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 and validate a deep learning radiomics nomogram (DLRN) derived from ultrasound images to improve predictive accuracy for lymph node metastasis (LNM) in pancreatic cancer (PC) patients. A retrospective analysis of 249 histopathologically confirmed PC cases, including 78 with LNM, was conducted, with an 8:2 division into training and testing cohorts. Eight transfer learning models and a baseline logistic regression model incorporating handcrafted radiomic and clinicopathological features were developed to evaluate predictive performance. Diagnostic effectiveness was assessed for junior and senior ultrasound physicians, both with and without DLRN assistance. InceptionV3 showed the highest performance among DL models (AUC = 0.844), while the DLRN model, integrating deep learning and radiomic features, demonstrated superior accuracy (AUC = 0.909), robust calibration, and significant clinical utility per decision curve analysis. DLRN assistance notably enhanced diagnostic performance, with AUC improvements of 0.238 (<i>p</i> = 0.006) for junior and 0.152 (<i>p</i> = 0.085) for senior physicians. The ultrasound-based DLRN model exhibits strong predictive capability for LNM in PC, offering a valuable decision-support tool that bolsters diagnostic accuracy, especially among less experienced clinicians, thereby supporting more tailored therapeutic strategies for PC patients.

Endoscopic image classification plays a pivotal role in medical diagnostics by identifying anatomical landmarks and pathological findings. However, conventional closed-set classification frameworks are inherently limited in open-world clinical settings, where previously unseen conditions can arise andcompromise model reliability. To address this, we explore the application of Open Set Recognition (OSR) techniques on the Kvasir dataset, a publicly available and diverse endoscopic image collection. In this study, we evaluate and compare the OSR capabilities of several representative deep learning architectures, including ResNet-50, Swin Transformer, and a hybrid ResNet-Transformer model, under both closed-set and open-set conditions. OpenMax is adopted as a baseline OSR method to assess the ability of these models to distinguish known classes from previously unseen categories. This work represents one of the first efforts to apply open set recognition to the Kvasir dataset and provides a foundational benchmark for evaluating OSR performance in medical image analysis. Our results offer practical insights into model behavior in clinically realistic settings and highlight the importance of OSR techniques for the safe deployment of AI systems in endoscopy.

Aimed to develop and validate a CT radiomics-based explainable machine learning model for diagnosing malignancy and benignity specifically in endometrial cancer (EC) patients. A total of 83 EC patients from two centers, including 46 with malignant and 37 with benign conditions, were included, with data split into a training set (n=59) and a testing set (n=24). The regions of interest (ROIs) were manually segmented from pre-surgical CT scans, and 1132 radiomic features were extracted from the pre-surgical CT scans using Pyradiomics. Six explainable machine learning modeling algorithms were implemented respectively, for determining the optimal radiomics pipeline. The diagnostic performance of the radiomic model was evaluated by using sensitivity, specificity, accuracy, precision, F1 score, confusion matrices, and ROC curves. To enhance clinical understanding and usability, we separately implemented SHAP analysis and feature mapping visualization, and evaluated the calibration curve and decision curve. By comparing six modeling strategies, the Random Forest model emerged as the optimal choice for diagnosing EC, with a training AUC of 1.00 and a testing AUC of 0.96. SHAP identified the most important radiomic features, revealing that all selected features were significantly associated with EC (P < 0.05). Radiomics feature maps also provide a feasible assessment tool for clinical applications. DCA indicated a higher net benefit for our model compared to the "All" and "None" strategies, suggesting its clinical utility in identifying high-risk cases and reducing unnecessary interventions. In conclusion, the CT radiomics-based explainable machine learning model achieved high diagnostic performance, which could be used as an intelligent auxiliary tool for the diagnosis of endometrial cancer.

