Image-to-image (I2I) translation networks have emerged as promising tools for generating synthetic medical images; however, their clinical reliability and ability to preserve diagnostically relevant features remain underexplored. This study evaluates the performance of state-of-the-art 2D/3D I2I networks for converting ultrasound (US) images to synthetic MRI in prostate cancer (PCa) imaging. The novelty lies in combining radiomics, expert clinical evaluation, and classification performance to comprehensively benchmark these models for potential integration into real-world diagnostic workflows. A dataset of 794 PCa patients was analyzed using ten leading I2I networks to synthesize MRI from US input. Radiomics feature (RF) analysis was performed using Spearman correlation to assess whether high-performing networks (SSIM > 0.85) preserved quantitative imaging biomarkers. A qualitative evaluation by seven experienced physicians assessed the anatomical realism, presence of artifacts, and diagnostic interpretability of synthetic images. Additionally, classification tasks using synthetic images were conducted using two machine learning and one deep learning model to assess the practical diagnostic benefit. Among all networks, 2D-Pix2Pix achieved the highest SSIM (0.855 ± 0.032). RF analysis showed that 76 out of 186 features were preserved post-translation, while the remainder were degraded or lost. Qualitative feedback revealed consistent issues with low-level feature preservation and artifact generation, particularly in lesion-rich regions. These evaluations were conducted to assess whether synthetic MRI retained clinically relevant patterns, supported expert interpretation, and improved diagnostic accuracy. Importantly, classification performance using synthetic MRI significantly exceeded that of US-based input, achieving average accuracy and AUC of ~ 0.93 ± 0.05. Although 2D-Pix2Pix showed the best overall performance in similarity and partial RF preservation, improvements are still required in lesion-level fidelity and artifact suppression. The combination of radiomics, qualitative, and classification analyses offered a holistic view of the current strengths and limitations of I2I models, supporting their potential in clinical applications pending further refinement and validation.

Lymphoma poses a critical health challenge worldwide, demanding computer aided solutions towards diagnosis, treatment, and research to significantly enhance patient outcomes and combat this pervasive disease. Accurate classification of lymphoma subtypes from Whole Slide Images (WSIs) remains a complex challenge due to morphological similarities among subtypes and the limitations of models that fail to jointly capture local and global features. Traditional diagnostic methods, limited by subjectivity and inconsistencies, highlight the need for advanced, Artificial Intelligence (AI)-driven solutions. This study proposes a hybrid deep learning framework-Hybrid Convolutional and Transformer Network for Lymphoma Classification (HCTN-LC)-designed to enhance the precision and interpretability of lymphoma subtype classification. The model employs a dual-pathway architecture that combines a lightweight SqueezeNet for local feature extraction with a Vision Transformer (ViT) for capturing global context. A Feature Fusion and Enhancement Module (FFEM) is introduced to dynamically integrate features from both pathways. The model is trained and evaluated on a large WSI dataset encompassing three lymphoma subtypes: CLL, FL, and MCL. HCTN-LC achieves superior performance with an overall accuracy of 99.87%, sensitivity of 99.87%, specificity of 99.93%, and AUC of 0.9991, outperforming several recent hybrid models. Grad-CAM visualizations confirm the model's focus on diagnostically relevant regions. The proposed HCTN-LC demonstrates strong potential for real-time and low-resource clinical deployment, offering a robust and interpretable AI tool for hematopathological diagnosis.

The thymus is an important immune organ involved in T-cell generation. Age-related involution of the thymus has been linked to various age-related pathologies in recent studies. However, there has been no method proposed to quantify age-related thymic involution based on a clinical image. The purpose of this study was to establish an objective and automatic method to quantify age-related thymic involution based on plain chest computed tomography (CT) images. We newly defined the thymic region for quantification (TRQ) as the target anatomical region. We manually segmented the TRQ in 135 CT studies, followed by construction of segmentation neural network (NN) models using the data. We developed the estimator of thymic volume (ETV), a quantitative indicator of the thymic tissue volume inside the segmented TRQ, based on simple mathematical modeling. The Hounsfield unit (HU) value and volume of the NN-segmented TRQ were measured, and the ETV was calculated in each CT study from 853 healthy subjects. We investigated how these measures were related to age and sex using quantile additive regression models. A significant correlation between the NN-segmented and manually segmented TRQ was seen for both the HU value and volume (r = 0.996 and r = 0.986, respectively). ETV declined exponentially with age (p < 0.001), consistent with age-related decline in the thymic tissue volume. In conclusion, our method enabled robust quantification of age-related thymic involution. Our method may aid in the prediction and risk classification of pathologies related to thymic involution.

