Machine learning (ML) classification of myocardial scarring in cardiac MRI is often hindered by limited explainability, particularly with convolutional neural networks (CNNs). To address this, we developed One Match (OM), an algorithm that builds on template matching to improve on both the explainability and performance of ML myocardial scaring classification. By incorporating OM, we aim to foster trust in AI models for medical diagnostics and demonstrate that improved interpretability does not have to compromise classification accuracy. Using a cardiac MRI dataset from 279 patients, this study evaluates One Match, which classifies myocardial scarring in images by matching each image to a set of labeled template images. It uses the highest correlation score from these matches for classification and is compared to a traditional sequential CNN. Enhancements such as autodidactic enhancement (AE) and patient-level classifications (PLCs) were applied to improve the predictive accuracy of both methods. Results are reported as follows: accuracy, sensitivity, specificity, precision, and F1-score. The highest classification performance was observed with the OM algorithm when enhanced by both AE and PLCs, 95.3% accuracy, 92.3% sensitivity, 96.7% specificity, 92.3% precision, and 92.3% F1-score, marking a significant improvement over the base configurations. AE alone had a positive impact on OM increasing accuracy from 89.0% to 93.2%, but decreased the accuracy of the CNN from 85.3% to 82.9%. In contrast, PLCs improved accuracy for both the CNN and OM, raising the CNN's accuracy by 4.2% and OM's by 7.4%. This study demonstrates the effectiveness of OM in classifying myocardial scars, particularly when enhanced with AE and PLCs. The interpretability of OM also enabled the examination of misclassifications, providing insights that could accelerate development and foster greater trust among clinical stakeholders.

<b>Background:</b> No robust biomarkers have been identified to predict the efficacy of programmed cell death protein 1 (PD-1) inhibitors in patients with locoregionally advanced nasopharyngeal carcinoma (LANPC). We aimed to develop radiomic models using pre-immunotherapy MRI to predict the response to PD-1 inhibitors and the patient prognosis. <b>Methods:</b> This study included 246 LANPC patients (training cohort, <i>n</i> = 117; external test cohort, <i>n</i> = 129) from 10 centers. The best-performing machine learning classifier was employed to create the radiomic models. A combined model was constructed by integrating clinical and radiomic data. A radiomic interpretability study was performed with whole slide images (WSIs) stained with hematoxylin and eosin (H&E) and immunohistochemistry (IHC). A total of 150 patient-level nuclear morphological features (NMFs) and 12 cell spatial distribution features (CSDFs) were extracted from WSIs. The correlation between the radiomic and pathological features was assessed using Spearman correlation analysis. <b>Results:</b> The radiomic model outperformed the clinical and combined models in predicting treatment response (area under the curve: 0.760 vs. 0.559 vs. 0.652). For overall survival estimation, the combined model performed comparably to the radiomic model but outperformed the clinical model (concordance index: 0.858 vs. 0.812 vs. 0.664). Six treatment response-related radiomic features correlated with 50 H&E-derived (146 pairs, |<i>r</i>|= 0.31 to 0.46) and 2 to 26 IHC-derived NMF, particularly for CD45RO (69 pairs, |<i>r</i>|= 0.31 to 0.48), CD8 (84, |<i>r</i>|= 0.30 to 0.59), PD-L1 (73, |<i>r</i>|= 0.32 to 0.48), and CD163 (53, |<i>r</i>| = 0.32 to 0.59). Eight prognostic radiomic features correlated with 11 H&E-derived (16 pairs, |<i>r</i>|= 0.48 to 0.61) and 2 to 31 IHC-derived NMF, particularly for PD-L1 (80 pairs, |<i>r</i>|= 0.44 to 0.64), CD45RO (65, |<i>r</i>|= 0.42 to 0.67), CD19 (35, |<i>r</i>|= 0.44 to 0.58), CD66b (61, |<i>r</i>| = 0.42 to 0.67), and FOXP3 (21, |<i>r</i>| = 0.41 to 0.71). In contrast, fewer CSDFs exhibited correlations with specific radiomic features. <b>Conclusion:</b> The radiomic model and combined model are feasible in predicting immunotherapy response and outcomes in LANPC patients. The radiology-pathology correlation suggests a potential biological basis for the predictive models.

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Comorbidities in patients with COPD significantly increase morbidity, mortality, and healthcare costs, posing a significant burden on the management of COPD. Given the complex clinical manifestations and varying severity of COPD comorbidities, accurate diagnosis and evaluation are particularly important in selecting appropriate treatment options. With the development of medical imaging technology, AI-based chest CT, as a noninvasive imaging modality, provides a detailed assessment of COPD comorbidities. Recent studies have shown that certain radiographic features on chest CT can be used as alternative markers of comorbidities in COPD patients. CT-based radiomics features provided incremental predictive value than clinical risk factors only, predicting an AUC of 0.73 for COPD combined with CVD. However, AI has inherent limitations such as lack of interpretability, and further research is needed to improve them. This review evaluates the progress of AI technology combined with chest CT imaging in COPD comorbidities, including lung cancer, cardiovascular disease, osteoporosis, sarcopenia, excess adipose depots, and pulmonary hypertension, with the aim of improving the understanding of imaging and the management of COPD comorbidities for the purpose of improving disease screening, efficacy assessment, and prognostic evaluation.

