Identifying whether there is a traumatic intracranial bleed (ICB+) on head CT is critical for clinical care and research. Free text CT reports are unstructured and therefore must undergo time-consuming manual review. Existing artificial intelligence classification schemes are not optimised for the emergency department endpoint of classification of ICB+ or ICB-. We sought to assess three methods for classifying CT reports: a text classification (TC) programme, a commercial natural language processing programme (Clinithink) and a generative pretrained transformer large language model (Digitalizing English-language CT Interpretation for Positive Haemorrhage Evaluation Reporting (DECIPHER)-LLM). Primary objective: determine the diagnostic classification performance of the dichotomous categorisation of each of the three approaches. determine whether the LLM could achieve a substantial reduction in CT report review workload while maintaining 100% sensitivity.Anonymised radiology reports of head CT scans performed for trauma were manually labelled as ICB+/-. Training and validation sets were randomly created to train the TC and natural language processing models. Prompts were written to train the LLM. 898 reports were manually labelled. Sensitivity and specificity (95% CI)) of TC, Clinithink and DECIPHER-LLM (with probability of ICB set at 10%) were respectively 87.9% (76.7% to 95.0%) and 98.2% (96.3% to 99.3%), 75.9% (62.8% to 86.1%) and 96.2% (93.8% to 97.8%) and 100% (93.8% to 100%) and 97.4% (95.3% to 98.8%).With DECIPHER-LLM probability of ICB+ threshold of 10% set to identify CT reports requiring manual evaluation, CT reports requiring manual classification reduced by an estimated 385/449 cases (85.7% (95% CI 82.1% to 88.9%)) while maintaining 100% sensitivity. DECIPHER-LLM outperformed other tested free-text classification methods.

Image-based automatic breast tumor detection has become a significant research focus, driven by recent advancements in machine learning (ML) algorithms. Traditional disease detection methods often involve manual feature extraction from images, a process requiring extensive expertise from specialists and pathologists. This labor-intensive approach is not only time-consuming but also impractical for widespread application. However, advancements in digital technologies and computer vision have enabled convolutional neural networks (CNNs) to learn features automatically, thereby overcoming these challenges. This paper presents a deep neural network model based on the MobileNet-V2 architecture, enhanced with a convolutional block attention mechanism for identifying tumor types in ultrasound images. The attention module improves the MobileNet-V2 model's performance by highlighting disease-affected areas within the images. The proposed model refines features extracted by MobileNet-V2 using the Nesterov-accelerated Adaptive Moment Estimation (Nadam) optimizer. This integration enhances convergence and stability, leading to improved classification accuracy. The proposed approach was evaluated on the BUSI ultrasound image dataset. Experimental results demonstrated strong performance, achieving an accuracy of 99.1%, sensitivity of 99.7%, specificity of 99.5%, precision of 97.7%, and an area under the curve (AUC) of 1.0 using an 80-20 data split. Additionally, under 10-fold cross-validation, the model achieved an accuracy of 98.7%, sensitivity of 99.1%, specificity of 98.3%, precision of 98.4%, F1-score of 98.04%, and an AUC of 0.99.

The integration of pathology and radiology in medical imaging has emerged as a critical need for advancing diagnostic accuracy and improving clinical workflows. Current AI-driven approaches for medical image analysis, despite significant progress, face several challenges, including handling multi-modal imaging, imbalanced datasets, and the lack of robust interpretability and uncertainty quantification. These limitations often hinder the deployment of AI systems in real-world clinical settings, where reliability and adaptability are essential. To address these issues, this study introduces a novel framework, the Domain-Informed Adaptive Network (DIANet), combined with an Adaptive Clinical Workflow Integration (ACWI) strategy. DIANet leverages multi-scale feature extraction, domain-specific priors, and Bayesian uncertainty modeling to enhance interpretability and robustness. The proposed model is tailored for multi-modal medical imaging tasks, integrating adaptive learning mechanisms to mitigate domain shifts and imbalanced datasets. Complementing the model, the ACWI strategy ensures seamless deployment through explainable AI (XAI) techniques, uncertainty-aware decision support, and modular workflow integration compatible with clinical systems like PACS. Experimental results demonstrate significant improvements in diagnostic accuracy, segmentation precision, and reconstruction fidelity across diverse imaging modalities, validating the potential of this framework to bridge the gap between AI innovation and clinical utility.


