Purpose To develop and evaluate an artificial intelligence-based model for real-time nuchal translucency (NT) plane identification and measurement in prenatal US assessments. Materials and Methods In this retrospective multicenter study conducted from January 2022 to October 2023, the Automated Identification and Measurement of NT (AIM-NT) model was developed and evaluated using internal and external datasets. NT plane assessment, including identification of the NT plane and measurement of NT thickness, was independently conducted by AIM-NT and experienced radiologists, with the results subsequently audited by radiology specialists and accuracy compared between groups. To assess alignment of artificial intelligence with radiologist workflow, discrepancies between the AIM-NT model and radiologists in NT plane identification time and thickness measurements were evaluated. Results The internal dataset included a total of 3959 NT images from 3153 fetuses, and the external dataset included 267 US videos from 267 fetuses. On the internal testing dataset, AIM-NT achieved an area under the receiver operating characteristic curve of 0.92 for NT plane identification. On the external testing dataset, there was no evidence of differences between AIM-NT and radiologists in NT plane identification accuracy (88.8% vs 87.6%, <i>P</i> = .69) or NT thickness measurements on standard and nonstandard NT planes (<i>P</i> = .29 and .59). AIM-NT demonstrated high consistency with radiologists in NT plane identification time, with 1-minute discrepancies observed in 77.9% of cases, and NT thickness measurements, with a mean difference of 0.03 mm and mean absolute error of 0.22 mm (95% CI: 0.19, 0.25). Conclusion AIM-NT demonstrated high accuracy in identifying the NT plane and measuring NT thickness on prenatal US images, showing minimal discrepancies with radiologist workflow. <b>Keywords:</b> Ultrasound, Fetus, Segmentation, Feature Detection, Diagnosis, Convolutional Neural Network (CNN) <i>Supplemental material is available for this article.</i> © RSNA, 2025 See also commentary by Horii in this issue.

Surface-based analysis of the cerebral cortex is ubiquitous in human neuroimaging with MRI. It is crucial for tasks like cortical registration, parcellation, and thickness estimation. Traditionally, such analyses require high-resolution, isotropic scans with good gray-white matter contrast, typically a T1-weighted scan with 1 mm resolution. This requirement precludes application of these techniques to most MRI scans acquired for clinical purposes, since they are often anisotropic and lack the required T1-weighted contrast. To overcome this limitation and enable large-scale neuroimaging studies using vast amounts of existing clinical data, we introduce recon-all-clinical, a novel methodology for cortical reconstruction, registration, parcellation, and thickness estimation for clinical brain MRI scans of any resolution and contrast. Our approach employs a hybrid analysis method that combines a convolutional neural network (CNN) trained with domain randomization to predict signed distance functions (SDFs), and classical geometry processing for accurate surface placement while maintaining topological and geometric constraints. The method does not require retraining for different acquisitions, thus simplifying the analysis of heterogeneous clinical datasets. We evaluated recon-all-clinical on multiple public datasets like ADNI, HCP, AIBL, OASIS and including a large clinical dataset of over 9,500 scans. The results indicate that our method produces geometrically precise cortical reconstructions across different MRI contrasts and resolutions, consistently achieving high accuracy in parcellation. Cortical thickness estimates are precise enough to capture aging effects, independently of MRI contrast, even though accuracy varies with slice thickness. Our method is publicly available at https://surfer.nmr.mgh.harvard.edu/fswiki/recon-all-clinical, enabling researchers to perform detailed cortical analysis on the huge amounts of already existing clinical MRI scans. This advancement may be particularly valuable for studying rare diseases and underrepresented populations where research-grade MRI data is scarce.

Exploring the dependencies between multimodal brain networks and integrating node features to enhance brain disease diagnosis remains a significant challenge. Some work has examined only brain connectivity changes in patients, ignoring important information about radiomics features such as shape and texture of individual brain regions in structural images. To this end, this study proposed a novel deep learning approach to integrate multimodal brain connectome information and regional radiomics features for brain disease diagnosis. A dual-branch autoencoder (ConnectomeAE) based on multimodal brain connectomes was proposed for brain disease diagnosis. Specifically, a matrix of radiomics feature extracted from structural magnetic resonance image (MRI) was used as Rad_AE branch inputs for learning important brain region features. Functional brain network built from functional MRI image was used as inputs to Cycle_AE for capturing brain disease-related connections. By separately learning node features and connection features from multimodal brain networks, the method demonstrates strong adaptability in diagnosing different brain diseases. ConnectomeAE was validated on two publicly available datasets. The experimental results show that ConnectomeAE achieved excellent diagnostic performance with an accuracy of 70.7 % for autism spectrum disorder and 90.5 % for Alzheimer's disease. A comparison of training time with other methods indicated that ConnectomeAE exhibits simplicity and efficiency suitable for clinical applications. Furthermore, the interpretability analysis of the model aligned with previous studies, further supporting the biological basis of ConnectomeAE. ConnectomeAE could effectively leverage the complementary information between multimodal brain connectomes for brain disease diagnosis. By separately learning radiomic node features and connectivity features, ConnectomeAE demonstrated good adaptability to different brain disease classification tasks.