Acute ischemic stroke (AIS) has a poor prognosis and a high recurrence rate. Predicting the outcomes of AIS patients in the early stages of the disease is therefore important. The establishment of intracerebral collateral circulation significantly improves the survival of brain cells and the outcomes of AIS patients. However, no machine learning method has been applied to investigate the correlation between the dynamic evolution of intracerebral venous collateral circulation and AIS prognosis. Therefore, we employed a support vector machine (SVM) algorithm to analyze asymmetrically prominent cortical veins (APCVs) and deep medullary veins (DMVs) to establish a radiomic model for predicting the prognosis of AIS by combining clinical indicators. The magnetic resonance imaging (MRI) data and clinical indicators of 150 AIS patients were retrospectively analyzed. Regions of interest corresponding to the DMVs and APCVs were delineated, and least absolute shrinkage and selection operator (LASSO) regression was used to select features extracted from these regions. An APCV-DMV radiomic model was created via the SVM algorithm, and independent clinical risk factors associated with AIS were combined with the radiomic model to generate a joint model. The SVM algorithm was selected because of its proven efficacy in handling high-dimensional radiomic data compared with alternative classifiers (<i>e.g.</i>, random forest) in pilot experiments. Nine radiomic features associated with AIS patient outcomes were ultimately selected. In the internal training test set, the AUCs of the clinical, DMV-APCV radiomic and joint models were 0.816, 0.976 and 0.996, respectively. The DeLong test revealed that the predictive performance of the joint model was better than that of the individual models, with a test set AUC of 0.996, sensitivity of 0.905, and specificity of 1.000 (<i>P</i> < 0.05). Using radiomic methods, we propose a novel joint predictive model that combines the imaging histologic features of the APCV and DMV with clinical indicators. This model quantitatively characterizes the morphological and functional attributes of venous collateral circulation, elucidating its important role in accurately evaluating the prognosis of patients with AIS and providing a noninvasive and highly accurate imaging tool for early prognostic prediction.

Magnetic Resonance Imaging (MRI) is a crucial diagnostic tool in medicine, widely used to detect and assess various health conditions. Different MRI sequences, such as T1-weighted, T2-weighted, and FLAIR, serve distinct roles by highlighting different tissue characteristics and contrasts. However, distinguishing them based solely on the description file is currently impossible due to confusing or incorrect annotations. Additionally, there is a notable lack of effective tools to differentiate these sequences. In response, we developed a deep learning-based toolkit tailored for small, unrefined MRI datasets. This toolkit enables precise sequence classification and delivers performance comparable to systems trained on large, meticulously curated datasets. Utilizing lightweight model architectures and incorporating a voting ensemble method, the toolkit enhances accuracy and stability. It achieves a 99% accuracy rate using only 10% of the data typically required in other research. The code is available at https://github.com/JinqianPan/MRISeqClassifier.

This study proposes a novel deep learning-based approach for aneurysm wall characteristics, including thin-walled (TW) and hyperplastic-remodeling (HR) regions. We analyzed fifty-two unruptured cerebral aneurysms employing 4D-computed tomography angiography (4D-CTA) and intraoperative recordings. The TW and HR regions were identified in intraoperative images. The 3D trajectories of observation points on aneurysm walls were processed to compute a time series of 3D speed, acceleration, and smoothness of motion, aiming to evaluate the aneurysm wall characteristics. To facilitate point-level risk evaluation using the time-series data, we developed a convolutional neural network (CNN)-long- short-term memory (LSTM)-based regression model enriched with attention layers. In order to accommodate patient heterogeneity, a patient-independent feature extraction mechanism was introduced. Furthermore, unlabeled data were incorporated to enhance the data-intensive deep model. The proposed method achieved an average diagnostic accuracy of 92%, significantly outperforming a simpler model lacking attention. These results underscore the significance of patient-independent feature extraction and the use of unlabeled data. This study demonstrates the efficacy of a fine-grained deep learning approach in predicting aneurysm wall characteristics using 4D-CTA. Notably, incorporating an attention-based network structure proved to be particularly effective, contributing to enhanced performance.

Breast cancer is the most common malignant tumor among women worldwide, and early diagnosis is crucial for reducing mortality rates. Traditional diagnostic methods have significant limitations in terms of accuracy and consistency. Imaging is a common technique for diagnosing and predicting breast cancer, but human error remains a concern. Increasingly, artificial intelligence (AI) is being employed to assist physicians in reducing diagnostic errors. We developed an intelligent diagnostic model combining deep learning and radiomics to enhance breast tumor diagnosis. The model integrates MobileNet with ResNeXt-inspired depthwise separable and grouped convolutions, improving feature processing and efficiency while reducing parameters. Using AI-Dhabyani and TCIA breast ultrasound datasets, we validated the model internally and externally, comparing it to VGG16, ResNet, AlexNet, and MobileNet. Results: The internal validation set achieved an accuracy of 83.84% with an AUC of 0.92, outperforming other models. The external validation set showed an accuracy of 69.44% with an AUC of 0.75, demonstrating high robustness and generalizability. Conclusions: We developed an intelligent diagnostic model using deep learning and radiomics to improve breast tumor diagnosis. The model combines MobileNet with ResNeXt-inspired depthwise separable and grouped convolutions, enhancing feature processing and efficiency while reducing parameters. It was validated internally and externally using the AI-Dhabyani and TCIA breast ultrasound datasets and compared with VGG16, ResNet, AlexNet, and MobileNet.

