Effective treatment for rectal cancer relies on accurate lymph node metastasis (LNM) staging. However, radiological criteria based on lymph node (LN) size, shape and texture morphology have limited diagnostic accuracy. In this work, we investigate applying a Variational Autoencoder (VAE) as a feature encoder model to replace the large pre-trained Convolutional Neural Network (CNN) used in existing approaches. The motivation for using a VAE is that the generative model aims to reconstruct the images, so it directly encodes visual features and meaningful patterns across the data. This leads to a disentangled and structured latent space which can be more interpretable than a CNN. Models are deployed on an in-house MRI dataset with 168 patients who did not undergo neo-adjuvant treatment. The post-operative pathological N stage was used as the ground truth to evaluate model predictions. Our proposed model 'VAE-MLP' achieved state-of-the-art performance on the MRI dataset, with cross-validated metrics of AUC 0.86 +/- 0.05, Sensitivity 0.79 +/- 0.06, and Specificity 0.85 +/- 0.05. Code is available at: https://github.com/benkeel/Lymph_Node_Classification_MIUA.

Accurate preoperative assessment of lymph node (LN) metastasis in rectal cancer guides treatment decisions, yet conventional MRI evaluation based on morphological criteria shows limited diagnostic performance. While some artificial intelligence models have been developed, they often operate as black boxes, lacking the interpretability needed for clinical trust. Moreover, these models typically evaluate nodes in isolation, overlooking the patient-level context. To address these limitations, we introduce LRMR, an LLM-Driven Relational Multi-node Ranking framework. This approach reframes the diagnostic task from a direct classification problem into a structured reasoning and ranking process. The LRMR framework operates in two stages. First, a multimodal large language model (LLM) analyzes a composite montage image of all LNs from a patient, generating a structured report that details ten distinct radiological features. Second, a text-based LLM performs pairwise comparisons of these reports between different patients, establishing a relative risk ranking based on the severity and number of adverse features. We evaluated our method on a retrospective cohort of 117 rectal cancer patients. LRMR achieved an area under the curve (AUC) of 0.7917 and an F1-score of 0.7200, outperforming a range of deep learning baselines, including ResNet50 (AUC 0.7708). Ablation studies confirmed the value of our two main contributions: removing the relational ranking stage or the structured prompting stage led to a significant performance drop, with AUCs falling to 0.6875 and 0.6458, respectively. Our work demonstrates that decoupling visual perception from cognitive reasoning through a two-stage LLM framework offers a powerful, interpretable, and effective new paradigm for assessing lymph node metastasis in rectal cancer.

The escalating adoption of high-resolution, large-field-of-view imagery amplifies the need for efficient compression methodologies. Conventional techniques frequently fail to preserve critical image details, while data-driven approaches exhibit limited generalizability. Implicit Neural Representations (INRs) present a promising alternative by learning continuous mappings from spatial coordinates to pixel intensities for individual images, thereby storing network weights rather than raw pixels and avoiding the generalization problem. However, INR-based compression of large images faces challenges including slow compression speed and suboptimal compression ratios. To address these limitations, we introduce COLI (Compressor for Large Images), a novel framework leveraging Neural Representations for Videos (NeRV). First, recognizing that INR-based compression constitutes a training process, we accelerate its convergence through a pretraining-finetuning paradigm, mixed-precision training, and reformulation of the sequential loss into a parallelizable objective. Second, capitalizing on INRs' transformation of image storage constraints into weight storage, we implement Hyper-Compression, a novel post-training technique to substantially enhance compression ratios while maintaining minimal output distortion. Evaluations across two medical imaging datasets demonstrate that COLI consistently achieves competitive or superior PSNR and SSIM metrics at significantly reduced bits per pixel (bpp), while accelerating NeRV training by up to 4 times.

