Medical image reconstruction from measurement data is a vital but challenging inverse problem. Deep learning approaches have achieved promising results, but often requires paired measurement and high-quality images, which is typically simulated through a forward model, i.e., retrospective reconstruction. However, training on simulated pairs commonly leads to performance degradation on real prospective data due to the retrospective-to-prospective gap caused by incomplete imaging knowledge in simulation. To address this challenge, this paper introduces imaging Knowledge-Informed Dynamic Optimal Transport (KIDOT), a novel dynamic optimal transport framework with optimality in the sense of preserving consistency with imaging physics in transport, that conceptualizes reconstruction as finding a dynamic transport path. KIDOT learns from unpaired data by modeling reconstruction as a continuous evolution path from measurements to images, guided by an imaging knowledge-informed cost function and transport equation. This dynamic and knowledge-aware approach enhances robustness and better leverages unpaired data while respecting acquisition physics. Theoretically, we demonstrate that KIDOT naturally generalizes dynamic optimal transport, ensuring its mathematical rationale and solution existence. Extensive experiments on MRI and CT reconstruction demonstrate KIDOT's superior performance.

Intraventricular hemorrhage (IVH) is a severe neurological complication among premature infants, necessitating early and accurate detection from brain ultrasound (US) images to improve clinical outcomes. While recent deep learning methods offer promise for computer-aided diagnosis, challenges remain in capturing both local spatial details and global contextual dependencies critical for segmenting brain anatomies. In this work, we propose an enhanced Residual U-Net architecture incorporating two complementary attention mechanisms: the Convolutional Block Attention Module (CBAM) and a Sparse Attention Layer (SAL). The CBAM improves the model's ability to refine spatial and channel-wise features, while the SAL introduces a dual-branch design, sparse attention filters out low-confidence query-key pairs to suppress noise, and dense attention ensures comprehensive information propagation. Extensive experiments on the Brain US dataset demonstrate that our method achieves state-of-the-art segmentation performance, with a Dice score of 89.04% and IoU of 81.84% for ventricle region segmentation. These results highlight the effectiveness of integrating spatial refinement and attention sparsity for robust brain anatomy detection. Code is available at: https://github.com/DanYuan001/BrainImgSegment.

Lung cancer has been one of the major threats across the world with the highest mortalities. Computer-aided detection (CAD) can help in early detection and thus can help increase the survival rate. Accurate lung parenchyma segmentation (to include the juxta-pleural nodules) and lung nodule segmentation, the primary symptom of lung cancer, play a crucial role in the overall accuracy of the Lung CAD pipeline. Lung nodule segmentation is quite challenging because of the diverse nodule types and other inhibit structures present within the lung lobes. Traditional machine/deep learning methods suffer from generalization and robustness. Recent Vision Language Models/Foundation Models perform well on the anatomical level, but they suffer on fine-grained segmentation tasks, and their semi-automatic nature limits their effectiveness in real-time clinical scenarios. In this paper, we propose a novel method for accurate 3D segmentation of lung parenchyma and lung nodules. The proposed architecture is an attention-based network with residual blocks at each encoder-decoder state. Max pooling is replaced by strided convolutions at the encoder, and trilinear interpolation is replaced by transposed convolutions at the decoder to maximize the number of learnable parameters. Dilated convolutions at each encoder-decoder stage allow the model to capture the larger context without increasing computational costs. The proposed method has been evaluated extensively on one of the largest publicly available datasets, namely LUNA16, and is compared with recent notable work in the domain using standard performance metrics like Dice score, IOU, etc. It can be seen from the results that the proposed method achieves better performance than state-of-the-art methods. The source code, datasets, and pre-processed data can be accessed using the link: https://github.com/EMeRALDsNRPU/Attention-Based-3D-ResUNet.

