This study aims to evaluate the effectiveness of a deep learning (DL)-enhanced four-fold parallel acquisition technique (P4) in improving prostate MR image quality while optimizing scan efficiency compared to the traditional two-fold parallel acquisition technique (P2). Patients undergoing prostate MRI with DL-enhanced acquisitions were analyzed from January 2024 to July 2024. The participants prospectively received T2-weighted sequences in all imaging planes using both P2 and P4. Three independent readers assessed image quality, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR). Significant differences in contrast and gray-level properties between P2 and P4 were identified through radiomics analysis (p <.05). A total of 51 participants (mean age 69.4 years ± 10.5 years) underwent P2 and P4 imaging. P4 demonstrated higher CNR and SNR values compared to P2 (p <.001). P4 was consistently rated superior to P2, demonstrating enhanced image quality and greater diagnostic precision across all evaluated categories (p <.001). Furthermore, radiomics analysis confirmed that P4 significantly altered structural and textural differentiation in comparison to P2. The P4 protocol reduced T2w scan times by 50.8%, from 11:48 min to 5:48 min (p <.001). In conclusion, P4 imaging enhances diagnostic quality and reduces scan times, improving workflow efficiency, and potentially contributing to a more patient-centered and sustainable radiology practice.

Accurately identifying difficult laparoscopic cholecystectomy (DLC) preoperatively remains a clinical challenge. Previous studies utilizing clinical variables or morphological imaging markers have demonstrated suboptimal predictive performance. This study aims to develop an optimal radiomics-clinical model by integrating preoperative CT-based radiomics features with clinical characteristics. A retrospective analysis was conducted on 2,055 patients who underwent laparoscopic cholecystectomy (LC) for cholecystitis at our center. Preoperative CT images were processed with super-resolution reconstruction to improve consistency, and high-throughput radiomic features were extracted from the gallbladder wall region. A combination of radiomic and clinical features was selected using the Boruta-LASSO algorithm. Predictive models were constructed using six machine learning algorithms and validated, with model performance evaluated based on the AUC, accuracy, Brier score, and DCA to identify the optimal model. Model interpretability was further enhanced using the SHAP method. The Boruta-LASSO algorithm identified 10 key radiomic and clinical features for model construction, including the Rad-Score, gallbladder wall thickness, fibrinogen, C-reactive protein, and low-density lipoprotein cholesterol. Among the six machine learning models developed, the radiomics-clinical model based on the random forest algorithm demonstrated the best predictive performance, with an AUC of 0.938 in the training cohort and 0.874 in the validation cohort. The Brier score, calibration curve, and DCA confirmed the superior predictive capability of this model, significantly outperforming previously published models. The SHAP analysis further visualized the importance of features, enhancing model interpretability. This study developed the first radiomics-clinical random forest model for the preoperative prediction of DLC by machine learning algorithms. This predictive model supports safer and individualized surgical planning and treatment strategies.

Accurately assessing the risk stratification of cN0 papillary thyroid carcinoma (PTC) preoperatively aids in making treatment decisions. We integrated preoperative ultrasound and cytological images of patients to develop and validate a multimodal deep learning (DL) model for non-invasive assessment of N0 PTC risk stratification before surgery. In this retrospective multicenter group study, we developed a comprehensive DL model based on ultrasound and cytological images. The model was trained and validated on 890 PTC patients undergoing thyroidectomy and lymph node dissection across five medical centers. The testing group included 107 patients from one medical center. We analyzed the model's performance, including the area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity. The combined DL model demonstrated strong performance, with an area under the curve (AUC) of 0.922 (0.866-0.979) in the internal validation group and an AUC of 0.845 (0.794-0.895) in the testing group. The diagnostic performance of the combined DL model surpassed that of clinical models. Image region heatmaps assisted in interpreting the diagnosis of risk stratification. The multimodal DL model based on ultrasound and cytological images can accurately determine the risk stratification of N0 PTC and guide treatment decisions.