Diffusion-weighted imaging (DWI) is a key modality for studying brain microstructure, but its signals are highly susceptible to noise due to the thermal motion of water molecules and interactions with tissue microarchitecture, leading to significant signal attenuation and a low signal-to-noise ratio (SNR). In this paper, we propose a novel approach, a Cycle-Conditional Diffusion Model (Cycle-CDM) using unpaired data learning, aimed at improving DWI quality and reliability through noise correction. Cycle-CDM leverages a cycle-consistent translation architecture to bridge the domain gap between noise-contaminated and noise-free DWIs, enabling the restoration of high-quality images without requiring paired datasets. By utilizing two conditional diffusion models, Cycle-CDM establishes data interrelationships between the two types of DWIs, while incorporating synthesized anatomical priors from the cycle translation process to guide noise removal. In addition, we introduce specific constraints to preserve anatomical fidelity, allowing Cycle-CDM to effectively learn the underlying noise distribution and achieve accurate denoising. Our experiments conducted on simulated datasets, as well as children and adolescents' datasets with strong clinical relevance. Our results demonstrate that Cycle-CDM outperforms comparative methods, such as U-Net, CycleGAN, Pix2Pix, MUNIT and MPPCA, in terms of noise correction performance. We demonstrated that Cycle-CDM can be generalized to DWIs with head motion when they were acquired using different MRI scannsers. Importantly, the denoised DWI data produced by Cycle-CDM exhibit accurate preservation of underlying tissue microstructure, thus substantially improving their medical applicability.

Large-scale generative models have garnered significant attention in the field of medical imaging, particularly for image editing utilizing diffusion models. However, current research has predominantly concentrated on pathological editing involving single or a limited number of labels, making it challenging to achieve precise modifications. Inaccurate alterations may lead to substantial discrepancies between the generated and original images, thereby impacting the clinical applicability of these models. This paper presents a diffusion model with untangling capabilities applied to chest X-ray image editing, incorporating a mask-based mechanism for bone and organ information. We successfully perform multi-label pathological editing of chest X-ray images without compromising the integrity of the original thoracic structure. The proposed technology comprises a chest X-ray image classifier and an intricate organ mask; the classifier supplies essential feature labels that require untangling for the stabilized diffusion model, while the complex organ mask facilitates directed and controllable edits to chest X-rays. We assessed the outcomes of our proposed algorithm, named Chest X-rays_Mpe, using MS-SSIM and CLIP scores alongside qualitative evaluations conducted by radiology experts. The results indicate that our approach surpasses existing algorithms across both quantitative and qualitative metrics.

Capturing rich multi-scale features is essential to address complex variations in medical image segmentation. Multiple hybrid networks have been developed to integrate the complementary benefits of convolutional neural networks (CNN) and Transformers. However, existing methods may suffer from either huge computational cost required by the complicated networks or unsatisfied performance of lighter networks. How to give full play to the advantages of both convolution and self-attention and design networks that are both effective and efficient still remains an unsolved problem. In this work, we propose a robust lightweight multi-stage hybrid architecture, named Multi-stage Aggregation Transformer version 2 (MA-TransformerV2), to extract multi-scale features with progressive aggregations for accurate segmentation of highly variable medical images at a low computational cost. Specifically, lightweight Trans blocks and lightweight CNN blocks are parallelly introduced into the dual-branch encoder module in each stage, and then a vector quantization block is incorporated at the bottleneck to discretizes the features and discard the redundance. This design not only enhances the representation capabilities and computational efficiency of the model, but also makes the model interpretable. Extensive experimental results on public datasets show that our method outperforms state-of-the-art methods, including CNN-based, Transformer-based, advanced hybrid CNN-Transformer-based models, and several lightweight models, in terms of both segmentation accuracy and model capacity. Code will be made publicly available at https://github.com/zjmiaprojects/MATransformerV2.

