Uncertainty assessment of deep learning autosegmentation (DLAS) models can support contour corrections in adaptive radiotherapy (ART), e.g. by utilizing Monte Carlo Dropout (MCD) uncertainty maps. However, poorly calibrated uncertainties at the patient level often render these clinically nonviable. We evaluated population-based and patient-specific DLAS accuracy and uncertainty calibration and propose a patient-specific post-training uncertainty calibration method for DLAS in ART.&#xD;&#xD;Approach. The study included 122 lung cancer patients treated with a low-field MR-linac (80/19/23 training/validation/test cases). Ten single-label 3D-U-Net population-based baseline models (BM) were trained with dropout using planning MRIs (pMRIs) and contours for nine organs-at-riks (OARs) and gross tumor volumes (GTVs). Patient-specific models (PS) were created by fine-tuning BMs with each test patient's pMRI. Model uncertainty was assessed with MCD, averaged into probability maps. Uncertainty calibration was evaluated with reliability diagrams and expected calibration error (ECE). A proposed post-training calibration method rescaled MCD probabilities for fraction images in BM (calBM) and PS (calPS) after fitting reliability diagrams from pMRIs. All models were evaluated on fraction images using Dice similarity coefficient (DSC), 95th percentile Hausdorff distance (HD95) and ECE. Metrics were compared among models for all OARs combined (n=163), and the GTV (n=23), using Friedman and posthoc-Nemenyi tests (α=0.05).&#xD;&#xD;Main results. For the OARs, patient-specific fine-tuning significantly (p<0.001) increased median DSC from 0.78 (BM) to 0.86 (PS) and reduced HD95 from 14mm (BM) to 6.0mm (PS). Uncertainty calibration achieved substantial reductions in ECE, from 0.25 (BM) to 0.091 (calBM) and 0.22 (PS) to 0.11 (calPS) (p<0.001), without significantly affecting DSC or HD95 (p>0.05). For the GTV, BM performance was poor (DSC=0.05) but significantly (p<0.001) improved with PS training (DSC=0.75) while uncertainty calibration reduced ECE from 0.22 (PS) to 0.15 (calPS) (p=0.45).&#xD;&#xD;Significance. Post-training uncertainty calibration yields geometrically accurate DLAS models with well-calibrated uncertainty estimates, crucial for ART applications.

In compressed sensing (CS) MRI, model-based methods are pivotal to achieving accurate reconstruction. One of the main challenges in model-based methods is finding an effective prior to describe the statistical distribution of the target image. Plug-and-Play (PnP) and REgularization by Denoising (RED) are two general frameworks that use denoisers as the prior. While PnP/RED methods with convolutional neural networks (CNNs) based denoisers outperform classical hand-crafted priors in CS MRI, their convergence theory relies on assumptions that do not hold for practical CNNs. The recently developed gradient-driven denoisers offer a framework that bridges the gap between practical performance and theoretical guarantees. However, the numerical solvers for the associated minimization problem remain slow for CS MRI reconstruction. This paper proposes a complex quasi-Newton proximal method that achieves faster convergence than existing approaches. To address the complex domain in CS MRI, we propose a modified Hessian estimation method that guarantees Hermitian positive definiteness. Furthermore, we provide a rigorous convergence analysis of the proposed method for nonconvex settings. Numerical experiments on both Cartesian and non-Cartesian sampling trajectories demonstrate the effectiveness and efficiency of our approach.

Timely intervention and improved prognosis for breast cancer patients rely on early metastasis risk detection and accurate treatment predictions. This study introduces an advanced multimodal MRI and AI-driven 3D deep learning model, termed the 3D-MMR-model, designed to predict recurrence risk in non-metastatic breast cancer patients. We conducted a multicenter study involving 1199 non-metastatic breast cancer patients from four institutions in China, with comprehensive MRI and clinical data retrospectively collected. Our model employed multimodal-data fusion, utilizing contrast-enhanced T1-weighted imaging (T1 + C) and T2-weighted imaging (T2WI) volumes, processed through a modified 3D-UNet for tumor segmentation and a DenseNet121-based architecture for disease-free survival (DFS) prediction. Additionally, we performed RNA-seq analysis to delve further into the relationship between concentrated hotspots within the tumor region and the tumor microenvironment. The 3D-MR-model demonstrated superior predictive performance, with time-dependent ROC analysis yielding AUC values of 0.90, 0.89, and 0.88 for 2-, 3-, and 4-year DFS predictions, respectively, in the training cohort. External validation cohorts corroborated these findings, highlighting the model's robustness across diverse clinical settings. Integration of clinicopathological features further enhanced the model's accuracy, with a multimodal approach significantly improving risk stratification and decision-making in clinical practice. Visualization techniques provided insights into the decision-making process, correlating predictions with tumor microenvironment characteristics. In summary, the 3D-MMR-model represents a significant advancement in breast cancer prognosis, combining cutting-edge AI technology with multimodal imaging to deliver precise and clinically relevant predictions of recurrence risk. This innovative approach holds promise for enhancing patient outcomes and guiding individualized treatment plans in breast cancer care.

