplored. Previous studies, limited by small and biased datasets, have demonstrated the feasibility of machine learning for testis volume segmentation. This paper presents an evaluation of segmentation methods for testicular volume using Magnetic Resonance Imaging data from the UKBiobank. The best model achieves a median dice score of 0.89, compared to median dice score of 0.85 for human interrater reliability on the same dataset, enabling large-scale annotation on a population scale for the first time. Our overall aim is to provide a trained model, comparative baseline methods, and annotated training data to enhance accessibility and reproducibility in testis MRI segmentation research.

High-Intensity Focused Ultrasound (HIFU) ablation has emerged as a non-invasive treatment option for uterine fibroids that preserves fertility and offers faster recovery. Pre-intervention prediction of HIFU efficacy can augment clinical decision-making and patient management. This systematic review and meta-analysis aims to evaluate the performance of MRI-based radiomics machine learning (ML) models in predicting the efficacy of HIFU ablation in uterine fibroids. Studies were retrieved by conducting a thorough literature search across databases including PubMed, Scopus, Embase, and Web of Science, up to June 2025. The quality of the included studies was assessed using the QUADAS-2 and METRICS tools. A meta-analysis of the radiomics models was conducted to pool sensitivity, specificity, and AUC using a bivariate random-effects model. A total of 13 studies were incorporated in the systematic review and meta-analysis. Meta-analysis of 608 patients from 7 internal and 6 external validation cohorts showed pooled AUC, sensitivity, and specificity of 0.84, 77%, and 78%, respectively. QUADAS-2 was notable for significant methodological biases in the index test and flow and timing domains. Across all studies, the mean METRICS score was 76.93%-with a range of 54.9%-90.3%-denoting good overall quality and performance in most domains but with notable gaps in the open science domain. MRI-based radiomics models show promise in predicting the effectiveness of HIFU ablation for uterine fibroids. However, limitations such as limited geographic diversity, inconsistent reporting standards, and poor open science practices hinder broader application. Therefore, future research should focus on standardizing imaging protocols, using multi-center designs with external validation, and integrating diverse data sources.

Cancer is a leading, highly complex, and deadly disease that has become a major concern in modern medicine. Hepatocellular carcinoma is the most common primary liver cancer and a leading cause of global cancer mortality. Its development is predominantly associated with chronic liver diseases such as hepatitis B and C infections, cirrhosis, alcohol consumption, and non-alcoholic fatty liver disease. Molecular mechanisms underlying HCC involve genetic mutations, epigenetic changes, and disrupted signalling pathways, including Wnt/β-catenin and PI3K/AKT/mTOR. Early diagnosis remains challenging, as most cases are detected at advanced stages, limiting curative treatment options. Diagnostic advancements, including biomarkers like alpha-fetoprotein and cutting-edge imaging techniques such as CT, MRI, and ultrasound-based radiomics, have improved early detection. Treatment strategies depend on the disease stage, ranging from curative options like surgical resection and liver transplantation to palliative therapies, including transarterial chemoembolization, systemic therapies, and immunotherapy. Immune checkpoint inhibitors targeting PD-1/PD-L1 and CTLA-4 have shown promise for advanced HCC. In this review we discuss about emerging technologies, including artificial intelligence and multi-omics platforms for HCC management by enhancing diagnostic accuracy, identifying novel therapeutic targets, and enabling personalized treatments. Despite these advancements, the prognosis for HCC patients remains poor, underscoring the need for continued research into early detection, innovative therapies, and translational applications to effectively address this global health challenge.

Medical image segmentation is a critical task for the early detection and diagnosis of various conditions, such as skin cancer, polyps, thyroid nodules, and pancreatic tumors. Recently, deep learning architectures have achieved significant success in this field. However, they face a critical trade-off between local feature extraction and global context modeling. To address this limitation, we present DCM-Net, a dual-encoder architecture that integrates pretrained CNN layers with Visual State Space (VSS) blocks through a Cross-Branch Feature Fusion Module (CBFFM). A Decoder Feature Enhancement Module (DFEM) combines depth-wise separable convolutions with MLP-based semantic rectification to extract enhanced decoded features and improve the segmentation performance. Additionally, we present a new 2D pancreas and pancreatic tumor dataset (CCH-PCT-CT) collected from Chongqing University Cancer Hospital, comprising 3,547 annotated CT slices, which is used to validate the proposed model. The proposed DCM-Net architecture achieves competitive performance across all datasets investigated in this study. We develop a novel DCM-Net architecture that generates robust features for tumor and organ segmentation in medical images. DCM-Net significantly outperforms all baseline models in segmentation tasks, with higher Dice Similarity Coefficient (DSC) and mean Intersection over Union (mIoU) scores. Its robustness confirms strong potential for clinical use.