Radiographic imaging is a non-invasive technique of considerable importance for evaluating tumor treatment response. However, redundancy in CT data and the lack of labeled data make it challenging to accurately assess the response of locally advanced rectal cancer (LARC) patients to neoadjuvant chemoradiotherapy (nCRT) using current imaging indicators. In this study, we propose a novel learning framework to automatically predict the response of LARC patients to nCRT. Specifically, we develop a deep learning network called the Expand Intensive Attention Network (EIA-Net), which enhances the network's feature extraction capability through cascaded 3D convolutions and coordinate attention. Instance-oriented collaborative self-supervised learning (IOC-SSL) is proposed to leverage unlabeled data for training, reducing the reliance on labeled data. In a dataset consisting of 1,575 volumes, the proposed method achieves an AUC score of 0.8562. The dataset includes two distinct parts: the self-supervised dataset containing 1,394 volumes and the supervised dataset comprising 195 volumes. Analysis of the lifetime predictions reveals that patients with pathological complete response (pCR) predicted by EIA-Net exhibit better overall survival (OS) compared to non-pCR patients with LARC. The retrospective study demonstrates that imaging-based pCR prediction for patients with low rectal cancer can assist clinicians in making informed decisions regarding the need for Miles operation, thereby improving the likelihood of anal preservation, with an AUC of 0.8222. These results underscore the potential of our method to enhance clinical decision-making, offering a promising tool for personalized treatment and improved patient outcomes in LARC management.

Medical image segmentation is crucial for computer-aided diagnosis and treatment planning, directly influencing clinical decision-making. To enhance segmentation accuracy, existing methods typically fuse local, global, and various other features. However, these methods often ignore the negative impact of noise on the results during the feature fusion process. In contrast, certain regions of the human visual system, such as the inferotemporal cortex and parietal cortex, effectively suppress irrelevant noise while integrating multiple features-a capability lacking in current methods. To address this gap, we propose MS-Net, a medical image segmentation network inspired by human visual perception. MS-Net incorporates a multi-feature compression (MFC) module that mimics the human visual system's processing of complex images, first learning various feature types and subsequently filtering out irrelevant ones. Additionally, MS-Net features a segmentation refinement (SR) module that emulates how physicians segment lesions. This module initially performs coarse segmentation to capture the lesion's approximate location and shape, followed by a refinement step to achieve precise boundary delineation. Experimental results demonstrate that MS-Net not only attains state-of-the-art segmentation performance across three public datasets but also significantly reduces the number of parameters compared to existing models. Code is available at https://github.com/guangguangLi/MS-Net.

Breast cancer poses a major health concern for women globally. Effective segmentation of breast tumors for ultrasound images is crucial for early diagnosis and treatment. Conventional convolutional neural networks have shown promising results in this domain but face challenges due to image complexities and are computationally expensive, limiting their practical application in real-time clinical settings. We propose Eff-AResUNet-GL, a segmentation model using EfficienetNet-B3 as the encoder. This design integrates attention gates in skip connections to focus on significant features and residual blocks in the decoder to retain details and reduce gradient loss. Additionally, guided loss functions are applied at each decoder layer to generate better features, subsequently improving segmentation accuracy. Experimental results on BUSIS and Dataset B demonstrate that Eff-AResUNet-GL achieves superior performance and computational efficiency compared to state-of-the-art models, showing robustness in handling complex breast ultrasound images. Eff-AResUNet-GL offers a practical, high-performing solution for breast tumor segmentation, demonstrating potential clinical through improved segmentation accuracy and efficiency.

Accurate cardiac MRI segmentation is vital for detailed cardiac analysis, yet the manual process is labor-intensive and prone to variability. Despite advancements in MRI technology, there remains a significant need for automated methods that can reliably and efficiently segment cardiac structures. This paper introduces HALSR-Net, a novel multi-level segmentation architecture designed to improve the accuracy and reproducibility of cardiac segmentation from Cine-MRI acquisitions, focusing on the left ventricle (LV). The methodology consists of two main phases: first, the extraction of the region of interest (ROI) using a regression model that accurately predicts the location of a bounding box around the LV; second, the semantic segmentation step based on HALSR-Net architecture. This architecture incorporates a Hybrid Attention Pooling Module (HAPM) that merges attention and pooling mechanisms to enhance feature extraction and capture contextual information. Additionally, a reconstruction module leverages latent space features to further improve segmentation accuracy. Experiments conducted on an in-house clinical dataset and two public datasets (ACDC and LVQuan19) demonstrate that HALSR-Net outperforms state-of-the-art architectures, achieving up to 98% accuracy and F1-score for the segmentation of the LV cavity and myocardium. The proposed approach effectively addresses the limitations of existing methods, offering a more accurate and robust solution for cardiac MRI segmentation, thereby likely to improve cardiac function analysis and patient care.