Timely intervention for Alzheimers disease (AD) requires early detection. The development of immunotherapies targeting amyloid-beta and tau underscores the need for accessible, time-efficient biomarkers for early diagnosis. Here, we directly applied our previously developed MRI-based deep learning model for AD to the large Chinese SILCODE cohort (722 participants, 1,105 brain MRI scans). The model -- initially trained on North American data -- demonstrated robust cross-ethnic generalization, without any retraining or fine-tuning, achieving an AUC of 91.3% in AD classification with a sensitivity of 95.2%. It successfully identified 86.7% of individuals at risk of AD progression more than 5 years in advance. Individuals identified as high-risk exhibited significantly shorter median progression times. By integrating an interpretable deep learning brain risk map approach, we identified AD brain subtypes, including an MCI subtype associated with rapid cognitive decline. The models risk scores showed significant correlations with cognitive measures and plasma biomarkers, such as tau proteins and neurofilament light chain (NfL). These findings underscore the exceptional generalizability and clinical utility of MRI-based deep learning models, especially in large and diverse populations, offering valuable tools for early therapeutic intervention. The model has been made open-source and deployed to a free online website for AD risk prediction, to assist in early screening and intervention.

Alzheimers Disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss. In 2024, in the US alone, it affected approximately 1 in 9 people aged 65 and older, equivalent to 6.9 million individuals. Early detection and accurate AD diagnosis are crucial for improving patient outcomes. Magnetic resonance imaging (MRI) has emerged as a valuable tool for examining brain structure and identifying potential AD biomarkers. This study performs predictive analyses by employing machine learning techniques to identify key brain regions associated with AD using numerical data derived from anatomical MRI scans, going beyond standard statistical methods. Using the Random Forest Algorithm, we achieved 92.87% accuracy in detecting AD from Mild Cognitive Impairment and Cognitive Normals. Subgroup analyses across nine sex- and age-based cohorts (69-76 years, 77-84 years, and unified 69-84 years) revealed the hippocampus, amygdala, and entorhinal cortex as consistent top-rank predictors. These regions showed distinct volume reductions across age and sex groups, reflecting distinct age- and sex-related neuroanatomical patterns. For instance, younger males and females (aged 69-76) exhibited volume decreases in the right hippocampus, suggesting its importance in the early stages of AD. Older males (77-84) showed substantial volume decreases in the left inferior temporal cortex. Additionally, the left middle temporal cortex showed decreased volume in females, suggesting a potential female-specific influence, while the right entorhinal cortex may have a male-specific impact. These age-specific sex differences could inform clinical research and treatment strategies, aiding in identifying neuroanatomical markers and therapeutic targets for future clinical interventions.

Craniopharyngiomas (CPs) are rare, benign brain tumors originating from Rathke's pouch remnants, typically located in the sellar/parasellar region. Accurate differentiation is crucial due to varying prognoses, with ACPs having higher recurrence and worse outcomes. MRI struggles with overlapping features, complicating diagnosis. this study evaluates the role of Artificial Intelligence (AI) in diagnosing, segmenting, and classifying CPs, emphasizing its potential to improve clinical decision-making, particularly for radiologists and neurosurgeons. This systematic review and meta-analysis assess AI applications in diagnosing, segmenting, and classifying on CPs patients. a comprehensive search was conducted across PubMed, Scopus, Embase and Web of Science for studies employing AI models in patients with CP. Performance metrics such as sensitivity, specificity, accuracy, and area under the curve (AUC) were extracted and synthesized. Eleven studies involving 1916 patients were included in the analysis. The pooled results revealed a sensitivity of 0.740 (95% CI: 0.673-0.808), specificity of 0.813 (95% CI: 0.729-0.898), and accuracy of 0.746 (95% CI: 0.679-0.813). The area under the curve (AUC) for diagnosis was 0.793 (95% CI: 0.719-0.866), and for classification, it was 0.899 (95% CI: 0.846-0.951). The sensitivity for segmentation was found to be 0.755 (95% CI: 0.704-0.805). AI-based models show strong potential in enhancing the diagnostic accuracy and clinical decision-making process for CPs. These findings support the use of AI tools for more reliable preoperative assessment, leading to better treatment planning and patient outcomes. Further research with larger datasets is needed to optimize and validate AI applications in clinical practice.

