This study aimed to develop and validate a multimodal deep learning model that leverages 2D grayscale ultrasound (US) images alongside readily available clinical data to improve diagnostic performance for ovarian cancer (OC). A retrospective analysis was conducted involving 1899 patients who underwent preoperative US examinations and subsequent surgeries for adnexal masses between 2019 and 2024. A multimodal deep learning model was constructed for OC diagnosis and extracting US morphological features from the images. The model's performance was evaluated using metrics such as receiver operating characteristic (ROC) curves, accuracy, and F1 score. The multimodal deep learning model exhibited superior performance compared to the image-only model, achieving areas under the curves (AUCs) of 0.9393 (95% CI 0.9139-0.9648) and 0.9317 (95% CI 0.9062-0.9573) in the internal and external test sets, respectively. The model significantly improved the AUCs for OC diagnosis by radiologists and enhanced inter-reader agreement. Regarding US morphological feature extraction, the model demonstrated robust performance, attaining accuracies of 86.34% and 85.62% in the internal and external test sets, respectively. Multimodal deep learning has the potential to enhance the diagnostic accuracy and consistency of radiologists in identifying OC. The model's effective feature extraction from ultrasound images underscores the capability of multimodal deep learning to automate the generation of structured ultrasound reports.

Prostate gland segmentation from T2-weighted MRI is a critical yet challenging task in clinical prostate cancer assessment. While deep learning-based methods have significantly advanced automated segmentation, most conventional approaches-particularly 2D convolutional neural networks (CNNs)-fail to leverage inter-slice anatomical continuity, limiting their accuracy and robustness. Fully 3D models offer improved spatial coherence but require large amounts of annotated data, which is often impractical in clinical settings. To address these limitations, we propose a hybrid architecture that models MRI sequences as spatiotemporal data. Our method uses a deep, pretrained DeepLabV3 backbone to extract high-level semantic features from each MRI slice and a recurrent convolutional head, built with ConvLSTM layers, to integrate information across slices while preserving spatial structure. This combination enables context-aware segmentation with improved consistency, particularly in data-limited and noisy imaging conditions. We evaluate our method on the PROMISE12 benchmark under both clean and contrast-degraded test settings. Compared to state-of-the-art 2D and 3D segmentation models, our approach demonstrates superior performance in terms of precision, recall, Intersection over Union (IoU), and Dice Similarity Coefficient (DSC), highlighting its potential for robust clinical deployment.

The clinical utility of the DeepSeek-V3 (DSV3) model in enhancing the accuracy of Liver Imaging Reporting and Data System (LI-RADS, LR) classification remains underexplored. This study aimed to evaluate the diagnostic performance of DSV3 in LR classifications compared to radiologists with varying levels of experience and to assess its potential as a decision-support tool in clinical practice. A dual-phase retrospective-prospective study analyzed 426 liver lesions (300 retrospective, 126 prospective) in high-risk HCC patients who underwent Magnetic Resonance Imaging (MRI) or Computed Tomography (CT). Three radiologists (one junior, two seniors) independently classified lesions using LR v2018 criteria, while DSV3 analyzed unstructured radiology reports to generate corresponding classifications. In the prospective cohort, DSV3 processed inputs in both Chinese and English to evaluate language impact. Performance was compared using chi-square test or Fisher's exact test, with pathology as the gold standard. In the retrospective cohort, DSV3 significantly outperformed junior radiologists in diagnostically challenging categories: LR-3 (17.8% vs. 39.7%, p<0.05), LR-4 (80.4% vs. 46.2%, p<0.05), and LR-5 (86.2% vs. 66.7%, p<0.05), while showing comparable accuracy in LR-1 (90.8% vs. 88.7%), LR-2 (11.9% vs. 25.6%), and LR-M (79.5% vs. 62.1%) classifications (all p>0.05). Prospective validation confirmed these findings, with DSV3 demonstrating superior performance for LR-3 (13.3% vs. 60.0%), LR-4 (93.3% vs. 66.7%), and LR-5 (93.5% vs. 67.7%) compared to junior radiologists (all p<0.05). Notably, DSV3 achieved diagnostic parity with senior radiologists across all categories (p>0.05) and maintained consistent performance between Chinese and English inputs. The DSV3 model effectively improves diagnostic accuracy of LR-3 to LR-5 classifications among junior radiologists . Its language-independent performance and ability to match senior-level expertise suggest strong potential for clinical implementation to standardize HCC diagnosis and optimize treatment decisions.