Objectives: Timely and accurate detection of colorectal polyps plays a crucial role in diagnosing and preventing colorectal cancer, a major cause of mortality worldwide. This study introduces a new, lightweight, and efficient framework for polyp detection that combines the Local Outlier Factor (LOF) algorithm for filtering noisy data with the YOLO-v11n deep learning model. Study design: An experimental study leveraging deep learning and outlier removal techniques across multiple public datasets. Methods: The proposed approach was tested on five diverse and publicly available datasets: CVC-ColonDB, CVC-ClinicDB, Kvasir-SEG, ETIS, and EndoScene. Since these datasets originally lacked bounding box annotations, we converted their segmentation masks into suitable detection labels. To enhance the robustness and generalizability of our model, we apply 5-fold cross-validation and remove anomalous samples using the LOF method configured with 30 neighbors and a contamination ratio of 5%. Cleaned data are then fed into YOLO-v11n, a fast and resource-efficient object detection architecture optimized for real-time applications. We train the model using a combination of modern augmentation strategies to improve detection accuracy under diverse conditions. Results: Our approach significantly improves polyp localization performance, achieving a precision of 95.83%, recall of 91.85%, F1-score of 93.48%, [email protected] of 96.48%, and [email protected]:0.95 of 77.75%. Compared to previous YOLO-based methods, our model demonstrates enhanced accuracy and efficiency. Conclusions: These results suggest that the proposed method is well-suited for real-time colonoscopy support in clinical settings. Overall, the study underscores how crucial data preprocessing and model efficiency are when designing effective AI systems for medical imaging.

Despite continued advances in oncology, cancer remains a leading cause of global mortality, highlighting the need for diagnostic and prognostic tools that are both accurate and interpretable. Unimodal approaches often fail to capture the biological and clinical complexity of tumors. In this study, we present a suite of task-specific AI models that leverage CT imaging, multi-omics profiles, and structured clinical data to address distinct challenges in segmentation, classification, and prognosis. We developed three independent models across large public datasets. Task 1 applied a 3D U-Net to segment pancreatic tumors from CT scans, achieving a Dice Similarity Coefficient (DSC) of 0.7062. Task 2 employed a hierarchical ensemble of omics-based classifiers to distinguish tumor from normal tissue and classify six major cancer types with 98.67% accuracy. Task 3 benchmarked classical machine learning models on clinical data for prognosis prediction across three cancers (LIHC, KIRC, STAD), achieving strong performance (e.g., C-index of 0.820 in KIRC, AUC of 0.978 in LIHC). Across all tasks, explainable AI methods such as SHAP and attention-based visualization enabled transparent interpretation of model outputs. These results demonstrate the value of tailored, modality-aware models and underscore the clinical potential of applying such tailored AI systems for precision oncology. Technical FoundationsO_LISegmentation (Task 1): A custom 3D U-Net was trained using the Task07_Pancreas dataset from the Medical Segmentation Decathlon (MSD). CT images were preprocessed with MONAI-based pipelines, resampled to (64, 96, 96) voxels, and intensity-windowed to HU ranges of -100 to 240. C_LIO_LIClassification (Task 2): Multi-omics data from TCGA--including gene expression, methylation, miRNA, CNV, and mutation profiles--were log-transformed and normalized. Five modality-specific LightGBM classifiers generated meta-features for a late-fusion ensemble. Stratified 5-fold cross-validation was used for evaluation. C_LIO_LIPrognosis (Task 3): Clinical variables from TCGA were curated and imputed (median/mode), with high-missing-rate columns removed. Survival models (e.g., Cox-PH, Random Forest, XGBoost) were trained with early stopping. No omics or imaging data were used in this task. C_LIO_LIInterpretability: SHAP values were computed for all tree-based models, and attention-based overlays were used in imaging tasks to visualize salient regions. C_LI

