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Large language models for efficient whole-organ MRI score-based reports and categorization in knee osteoarthritis.

Xie Y, Hu Z, Tao H, Hu Y, Liang H, Lu X, Wang L, Li X, Chen S

pubmed logopapersMay 14 2025
To evaluate the performance of large language models (LLMs) in automatically generating whole-organ MRI score (WORMS)-based structured MRI reports and predicting osteoarthritis (OA) severity for the knee. A total of 160 consecutive patients suspected of OA were included. Knee MRI reports were reviewed by three radiologists to establish the WORMS reference standard for 39 key features. GPT-4o and GPT-4o-mini were prompted using in-context knowledge (ICK) and chain-of-thought (COT) to generate WORMS-based structured reports from original reports and to automatically predict the OA severity. Four Orthopedic surgeons reviewed original and LLM-generated reports to conduct pairwise preference and difficulty tests, and their review times were recorded. GPT-4o demonstrated perfect performance in extracting the laterality of the knee (accuracy = 100%). GPT-4o outperformed GPT-4o mini in generating WORMS reports (Accuracy: 93.9% vs 76.2%, respectively). GPT-4o achieved higher recall (87.3% s 46.7%, p < 0.001), while maintaining higher precision compared to GPT-4o mini (94.2% vs 71.2%, p < 0.001). For predicting OA severity, GPT-4o outperformed GPT-4o mini across all prompt strategies (best accuracy: 98.1% vs 68.7%). Surgeons found it easier to extract information and gave more preference to LLM-generated reports over the original reports (both p < 0.001) while spending less time on each report (51.27 ± 9.41 vs 87.42 ± 20.26 s, p < 0.001). GPT-4o generated expert multi-feature, WORMS-based reports from original free-text knee MRI reports. GPT-4o with COT achieved high accuracy in categorizing OA severity. Surgeons reported greater preference and higher efficiency when using LLM-generated reports. The perfect performance of generating WORMS-based reports and the high efficiency and ease of use suggest that integrating LLMs into clinical workflows could greatly enhance productivity and alleviate the documentation burden faced by clinicians in knee OA. GPT-4o successfully generated WORMS-based knee MRI reports. GPT-4o with COT prompting achieved impressive accuracy in categorizing knee OA severity. Greater preference and higher efficiency were reported for LLM-generated reports.

Fed-ComBat: A Generalized Federated Framework for Batch Effect Harmonization in Collaborative Studies

Silva, S., Lorenzi, M., Altmann, A., Oxtoby, N.

biorxiv logopreprintMay 14 2025
In neuroimaging research, the utilization of multi-centric analyses is crucial for obtaining sufficient sample sizes and representative clinical populations. Data harmonization techniques are typically part of the pipeline in multi-centric studies to address systematic biases and ensure the comparability of the data. However, most multi-centric studies require centralized data, which may result in exposing individual patient information. This poses a significant challenge in data governance, leading to the implementation of regulations such as the GDPR and the CCPA, which attempt to address these concerns but also hinder data access for researchers. Federated learning offers a privacy-preserving alternative approach in machine learning, enabling models to be collaboratively trained on decentralized data without the need for data centralization or sharing. In this paper, we present Fed-ComBat, a federated framework for batch effect harmonization on decentralized data. Fed-ComBat extends existing centralized linear methods, such as ComBat and distributed as d-ComBat, and nonlinear approaches like ComBat-GAM in accounting for potentially nonlinear and multivariate covariate effects. By doing so, Fed-ComBat enables the preservation of nonlinear covariate effects without requiring centralization of data and without prior knowledge of which variables should be considered nonlinear or their interactions, differentiating it from ComBat-GAM. We assessed Fed-ComBat and existing approaches on simulated data and multiple cohorts comprising healthy controls (CN) and subjects with various disorders such as Parkinson's disease (PD), Alzheimer's disease (AD), and autism spectrum disorder (ASD). The results of our study show that Fed-ComBat performs better than centralized ComBat when dealing with nonlinear effects and is on par with centralized methods like ComBat-GAM. Through experiments using synthetic data, Fed-ComBat demonstrates a superior ability to reconstruct the target unbiased function, achieving a 35% improvement (RMSE=0.5952) compared to d-ComBat (RMSE=0.9162) and a 12% improvement compared to our proposal to federate ComBat-GAM, d-ComBat-GAM (RMSE=0.6751). Additionally, Fed-ComBat achieves comparable results to centralized methods like ComBat-GAM for MRI-derived phenotypes without requiring prior knowledge of potential nonlinearities.