This study aimed to develop a deep learning (DL) model based on three-dimensional multi-parametric magnetic resonance imaging (mpMRI) for preoperative assessment of lymph node metastasis (LNM) in rectal cancer (RC) and to investigate the contribution of different MRI sequences. A total of 613 eligible patients with RC from four medical centres who underwent preoperative mpMRI were retrospectively enrolled and randomly assigned to training (n = 372), validation (n = 106), internal test (n = 88) and external test (n = 47) cohorts. A multi-parametric multi-scale EfficientNet (MMENet) was designed to effectively extract LNM-related features from mpMR for preoperative LNM assessment. Its performance was compared with other DL models and radiologists using metrics of area under the receiver operating curve (AUC), accuracy (ACC), sensitivity, specificity and average precision with 95% confidence interval (CI). To investigate the utility of various MRI sequences, the performances of the mono-parametric model and the MMENet with different sequences combinations as input were compared. The MMENet using a combination of T2WI, DWI and DCE sequence achieved an AUC of 0.808 (95% CI 0.720-0.897) with an ACC of 71.6% (95% CI 62.3-81.0) in the internal test cohort and an AUC of 0.782 (95% CI 0.636-0.925) with an ACC of 76.6% (95% CI 64.6-88.6) in the external test cohort, outperforming the mono-parametric model, the MMENet with other sequences combinations and the radiologists. The MMENet, leveraging a combination of T2WI, DWI and DCE sequences, can accurately assess LNM in RC preoperatively and holds great promise for automated evaluation of LNM in clinical practice.

To evaluate PANCANAI, a previously developed AI model for pancreatic cancer (PC) detection, on a longitudinal cohort of patients. In particular, aiming for PC detection on scans acquired before histopathologic diagnosis was assessed. The model has been previously trained to predict PC suspicion on 2134 portal venous CTs. In this study, the algorithm was evaluated on a retrospective cohort of Danish patients with biopsy-confirmed PC and with CT scans acquired between 2006 and 2016. The sensitivity was measured, and bootstrapping was performed to provide median and 95% CI. The study included 1083 PC patients (mean age: 69 y ± 11, 575 men). CT scans were divided into 2 groups: (1) concurrent diagnosis (CD): 1022 CT scans acquired within 2 months around histopathologic diagnosis, and (2) prediagnosis (PD): 198 CT scans acquired before histopathologic diagnosis (median 7 months before diagnosis). The sensitivity was 91.8% (938 of 1022; 95% CI: 89.9-93.5) and 68.7% (137 of 198; 95% CI: 62.1-75.3) on the CD and PD groups, respectively. Sensitivity on CT scans acquired 1 year or more before diagnosis was 53.9% (36 of 67; 95% CI: 41.8-65.7). Sensitivity on CT scans acquired at stage I was 82.9% (29 of 35; 95% CI: 68.6-94.3). PANCANAI showed high sensitivity for automatic PC detection on a large retrospective cohort of biopsy-confirmed patients. PC suspicion was detected in more than half of the CT scans that were acquired at least a year before histopathologic diagnosis.

Artificial intelligence (AI) is a disruptive technology that is currently finding widespread application after having long been confined to the domain of specialists. In urology, in particular, new fields of application are continuously emerging, which are being studied both in preclinical basic research and in clinical applications. Potential applications include image recognition in the operating room or interpreting images from radiology and pathology, the automatic measurement of urinary stones and radiotherapy. Certain medical devices, particularly in the field of AI-based predictive biomarkers, have already been incorporated into international guidelines. In addition, AI is playing an increasingly more important role in administrative tasks and is expected to lead to enormous changes, especially in the outpatient sector. For urologists, it is becoming increasingly more important to engage with this technology, to pursue appropriate training and therefore to optimally implement AI into the treatment of patients and in the management of their practices or hospitals.

The International Society of Urological Pathology (ISUP) grading of prostate cancer (PCa) is a crucial factor in the management and treatment planning for PCa patients. An accurate and non-invasive assessment of the ISUP grading group could significantly improve biopsy decisions and treatment planning. The use of PSMA-PET/CT radiomics for predicting ISUP has not been widely studied. The aim of this study is to investigate the role of ⁶⁸Ga-PSMA PET/CT radiomics in predicting the ISUP grading of primary PCa. This study included 415 PCa patients who underwent ⁶⁸Ga-PSMA PET/CT scans before prostate biopsy or radical prostatectomy. Patients were from three centers: Xiangya Hospital, Central South University (252 cases), Qilu Hospital of Shandong University (External Validation 1, 108 cases), and Qingdao University Medical College (External Validation 2, 55 cases). Xiangya Hospital cases were split into training and testing groups (1:1 ratio), with the other centers serving as external validation groups. Feature selection was performed using Minimum Redundancy Maximum Relevance (mRMR) and Least Absolute Shrinkage and Selection Operator (LASSO) algorithms. Eight machine learning classifiers were trained and tested with ten-fold cross-validation. Sensitivity, specificity, and AUC were calculated for each model. Additionally, we combined the radiomic features with maximum Standardized Uptake Value (SUVmax) and prostate-specific antigen (PSA) to create prediction models and tested the corresponding performances. The best-performing model in the Xiangya Hospital training cohort achieved an AUC of 0.868 (sensitivity 72.7%, specificity 96.0%). Similar trends were seen in the testing cohort and external validation centers (AUCs: 0.860, 0.827, and 0.812). After incorporating PSA and SUVmax, a more robust model was developed, achieving an AUC of 0.892 (sensitivity 77.9%, specificity 96.0%) in the training group. This study established and validated a radiomics model based on ⁶⁸Ga-PSMA PET/CT, offering an accurate, non-invasive method for predicting ISUP grades in prostate cancer. A multicenter design with external validation ensured the model's robustness and broad applicability. This is the largest study to date on PSMA radiomics for predicting ISUP grades. Notably, integrating SUVmax and PSA metrics with radiomic features significantly improved prediction accuracy, providing new insights and tools for personalized diagnosis and treatment.