To develop a radiomics risk-predictive model for differentiating the different stages of Hashimoto's thyroiditis (HT). Data from patients with HT who underwent definitive surgical pathology between January 2018 and December 2023 were retrospectively collected and categorized into early HT (HT patients with simple positive antibodies or simultaneously accompanied by elevated thyroid hormones) and late HT (HT patients with positive antibodies and beginning to present subclinical hypothyroidism or developing hypothyroidism). Ultrasound images and five clinical and 12 laboratory indicators were obtained. Six classifiers were used to construct radiomics models. The gradient boosting decision tree (GBDT) classifier was used to screen for the best features to explore the main risk factors for differentiating early HT. The performance of each model was evaluated by receiver operating characteristic (ROC) curve. The model was validated using one internal and two external test cohorts. A total of 785 patients were enrolled. Extreme gradient boosting (XGBOOST) showed best performance in the training cohort, with an AUC of 0.999 (0.998, 1), and AUC values of 0.993 (0.98, 1), 0.947 (0.866, 1), and 0.98 (0.939, 1), respectively, in the internal test, first external, and second external cohorts. Ultrasound radiomic features contributed to 78.6% (11/14) of the model. The first-order feature of traverse section of thyroid ultrasound image, texture feature gray-level run length matrix (GLRLM) of longitudinal section of thyroid ultrasound image and free thyroxine showed the greatest contributions in the model. Our study developed and tested a risk-predictive model that effectively differentiated HT stages to more precisely and actively manage patients with HT at an earlier stage.

A reliable evaluation of surgical difficulty can improve the success of the treatment for rectal cancer and the current evaluation method is based on clinical data. However, more data about rectal cancer can be collected with the development of technology. Meanwhile, with the development of artificial intelligence, its application in rectal cancer treatment is becoming possible. In this paper, a multi-view rectal cancer dataset is first constructed to give a more comprehensive view of patients, including the high-resolution MRI image view, pressed-fat MRI image view, and clinical data view. Then, an interpretable incomplete multi-view surgical evaluation model is proposed, considering that it is hard to obtain extensive and complete patient data in real application scenarios. Specifically, a dual representation incomplete multi-view learning model is first proposed to extract the common information between views and specific information in each view. In this model, the missing view imputation is integrated into representation learning, and second-order similarity constraint is also introduced to improve the cooperative learning between these two parts. Then, based on the imputed multi-view data and the learned dual representation, a multi-view surgical evaluation model with the TSK fuzzy system is proposed. In the proposed model, a cooperative learning mechanism is constructed to explore the consistent information between views, and Shannon entropy is also introduced to adapt the view weight. On the MVRC dataset, we compared it with several advanced algorithms and DRIMV_TSK obtained the best results.

This study considers the application of ultrasound placental image texture analysis for the prediction of hypertensive disorders of pregnancy (HDP) using deep learning (DL) algorithm. In this prospective observational study, placental ultrasound images were taken serially at 11-14 weeks (T1), 20-24 weeks (T2), and 28-32 weeks (T3). Pregnant women with blood pressure at or above 140/90 mmHg on two occasions 4 h apart were considered to have HDP. The image data of women with HDP were compared with those with a normal outcome using DL techniques such as convolutional neural networks (CNN), transfer learning, and a Vision Transformer (ViT) with a TabNet classifier. The accuracy and the Cohen kappa scores of the different DL techniques were compared. A total of 600/1008 (59.5%) subjects had a normal outcome, and 143/1008 (14.2%) had HDP; the reminder, 265/1008 (26.3%), had other adverse outcomes. In the basic CNN model, the accuracy was 81.6% for T1, 80% for T2, and 82.8% for T3. Using the Efficient Net B0 transfer learning model, the accuracy was 87.7%, 85.3%, and 90.3% for T1, T2, and T3, respectively. Using a TabNet classifier with a ViT, the accuracy and area under the receiver operating characteristic curve scores were 91.4% and 0.915 for T1, 90.2% and 0.904 for T2, and 90.3% and 0.907 for T3. The sensitivity and specificity for HDP prediction using ViT were 89.1% and 91.7% for T1, 86.6% and 93.7% for T2, and 85.6% and 94.6% for T3. Ultrasound placental image texture analysis using DL could differentiate women with a normal outcome and those with HDP with excellent accuracy and could open new avenues for research in this field.

