We propose a deep learning approach for detecting anterior cruciate ligament (ACL) tears from knee MRI using a dual-branch convolutional architecture. The model independently processes sagittal and coronal MRI sequences using EfficientNet-B2 backbones with spatial attention modules, followed by a late fusion classifier for binary prediction. MRI volumes are standardized to a fixed number of slices, and domain-specific normalization and data augmentation are applied to enhance model robustness. Trained on a stratified 80/20 split of the MRNet dataset, our best model--using the Adam optimizer and a learning rate of 1e-4--achieved a validation AUC of 0.98 and a test AUC of 0.93. These results show strong predictive performance while maintaining computational efficiency. This work demonstrates that accurate diagnosis is achievable using only two anatomical planes and sets the stage for further improvements through architectural enhancements and broader data integration.

Precise temperature control is challenging during transcranial MR-guided focused ultrasound (MRgFUS) treatment. The aim of this study was to develop a deep learning model integrating the treatment parameters for each sonication, along with patient-specific clinical information and skull metrics, for prediction of the MRgFUS therapeutic temperature. This is a retrospective analysis of sonications from patients with essential tremor or Parkinson's disease who underwent unilateral MRgFUS thalamotomy or pallidothalamic tractotomy at a single hospital from January 2019 to June 2023. For model training, a dataset of 600 sonications (72 patients) was used, while a validation dataset comprising 199 sonications (18 patients) was used to assess model performance. Additionally, an external dataset of 146 sonications (20 patients) was used for external validation. The developed deep learning model, called Fust-Net, achieved high predictive accuracy, with normalized mean absolute errors of 1.655°C for the internal dataset and 2.432°C for the external dataset, which closely matched the actual temperature. The graded evaluation showed that Fust-Net achieved an effective temperature prediction rate of 82.6%. These results showcase the exciting potential of Fust-Net for achieving precise temperature control during MRgFUS treatment, opening new doors for enhanced precision and safety in clinical applications.

Machine learning (ML) has been increasingly applied to cervical cancer (CC) research. However, few studies have combined both clinical parameters and imaging data. At the same time, there remains an urgent need for more robust and accurate preoperative assessment of parametrial invasion and lymph node metastasis, as well as postoperative prognosis prediction. The objective of this study is to develop an integrated ML model combining clinicopathological variables and magnetic resonance image features for (1) preoperative parametrial invasion and lymph node metastasis detection and (2) postoperative recurrence and survival prediction. Retrospective data from 250 patients with CC (2014-2022; 2 tertiary hospitals) were analyzed. Variables were assessed for their predictive value regarding parametrial invasion, lymph node metastasis, survival, and recurrence using 7 ML models: K-nearest neighbor (KNN), support vector machine, decision tree, random forest (RF), balanced RF, weighted DT, and weighted KNN. Performance was assessed via 5-fold cross-validation using accuracy, sensitivity, specificity, precision, F1-score, and area under the receiver operating characteristic curve (AUC). The optimal models were deployed in an artificial intelligence-assisted contouring and prognosis prediction system. Among 250 women, there were 11 deaths and 24 recurrences. (1) For preoperative evaluation, the integrated model using balanced RF achieved optimal performance (sensitivity 0.81, specificity 0.85) for parametrial invasion, while weighted KNN achieved the best performance for lymph node metastasis (sensitivity 0.98, AUC 0.72). (2) For postoperative prognosis, weighted KNN also demonstrated high accuracy for recurrence (accuracy 0.94, AUC 0.86) and mortality (accuracy 0.97, AUC 0.77), with relatively balanced sensitivity of 0.80 and 0.33, respectively. (3) An artificial intelligence-assisted contouring and prognosis prediction system was developed to support preoperative evaluation and postoperative prognosis prediction. The integration of clinical data and magnetic resonance images provides enhanced diagnostic capability to preoperatively detect parametrial invasion and lymph node metastasis detection and prognostic capability to predict recurrence and mortality for CC, facilitating personalized, precise treatment strategies.