Intrathoracic airway segmentation in computed tomography (CT) is important for quantitative and qualitative analysis of various chronic respiratory diseases and bronchial surgery navigation. However, the airway tree's morphological complexity, incomplete labels resulting from annotation difficulty, and intra-class imbalance between main and terminal airways limit the segmentation performance.
Methods:
Three methodological improvements are proposed to deal with the challenges. Firstly, we design a DCT-UNet to collect better information on neighbouring voxels and ones within a larger spatial region. Secondly, an airway label self-updating (ALSU) strategy is proposed to iteratively update the reference labels to conquer the problem of incomplete labels. Thirdly, a deep learning-based terminal region growing (TRG) is adopted to extract terminal airways. Extensive experiments were conducted on two internal datasets and three public datasets.
Results:
Compared to the counterparts, the proposed method can achieve a higher Branch Detected, Tree-length Detected, Branch Ratio, and Tree-length Ratio (ISICDM2021 dataset, 95.19%, 94.89%, 166.45%, and 172.29%; BAS dataset, 96.03%, 95.11%, 129.35%, and 137.00%). Ablation experiments show the effectiveness of three proposed solutions. Our method is applied to an in-house Chorionic Obstructive Pulmonary Disease (COPD) dataset. The measures of branch count, tree length, endpoint count, airway volume, and airway surface area are significantly different between COPD severity stages.
Conclusions:
The proposed methods can segment more terminal bronchi and larger length of airway, even some bronchi which are real but missed in the manual annotation can be detected. Potential application significance has been presented in characterizing COPD airway lesions and severity stages.&#xD.

Medical image segmentation continues to advance rapidly, yet rigorous comparison between methods remains challenging due to a lack of standardized and customizable tooling. In this work, we present the current state of the Medical Imaging Segmentation Toolkit (MIST), with a particular focus on its flexible and modular postprocessing framework designed for the BraTS 2025 pre- and post-treatment glioma segmentation challenge. Since its debut in the 2024 BraTS adult glioma post-treatment segmentation challenge, MIST's postprocessing module has been significantly extended to support a wide range of transforms, including removal or replacement of small objects, extraction of the largest connected components, and morphological operations such as hole filling and closing. These transforms can be composed into user-defined strategies, enabling fine-grained control over the final segmentation output. We evaluate three such strategies - ranging from simple small-object removal to more complex, class-specific pipelines - and rank their performance using the BraTS ranking protocol. Our results highlight how MIST facilitates rapid experimentation and targeted refinement, ultimately producing high-quality segmentations for the BraTS 2025 challenge. MIST remains open source and extensible, supporting reproducible and scalable research in medical image segmentation.

Conventional multimodal data integration methods provide a comprehensive assessment of the shared or unique structure within each individual data type but suffer from several limitations such as the inability to handle high-dimensional data and identify nonlinear structures. In this paper, we introduce DeepJIVE, a deep-learning approach to performing Joint and Individual Variance Explained (JIVE). We perform mathematical derivation and experimental validations using both synthetic and real-world 1D, 2D, and 3D datasets. Different strategies of achieving the identity and orthogonality constraints for DeepJIVE were explored, resulting in three viable loss functions. We found that DeepJIVE can successfully uncover joint and individual variations of multimodal datasets. Our application of DeepJIVE to the Alzheimer's Disease Neuroimaging Initiative (ADNI) also identified biologically plausible covariation patterns between the amyloid positron emission tomography (PET) and magnetic resonance (MR) images. In conclusion, the proposed DeepJIVE can be a useful tool for multimodal data analysis.

Data scarcity is a major challenge in medical imaging, particularly for deep learning models. While data pooling (combining datasets from multiple sources) and data addition (adding more data from a new dataset) have been shown to enhance model performance, they are not without complications. Specifically, increasing the size of the training dataset through pooling or addition can induce distributional shifts, negatively affecting downstream model performance, a phenomenon known as the "Data Addition Dilemma". While the traditional i.i.d. assumption may not hold in multi-source contexts, assuming exchangeability across datasets provides a more practical framework for data pooling. In this work, we investigate medical image segmentation under these conditions, drawing insights from causal frameworks to propose a method for controlling foreground-background feature discrepancies across all layers of deep networks. This approach improves feature representations, which are crucial in data-addition scenarios. Our method achieves state-of-the-art segmentation performance on histopathology and ultrasound images across five datasets, including a novel ultrasound dataset that we have curated and contributed. Qualitative results demonstrate more refined and accurate segmentation maps compared to prominent baselines across three model architectures. The code will be available on Github.