Breast cancer is one of the most prevalent malignancies among women worldwide and remains a major public health concern. Accurate classification of breast tumor subtypes is essential for guiding treatment decisions and improving patient outcomes. However, existing deep learning methods for histopathological image analysis often face limitations in balancing classification accuracy with computational efficiency, while failing to fully exploit the deep semantic features in complex tumor images. We developed 3DSN-net, a dual-attention interaction network for multiclass breast tumor classification. The model combines two complementary strategies: (i) spatial–channel attention mechanisms to strengthen the representation of discriminative features, and (ii) deformable convolutional layers to capture fine-grained structural variations in histopathological images. To further improve efficiency, a lightweight attention component was introduced to support stable gradient propagation and multi-scale feature fusion Experimental findings demonstrate that 3DSN-net consistently outperforms competing methods in both accuracy and robustness while maintaining favorable computational efficiency. The model effectively distinguishes benign and malignant tumors as well as multiple subtypes, highlighting the advantages of combining spatial–channel attention with deformable feature modeling. The model was trained and evaluated on two histopathological datasets, BreakHis and BCPSD, and benchmarked against several state-of-the-art CNN and Transformer-based approaches under identical experimental conditions. Experimental results show that 3DSN-net consistently outperforms baseline CNN and Transformer models, achieving 92%–100% accuracy for benign tumors and 86%–99% for malignant tumors, with error rates below 8%. On average, it improves classification accuracy by 3%–5% and ROC-AUC by 0.02 to 0.04 compared with state-of-the-art methods, while maintaining competitive computational efficiency. By enhancing the interaction between spatial and channel attention mechanisms, the model effectively distinguishes breast cancer subtypes, with only a slight reduction in classification speed on larger datasets due to increased data complexity. This study presents 3DSN-net as a reliable and effective framework for breast tumor classification from histopathological images. Beyond methodological improvements, the enhanced diagnostic performance has direct clinical implications, offering potential to reduce misclassification, assist pathologists in decision-making, and improve patient outcomes. The approach can also be extended to other medical imaging tasks. Future work will focus on optimizing computational efficiency and validating generalizability across larger, multi-center datasets. The online version contains supplementary material available at 10.1186/s12880-025-01936-2.

In breast magnetic resonance imaging (MRI), the differentiation between benign and malignant breast masses relies on the Breast Imaging Reporting and Data System Magnetic Resonance Imaging (BI-RADS-MRI) lexicon. While BI-RADS-MRI classification demonstrates high sensitivity, specificities vary. This study aimed to evaluate the feasibility of machine learning models utilizing radiomics features derived from synthetic MRI to distinguish benign from malignant breast masses. Patients who underwent breast MRI, including a multi-dynamic multi-echo (MDME) sequence using 3.0 T MRI, and had histopathologically diagnosed enhanced breast mass lesions were retrospectively included. Clinical features, lesion shape features, texture features, and textural evaluation metrics were extracted. Machine learning models were trained and evaluated, and an ensemble model integrating BI-RADS and the machine learning model was also assessed. A total of 199 lesions (48 benign, 151 malignant) in 199 patients were included in the cross-validation dataset, while 43 lesions (15 benign, 28 malignant) in 40 new patients were included in the test dataset. For the test dataset, the sensitivity, specificity, accuracy, and area under the curve (AUC) of the receiver operating characteristic for BI-RADS were 100%, 33.3%, 76.7%, and 0.667, respectively. The logistic regression model yielded 64.3% sensitivity, 80.0% specificity, 69.8% accuracy, and an AUC of 0.707. The ensemble model achieved 82.1% sensitivity, 86.7% specificity, 83.7% accuracy, and an AUC of 0.883. The AUC of the ensemble model was significantly larger than that of both BI-RADS and the machine learning model. The ensemble model integrating BI-RADS and machine learning improved lesion classification. The online version contains supplementary material available at 10.1186/s12880-025-01930-8.