A multi-layered defense against adversarial attacks in brain tumor classification using ensemble adversarial training and feature squeezing.

Yinusa A, Faezipour M

pubmed logopapersMay 14 2025
Deep learning, particularly convolutional neural networks (CNNs), has proven valuable for brain tumor classification, aiding diagnostic and therapeutic decisions in medical imaging. Despite their accuracy, these models are vulnerable to adversarial attacks, compromising their reliability in clinical settings. In this research, we utilized a VGG16-based CNN model to classify brain tumors, achieving 96% accuracy on clean magnetic resonance imaging (MRI) data. To assess robustness, we exposed the model to Fast Gradient Sign Method (FGSM) and Projected Gradient Descent (PGD) attacks, which reduced accuracy to 32% and 13%, respectively. We then applied a multi-layered defense strategy, including adversarial training with FGSM and PGD examples and feature squeezing techniques such as bit-depth reduction and Gaussian blurring. This approach improved model resilience, achieving 54% accuracy on FGSM and 47% on PGD adversarial examples. Our results highlight the importance of proactive defense strategies for maintaining the reliability of AI in medical imaging under adversarial conditions.

Early detection of Alzheimer's disease progression stages using hybrid of CNN and transformer encoder models.

Almalki H, Khadidos AO, Alhebaishi N, Senan EM

pubmed logopapersMay 14 2025
Alzheimer's disease (AD) is a neurodegenerative disorder that affects memory and cognitive functions. Manual diagnosis is prone to human error, often leading to misdiagnosis or delayed detection. MRI techniques help visualize the fine tissues of the brain cells, indicating the stage of disease progression. Artificial intelligence techniques analyze MRI with high accuracy and extract subtle features that are difficult to diagnose manually. In this study, a modern methodology was designed that combines the power of CNN models (ResNet101 and GoogLeNet) to extract local deep features and the power of Vision Transformer (ViT) models to extract global features and find relationships between image spots. First, the MRI images of the Open Access Imaging Studies Series (OASIS) dataset were improved by two filters: the adaptive median filter (AMF) and Laplacian filter. The ResNet101 and GoogLeNet models were modified to suit the feature extraction task and reduce computational cost. The ViT architecture was modified to reduce the computational cost while increasing the number of attention vertices to further discover global features and relationships between image patches. The enhanced images were fed into the proposed ViT-CNN methodology. The enhanced images were fed to the modified ResNet101 and GoogLeNet models to extract the deep feature maps with high accuracy. Deep feature maps were fed into the modified ViT model. The deep feature maps were partitioned into 32 feature maps using ResNet101 and 16 feature maps using GoogLeNet, both with a size of 64 features. The feature maps were encoded to recognize the spatial arrangement of the patch and preserve the relationship between patches, helping the self-attention layers distinguish between patches based on their positions. They were fed to the transformer encoder, which consisted of six blocks and multiple vertices to focus on different patterns or regions simultaneously. Finally, the MLP classification layers classify each image into one of four dataset classes. The improved ResNet101-ViT hybrid methodology outperformed the GoogLeNet-ViT hybrid methodology. ResNet101-ViT achieved 98.7% accuracy, 95.05% AUC, 96.45% precision, 99.68% sensitivity, and 97.78% specificity.

An Annotated Multi-Site and Multi-Contrast Magnetic Resonance Imaging Dataset for the study of the Human Tongue Musculature.

Ribeiro FL, Zhu X, Ye X, Tu S, Ngo ST, Henderson RD, Steyn FJ, Kiernan MC, Barth M, Bollmann S, Shaw TB

pubmed logopapersMay 14 2025
This dataset provides the first annotated, openly available MRI-based imaging dataset for investigations of tongue musculature, including multi-contrast and multi-site MRI data from non-disease participants. The present dataset includes 47 participants collated from three studies: BeLong (four participants; T2-weighted images), EATT4MND (19 participants; T2-weighted images), and BMC (24 participants; T1-weighted images). We provide manually corrected segmentations of five key tongue muscles: the superior longitudinal, combined transverse/vertical, genioglossus, and inferior longitudinal muscles. Other phenotypic measures, including age, sex, weight, height, and tongue muscle volume, are also available for use. This dataset will benefit researchers across domains interested in the structure and function of the tongue in health and disease. For instance, researchers can use this data to train new machine learning models for tongue segmentation, which can be leveraged for segmentation and tracking of different tongue muscles engaged in speech formation in health and disease. Altogether, this dataset provides the means to the scientific community for investigation of the intricate tongue musculature and its role in physiological processes and speech production.