Recent advances in deep learning-based parallel compressed sensing magnetic resonance imaging (p-CSMRI) have significantly improved reconstruction quality. However, current p-CSMRI methods often require training separate deep neural network (DNN) for each organ due to anatomical variations, creating a barrier to developing generalized medical image reconstruction systems. To address this, we propose CAPNet (cross-organ all-in-one deep unfolding p-CSMRI network), a unified framework that implements a p-CSMRI iterative algorithm via three specialized modules: auxiliary variable module, prior module, and data consistency module. Recognizing that p-CSMRI systems often employ varying sampling ratios for different organs, resulting in organ-specific artifact patterns, we introduce an artifact generation submodule, which extracts and integrates artifact features into the data consistency module to enhance the discriminative capability of the overall network. For the prior module, we design an organ structure-prompt generation submodule that leverages structural features extracted from the segment anything model (SAM) to create cross-organ prompts. These prompts are strategically incorporated into the prior module through an organ structure-aware Mamba submodule. Comprehensive evaluations on a cross-organ dataset confirm that CAPNet achieves state-of-the-art reconstruction performance across multiple anatomical structures using a single unified model. Our code will be published at https://github.com/shibaoshun/CAPNet.

A three-dimensional convolutional neural network was developed to classify T1-weighted brain MRI scans as healthy or Alzheimer. The network comprises 3D convolution, pooling, batch normalization, dense ReLU layers, and a sigmoid output. Using stochastic noise injection and five-fold cross-validation, the model achieved test set accuracy of 0.912 and area under the ROC curve of 0.961, an improvement of approximately 0.027 over resizing alone. Sensitivity and specificity both exceeded 0.90. These results align with prior work reporting up to 0.10 gain via synthetic augmentation. The findings demonstrate the effectiveness of simple augmentation for 3D MRI classification and motivate future exploration of advanced augmentation methods and architectures such as 3D U-Net and vision transformers.

Our study presents PNN-UNet as a method for constructing deep neural networks that replicate the planarian neural network (PNN) structure in the context of 3D medical image data. Planarians typically have a cerebral structure comprising two neural cords, where the cerebrum acts as a coordinator, and the neural cords serve slightly different purposes within the organism's neurological system. Accordingly, PNN-UNet comprises a Deep-UNet and a Wide-UNet as the nerve cords, with a densely connected autoencoder performing the role of the brain. This distinct architecture offers advantages over both monolithic (UNet) and modular networks (Ensemble-UNet). Our outcomes on a 3D MRI hippocampus dataset, with and without data augmentation, demonstrate that PNN-UNet outperforms the baseline UNet and several other UNet variants in image segmentation.

Magnetic Resonance Imaging (MRI) is the gold standard in countless diagnostic procedures, yet hardware complexity, long scans, and cost preclude rapid screening and point-of-care use. We introduce Imageless Magnetic Resonance Diagnosis (IMRD), a framework that bypasses k-space sampling and image reconstruction by analyzing raw one-dimensional MR signals. We identify potentially impactful embodiments where IMRD requires only optimized pulse sequences for time-domain contrast, minimal low-field hardware, and pattern recognition algorithms to answer clinical closed queries and quantify lesion burden. As a proof of concept, we simulate multiple sclerosis lesions in silico within brain phantoms and deploy two extremely fast protocols (approximately 3 s), with and without spatial information. A 1D convolutional neural network achieves AUC close to 0.95 for lesion detection and R2 close to 0.99 for volume estimation. We also perform robustness tests under reduced signal-to-noise ratio, partial signal omission, and relaxation-time variability. By reframing MR signals as direct diagnostic metrics, IMRD paves the way for fast, low-cost MR screening and monitoring in resource-limited environments.