To develop and validate radiomics and deep learning models based on Gd-EOB-DTPA enhanced MRI for differentiation between hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH) showing iso- or hyperintensity in the hepatobiliary phase (HBP). 112 patients from three hospitals were collected totally. 84 patients from hospital a and b with 54 HCCs and 30 FNHs randomly divided into a training cohort (<i>n</i> = 59: 38 HCC; 21 FNH) and an internal validation cohort (<i>n</i> = 25: 16 HCC; 9 FNH). A total of 28 patients from hospital c (<i>n</i> = 28: 20 HCC; 8 FNH) acted as an external test cohort. 1781 radiomics features were extracted from tumor volumes of interest (VOIs) in the pre-contrast phase (Pre), arterial phase (AP), portal venous phase (PP) and HBP images. 512 deep learning features were extracted from VOIs in the AP, PP and HBP images. Pearson correlation coefficient (PCC) and analysis of variance (ANOVA) were used to select the useful features. Conventional, delta radiomics and deep learning models were established using machine learning algorithms (support vector machine [SVM] and logistic regression [LR]) and their discriminatory efficacy assessed and compared. The combined deep learning models demonstrated the highest diagnostic performance in both the internal validation and external test cohorts, with area under the curve (AUC) values of 0.965 (95% confidence interval [CI]: 0.906, 1.000) and 0.851 (95% CI: 0.620, 1.000) respectively. The conventional and delta radiomics models achieved AUCs of 0.944 (95% CI: 0.779–0.979) and 0.938 (95% CI: 0.836–1.000) respectively, which were not significantly different from the deep learning models or each other (<i>P</i> = 0.559, 0.256, and 0.137). The combined deep learning models based on Gd-EOB-DTPA enhanced MRI may be useful for discriminating HCC from FNH showing iso-or hyperintensity in the HBP. The online version contains supplementary material available at 10.1186/s12880-025-01927-3.

Late radiation-associated dysphagia after head and neck cancer (HNC) significantly impacts patient's health and quality of life. Conventional normal tissue complication probability (NTCP) models use discrete dose parameters to predict toxicity risk but fail to fully capture the complexity of this side effect. Deep learning (DL) offers potential improvements by incorporating 3D dose data for all anatomical structures involved in swallowing. This study aims to enhance dysphagia prediction with 3D DL NTCP models compared to conventional NTCP models. A multi-institutional cohort of 1484 HNC patients was used to train and validate a 3D DL model (Residual Network) incorporating 3D dose distributions, organ-at-risk segmentations, and CT scans, with or without patient- or treatment-related data. Predictions of grade ≥ 2 dysphagia (CTCAEv4) at six months post-treatment were evaluated using area under the curve (AUC) and calibration curves. Results were compared to a conventional NTCP model based on pre-treatment dysphagia, tumour location, and mean dose to swallowing organs. Attention maps highlighting regions of interest for individual patients were assessed. DL models outperformed the conventional NTCP model in both the independent test set (AUC = 0.80-0.84 versus 0.76) and external test set (AUC = 0.73-0.74 versus 0.63) in AUC and calibration. Attention maps showed a focus on the oral cavity and superior pharyngeal constrictor muscle. DL NTCP models performed significantly better than the conventional NTCP model, suggesting the benefit of using 3D-input over the conventional discrete dose parameters. Attention maps highlighted relevant regions linked to dysphagia, supporting the utility of DL for improved predictions.

Osteoporosis silently erodes skeletal integrity worldwide; however, early detection through imaging can prevent most fragility fractures. Artificial intelligence (AI) methods now mine routine Dual-energy X-ray Absorptiometry (DXA), X-ray, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI) scans for subtle, clinically actionable markers, but the literature is fragmented. This survey unifies the field through a tri-axial framework that couples imaging modalities with clinical tasks and AI methodologies (classical machine learning, convolutional neural networks (CNNs), transformers, self-supervised learning, and explainable AI). Following a concise clinical and technical primer, we detail our Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided search strategy, introduce the taxonomy via a roadmap figure, and synthesize cross-study insights on data scarcity, external validation, and interpretability. By identifying emerging trends, open challenges, and actionable research directions, this review provides AI scientists, medical imaging researchers, and musculoskeletal clinicians with a clear compass to accelerate rigorous, patient-centered innovation in osteoporosis care. The project page of this survey can also be found on Github.

We present Causal-Adapter, a modular framework that adapts frozen text-to-image diffusion backbones for counterfactual image generation. Our method enables causal interventions on target attributes, consistently propagating their effects to causal dependents without altering the core identity of the image. In contrast to prior approaches that rely on prompt engineering without explicit causal structure, Causal-Adapter leverages structural causal modeling augmented with two attribute regularization strategies: prompt-aligned injection, which aligns causal attributes with textual embeddings for precise semantic control, and a conditioned token contrastive loss to disentangle attribute factors and reduce spurious correlations. Causal-Adapter achieves state-of-the-art performance on both synthetic and real-world datasets, with up to 91% MAE reduction on Pendulum for accurate attribute control and 87% FID reduction on ADNI for high-fidelity MRI image generation. These results show that our approach enables robust, generalizable counterfactual editing with faithful attribute modification and strong identity preservation.