Highly Undersampled MRI Reconstruction via a Single Posterior Sampling of Diffusion Models

Jin Liu, Qing Lin, Zhuang Xiong, Shanshan Shan, Chunyi Liu, Min Li, Feng Liu, G. Bruce Pike, Hongfu Sun, Yang Gao

arxiv logopreprintMay 13 2025
Incoherent k-space under-sampling and deep learning-based reconstruction methods have shown great success in accelerating MRI. However, the performance of most previous methods will degrade dramatically under high acceleration factors, e.g., 8$\times$ or higher. Recently, denoising diffusion models (DM) have demonstrated promising results in solving this issue; however, one major drawback of the DM methods is the long inference time due to a dramatic number of iterative reverse posterior sampling steps. In this work, a Single Step Diffusion Model-based reconstruction framework, namely SSDM-MRI, is proposed for restoring MRI images from highly undersampled k-space. The proposed method achieves one-step reconstruction by first training a conditional DM and then iteratively distilling this model. Comprehensive experiments were conducted on both publicly available fastMRI images and an in-house multi-echo GRE (QSM) subject. Overall, the results showed that SSDM-MRI outperformed other methods in terms of numerical metrics (PSNR and SSIM), qualitative error maps, image fine details, and latent susceptibility information hidden in MRI phase images. In addition, the reconstruction time for a 320*320 brain slice of SSDM-MRI is only 0.45 second, which is only comparable to that of a simple U-net, making it a highly effective solution for MRI reconstruction tasks.

AmygdalaGo-BOLT: an open and reliable AI tool to trace boundaries of human amygdala

Zhou, Q., Dong, B., Gao, P., Jintao, W., Xiao, J., Wang, W., Liang, P., Lin, D., Zuo, X.-N., He, H.

biorxiv logopreprintMay 13 2025
Each year, thousands of brain MRI scans are collected to study structural development in children and adolescents. However, the amygdala, a particularly small and complex structure, remains difficult to segment reliably, especially in developing populations where its volume is even smaller. To address this challenge, we developed AmygdalaGo-BOLT, a boundary-aware deep learning model tailored for human amygdala segmentation. It was trained and validated using 854 manually labeled scans from pediatric datasets, with independent samples used to ensure performance generalizability. The model integrates multiscale image features, spatial priors, and self-attention mechanisms within a compact encoder-decoder architecture to enhance boundary detection. Validation across multiple imaging centers and age groups shows that AmygdalaGo-BOLT closely matches expert manual labels, improves processing efficiency, and outperforms existing tools in accuracy. This enables robust and scalable analysis of amygdala morphology in developmental neuroimaging studies where manual tracing is impractical. To support open and reproducible science, we publicly release both the labeled datasets and the full source code.

Deep Learning-accelerated MRI in Body and Chest.

Rajamohan N, Bagga B, Bansal B, Ginocchio L, Gupta A, Chandarana H

pubmed logopapersMay 13 2025
Deep learning reconstruction (DLR) provides an elegant solution for MR acceleration while preserving image quality. This advancement is crucial for body imaging, which is frequently marred by the increased likelihood of motion-related artifacts. Multiple vendor-specific models focusing on T2, T1, and diffusion-weighted imaging have been developed for the abdomen, pelvis, and chest, with the liver and prostate being the most well-studied organ systems. Variational networks with supervised DL models, including data consistency layers and regularizers, are the most common DLR methods. The common theme for all single-center studies on this subject has been noninferior or superior image quality metrics and lesion conspicuity to conventional sequences despite significant acquisition time reduction. DLR also provides a potential for denoising, artifact reduction, increased resolution, and increased signal-noise ratio (SNR) and contrast-to-noise ratio (CNR) that can be balanced with acceleration benefits depending on the imaged organ system. Some specific challenges faced by DLR include slightly reduced lesion detection, cardiac motion-related signal loss, regional SNR variations, and variabilities in ADC measurements as reported in different organ systems. Continued investigations with large-scale multicenter prospective clinical validation of DLR to document generalizability and demonstrate noninferior diagnostic accuracy with histopathologic correlation are the need of the hour. The creation of vendor-neutral solutions, open data sharing, and diversifying training data sets are also critical to strengthening model robustness.