Hepatocellular carcinoma (HCC) is the most common subtype of primary liver cancer, with significant variability in patient outcomes even within the same stage according to the Barcelona Clinic Liver Cancer staging system. Accurately predicting patient prognosis and potential treatment response prior to therapy initiation is crucial for personalized clinical decision-making. This review focuses on the application of artificial intelligence (AI) in magnetic resonance imaging for guiding individualized treatment strategies in HCC management. Specifically, we emphasize AI-based tools for pre-treatment prediction of therapeutic response and prognosis. AI techniques such as radiomics and deep learning have shown strong potential in extracting high-dimensional imaging features to characterize tumors and liver parenchyma, predict treatment outcomes, and support prognostic stratification. These advances contribute to more individualized and precise treatment planning. However, challenges remain in model generalizability, interpretability, and clinical integration, highlighting the need for standardized imaging datasets and multi-omics fusion to fully realize the potential of AI in personalized HCC care. Evidence level: 5. Technical efficacy: 4.

This study aimed to identify patient characteristics linked to mistaken treatments and major adverse cardiovascular events (MACE) in percutaneous coronary intervention (PCI) for coronary artery disease (CAD) using deep learning-based fractional flow reserve (DEEPVESSEL-FFR, DVFFR). A retrospective cohort of 3,840 PCI patients was analyzed using latent class analysis (LCA) based on eight factors. Mistaken treatment was defined as negative DVFFR patients undergoing revascularization or positive DVFFR patients not receiving it. MACE included all-cause mortality, rehospitalization for unstable angina, and non-fatal myocardial infarction. Patients were classified into comorbidities (Class 1), smoking-drinking (Class 2), and relatively healthy (Class 3) groups. Mistaken treatment was highest in Class 2 (15.4% vs. 6.7%, <i>P</i> < .001), while MACE was highest in Class 1 (7.0% vs. 4.8%, <i>P</i> < .001). Adjusted analyses showed increased mistaken treatment risk in Class 1 (OR 1.96; 95% CI 1.49-2.57) and Class 2 (OR 1.69; 95% CI 1.28-2.25) compared with Class 3. Class 1 also had higher MACE risk (HR 1.53; 95% CI 1.10-2.12). In conclusion, comorbidities and smoking-drinking classes had higher mistaken treatment and MACE risks compared with the relatively healthy class.

Medical radiology reports play a crucial role in diagnosing various diseases, yet generating them manually is time-consuming and burdens clinical workflows. Medical radiology report generation aims to automate this process using deep learning to assist radiologists and reduce patient wait times. This study presents the most comprehensive systematic review to date on deep learning-based MRRG, encompassing recent advances that span traditional architectures to large language models. We focus on available datasets, modeling approaches, and evaluation practices. Following PRISMA guidelines, we retrieved 323 articles from major academic databases and included 78 studies after eligibility screening. We critically analyze key components such as model architectures, loss functions, datasets, evaluation metrics, and optimizers - identifying 22 widely used datasets, 14 evaluation metrics, around 20 loss functions, over 25 visual backbones, and more than 30 textual backbones. To support reproducibility and accelerate future research, we also compile links to modern models, toolkits, and pretrained resources. Our findings provide technical insights and outline future directions to address current limitations, promoting collaboration at the intersection of medical imaging, natural language processing, and deep learning to advance trustworthy AI systems in radiology.

To evaluate the cost-effectiveness of AI-assisted digital mammography (AI-DM) compared to conventional biennial breast cancer digital mammography screening (cDM) with double reading of screening mammograms, and to investigate the change in cost-effectiveness based on four different sub-strategies of AI-DM. A decision-analytic state-transition Markov model was used to analyse the decision of whether to use cDM or AI-DM in breast cancer screening. In this Markov model, one-year cycles were used, and the analysis was performed from a healthcare perspective with a lifetime horizon. In the model, we analysed 1000 hypothetical individuals attending mammography screenings assessed with AI-DM compared with 1000 hypothetical individuals assessed with cDM. The total costs, including both screening-related costs and breast cancer-related costs, were €3,468,967 and €3,528,288 for AI-DM and cDM, respectively. AI-DM resulted in a cost saving of €59,320 compared to cDM. Per 1000 individuals, AI-DM gained 10.8 quality-adjusted life years (QALYs) compared to cDM. Gained QALYs at a lower cost means that the AI-DM screening strategy was dominant compared to cDM. Break-even occurred at the second screening at age 42 years. This analysis showed that AI-assisted mammography for biennial breast cancer screening in a Swedish population of women aged 40-74 years is a cost-saving strategy compared to a conventional strategy using double human screen reading. Further clinical studies are needed, as scenario analyses showed that other strategies, more dependent on AI, are also cost-saving. Question To evaluate the cost-effectiveness of AI-DM in comparison to conventional biennial breast cDM screening. Findings AI-DM is cost-effective, and the break-even point occurred at the second screening at age 42 years. Clinical relevance The implementation of AI is clearly cost-effective as it reduces the total cost for the healthcare system and simultaneously results in a gain in QALYs.

