Synthetic data generation represents a significant advancement in boosting the performance of machine learning (ML) models, particularly in fields where data acquisition is challenging, such as echocardiography. The acquisition and labeling of echocardiograms (echo) for heart assessment, crucial in point-of-care ultrasound (POCUS) settings, often encounter limitations due to the restricted number of echo views available, typically captured by operators with varying levels of experience. This study proposes a novel approach for enhancing clinical diagnosis accuracy by synthetically generating echo views. These views are conditioned on existing, real views of the heart, focusing specifically on the estimation of ejection fraction (EF), a critical parameter traditionally measured from biplane apical views. By integrating a conditional generative model, we demonstrate an improvement in EF estimation accuracy, providing a comparative analysis with traditional methods. Preliminary results indicate that our synthetic echoes, when used to augment existing datasets, not only enhance EF estimation but also show potential in advancing the development of more robust, accurate, and clinically relevant ML models. This approach is anticipated to catalyze further research in synthetic data applications, paving the way for innovative solutions in medical imaging diagnostics.

Carotid ultrasound requires skilled operators due to small vessel dimensions and high anatomical variability, exacerbating sonographer shortages and diagnostic inconsistencies. Prior automation attempts, including rule-based approaches with manual heuristics and reinforcement learning trained in simulated environments, demonstrate limited generalizability and fail to complete real-world clinical workflows. Here, we present UltraBot, a fully learning-based autonomous carotid ultrasound robot, achieving human-expert-level performance through four innovations: (1) A unified imitation learning framework for acquiring anatomical knowledge and scanning operational skills; (2) A large-scale expert demonstration dataset (247,000 samples, 100 × scale-up), enabling embodied foundation models with strong generalization; (3) A comprehensive scanning protocol ensuring full anatomical coverage for biometric measurement and plaque screening; (4) The clinical-oriented validation showing over 90% success rates, expert-level accuracy, up to 5.5 × higher reproducibility across diverse unseen populations. Overall, we show that large-scale deep learning offers a promising pathway toward autonomous, high-precision ultrasonography in clinical practice.

The objective of this study was to identify risk factors for enema reduction failure and to establish a combined model that integrates deep learning (DL) features and clinical features for predicting surgical intervention in intussusception in children younger than 8 months of age. A retrospective study with a prospective validation cohort of intussusception. The retrospective data were collected from two hospitals in south east China between January 2017 and December 2022. The prospective data were collected between January 2023 and July 2024. A total of 415 intussusception cases in patients younger than 8 months were included in the study. 280 cases collected from Centre 1 were randomly divided into two groups at a 7:3 ratio: the training cohort (n=196) and the internal validation cohort (n=84). 85 cases collected from Centre 2 were designed as external validation cohort. Pretrained DL networks were used to extract deep transfer learning features, with least absolute shrinkage and selection operator regression selecting the non-zero coefficient features. The clinical features were screened by univariate and multivariate logistic regression analyses. We constructed a combined model that integrated the selected two types of features, along with individual clinical and DL models for comparison. Additionally, the combined model was validated in a prospective cohort (n=50) collected from Centre 1. In the internal and external validation cohorts, the combined model (area under curve (AUC): 0.911 and 0.871, respectively) demonstrated better performance for predicting surgical intervention in intussusception in children younger than 8 months of age than the clinical model (AUC: 0.776 and 0.740, respectively) and the DL model (AUC: 0.828 and 0.793, respectively). In the prospective validation cohort, the combined model also demonstrated impressive performance with an AUC of 0.890. The combined model, integrating DL and clinical features, demonstrated stable predictive accuracy, suggesting its potential for improving clinical therapeutic strategies for intussusception.

The thickness of the diaphragm serves as a crucial biometric indicator, particularly in assessing rehabilitation and respiratory dysfunction. However, measuring diaphragm thickness from ultrasound images mainly depends on manual delineation of the fascia, which is subjective, time-consuming, and sensitive to the inherent speckle noise. In this study, we introduce an edge-aware diffusion segmentation model (ESADiff), which incorporates prior structural knowledge of the fascia to improve the accuracy and reliability of diaphragm thickness measurements in ultrasound imaging. We first apply a diffusion model, guided by annotations, to learn the image features while preserving edge details through an iterative denoising process. Specifically, we design an anisotropic edge-sensitive annotation refinement module that corrects inaccurate labels by integrating Hessian geometric priors with a backtracking shortest-path connection algorithm, further enhancing model accuracy. Moreover, a curvature-aware deformable convolution and edge-prior ranking loss function are proposed to leverage the shape prior knowledge of the fascia, allowing the model to selectively focus on relevant linear structures while mitigating the influence of noise on feature extraction. We evaluated the proposed model on an in-house diaphragm ultrasound dataset, a public calf muscle dataset, and an internal tongue muscle dataset to demonstrate robust generalization. Extensive experimental results demonstrate that our method achieves finer fascia segmentation and significantly improves the accuracy of thickness measurements compared to other state-of-the-art techniques, highlighting its potential for clinical applications.