Renal cancer is amid the several reasons of increasing mortality rates globally, which can be reduced by early detection and diagnosis. The classification of lesions is based mostly on their characteristics, which include varied shape and texture properties. Computed tomography (CT) imaging is a regularly used imaging modality for study of the renal soft tissues. Furthermore, a radiologist's ability to assess a corpus of CT images is limited, which can lead to misdiagnosis of kidney lesions, which might lead to cancer progression or unnecessary chemotherapy. To address these challenges, this study presents a machine learning technique based on a novel feature vector for the automated classification of renal lesions using a multi-model texture-based feature extraction. The proposed feature vector could serve as an integral component in improving the accuracy of a computer aided diagnosis (CAD) system for identifying the texture of renal lesion and can assist physicians in order to provide more precise lesion interpretation. In this work, the authors employed different texture models for the analysis of CT scans, in order to classify benign and malignant kidney lesions. Texture analysis is performed using features such as first-order statistics (FoS), spatial gray level co-occurrence matrix (SGLCM), Fourier power spectrum (FPS), statistical feature matrix (SFM), Law's texture energy measures (TEM), gray level difference statistics (GLDS), fractal, and neighborhood gray tone difference matrix (NGTDM). Multiple texture models were utilized to quantify the renal texture patterns, which used image texture analysis on a selected region of interest (ROI) from the renal lesions. In addition, dimensionality reduction is employed to discover the most discriminative features for categorization of benign and malignant lesions, and a unique feature vector based on correlation-based feature selection, information gain, and gain ratio is proposed. Different machine learning-based classifiers were employed to test the performance of the proposed features, out of which the random forest (RF) model outperforms all other techniques to distinguish benign from malignant tumors in terms of distinct performance evaluation metrics. The final feature set is evaluated using various machine learning classifiers, with the RF model achieving the highest performance. The proposed system is validated on a dataset of 50 subjects, achieving a classification accuracy of 95.8%, outperforming other conventional models.

Food insecurity (FI) is associated with increased adiposity and obesity-related medical conditions, and body composition can affect metabolic risk. Bariatric surgery effectively treats obesity and metabolic diseases. The association of FI with baseline computerized tomography (CT)-based body composition and bariatric surgery outcomes was investigated in this exploratory study. Fifty-four retrospectively identified adults had bariatric surgery, preoperative CT scan from 2017 to 2019, completed a six-item food security survey, and had body composition measured by bioelectrical impedance analysis (BIA). Skeletal muscle, visceral fat, and subcutaneous fat areas were determined from abdominal CT and normalized to published age, sex, and race reference values. Anthropometric data, related medical conditions, and medications were collected preoperatively, and at 6 months and at 12 months postoperatively. Patients were stratified into food security (FS) or FI based on survey responses. Fourteen (26%) patients were categorized as FI. Patients with FI had lower skeletal muscle area and higher subcutaneous fat area than patients with FS on baseline CT exam (p < 0.05). There was no difference in baseline BIA between patients with FS and FI. The two groups had similar weight loss, reduction in obesity-related medications, and healthcare utilization following bariatric surgery at 6 and 12 months postoperatively. Patients with FI had higher subcutaneous fat and lower skeletal muscle than patients with FS by baseline CT exam, findings which were not detected by BIA. CT analysis enabled by an artificial intelligence workflow offers more precise and detailed body composition data.

