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Topology Optimization in Medical Image Segmentation with Fast Euler Characteristic

Liu Li, Qiang Ma, Cheng Ouyang, Johannes C. Paetzold, Daniel Rueckert, Bernhard Kainz

arxiv logopreprintJul 31 2025
Deep learning-based medical image segmentation techniques have shown promising results when evaluated based on conventional metrics such as the Dice score or Intersection-over-Union. However, these fully automatic methods often fail to meet clinically acceptable accuracy, especially when topological constraints should be observed, e.g., continuous boundaries or closed surfaces. In medical image segmentation, the correctness of a segmentation in terms of the required topological genus sometimes is even more important than the pixel-wise accuracy. Existing topology-aware approaches commonly estimate and constrain the topological structure via the concept of persistent homology (PH). However, these methods are difficult to implement for high dimensional data due to their polynomial computational complexity. To overcome this problem, we propose a novel and fast approach for topology-aware segmentation based on the Euler Characteristic ($\chi$). First, we propose a fast formulation for $\chi$ computation in both 2D and 3D. The scalar $\chi$ error between the prediction and ground-truth serves as the topological evaluation metric. Then we estimate the spatial topology correctness of any segmentation network via a so-called topological violation map, i.e., a detailed map that highlights regions with $\chi$ errors. Finally, the segmentation results from the arbitrary network are refined based on the topological violation maps by a topology-aware correction network. Our experiments are conducted on both 2D and 3D datasets and show that our method can significantly improve topological correctness while preserving pixel-wise segmentation accuracy.

Out-of-Distribution Detection in Medical Imaging via Diffusion Trajectories

Lemar Abdi, Francisco Caetano, Amaan Valiuddin, Christiaan Viviers, Hamdi Joudeh, Fons van der Sommen

arxiv logopreprintJul 31 2025
In medical imaging, unsupervised out-of-distribution (OOD) detection offers an attractive approach for identifying pathological cases with extremely low incidence rates. In contrast to supervised methods, OOD-based approaches function without labels and are inherently robust to data imbalances. Current generative approaches often rely on likelihood estimation or reconstruction error, but these methods can be computationally expensive, unreliable, and require retraining if the inlier data changes. These limitations hinder their ability to distinguish nominal from anomalous inputs efficiently, consistently, and robustly. We propose a reconstruction-free OOD detection method that leverages the forward diffusion trajectories of a Stein score-based denoising diffusion model (SBDDM). By capturing trajectory curvature via the estimated Stein score, our approach enables accurate anomaly scoring with only five diffusion steps. A single SBDDM pre-trained on a large, semantically aligned medical dataset generalizes effectively across multiple Near-OOD and Far-OOD benchmarks, achieving state-of-the-art performance while drastically reducing computational cost during inference. Compared to existing methods, SBDDM achieves a relative improvement of up to 10.43% and 18.10% for Near-OOD and Far-OOD detection, making it a practical building block for real-time, reliable computer-aided diagnosis.

DICOM De-Identification via Hybrid AI and Rule-Based Framework for Scalable, Uncertainty-Aware Redaction

Kyle Naddeo, Nikolas Koutsoubis, Rahul Krish, Ghulam Rasool, Nidhal Bouaynaya, Tony OSullivan, Raj Krish

arxiv logopreprintJul 31 2025
Access to medical imaging and associated text data has the potential to drive major advances in healthcare research and patient outcomes. However, the presence of Protected Health Information (PHI) and Personally Identifiable Information (PII) in Digital Imaging and Communications in Medicine (DICOM) files presents a significant barrier to the ethical and secure sharing of imaging datasets. This paper presents a hybrid de-identification framework developed by Impact Business Information Solutions (IBIS) that combines rule-based and AI-driven techniques, and rigorous uncertainty quantification for comprehensive PHI/PII removal from both metadata and pixel data. Our approach begins with a two-tiered rule-based system targeting explicit and inferred metadata elements, further augmented by a large language model (LLM) fine-tuned for Named Entity Recognition (NER), and trained on a suite of synthetic datasets simulating realistic clinical PHI/PII. For pixel data, we employ an uncertainty-aware Faster R-CNN model to localize embedded text, extract candidate PHI via Optical Character Recognition (OCR), and apply the NER pipeline for final redaction. Crucially, uncertainty quantification provides confidence measures for AI-based detections to enhance automation reliability and enable informed human-in-the-loop verification to manage residual risks. This uncertainty-aware deidentification framework achieves robust performance across benchmark datasets and regulatory standards, including DICOM, HIPAA, and TCIA compliance metrics. By combining scalable automation, uncertainty quantification, and rigorous quality assurance, our solution addresses critical challenges in medical data de-identification and supports the secure, ethical, and trustworthy release of imaging data for research.