Bias field artifacts in magnetic resonance imaging (MRI) scans introduce spatially smooth intensity inhomogeneities that degrade image quality and hinder downstream analysis. To address this challenge, we propose a novel variational Hadamard U-Net (VHU-Net) for effective body MRI bias field correction. The encoder comprises multiple convolutional Hadamard transform blocks (ConvHTBlocks), each integrating convolutional layers with a Hadamard transform (HT) layer. Specifically, the HT layer performs channel-wise frequency decomposition to isolate low-frequency components, while a subsequent scaling layer and semi-soft thresholding mechanism suppress redundant high-frequency noise. To compensate for the HT layer's inability to model inter-channel dependencies, the decoder incorporates an inverse HT-reconstructed transformer block, enabling global, frequency-aware attention for the recovery of spatially consistent bias fields. The stacked decoder ConvHTBlocks further enhance the capacity to reconstruct the underlying ground-truth bias field. Building on the principles of variational inference, we formulate a new evidence lower bound (ELBO) as the training objective, promoting sparsity in the latent space while ensuring accurate bias field estimation. Comprehensive experiments on abdominal and prostate MRI datasets demonstrate the superiority of VHU-Net over existing state-of-the-art methods in terms of intensity uniformity, signal fidelity, and tissue contrast. Moreover, the corrected images yield substantial downstream improvements in segmentation accuracy. Our framework offers computational efficiency, interpretability, and robust performance across multi-center datasets, making it suitable for clinical deployment.

Endoscopic ultrasound (EUS) is a vital tool for diagnosing biliopancreatic disease, offering detailed imaging to identify key abnormalities. Its interpretation demands expertise, which limits its accessibility for less trained practitioners. Thus, the creation of tools or systems to assist in interpreting EUS images is crucial for improving diagnostic accuracy and efficiency. To develop an AI-assisted EUS system for accurate pancreatic and biliopancreatic duct segmentation, and evaluate its impact on endoscopists' ability to identify biliary-pancreatic diseases during segmentation and anatomical localization. The EUS-AI system was designed to perform station positioning and anatomical structure segmentation. A total of 45,737 EUS images from 1852 patients were used for model training. Among them, 2881 images were for internal testing, and 2747 images from 208 patients were for external validation. Additionally, 340 images formed a man-machine competition test set. During the research process, various newer state-of-the-art (SOTA) deep learning algorithms were also compared. In classification, in the station recognition task, compared to the ResNet-50 and YOLOv8-CLS algorithms, the Mean Teacher algorithm achieved the highest accuracy, with an average of 95.60% (92.07%-99.12%) in the internal test set and 92.72% (88.30%-97.15%) in the external test set. For segmentation, compared to the UNet ++ and YOLOv8 algorithms, the U-Net v2 algorithm was optimal. Ultimately, the EUS-AI system was constructed using the optimal models from two tasks, and a man-machine competition experiment was conducted. The results demonstrated that the performance of the EUS-AI system significantly outperformed that of mid-level endoscopists, both in terms of position recognition (p < 0.001) and pancreas and biliopancreatic duct segmentation tasks (p < 0.001, p = 0.004). The EUS-AI system is expected to significantly shorten the learning curve for the pancreatic EUS examination and enhance procedural standardization.

This study aimed to develop radiomic-based machine learning models using computed tomography enterography (CTE) features derived from the intestinal wall, mesenteric fat, and visceral fat to differentiate between ulcerative colitis (UC) and colonic Crohn's disease (CD). Clinical and imaging data from 116 patients with inflammatory bowel disease (IBD) (68 with UC and 48 with colonic CD) were retrospectively collected. Radiomic features were extracted from venous-phase CTE images. Feature selection was performed via the intraclass correlation coefficient (ICC), correlation analysis, SelectKBest, and least absolute shrinkage and selection operator (LASSO) regression. Support vector machine models were constructed using features from individual and combined regions, with model performance evaluated using the area under the ROC curve (AUC). The combined radiomic model, integrating features from all three regions, exhibited superior classification performance (AUC= 0.857, 95% CI, 0.732-0.982), with a sensitivity of 0.762 (95% CI, 0.547-0.903) and specificity of 0.857 (95% CI, 0.601-0.960) in the testing cohort. The models based on features from the intestinal wall, mesenteric fat, and visceral fat achieved AUCs of 0.847 (95% CI, 0.710-0.984), 0.707 (95% CI, 0.526-0.889), and 0.731 (95% CI, 0.553-0.910), respectively, in the testing cohort. The intestinal wall model demonstrated the best calibration. This study demonstrated the feasibility of constructing machine learning models based on radiomic features of the intestinal wall, mesenteric fat, and visceral fat to distinguish between UC and colonic CD.