An automated cascade framework for glioma prognosis via segmentation, multi-feature fusion and classification techniques.

Hamoud M, Chekima NEI, Hima A, Kholladi NH

pubmed logopapersMay 13 2025
Glioma is one of the most lethal types of brain tumors, accounting for approximately 33% of all diagnosed brain tumor cases. Accurate segmentation and classification are crucial for precise glioma characterization, emphasizing early detection of malignancy, effective treatment planning, and prevention of tumor progression. Magnetic Resonance Imaging (MRI) serves as a non-invasive imaging modality that allows detailed examination of gliomas without exposure to ionizing radiation. However, manual analysis of MRI scans is impractical, time-consuming, subjective, and requires specialized expertise from radiologists. To address this, computer-aided diagnosis (CAD) systems have greatly evolved as powerful tools to support neuro-oncologists in the brain cancer screening process. In this work, we present a glioma classification framework based on 3D multi-modal MRI segmentation using the CNN models SegResNet and Swin UNETR which incorporates transformer mechanisms for enhancing segmentation performance. MRI images undergo preprocessing with a Gaussian filter and skull stripping to improve tissue localization. Key textural features are then extracted from segmented tumor regions using Gabor Transform, Discrete Wavelet Transform (DWT), and deep features from ResNet50. These features are fused, normalized, and classified using a Support Vector Machine (SVM) to distinguish between Low-Grade Glioma (LGG) and High-Grade Glioma (HGG). Extensive experiments on benchmark datasets, including BRATS2020 and BRATS2023, demonstrate the effectiveness of the proposed approach. Our model achieved Dice scores of 0.815 for Tumor Core, 0.909 for Whole Tumor, and 0.829 for Enhancing Tumor. Concerning classification, the framework attained 97% accuracy, 94% precision, 96% recall, and a 95% F1-score. These results highlight the potential of the proposed framework to provide reliable support for radiologists in the early detection and classification of gliomas.

Signal-based AI-driven software solution for automated quantification of metastatic bone disease and treatment response assessment using Whole-Body Diffusion-Weighted MRI (WB-DWI) biomarkers in Advanced Prostate Cancer

Antonio Candito, Matthew D Blackledge, Richard Holbrey, Nuria Porta, Ana Ribeiro, Fabio Zugni, Luca D'Erme, Francesca Castagnoli, Alina Dragan, Ricardo Donners, Christina Messiou, Nina Tunariu, Dow-Mu Koh

arxiv logopreprintMay 13 2025
We developed an AI-driven software solution to quantify metastatic bone disease from WB-DWI scans. Core technologies include: (i) a weakly-supervised Residual U-Net model generating a skeleton probability map to isolate bone; (ii) a statistical framework for WB-DWI intensity normalisation, obtaining a signal-normalised b=900s/mm^2 (b900) image; and (iii) a shallow convolutional neural network that processes outputs from (i) and (ii) to generate a mask of suspected bone lesions, characterised by higher b900 signal intensity due to restricted water diffusion. This mask is applied to the gADC map to extract TDV and gADC statistics. We tested the tool using expert-defined metastatic bone disease delineations on 66 datasets, assessed repeatability of imaging biomarkers (N=10), and compared software-based response assessment with a construct reference standard based on clinical, laboratory and imaging assessments (N=118). Dice score between manual and automated delineations was 0.6 for lesions within pelvis and spine, with an average surface distance of 2mm. Relative differences for log-transformed TDV (log-TDV) and median gADC were below 9% and 5%, respectively. Repeatability analysis showed coefficients of variation of 4.57% for log-TDV and 3.54% for median gADC, with intraclass correlation coefficients above 0.9. The software achieved 80.5% accuracy, 84.3% sensitivity, and 85.7% specificity in assessing response to treatment compared to the construct reference standard. Computation time generating a mask averaged 90 seconds per scan. Our software enables reproducible TDV and gADC quantification from WB-DWI scans for monitoring metastatic bone disease response, thus providing potentially useful measurements for clinical decision-making in APC patients.
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