The therapeutic management of neoplasm employs high level energy beam to ablate malignant cells, which can cause collateral damage to adjacent normal tissue. Furthermore, respiration-induced organ motion, during radiotherapy can lead to significant displacement of neoplasms. In this work, a non-invasive ultrasound-based deep learning algorithm for respiratory motion compensation system (RMCS) was developed to mitigate the effect of respiratory motion induced neoplasm movement in radiotherapy. The deep learning algorithm generated based on modified YOLOv8n (You Only Look Once), by incorporating squeeze and excitation blocks for channel wise recalibration and enhanced attention mechanisms for spatial channel focus (SE-ATT-YOLO) to cope up with enhanced ultrasound image detection in real time scenario. The trained model was inferred with ultrasound movement of human diaphragm and tracked the bounding box coordinates using BoT-Sort, which drives the RMCS. The SE-ATT-YOLO model achieved mean average precision (mAP) of 0.88 which outperforms YOLOv8n with the value of 0.85. The root mean square error (RMSE) obtained from prerecorded respiratory signals with the compensated RMCS signal was calculated. The model achieved an inference speed of approximately 50 FPS. The RMSE values recorded were 4.342 for baseline shift, 3.105 for sinusoidal signal, 1.778 for deep breath, and 1.667 for slow signal. The SE-ATT-YOLO model outperformed all the results of previous models. The loss function uncertainty in YOLOv8n model was rectified in SE-ATT YOLO depicting the stability of the model. The model' stability, speed and accuracy of the model optimized the performance of the RMCS.

Being born small carries significant health risks, including increased neonatal mortality and a higher likelihood of future cardiac diseases. Accurate estimation of gestational age is critical for monitoring fetal growth, but traditional methods, such as estimation based on the last menstrual period, are in some situations difficult to obtain. While ultrasound-based approaches offer greater reliability, they rely on manual measurements that introduce variability. This study presents an interpretable deep learning-based method for automated gestational age calculation, leveraging a novel segmentation architecture and distance maps to overcome dataset limitations and the scarcity of segmentation masks. Our approach achieves performance comparable to state-of-the-art models while reducing complexity, making it particularly suitable for resource-constrained settings and with limited annotated data. Furthermore, our results demonstrate that the use of distance maps is particularly suitable for estimating femur endpoints.

Endometrial cancer (EC) is a common gynecologic malignancy; accurate assessment of key prognostic factors is important for treatment planning. To develop a deep learning (DL) framework based on biparametric MRI for automated segmentation and multitask classification of EC key prognostic factors, including grade, stage, histological subtype, lymphovascular space invasion (LVSI), and deep myometrial invasion (DMI). Retrospective. A total of 325 patients with histologically confirmed EC were included: 211 training, 54 validation, and 60 test cases. T2-weighted imaging (T2WI, FSE/TSE) and diffusion-weighted imaging (DWI, SS-EPI) sequences at 1.5 and 3 T. The DL model comprised tumor segmentation and multitask classification. Manual delineation on T2WI and DWI acted as the reference standard for segmentation. Separate models were trained using T2WI alone, DWI alone and combined T2WI + DWI to classify dichotomized key prognostic factors. Performance was assessed in validation and test cohorts. For DMI, the combined model's was compared with visual assessment by four radiologists (with 1, 4, 7, and 20 years' experience), each of whom independently reviewed all cases. Segmentation was evaluated using the dice similarity coefficient (DSC), Jaccard similarity coefficient (JSC), Hausdorff distance (HD95), and average surface distance (ASD). Classification performance was assessed using area under the receiver operating characteristic curve (AUC). Model AUCs were compared using DeLong's test. p < 0.05 was considered significant. In the test cohort, DSCs were 0.80 (T2WI) and 0.78 (DWI) and JSCs were 0.69 for both. HD95 and ASD were 7.02/1.71 mm (T2WI) versus 10.58/2.13 mm (DWI). The classification framework achieved AUCs of 0.78-0.94 (validation) and 0.74-0.94 (test). For DMI, the combined model performed comparably to radiologists (p = 0.07-0.84). The unified DL framework demonstrates strong EC segmentation and classification performance, with high accuracy across multiple tasks. 3. Stage 3.