DiSC-Med: Diffusion-based Semantic Communications for Robust Medical Image Transmission

Fupei Guo, Hao Zheng, Xiang Zhang, Li Chen, Yue Wang, Songyang Zhang

arxiv logopreprintJul 31 2025
The rapid development of artificial intelligence has driven smart health with next-generation wireless communication technologies, stimulating exciting applications in remote diagnosis and intervention. To enable a timely and effective response for remote healthcare, efficient transmission of medical data through noisy channels with limited bandwidth emerges as a critical challenge. In this work, we propose a novel diffusion-based semantic communication framework, namely DiSC-Med, for the medical image transmission, where medical-enhanced compression and denoising blocks are developed for bandwidth efficiency and robustness, respectively. Unlike conventional pixel-wise communication framework, our proposed DiSC-Med is able to capture the key semantic information and achieve superior reconstruction performance with ultra-high bandwidth efficiency against noisy channels. Extensive experiments on real-world medical datasets validate the effectiveness of our framework, demonstrating its potential for robust and efficient telehealth applications.

Precision Medicine in Substance Use Disorders: Integrating Behavioral, Environmental, and Biological Insights.

Guerrin CGJ, Tesselaar DRM, Booij J, Schellekens AFA, Homberg JR

pubmed logopapersJul 31 2025
Substance use disorders (SUD) are chronic, relapsing conditions marked by high variability in treatment response and frequent relapse. This variability arises from complex interactions among behavioral, environmental, and biological factors unique to each individual. Precision medicine, which tailors treatment to patient-specific characteristics, offers a promising avenue to address these challenges. This review explores key factors influencing SUD, including severity, comorbidities, drug use motives, polysubstance use, cognitive impairments, and biological and environmental influences. Advanced neuroimaging, such as MRI and PET, enables patient subtyping by identifying altered brain mechanisms, including reward, relief, and cognitive pathways, and striatal dopamine D<sub>2/3</sub> receptor binding. Pharmacogenetic and epigenetic studies uncover how variations in dopaminergic, serotoninergic, and opioidergic systems shape treatment outcomes. Emerging biomarkers, such as neurofilament light chain, offer non-invasive relapse monitoring. Multifactorial models integrating behavioral and neural markers outperform single-factor approaches in predicting treatment success. Machine learning refines these models, while longitudinal and preclinical studies support individualized care. Despite translational hurdles, precision medicine offers transformative potential for improving SUD treatment outcomes.

Modality-Aware Feature Matching: A Comprehensive Review of Single- and Cross-Modality Techniques

Weide Liu, Wei Zhou, Jun Liu, Ping Hu, Jun Cheng, Jungong Han, Weisi Lin

arxiv logopreprintJul 30 2025
Feature matching is a cornerstone task in computer vision, essential for applications such as image retrieval, stereo matching, 3D reconstruction, and SLAM. This survey comprehensively reviews modality-based feature matching, exploring traditional handcrafted methods and emphasizing contemporary deep learning approaches across various modalities, including RGB images, depth images, 3D point clouds, LiDAR scans, medical images, and vision-language interactions. Traditional methods, leveraging detectors like Harris corners and descriptors such as SIFT and ORB, demonstrate robustness under moderate intra-modality variations but struggle with significant modality gaps. Contemporary deep learning-based methods, exemplified by detector-free strategies like CNN-based SuperPoint and transformer-based LoFTR, substantially improve robustness and adaptability across modalities. We highlight modality-aware advancements, such as geometric and depth-specific descriptors for depth images, sparse and dense learning methods for 3D point clouds, attention-enhanced neural networks for LiDAR scans, and specialized solutions like the MIND descriptor for complex medical image matching. Cross-modal applications, particularly in medical image registration and vision-language tasks, underscore the evolution of feature matching to handle increasingly diverse data interactions.

Applications of artificial intelligence and advanced imaging in pediatric diffuse midline glioma.

Haddadi Avval A, Banerjee S, Zielke J, Kann BH, Mueller S, Rauschecker AM

pubmed logopapersJul 30 2025
Diffuse midline glioma (DMG) is a rare, aggressive, and fatal tumor that largely occurs in the pediatric population. To improve outcomes, it is important to characterize DMGs, which can be performed via magnetic resonance imaging (MRI) assessment. Recently, artificial intelligence (AI) and advanced imaging have demonstrated their potential to improve the evaluation of various brain tumors, gleaning more information from imaging data than is possible without these methods. This narrative review compiles the existing literature on the intersection of MRI-based AI use and DMG tumors. The applications of AI in DMG revolve around classification and diagnosis, segmentation, radiogenomics, and prognosis/survival prediction. Currently published articles have utilized a wide spectrum of AI algorithms, from traditional machine learning and radiomics to neural networks. Challenges include the lack of cohorts of DMG patients with publicly available, multi-institutional, multimodal imaging and genomics datasets as well as the overall rarity of the disease. As an adjunct to AI, advanced MRI techniques, including diffusion-weighted imaging, perfusion-weighted imaging, and Magnetic Resonance Spectroscopy (MRS), as well as positron emission tomography (PET), provide additional insights into DMGs. Establishing AI models in conjunction with advanced imaging modalities has the potential to push clinical practice toward precision medicine.