PSMA PET/CT imaging has been increasingly utilized in the management of patients with metastatic prostate cancer (mPCa). Imaging biomarkers derived from PSMA PET may provide improved prognostication and prediction of treatment response for mPCa patients. This study investigates a novel deep learning-derived imaging biomarker framework for outcome prediction using multi-modal PSMA PET/CT and clinical features. A single institution cohort of 99 mPCa patients with 396 lesions was evaluated. Imaging features were extracted from cropped lesion areas and combined with clinical variables including body mass index, ECOG performance status, prostate specific antigen (PSA) level, Gleason score, and treatments received. The PSA progression-free survival (PFS) model was trained using a ResNet architecture with a Cox proportional hazards loss function using five-fold cross-validation. Performance was assessed using concordance index (C-index) and Kaplan-Meier survival analysis. Among evaluated model architectures, the ResNet-18 backbone offered the best performance. The multi-modal deep learning framework achieved a 5-fold cross-validation C-index ranging from 0.75 to 0.94, outperforming models incorporating imaging only (0.70-0.89) and clinical features only (0.53-0.65). Kaplan-Meir survival analysis performed on the deep learning-derived predictions demonstrated clear risk stratification, with a median PSA progression free survival (PFS) of 19.7 months in the high-risk group and 26 months in the low-risk group (P < 0.001). Deep learning-derived imaging biomarker based on PSMA PET/CT can effectively predict PSA PFS for mPCa patients. Further clinical validation in prospective cohorts is warranted.

Accurate liver vessel segmentation is essential for effective liver surgery pre-planning, and reducing surgical risks since it enables the precise localization and extensive assessment of complex vessel structures. Manual liver vessel segmentation is a time-intensive process reliant on operator expertise and skill. The complex, tree-like architecture of hepatic and portal veins, which are interwoven and anatomically variable, further complicates this challenge. This study addresses these challenges by proposing the UNETR (U-Net Transformers) architecture for the multi-class segmentation of portal and hepatic veins in liver CT images. UNETR leverages a transformer-based encoder to effectively capture long-range dependencies, overcoming the limitations of convolutional neural networks (CNNs) in handling complex anatomical structures. The proposed method was evaluated on contrast-enhanced CT images from the IRCAD as well as a locally dataset developed from a hospital. On the local dataset, the UNETR model achieved Dice coefficients of 49.71% for portal veins, 69.39% for hepatic veins, and 76.74% for overall vessel segmentation, while reaching Dice coefficients of 62.54% for vessel segmentation on the IRCAD dataset. These results highlight the method's effectiveness in identifying complex vessel structures across diverse datasets. These findings underscore the critical role of advanced architectures and precise annotations in improving segmentation accuracy. This work provides a foundation for future advancements in automated liver surgery pre-planning, with the potential to enhance clinical outcomes significantly. The implementation code is available on GitHub: https://github.com/saharsarkar/Multiclass-Vessel-Segmentation .

Robot-assisted radical prostatectomy (RARP) is the standard surgical procedure for the treatment of prostate cancer. RARP requires a trade-off between performing a wider resection in order to reduce the risk of positive surgical margins (PSMs) and performing minimal resection of the nerve bundles that determine functional outcomes, such as incontinence and potency, which affect patients' quality of life. In order to achieve favourable outcomes, a precise understanding of the three-dimensional (3D) anatomy of the prostate, nerve bundles and tumour lesion is needed. This is the protocol for a single-centre feasibility study including a prospective two-arm interventional group (a 3D virtual and a 3D printed prostate model), and a prospective control group. The primary endpoint will be PSM status and the secondary endpoint will be functional outcomes, including incontinence and sexual function. The study will consist of a total of 270 patients: 54 patients will be included in each of the interventional groups (3D virtual, 3D printed models), 54 in the retrospective control group and 108 in the prospective control group. Automated segmentation of prostate gland and lesions will be conducted on multiparametric magnetic resonance imaging (mpMRI) using 'AutoProstate' and 'AutoLesion' deep learning approaches, while manual annotation of the neurovascular bundles, urethra and external sphincter will be conducted on mpMRI by a radiologist. This will result in masks that will be post-processed to generate 3D printed/virtual models. Patients will be allocated to either interventional arm and the surgeon will be given either a 3D printed or a 3D virtual model at the start of the RARP procedure. At the 6-week follow-up, the surgeon will meet with the patient to present PSM status and capture functional outcomes from the patient via questionnaires. We will capture these measures as endpoints for analysis. These questionnaires will be re-administered at 3, 6 and 12 months postoperatively.