Aortic stenosis (AS), a prevalent and serious heart valve disorder, requires early detection but remains difficult to diagnose in routine practice. Although echocardiography with Doppler imaging is the clinical standard, these assessments are typically limited to trained specialists. Point-of-care ultrasound (POCUS) offers an accessible alternative for AS screening but is restricted to basic 2D B-mode imaging, often lacking the analysis Doppler provides. Our project introduces MultiASNet, a multimodal machine learning framework designed to enhance AS screening with POCUS by combining 2D B-mode videos with structured data from echocardiography reports, including Doppler parameters. Using contrastive learning, MultiASNet aligns video features with report features in tabular form from the same patient to improve interpretive quality. To address misalignment where a single report corresponds to multiple video views, some irrelevant to AS diagnosis, we use cross-attention in a transformer-based video and tabular network to assign less importance to irrelevant report data. The model integrates structured data only during training, enabling independent use with B-mode videos during inference for broader accessibility. MultiASNet also incorporates sample selection to counteract label noise from observer variability, yielding improved accuracy on two datasets. We achieved balanced accuracy scores of 93.0% on a private dataset and 83.9% on the public TMED-2 dataset for AS detection. For severity classification, balanced accuracy scores were 80.4% and 59.4% on the private and public datasets, respectively. This model facilitates reliable AS screening in non-specialist settings, bridging the gap left by Doppler data while reducing noise-related errors. Our code is publicly available at github.com/DeepRCL/MultiASNet.

To assess and compare the accuracy and legitimacy of multimodal large language models (LLMs) on the Japan Diagnostic Radiology Board Examination (JDRBE). The dataset comprised questions from JDRBE 2021, 2023, and 2024, with ground-truth answers established through consensus among multiple board-certified diagnostic radiologists. Questions without associated images and those lacking unanimous agreement on answers were excluded. Eight LLMs were evaluated: GPT-4 Turbo, GPT-4o, GPT-4.5, GPT-4.1, o3, o4-mini, Claude 3.7 Sonnet, and Gemini 2.5 Pro. Each model was evaluated under two conditions: with inputting images (vision) and without (text-only). Performance differences between the conditions were assessed using McNemar's exact test. Two diagnostic radiologists (with 2 and 18 years of experience) independently rated the legitimacy of responses from four models (GPT-4 Turbo, Claude 3.7 Sonnet, o3, and Gemini 2.5 Pro) using a five-point Likert scale, blinded to model identity. Legitimacy scores were analyzed using Friedman's test, followed by pairwise Wilcoxon signed-rank tests with Holm correction. The dataset included 233 questions. Under the vision condition, o3 achieved the highest accuracy at 72%, followed by o4-mini (70%) and Gemini 2.5 Pro (70%). Under the text-only condition, o3 topped the list with an accuracy of 67%. Addition of image input significantly improved the accuracy of two models (Gemini 2.5 Pro and GPT-4.5), but not the others. Both o3 and Gemini 2.5 Pro received significantly higher legitimacy scores than GPT-4 Turbo and Claude 3.7 Sonnet from both raters. Recent multimodal LLMs, particularly o3 and Gemini 2.5 Pro, have demonstrated remarkable progress on JDRBE questions, reflecting their rapid evolution in diagnostic radiology. Eight multimodal large language models were evaluated on the Japan Diagnostic Radiology Board Examination. OpenAI's o3 and Google DeepMind's Gemini 2.5 Pro achieved high accuracy rates (72% and 70%) and received good legitimacy scores from human raters, demonstrating steady progress.