Precise and automated segmentation of the liver and its tumor within CT scans plays a pivotal role in swift diagnosis and the development of optimal treatment plans for individuals with liver diseases and malignancies. However, automated liver and tumor segmentation faces significant hurdles arising from the inherent heterogeneity of tumors and the diverse visual characteristics of livers across a broad spectrum of patients. Aiming to address these challenges, we present a novel Transformer-aware Multiscale Progressive Encoder-Decoder Network (T-MPEDNet) for automated segmentation of tumor and liver. T-MPEDNet leverages a deep adaptive features backbone through a progressive encoder-decoder structure, enhanced by skip connections for recalibrating channel-wise features while preserving spatial integrity. A Transformer-inspired dynamic attention mechanism captures long-range contextual relationships within the spatial domain, further enhanced by multi-scale feature utilization for refined local details, leading to accurate prediction. Morphological boundary refinement is then employed to address indistinct boundaries with neighboring organs, capturing finer details and yielding precise boundary labels. The efficacy of T-MPEDNet is comprehensively assessed on two widely utilized public benchmark datasets, LiTS and 3DIRCADb. Extensive quantitative and qualitative analyses demonstrate the superiority of T-MPEDNet compared to twelve state-of-the-art methods. On LiTS, T-MPEDNet achieves outstanding Dice Similarity Coefficients (DSC) of 97.6% and 89.1% for liver and tumor segmentation, respectively. Similar performance is observed on 3DIRCADb, with DSCs of 98.3% and 83.3% for liver and tumor segmentation, respectively. Our findings prove that T-MPEDNet is an efficacious and reliable framework for automated segmentation of the liver and its tumor in CT scans.

Purpose: To develop a reconstruction framework for 3D real-time cine cardiovascular magnetic resonance (CMR) from highly undersampled data without requiring fully sampled training data. Methods: We developed a multi-dynamic low-rank deep image prior (ML-DIP) framework that models spatial image content and temporal deformation fields using separate neural networks. These networks are optimized per scan to reconstruct the dynamic image series directly from undersampled k-space data. ML-DIP was evaluated on (i) a 3D cine digital phantom with simulated premature ventricular contractions (PVCs), (ii) ten healthy subjects (including two scanned during both rest and exercise), and (iii) five patients with PVCs. Phantom results were assessed using peak signal-to-noise ratio (PSNR) and structural similarity index measure (SSIM). In vivo performance was evaluated by comparing left-ventricular function quantification (against 2D real-time cine) and image quality (against 2D real-time cine and binning-based 5D-Cine). Results: In the phantom study, ML-DIP achieved PSNR > 29 dB and SSIM > 0.90 for scan times as short as two minutes, while recovering cardiac motion, respiratory motion, and PVC events. In healthy subjects, ML-DIP yielded functional measurements comparable to 2D cine and higher image quality than 5D-Cine, including during exercise with high heart rates and bulk motion. In PVC patients, ML-DIP preserved beat-to-beat variability and reconstructed irregular beats, whereas 5D-Cine showed motion artifacts and information loss due to binning. Conclusion: ML-DIP enables high-quality 3D real-time CMR with acceleration factors exceeding 1,000 by learning low-rank spatial and temporal representations from undersampled data, without relying on external fully sampled training datasets.

Unsupervised anomaly detection (UAD) aims to detect anomalies without labeled data, a necessity in many machine learning applications where anomalous samples are rare or not available. Most state-of-the-art methods fall into two categories: reconstruction-based approaches, which often reconstruct anomalies too well, and decoupled representation learning with density estimators, which can suffer from suboptimal feature spaces. While some recent methods attempt to couple feature learning and anomaly detection, they often rely on surrogate objectives, restrict kernel choices, or introduce approximations that limit their expressiveness and robustness. To address this challenge, we propose a novel method that tightly couples representation learning with an analytically solvable one-class SVM (OCSVM), through a custom loss formulation that directly aligns latent features with the OCSVM decision boundary. The model is evaluated on two tasks: a new benchmark based on MNIST-C, and a challenging brain MRI subtle lesion detection task. Unlike most methods that focus on large, hyperintense lesions at the image level, our approach succeeds to target small, non-hyperintense lesions, while we evaluate voxel-wise metrics, addressing a more clinically relevant scenario. Both experiments evaluate a form of robustness to domain shifts, including corruption types in MNIST-C and scanner/age variations in MRI. Results demonstrate performance and robustness of our proposed mode,highlighting its potential for general UAD and real-world medical imaging applications. The source code is available at https://github.com/Nicolas-Pinon/uad_ocsvm_guided_repr_learning