BackgroundThis study aims to present the Segmentation-based Myocardial Advanced Refinement Tracking (SMART) system, a novel artificial intelligence (AI)-based framework for transthoracic echocardiography (TTE) that incorporates motion tracking and left ventricular (LV) myocardial segmentation for automated LV mass (LVM) and global longitudinal strain (LVGLS) assessment. MethodsThe SMART system demonstrates LV speckle tracking based on motion vector estimation, refined by structural information using endocardial and epicardial segmentation throughout the cardiac cycle. This approach enables automated measurement of LVMSMART and LVGLSSMART. The feasibility of SMART is validated in 111 hypertrophic cardiomyopathy (HCM) patients (median age: 58 years, 69% male) who underwent TTE and cardiac magnetic resonance imaging (CMR). ResultsLVGLSSMART showed a strong correlation with conventional manual LVGLS measurements (Pearsons correlation coefficient [PCC] 0.851; mean difference 0 [-2-0]). When compared to CMR as the reference standard for LVM, the conventional dimension-based TTE method overestimated LVM (PCC 0.652; mean difference: 106 [90-123]), whereas LVMSMART demonstrated excellent agreement with CMR (PCC 0.843; mean difference: 1 [-11-13]). For predicting extensive myocardial fibrosis, LVGLSSMART and LVMSMART exhibited performance comparable to conventional LVGLS and CMR (AUC: 0.72 and 0.66, respectively). Patients identified as high-risk for extensive fibrosis by LVGLSSMART and LVMSMART had significantly higher rates of adverse outcomes, including heart failure hospitalization, new-onset atrial fibrillation, and defibrillator implantation. ConclusionsThe SMART technique provides a comparable LVGLS evaluation and a more accurate LVM assessment than conventional TTE, with predictive values for myocardial fibrosis and adverse outcomes. These findings support its utility in HCM management.

Functional ultrasound (fUS) imaging provides exceptional spatiotemporal resolution for neurovascular mapping, yet its practical application is significantly hampered by critical challenges. Foremost among these are data scarcity, arising from ethical considerations and signal degradation through the cranium, which collectively limit dataset diversity and compromise the fairness of downstream machine learning models.

Stroke is among the top three causes of death worldwide, and accurate identification of stroke lesion boundaries is critical for diagnosis and treatment. Supervised deep learning methods have emerged as the leading solution for stroke lesion segmentation but require large, diverse, and annotated datasets. The ISLES'24 challenge addresses this need by providing longitudinal stroke imaging data, including CT scans taken on arrival to the hospital and follow-up MRI taken 2-9 days from initial arrival, with annotations derived from follow-up MRI. Importantly, models submitted to the ISLES'24 challenge are evaluated using only CT inputs, requiring prediction of lesion progression that may not be visible in CT scans for segmentation. Our winning solution shows that a carefully designed preprocessing pipeline including deep-learning-based skull stripping and custom intensity windowing is beneficial for accurate segmentation. Combined with a standard large residual nnU-Net architecture for segmentation, this approach achieves a mean test Dice of 28.5 with a standard deviation of 21.27.

Background and purposeMRI is critical for the detection of subtle cortical pathology in epilepsy surgery assessment. This can be aided by improved MRI quality and resolution using ultra-high field (7T). But poor access and long scan durations limit widespread use, particularly in a paediatric setting. AI-based learning approaches may provide similar information by enhancing data obtained with conventional MRI (3T). We used a convolutional neural network trained on matched 3T and 7T images to enhance quantitative R1-maps (longitudinal relaxation rate) obtained at 3T in paediatric epilepsy patients and to determine their potential clinical value for lesion identification. Materials and MethodsA 3D U-Net was trained using paired patches from 3T and 7T R1-maps from n=10 healthy volunteers. The trained network was applied to enhance paediatric focal epilepsy 3T R1 images from a different scanner/site (n=17 MRI lesion positive / n=14 MR-negative). Radiological review assessed image quality, as well as lesion identification and visualization of enhanced maps in comparison to the 3T R1-maps without clinical information. Lesion appearance was then compared to 3D-FLAIR. ResultsAI enhanced R1 maps were superior in terms of image quality in comparison to the original 3T R1 maps, while preserving and enhancing the visibility of lesions. After exclusion of 5/31 patients (due to movement artefact or incomplete data), lesions were detected in AI Enhanced R1 maps for 14/15 (93%) MR-positive and 4/11 (36%) MR-negative patients. ConclusionAI enhanced R1 maps improved the visibility of lesions in MR positive patients, as well as providing higher sensitivity in the MR-negative group compared to either the original 3T R1-maps or 3D-FLAIR. This provides promising initial evidence that 3T quantitative maps can outperform conventional 3T imaging via enhancement by an AI model trained on 7T MRI data, without the need for pathology-specific information.