Thyroid nodule, as a common clinical endocrine disease, has become increasingly prevalent worldwide. Ultrasound, as the premier method of thyroid imaging, plays an important role in accurately diagnosing and managing thyroid nodules. However, there is a high degree of inter- and intra-observer variability in image interpretation due to the different knowledge and experience of sonographers who have huge ultrasound examination tasks everyday. Artificial intelligence based on computer-aided diagnosis technology maybe improve the accuracy and time efficiency of thyroid nodules diagnosis. This study introduced an artificial intelligence software called SW-TH01/II to evaluate ultrasound image characteristics of thyroid nodules including echogenicity, shape, border, margin, and calcification. We included 225 ultrasound images from two hospitals in Shanghai, respectively. The sonographers and software performed characteristics analysis on the same group of images. We analyzed the consistency of the two results and used the sonographers' results as the gold standard to evaluate the accuracy of SW-TH01/II. A total of 449 images were included in the statistical analysis. For the seven indicators, the proportions of agreement between SW-TH01/II and sonographers' analysis results were all greater than 0.8. For the echogenicity (with very hypoechoic), aspect ratio and margin, the kappa coefficient between the two methods were above 0.75 (P < 0.001). The kappa coefficients of echogenicity (echotexture and echogenicity level), border and calcification between the two methods were above 0.6 (P < 0.001). The median time it takes for software and sonographers to interpret an image were 3 (2, 3) seconds and 26.5 (21.17, 34.33) seconds, respectively, and the difference were statistically significant (z = -18.36, P < 0.001). SW-TH01/II has a high degree of accuracy and great time efficiency benefits in judging the characteristics of thyroid nodule. It can provide more objective results and improve the efficiency of ultrasound examination. SW-TH01/II can be used to assist the sonographers in characterizing the thyroid nodule ultrasound images.

Currently, there are inconsistencies among different studies on preoperative prediction of Cytokeratin 19 (CK19) expression in HCC using traditional imaging, radiomics, and deep learning. We aimed to systematically analyze and compare the performance of non-invasive methods for predicting CK19-positive HCC, thereby providing insights for the stratified management of HCC patients. A comprehensive literature search was conducted in PubMed, EMBASE, Web of Science, and the Cochrane Library from inception to February 2025. Two investigators independently screened and extracted data based on inclusion and exclusion criteria. Eligible studies were included, and key findings were summarized in tables to provide a clear overview. Ultimately, 22 studies involving 3395 HCC patients were included. 72.7% (16/22) focused on traditional imaging, 36.4% (8/22) on radiomics, 9.1% (2/22) on deep learning, and 54.5% (12/22) on combined models. The magnetic resonance imaging was the most commonly used imaging modality (19/22), and over half of the studies (12/22) were published between 2022 and 2025. Moreover, 27.3% (6/22) were multicenter studies, 36.4% (8/22) included a validation set, and only 13.6% (3/22) were prospective. The area under the curve (AUC) range of using clinical and traditional imaging was 0.560 to 0.917. The AUC ranges of radiomics were 0.648 to 0.951, and the AUC ranges of deep learning were 0.718 to 0.820. Notably, the AUC ranges of combined models of clinical, imaging, radiomics and deep learning were 0.614 to 0.995. Nevertheless, the multicenter external data were limited, with only 13.6% (3/22) incorporating validation. The combined model integrating traditional imaging, radiomics and deep learning achieves excellent potential and performance for predicting CK19 in HCC. Based on current limitations, future research should focus on building an easy-to-use dynamic online tool, combining multicenter-multimodal imaging and advanced deep learning approaches to enhance the accuracy and robustness of model predictions.

Lung cancer is a major cause of cancer-related deaths, and early diagnosis and treatment are crucial for improving patients' survival outcomes. In this paper, we propose to employ convolutional neural networks to model the non-linear relationship between the risk of lung cancer and the lungs' morphology revealed in the CT images. We apply a mini-batched loss that extends the Cox proportional hazards model to handle the non-convexity induced by neural networks, which also enables the training of large data sets. Additionally, we propose to combine mini-batched loss and binary cross-entropy to predict both lung cancer occurrence and the risk of mortality. Simulation results demonstrate the effectiveness of both the mini-batched loss with and without the censoring mechanism, as well as its combination with binary cross-entropy. We evaluate our approach on the National Lung Screening Trial data set with several 3D convolutional neural network architectures, achieving high AUC and C-index scores for lung cancer classification and survival prediction. These results, obtained from simulations and real data experiments, highlight the potential of our approach to improving the diagnosis and treatment of lung cancer.