This meta-analysis aims to assess the diagnostic performance of artificial intelligence (AI) based on magnetic resonance imaging (MRI) in detecting molecular subtypes of pediatric medulloblastoma (MB) in children. A thorough review of the literature was performed using PubMed, Embase, and Web of Science to locate pertinent studies released prior to October 2024. Selected studies focused on the diagnostic performance of AI based on MRI in detecting molecular subtypes of pediatric MB. A bivariate random-effects model was used to calculate pooled sensitivity and specificity, both with 95% confidence intervals (CI). Study heterogeneity was assessed using I² statistics. Among the 540 studies determined, eight studies (involving 1195 patients) were included. For the wingless (WNT), the combined sensitivity, specificity, and receiver operating characteristic curve (AUC) based on MRI were 0.73 (95% CI: 0.61-0.83, I² = 19%), 0.94 (95% CI: 0.79-0.99, I² = 93%), and 0.80 (95% CI: 0.77-0.83), respectively. For the sonic hedgehog (SHH), the combined sensitivity, specificity, and AUC were 0.64 (95% CI: 0.51-0.75, I² = 69%), 0.84 (95% CI: 0.80-0.88, I² = 54%), and 0.85 (95% CI: 0.81-0.88), respectively. For Group 3 (G3), the combined sensitivity, specificity, and AUC were 0.89 (95% CI: 0.52-0.98, I² = 82%), 0.70 (95% CI: 0.62-0.77, I² = 44%), and 0.88 (95% CI: 0.84-0.90), respectively. For Group 4 (G4), the combined sensitivity, specificity, and AUC were 0.77 (95% CI: 0.64-0.87, I² = 54%), 0.91 (95% CI: 0.68-0.98, I² = 80%), and 0.86 (95% CI: 0.83-0.89), respectively. MRI-based artificial intelligence shows high diagnostic performance in detecting molecular subtypes of pediatric MB. However, all included studies employed retrospective designs, which may introduce potential biases. More researches using external validation datasets are needed to confirm the results and assess their clinical applicability.

The success of intravenous thrombolysis with tPA (IV-tPA) as the fastest and easiest treatment for stroke patients is closely related to time since stroke onset (TSS). Administering IV-tPA after the recommended time interval (< 4.5 h) increases the risk of cerebral hemorrhage. Despite advances in diagnostic approaches have been made, the determination of TSS remains a clinical challenge. In this study, the performances of different diagnostic approaches were investigated to classify TSS. A systematic literature search was conducted in Web of Science, Pubmed, Scopus, Embase, and Cochrane databases until July 2025. The overall AUC, sensitivity, and specificity magnitudes with their 95%CIs were determined for each diagnostic approach to evaluate their classification performances. This systematic review retrieved a total number of 9030 stroke patients until July 2025. The results showed that the human readings of DWI-FLAIR mismatch as the current gold standard method with AUC = 0.71 (95%CI: 0.66-0.76), sensitivity = 0.62 (95%CI: 0.54-0.71), and specificity = 0.78 (95%CI: 0.72-0.84) has a moderate performance to identify the TSS. ML model fed by radiomic features of CT data with AUC = 0.89 (95%CI: 0.80-0.98), sensitivity = 0.85 (95%CI: 0.75-0.96), and specificity = 0.86 (95%CI: 0.73-1.00) has the best performance in classifying TSS among the models reviewed. ML models fed by radiomic features better classify TSS than the human reading of DWI-FLAIR mismatch. An efficient AI model fed by CT radiomic data could yield the best classification performance to determine patients' eligibility for IV-tPA treatment and improve treatment outcomes.

The volume of in vivo human brains is determined with various MRI measurement tools that have not been assessed against a gold standard. The purpose of this study was to validate the MRI brain volumes by scanning ex vivo, in situ specimens, which allows the extraction of the brain after the scan to compare its volume with the gold-standard water displacement method (WDM). The 3T MRI T₂-weighted, T₁-weighted, and MP2RAGE images of seven anatomical heads fixed with an alcohol-formaldehyde solution were acquired. The gray and white matter were assessed using two methods: (i) a manual intensity-based threshold segmentation using Display (MINC-ToolKit) and (ii) an automatic deep learning-based segmentation tool (SynthSeg). The brains were extracted and their volumes measured with the WDM after the removal of their meninges and a midsagittal cut. Volumes from all methods were compared with the ground truth (WDM volumes) using a repeated-measures analysis of variance. Mean brain volumes, in cubic centimeters, were 1111.14 ± 121.78 for WDM, 1020.29 ± 70.01 for manual T₂-weighted, 1056.29 ± 90.54 for automatic T₂-weighted, 1094.69 ± 100.51 for automatic T₁-weighted, 1066.56 ± 96.52 for automatic magnetization-prepared 2 rapid gradient-echo first inversion time, and 1156.18 ± 121.87 for automatic magnetization-prepared 2 rapid gradient-echo second inversion time. All volumetry methods were significantly different (F = 17.874; p < 0.001) from the WDM volumes, except the automatic T₁-weighted volumes. SynthSeg accurately determined the brain volume in ex vivo, in situ T₁-weighted MRI scans. The results suggested that given the contrast similarity between the ex vivo and in vivo sequences, the brain volumes of clinical studies are most probably sufficiently accurate, with some degree of underestimation depending on the sequence used.