Foundation models, pre-trained on large image datasets and capable of capturing rich feature representations, have recently shown potential for zero-shot image registration. However, their performance has mostly been tested in the context of rigid or less complex structures, such as the brain or abdominal organs, and it remains unclear whether these models can handle more challenging, deformable anatomy. Breast MRI registration is particularly difficult due to significant anatomical variation between patients, deformation caused by patient positioning, and the presence of thin and complex internal structure of fibroglandular tissue, where accurate alignment is crucial. Whether foundation model-based registration algorithms can address this level of complexity remains an open question. In this study, we provide a comprehensive evaluation of foundation model-based registration algorithms for breast MRI. We assess five pre-trained encoders, including DINO-v2, SAM, MedSAM, SSLSAM, and MedCLIP, across four key breast registration tasks that capture variations in different years and dates, sequences, modalities, and patient disease status (lesion versus no lesion). Our results show that foundation model-based algorithms such as SAM outperform traditional registration baselines for overall breast alignment, especially under large domain shifts, but struggle with capturing fine details of fibroglandular tissue. Interestingly, additional pre-training or fine-tuning on medical or breast-specific images in MedSAM and SSLSAM, does not improve registration performance and may even decrease it in some cases. Further work is needed to understand how domain-specific training influences registration and to explore targeted strategies that improve both global alignment and fine structure accuracy. We also publicly release our code at \href{https://github.com/mazurowski-lab/Foundation-based-reg}{Github}.

Computed Tomography (CT) is a widely utilized imaging modality in clinical settings. Using densely acquired rotational X-ray arrays, CT can capture 3D spatial features. However, it is confronted with challenged such as significant time consumption and high radiation exposure. CT reconstruction methods based on sparse-view X-ray images have garnered substantial attention from researchers as they present a means to mitigate costs and risks. In recent years, diffusion models, particularly the Latent Diffusion Model (LDM), have demonstrated promising potential in the domain of 3D CT reconstruction. Nonetheless, due to the substantial differences between the 2D latent representation of X-ray modalities and the 3D latent representation of CT modalities, the vanilla LDM is incapable of achieving effective alignment within the latent space. To address this issue, we propose the Consistent Latent Space Diffusion Model (CLS-DM), which incorporates cross-modal feature contrastive learning to efficiently extract latent 3D information from 2D X-ray images and achieve latent space alignment between modalities. Experimental results indicate that CLS-DM outperforms classical and state-of-the-art generative models in terms of standard voxel-level metrics (PSNR, SSIM) on the LIDC-IDRI and CTSpine1K datasets. This methodology not only aids in enhancing the effectiveness and economic viability of sparse X-ray reconstructed CT but can also be generalized to other cross-modal transformation tasks, such as text-to-image synthesis. We have made our code publicly available at https://anonymous.4open.science/r/CLS-DM-50D6/ to facilitate further research and applications in other domains.

Recent advances in automated radiology report generation from chest X-rays using deep learning algorithms have the potential to significantly reduce the arduous workload of radiologists. However, due to the inherent massive data bias in radiology images, where abnormalities are typically subtle and sparsely distributed, existing methods often produce fluent yet medically inaccurate reports, limiting their applicability in clinical practice. To address this issue effectively, we propose a Semantically Informed Salient Regions-guided (SISRNet) report generation method. Specifically, our approach explicitly identifies salient regions with medically critical characteristics using fine-grained cross-modal semantics. Then, SISRNet systematically focuses on these high-information regions during both image modeling and report generation, effectively capturing subtle abnormal findings, mitigating the negative impact of data bias, and ultimately generating clinically accurate reports. Compared to its peers, SISRNet demonstrates superior performance on widely used IU-Xray and MIMIC-CXR datasets.

We present a novel framework for CBCT-to-MDCT translation, grounded in the Schrodinger Bridge (SB) formulation, which integrates GAN-derived priors with human-guided conditional diffusion. Unlike conventional GANs or diffusion models, our approach explicitly enforces boundary consistency between CBCT inputs and pseudo targets, ensuring both anatomical fidelity and perceptual controllability. Binary human feedback is incorporated via classifier-free guidance (CFG), effectively steering the generative process toward clinically preferred outcomes. Through iterative refinement and tournament-based preference selection, the model internalizes human preferences without relying on a reward model. Subtraction image visualizations reveal that the proposed method selectively attenuates shade artifacts in key anatomical regions while preserving fine structural detail. Quantitative evaluations further demonstrate superior performance across RMSE, SSIM, LPIPS, and Dice metrics on clinical datasets -- outperforming prior GAN- and fine-tuning-based feedback methods -- while requiring only 10 sampling steps. These findings underscore the effectiveness and efficiency of our framework for real-time, preference-aligned medical image translation.