Deep learning has transformed computer vision but relies heavily on large labeled datasets and computational resources. Transfer learning, particularly fine-tuning pretrained models, offers a practical alternative; however, models pretrained on natural image datasets such as ImageNet may fail to capture domain-specific characteristics in medical imaging. This study introduces an unsupervised learning framework that extracts high-value dermatological features instead of relying solely on ImageNet-based pretraining. We employ a Variational Autoencoder (VAE) trained from scratch on a proprietary dermatological dataset, allowing the model to learn a structured and clinically relevant latent space. This self-supervised feature extractor is then compared to an ImageNet-pretrained backbone under identical classification conditions, highlighting the trade-offs between general-purpose and domain-specific pretraining. Our results reveal distinct learning patterns. The self-supervised model achieves a final validation loss of 0.110 (-33.33%), while the ImageNet-pretrained model stagnates at 0.100 (-16.67%), indicating overfitting. Accuracy trends confirm this: the self-supervised model improves from 45% to 65% (+44.44%) with a near-zero overfitting gap, whereas the ImageNet-pretrained model reaches 87% (+50.00%) but plateaus at 75% (+19.05%), with its overfitting gap increasing to +0.060. These findings suggest that while ImageNet pretraining accelerates convergence, it also amplifies overfitting on non-clinically relevant features. In contrast, self-supervised learning achieves steady improvements, stronger generalization, and superior adaptability, underscoring the importance of domain-specific feature extraction in medical imaging.

Background and Purpose Assessment of brain lesions on MRI is crucial for research in multiple sclerosis (MS). Manual segmentation is time consuming and inconsistent. We aimed to develop an automated MS lesion segmentation algorithm for T2-weighted fluid-attenuated inversion recovery (FLAIR) MRI. Methods We developed FLAIR Lesion Analysis in Multiple Sclerosis (FLAMeS), a deep learning-based MS lesion segmentation algorithm based on the nnU-Net 3D full-resolution U-Net and trained on 668 FLAIR 1.5 and 3 tesla scans from persons with MS. FLAMeS was evaluated on three external datasets: MSSEG-2 (n=14), MSLesSeg (n=51), and a clinical cohort (n=10), and compared to SAMSEG, LST-LPA, and LST-AI. Performance was assessed qualitatively by two blinded experts and quantitatively by comparing automated and ground truth lesion masks using standard segmentation metrics. Results In a blinded qualitative review of 20 scans, both raters selected FLAMeS as the most accurate segmentation in 15 cases, with one rater favoring FLAMeS in two additional cases. Across all testing datasets, FLAMeS achieved a mean Dice score of 0.74, a true positive rate of 0.84, and an F1 score of 0.78, consistently outperforming the benchmark methods. For other metrics, including positive predictive value, relative volume difference, and false positive rate, FLAMeS performed similarly or better than benchmark methods. Most lesions missed by FLAMeS were smaller than 10 mm3, whereas the benchmark methods missed larger lesions in addition to smaller ones. Conclusions FLAMeS is an accurate, robust method for MS lesion segmentation that outperforms other publicly available methods.

Prostate cancer (PCa) is the most commonly diagnosed malignancy in men worldwide. Accurate triage of patients based on tumor aggressiveness and staging is critical for selecting appropriate management pathways. While magnetic resonance imaging (MRI) has become a mainstay in PCa diagnosis, most predictive models rely on multiparametric imaging or invasive inputs, limiting generalizability in real-world clinical settings. This study aimed to develop and validate machine learning (ML) models using radiomic features extracted from T2-weighted MRI--alone and in combination with clinical variables--to predict ISUP grade (tumor aggressiveness), lymph node involvement (cN) and distant metastasis (cM). A retrospective multicenter cohort from three European sites in the Chaimeleon project was analyzed. Radiomic features were extracted from prostate zone segmentations and lesion masks, following standardized preprocessing and ComBat harmonization. Feature selection and model optimization were performed using nested cross-validation and Bayesian tuning. Hybrid models were trained using XGBoost and interpreted with SHAP values. The ISUP model achieved an AUC of 0.66, while the cN and cM models reached AUCs of 0.77 and 0.80, respectively. The best-performing models consistently combined prostate zone radiomics with clinical features such as PSA, PIRADSv2 and ISUP grade. SHAP analysis confirmed the importance of both clinical and texture-based radiomic features, with entropy and non-uniformity measures playing central roles in all tasks. Our results demonstrate the feasibility of using T2-weighted MRI and zonal radiomics for robust prediction of aggressiveness, nodal involvement and distant metastasis in PCa. This fully automated pipeline offers an interpretable, accessible and clinically translatable tool for first-line PCa triage, with potential integration into real-world diagnostic workflows.