Automated segmentation methods may potentially increase the reliability and applicability of radiomics in skeletal oncology. Our aim was to propose a deep learning-based method for automated segmentation of atypical cartilaginous tumor (ACT) and grade II chondrosarcoma (CS2) of long bones on magnetic resonance imaging (MRI). This institutional review board-approved retrospective study included 164 patients with surgically treated and histology-proven cartilaginous tumors at two tertiary bone tumor centers. The first cohort consisted of 99 MRI scans from center 1 (79 ACT, 20 CS2). The second cohort consisted of 65 MRI scans from center 2 (45 ACT, 20 CS2). Supervised Edge-Attention Guidance segmentation Network (SEAGNET) architecture was employed for automated image segmentation on T1-weighted images, using manual segmentations drawn by musculoskeletal radiologists as the ground truth. In the first cohort, a total of 1,037 slices containing the tumor out of 99 patients were split into 70% training, 15% validation, and 15% internal test sets, respectively, and used for model tuning. The second cohort was used for independent external testing. In the first cohort, Dice Score (DS) and Intersection over Union (IoU) per patient were 0.782 ± 0.148 and 0.663 ± 0.175, and 0.748 ± 0.191 and 0.630 ± 0.210 in the validation and internal test sets, respectively. DS and IoU per slice were 0.742 ± 0.273 and 0.646 ± 0.266, and 0.752 ± 0.256 and 0.656 ± 0.261 in the validation and internal test sets, respectively. In the independent external test dataset, the model achieved DS of 0.828 ± 0.175 and IoU of 0.706 ± 0.180. Deep learning proved excellent for automated segmentation of central cartilage tumors on MRI. A deep learning model based on SEAGNET architecture achieved excellent performance for automated segmentation of cartilage tumors of long bones on MRI and may be beneficial, given the increasing detection rate of these lesions in clinical practice. Automated segmentation may potentially increase the reliability and applicability of radiomics-based models. A deep learning architecture was proposed for automated segmentation of appendicular cartilage tumors on MRI. Deep learning proved excellent with a mean Dice Score of 0.828 in the external test cohort.

Shoulder pain is a common musculoskeletal complaint requiring accurate imaging for diagnosis and management. Ultrasound is favored for its accessibility, dynamic imaging, and high-resolution soft tissue visualization. However, its operator dependency and variability in interpretation present challenges. Recent advancements in artificial intelligence (AI), particularly deep learning algorithms like convolutional neural networks, offer promising applications in musculoskeletal imaging, enhancing diagnostic accuracy and efficiency. This narrative review explores AI integration in shoulder ultrasound, emphasizing automated pathology detection, image segmentation, and outcome prediction. Deep learning models have demonstrated high accuracy in grading bicipital peritendinous effusion and discriminating rotator cuff tendon tears, while machine learning techniques have shown efficacy in predicting the success of ultrasound-guided percutaneous irrigation for rotator cuff calcification. AI-powered segmentation models have improved anatomical delineation; however, despite these advancements, challenges remain, including the need for large, well-annotated datasets, model generalizability across diverse populations, and clinical validation. Future research should optimize AI algorithms for real-time applications, integrate multimodal imaging, and enhance clinician-AI collaboration.