Accurately imaging the spatial distribution of longitudinal speed of sound (SoS) has a profound impact on image quality and the diagnostic value of ultrasound. Knowledge of SoS distribution allows effective aberration correction to improve image quality. SoS imaging also provides a new contrast mechanism to facilitate disease diagnosis. However, SoS imaging is challenging in the pulse-echo mode. Deep learning (DL) is a promising approach for pulse-echo SoS imaging, which may yield more accurate results than pure physics-based approaches. Herein, we developed a robust DL approach for SoS imaging that learns the nonlinear mapping between measured time shifts and the underlying SoS without subjecting to the constraints of a specific forward model. Various strategies were adopted to enhance model performance. Time-shift maps were computed by adopting a common mid-angle configuration from the non-DL literature, normalizing complex beamformed ultrasound data, and accounting for depth-dependent frequency when converting phase shifts to time shifts. The structural similarity index measure (SSIM) was incorporated into the loss function to learn the global structure for SoS imaging. A two-stage training strategy was employed, leveraging computationally efficient ray-tracing synthesis for extensive pretraining, and more realistic but computationally expensive full-wave simulations for fine-tuning. Using these combined strategies, our model was shown to be robust and generalizable across different conditions. The simulation-trained model successfully reconstructed the SoS maps of phantoms using experimental data. Compared with the physics-based inversion approach, our method improved reconstruction accuracy and contrast-to-noise ratio in phantom experiments. These results demonstrated the accuracy and robustness of our approach.

<b><i>Background:</i></b> Colon cancer is a heterogeneous disease, and rare subtypes like triphasic colon cancer are difficult to detect with standard methods. Artificial intelligence (AI)-driven ultrasound combined with genomic analysis offers a promising approach to improve subtype identification and uncover molecular mechanisms. <b><i>Methods:</i></b> The authors used an AI-driven ultrasound model to identify rare triphasic colon cancer, characterized by a mix of epithelial, mesenchymal, and proliferative components. The molecular features were validated using immunohistochemistry, targeting classical epithelial markers, mesenchymal markers, and proliferation indices. Subsequently, ultrasound genomic techniques were applied to map transcriptomic alterations in conventional colon cancer onto ultrasound images. Differentially expressed genes were identified using the <i>edgeR</i> package. Pearson correlation analysis was performed to assess the relationship between imaging features and molecular markers. <b><i>Results:</i></b> The AI-driven ultrasound model successfully identified rare triphasic features in colon cancer. These imaging features showed significant correlation with immunohistochemical expression of epithelial markers, mesenchymal markers, and proliferation index. Moreover, ultrasound genomic techniques revealed that multiple oncogenic transcripts could be spatially mapped to distinct patterns within the ultrasound images of conventional colon cancer and were involved in classical cancer-related pathway. <b><i>Conclusions:</i></b> AI-enhanced ultrasound imaging enables noninvasive identification of rare triphasic colon cancer and reveals functional molecular signatures in general colon cancer. This integrative approach may support future precision diagnostics and image-guided therapies.

Congenital heart defect (CHD) detection in ultrasound videos is hindered by image noise and probe positioning variability. While automated methods can reduce operator dependence, current machine learning approaches often neglect temporal information, limit themselves to binary classification, and do not account for prediction calibration. We propose Temporal Prompt Alignment (TPA), a method leveraging foundation image-text model and prompt-aware contrastive learning to classify fetal CHD on cardiac ultrasound videos. TPA extracts features from each frame of video subclips using an image encoder, aggregates them with a trainable temporal extractor to capture heart motion, and aligns the video representation with class-specific text prompts via a margin-hinge contrastive loss. To enhance calibration for clinical reliability, we introduce a Conditional Variational Autoencoder Style Modulation (CVAESM) module, which learns a latent style vector to modulate embeddings and quantifies classification uncertainty. Evaluated on a private dataset for CHD detection and on a large public dataset, EchoNet-Dynamic, for systolic dysfunction, TPA achieves state-of-the-art macro F1 scores of 85.40% for CHD diagnosis, while also reducing expected calibration error by 5.38% and adaptive ECE by 6.8%. On EchoNet-Dynamic's three-class task, it boosts macro F1 by 4.73% (from 53.89% to 58.62%). Temporal Prompt Alignment (TPA) is a framework for fetal congenital heart defect (CHD) classification in ultrasound videos that integrates temporal modeling, prompt-aware contrastive learning, and uncertainty quantification.