A privacy preserving machine learning framework for medical image analysis using quantized fully connected neural networks with TFHE based inference.

Selvakumar S, Senthilkumar B

pubmed logopapersJul 30 2025
Medical image analysis using deep learning algorithms has become a basis of modern healthcare, enabling early detection, diagnosis, treatment planning, and disease monitoring. However, sharing sensitive raw medical data with third parties for analysis raises significant privacy concerns. This paper presents a privacy-preserving machine learning (PPML) framework using a Fully Connected Neural Network (FCNN) for secure medical image analysis using the MedMNIST dataset. The proposed PPML framework leverages a torus-based fully homomorphic encryption (TFHE) to ensure data privacy during inference, maintain patient confidentiality, and ensure compliance with privacy regulations. The FCNN model is trained in a plaintext environment for FHE compatibility using Quantization-Aware Training to optimize weights and activations. The quantized FCNN model is then validated under FHE constraints through simulation and compiled into an FHE-compatible circuit for encrypted inference on sensitive data. The proposed framework is evaluated on the MedMNIST datasets to assess its accuracy and inference time in both plaintext and encrypted environments. Experimental results reveal that the PPML framework achieves a prediction accuracy of 88.2% in the plaintext setting and 87.5% during encrypted inference, with an average inference time of 150 milliseconds per image. This shows that FCNN models paired with TFHE-based encryption achieve high prediction accuracy on MedMNIST datasets with minimal performance degradation compared to unencrypted inference.

WSDC-ViT: a novel transformer network for pneumonia image classification based on windows scalable attention and dynamic rectified linear unit convolutional modules.

Gu Y, Bai H, Chen M, Yang L, Zhang B, Wang J, Lu X, Li J, Liu X, Yu D, Zhao Y, Tang S, He Q

pubmed logopapersJul 30 2025
Accurate differential diagnosis of pneumonia remains a challenging task, as different types of pneumonia require distinct treatment strategies. Early and precise diagnosis is crucial for minimizing the risk of misdiagnosis and for effectively guiding clinical decision-making and monitoring treatment response. This study proposes the WSDC-ViT network to enhance computer-aided pneumonia detection and alleviate the diagnostic workload for radiologists. Unlike existing models such as Swin Transformer or CoAtNet, which primarily improve attention mechanisms through hierarchical designs or convolutional embedding, WSDC-ViT introduces a novel architecture that simultaneously enhances global and local feature extraction through a scalable self-attention mechanism and convolutional refinement. Specifically, the network integrates a scalable self-attention mechanism that decouples the query, key, and value dimensions to reduce computational overhead and improve contextual learning, while an interactive window-based attention module further strengthens long-range dependency modeling. Additionally, a convolution-based module equipped with a dynamic ReLU activation function is embedded within the transformer encoder to capture fine-grained local details and adaptively enhance feature expression. Experimental results demonstrate that the proposed method achieves an average classification accuracy of 95.13% and an F1-score of 95.63% on a chest X-ray dataset, along with 99.36% accuracy and a 99.34% F1-score on a CT dataset. These results highlight the model's superior performance compared to existing automated pneumonia classification approaches, underscoring its potential clinical applicability.

Feature Selection in Healthcare Datasets: Towards a Generalizable Solution.

Maruotto I, Ciliberti FK, Gargiulo P, Recenti M

pubmed logopapersJul 29 2025
The increasing dimensionality of healthcare datasets presents major challenges for clinical data analysis and interpretation. This study introduces a scalable ensemble feature selection (FS) strategy optimized for multi-biometric healthcare datasets aiming to: address the need for dimensionality reduction, identify the most significant features, improve machine learning models' performance, and enhance interpretability in a clinical context. The novel waterfall selection, that integrates sequentially (a) tree-based feature ranking and (b) greedy backward feature elimination, produces as output several sets of features. These subsets are then combined using a specific merging strategy to produce a single set of clinically relevant features. The overall method is applied to two healthcare datasets: the biosignal-based BioVRSea dataset, containing electromyography, electroencephalography, and center-of-pressure data for postural control and motion sickness assessment, and the image-based SinPain dataset, which includes MRI and CT-scan data to study knee osteoarthritis. Our ensemble FS approach demonstrated effective dimensionality reduction, achieving over a 50% decrease in certain feature subsets. The new reduced feature set maintained or improved the model classification metrics when tested with Support Vector Machine and Random Forest models. The proposed ensemble FS method retains selected features essential for distinguishing clinical outcomes, leading to models that are both computationally efficient and clinically interpretable. Furthermore, the adaptability of this method across two heterogeneous healthcare datasets and the scalability of the algorithm indicates its potential as a generalizable tool in healthcare studies. This approach can advance clinical decision support systems, making high-dimensional healthcare datasets more accessible and clinically interpretable.
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