Recent advances in medical image segmentation have been driven by deep learning; however, most existing methods remain limited by modality-specific designs and exhibit poor adaptability to dynamic medical imaging scenarios. The Segment Anything Model 2 (SAM2) and its related variants, which introduce a streaming memory mechanism for real-time video segmentation, present new opportunities for prompt-based, generalizable solutions. Nevertheless, adapting these models to medical video scenarios typically requires large-scale datasets for retraining or transfer learning, leading to high computational costs and the risk of catastrophic forgetting. To address these challenges, we propose DD-SAM2, an efficient adaptation framework for SAM2 that incorporates a Depthwise-Dilated Adapter (DD-Adapter) to enhance multi-scale feature extraction with minimal parameter overhead. This design enables effective fine-tuning of SAM2 on medical videos with limited training data. Unlike existing adapter-based methods focused solely on static images, DD-SAM2 fully exploits SAM2's streaming memory for medical video object tracking and segmentation. Comprehensive evaluations on TrackRad2025 (tumor segmentation) and EchoNet-Dynamic (left ventricle tracking) datasets demonstrate superior performance, achieving Dice scores of 0.93 and 0.97, respectively. To the best of our knowledge, this work provides an initial attempt at systematically exploring adapter-based SAM2 fine-tuning for medical video segmentation and tracking. Code, datasets, and models will be publicly available at https://github.com/apple1986/DD-SAM2.

The prevalence of Alzheimer's disease and other dementias is increasing as populations live longer lifespans. Imaging is becoming a key component of the workup for patients with cognitive impairment or dementia. Integrated PET-MRI provides a unique opportunity for same-session multimodal characterization with many practical benefits to patients, referring physicians, radiologists, and researchers. The impact of integrated PET-MRI on clinical practice for early adopters of this technology can be profound. Classic imaging findings with integrated PET-MRI are illustrated for common neurodegenerative diseases or clinical-radiological syndromes. This review summarizes recent technical innovations that are being introduced into PET-MRI clinical practice and research for neurodegenerative disease. More recent MRI-based attenuation correction now performs similarly compared to PET-CT (e.g., whole-brain bias < 0.5%) such that early concerns for accurate PET tracer quantification with integrated PET-MRI appear resolved. Head motion is common in this patient population. MRI- and PET data-driven motion correction appear ready for routine use and should substantially improve PET-MRI image quality. PET-MRI by definition eliminates ~50% of the radiation from CT. Multiple hardware and software techniques for improving image quality with lower counts are reviewed (including motion correction). These methods can lower radiation to patients (and staff), increase scanner throughput, and generate better temporal resolution for dynamic PET. Deep learning has been broadly applied to PET-MRI. Deep learning analysis of PET and MRI data may provide accurate classification of different stages of Alzheimer's disease or predict progression to dementia. Over the past 5 years, clinical imaging of neurodegenerative disease has changed due to imaging research and the introduction of anti-amyloid immunotherapy-integrated PET-MRI is best suited for imaging these patients and its use appears poised for rapid growth outside academic medical centers. Evidence level: 5. Technical efficacy: Stage 3.

Chest X-rays (CXR) rank among the most conducted X-ray examinations. They often require repeat imaging due to inadequate quality, leading to increased radiation exposure and delays in patient care and diagnosis. This research assesses the efficacy of DenseNet121 and YOLOv8 neural networks in detecting suboptimal CXRs, which may minimise delays and enhance patient outcomes. The study included 3587 patients with a median age of 67 (0-102). It utilised an initial dataset comprising 10,000 CXRs randomly divided into a training subset (4000 optimal and 4000 suboptimal) and a validation subset (400 optimal and 400 suboptimal). The test subset (25 optimal and 25 suboptimal) was curated from the remaining images to provide adequate variation. Neural networks DenseNet121 and YOLOv8 were chosen due to their capabilities in image classification. DenseNet121 is a robust, well-tested model in the medical industry with high accuracy in object recognition. YOLOv8 is a cutting-edge commercial model targeted at all industries. Their performance was assessed via the area under the receiver operating curve (AUROC) and compared to radiologist classification, utilising the chi-squared test. DenseNet121 attained an AUROC of 0.97, while YOLOv8 recorded a score of 0.95, indicating a strong capability in differentiating between optimal and suboptimal CXRs. The alignment between radiologists and models exhibited variability, partly due to the lack of clinical indications. However, the performance was not statistically significant. Both AI models effectively classified chest X-ray quality, demonstrating the potential for providing radiographers with feedback to improve image quality. Notably, this was the first study to include both PA and lateral CXRs as well as paediatric cases and the first to evaluate YOLOv8 for this application.