Thyroid ultrasound has emerged as a critical diagnostic modality, attracting substantial research attention. This bibliometric analysis systematically maps the 30-year evolution of thyroid ultrasound research to identify developmental trends, research hotspots, and emerging frontiers. English-language articles and reviews (1994-2023) from Web of Science Core Collection were extracted. Bibliometric analysis was performed using VOSviewer and CiteSpace to examine collaborative networks among countries/institutions/authors, reference timeline visualization, and keyword burst detection. A total of 8,489 documents were included for further analysis. An overall upward trend in research publications was found. China, the United States, and Italy were the productive countries, while the United States, Italy, and South Korea had the greatest influence. The journal Thyroid obtained the highest IF. The keywords with the greatest strength were "disorders", "thyroid volume", and "association guidelines". The timeline view of reference demonstrated that deep learning, ultrasound-based risk stratification systems, and radiofrequency ablation were the latest reference clusters. Three dominant themes emerged: the ultrasound characteristics of thyroid disorders, the application of new techniques, and the assessment of the risk of malignancy of thyroid nodules. Applications of deep learning and the development and improvement of correlation guides such as TIRADS are the present focus of research. The specific application efficacy and improvement of TI-RADS and the optimization of deep learning algorithms and their clinical applicability will be the focus of subsequent research.

In medical imaging, inter-observer variability among radiologists often introduces label uncertainty, particularly in modalities where visual interpretation is subjective. Lung ultrasound (LUS) is a prime example-it frequently presents a mixture of highly ambiguous regions and clearly discernible structures, making consistent annotation challenging even for experienced clinicians. In this work, we introduce a novel approach to both labeling and training AI models using expert-supplied, per-pixel confidence values. Rather than treating annotations as absolute ground truth, we design a data annotation protocol that captures the confidence that radiologists have in each labeled region, modeling the inherent aleatoric uncertainty present in real-world clinical data. We demonstrate that incorporating these confidence values during training leads to improved segmentation performance. More importantly, we show that this enhanced segmentation quality translates into better performance on downstream clinically-critical tasks-specifically, estimating S/F oxygenation ratio values, classifying S/F ratio change, and predicting 30-day patient readmission. While we empirically evaluate many methods for exposing the uncertainty to the learning model, we find that a simple approach that trains a model on binarized labels obtained with a (60%) confidence threshold works well. Importantly, high thresholds work far better than a naive approach of a 50% threshold, indicating that training on very confident pixels is far more effective. Our study systematically investigates the impact of training with varying confidence thresholds, comparing not only segmentation metrics but also downstream clinical outcomes. These results suggest that label confidence is a valuable signal that, when properly leveraged, can significantly enhance the reliability and clinical utility of AI in medical imaging.

Congenital heart defect (CHD) detection in ultrasound videos is hindered by image noise and probe positioning variability. While automated methods can reduce operator dependence, current machine learning approaches often neglect temporal information, limit themselves to binary classification, and do not account for prediction calibration. We propose Temporal Prompt Alignment (TPA), a method leveraging foundation image-text model and prompt-aware contrastive learning to classify fetal CHD on cardiac ultrasound videos. TPA extracts features from each frame of video subclips using an image encoder, aggregates them with a trainable temporal extractor to capture heart motion, and aligns the video representation with class-specific text prompts via a margin-hinge contrastive loss. To enhance calibration for clinical reliability, we introduce a Conditional Variational Autoencoder Style Modulation (CVAESM) module, which learns a latent style vector to modulate embeddings and quantifies classification uncertainty. Evaluated on a private dataset for CHD detection and on a large public dataset, EchoNet-Dynamic, for systolic dysfunction, TPA achieves state-of-the-art macro F1 scores of 85.40% for CHD diagnosis, while also reducing expected calibration error by 5.38% and adaptive ECE by 6.8%. On EchoNet-Dynamic's three-class task, it boosts macro F1 by 4.73% (from 53.89% to 58.62%). Temporal Prompt Alignment (TPA) is a framework for fetal congenital heart defect (CHD) classification in ultrasound videos that integrates temporal modeling, prompt-aware contrastive learning, and uncertainty quantification.