Glioma is the most common primary malignant brain tumor and preoperative genetic profiling is essential for the management of glioma patients. Our study focused on tumor regions segmentation and predicting the World Health Organization (WHO) grade, isocitrate dehydrogenase (IDH) mutation, and 1p/19q codeletion status using deep learning models on preoperative MRI. To achieve accurate tumor segmentation, we developed an optimal mass transport (OMT) approach to transform irregular MRI brain images into tensors. In addition, we proposed an algebraic preclassification (APC) model utilizing multimode OMT tensor singular value decomposition (SVD) to estimate preclassification probabilities. The fully automated deep learning model named OMT-APC was used for multitask classification. Our study incorporated preoperative brain MRI data from 3,565 glioma patients across 16 datasets spanning Asia, Europe, and America. Among these, 2,551 patients from 5 datasets were used for training and internal validation. In comparison, 1,014 patients from 11 datasets, including 242 patients from The Cancer Genome Atlas (TCGA), were used as independent external test. The OMT segmentation model achieved mean lesion-wise Dice scores of 0.880. The OMT-APC model was evaluated on the TCGA dataset, achieving accuracies of 0.855, 0.917, and 0.809, with AUC scores of 0.845, 0.908, and 0.769 for WHO grade, IDH mutation, and 1p/19q codeletion, respectively, which outperformed the four radiologists in all tasks. These results highlighted the effectiveness of our OMT and tensor SVD-based methods in brain tumor genetic profiling, suggesting promising applications for algebraic and geometric methods in medical image analysis.

Autism spectrum disorder (ASD) affects social interaction, communication, and behavior. Early diagnosis is important as it enables timely intervention that can significantly improve long-term outcomes, but current diagnostic, which rely heavily on behavioral observations and clinical interviews, are often subjective and time-consuming. This study introduces an AI-based approach that uses T1-weighted structural MRI (sMRI) scans, network analysis, and vision transformers to automatically diagnose ASD. sMRI data from 79 ASD patients and 105 healthy controls were obtained from the Autism Brain Imaging Data Exchange (ABIDE) database. Complex network analysis (CNA) features and ViT (Vision Transformer) features were developed for predicting ASD. Five models were developed for each type of features: logistic regression, support vector machine (SVM), gradient boosting (GB), K-nearest neighbors (KNN), and neural network (NN). 25 models were further developed by federating the two sets of 5 models. Model performance was evaluated using accuracy, area under the receiver operating characteristic curve (AUC-ROC), sensitivity, and specificity via fivefold cross-validation. The federate model CNA(KNN)-ViT(NN) achieved highest performance, with accuracy 0.951 ± 0.067, AUC-ROC 0.980 ± 0.020, sensitivity 0.963 ± 0.050, and specificity 0.943 ± 0.047. The performance of the ViT-based models exceeds that of the complex network-based models on 80% of the performance metrics. By federating CNA models, the ViT models can achieve better performance. This study demonstrates the feasibility of using CNA and ViT models for the automated diagnosis of ASD. The proposed CNA(KNN)-ViT(NN) model achieved better accuracy in ASD classification based solely on T1 sMRI images. The proposed method's reliance on widely available T1 sMRI scans highlights its potential for integration into routine clinical examinations, facilitating more efficient and accessible ASD screening.

Deformable image registration (DIR) is critical for accurate clinical diagnosis and effective treatment planning. However, patient movement, significant intensity differences, and large breathing deformations hinder accurate anatomical alignment in multi-modal image registration. These factors exacerbate the entanglement of anatomical and modality-specific style information, thereby severely limiting the performance of multi-modal registration. To address this, we propose a novel LAtent Diffusion-based Domain-Adaptive feature disentangling (LADDA) framework for unsupervised multi-modal medical image registration, which explicitly addresses the representation disentanglement. First, LADDA extracts reliable anatomical priors from the Latent Diffusion Model (LDM), facilitating downstream content-style disentangled learning. A Domain-Adaptive Feature Disentangling (DAFD) module is proposed to promote anatomical structure alignment further. This module disentangles image features into content and style information, boosting the network to focus on cross-modal content information. Next, a Neighborhood-Preserving Hashing (NPH) is constructed to further perceive and integrate hierarchical content information through local neighbourhood encoding, thereby maintaining cross-modal structural consistency. Furthermore, a Unilateral-Query-Frozen Attention (UQFA) module is proposed to enhance the coupling between upstream prior and downstream content information. The feature interaction within intra-domain consistent structures improves the fine recovery of detailed textures. The proposed framework is extensively evaluated on large-scale multi-center datasets, demonstrating superior performance across diverse clinical scenarios and strong generalization on out-of-distribution (OOD) data.