The locus coeruleus (LC) is linked to the development and pathophysiology of neurodegenerative diseases such as Alzheimer's disease (AD). Magnetic resonance imaging-based LC features have shown potential to assess LC integrity in vivo. We present a deep learning-based LC segmentation and feature extraction method called Ensemble-based Locus Coeruleus Segmentation Network (ELSI-Net) and apply it to healthy aging and AD dementia datasets. Agreement to expert raters and previously published LC atlases were assessed. We aimed to reproduce previously reported differences in LC integrity in aging and AD dementia and correlate extracted features to cerebrospinal fluid (CSF) biomarkers of AD pathology. ELSI-Net demonstrated high agreement to expert raters and published atlases. Previously reported group differences in LC integrity were detected and correlations to CSF biomarkers were found. Although we found excellent performance, further evaluations on more diverse datasets from clinical cohorts are required for a conclusive assessment of ELSI-Net's general applicability. We provide a thorough evaluation of a fully automatic locus coeruleus (LC) segmentation method termed Ensemble-based Locus Coeruleus Segmentation Network (ELSI-Net) in aging and Alzheimer's disease (AD) dementia.ELSI-Net outperforms previous work and shows high agreement with manual ratings and previously published LC atlases.ELSI-Net replicates previously shown LC group differences in aging and AD.ELSI-Net's LC mask volume correlates with cerebrospinal fluid biomarkers of AD pathology.

Prostate cancer is a common malignancy in men, and accurately distinguishing between benign and malignant nodules at an early stage is crucial for optimizing treatment. Multimodal imaging (such as ADC and T2) plays an important role in the diagnosis of prostate cancer, but effectively combining these imaging features for accurate classification remains a challenge. This retrospective study included MRI data from 199 prostate cancer patients. Radiomic features from both the tumor and peritumoral regions were extracted, and a random forest model was used to select the most contributive features for classification. Three machine learning models-Random Forest, XGBoost, and Extra Trees-were then constructed and trained on four different feature combinations (tumor ADC, tumor T2, tumor ADC+T2, and tumor + peritumoral ADC+T2). The model incorporating multimodal imaging features and peritumoral characteristics showed superior classification performance. The Extra Trees model outperformed the others across all feature combinations, particularly in the tumor + peritumoral ADC+T2 group, where the AUC reached 0.729. The AUC values for the other combinations also exceeded 0.65. While the Random Forest and XGBoost models performed slightly lower, they still demonstrated strong classification abilities, with AUCs ranging from 0.63 to 0.72. SHAP analysis revealed that key features, such as tumor texture and peritumoral gray-level features, significantly contributed to the model's classification decisions. The combination of multimodal imaging data with peritumoral features moderately improved the accuracy of prostate cancer classification. This model provides a non-invasive and effective diagnostic tool for clinical use and supports future personalized treatment decisions.

Early and accurate detection of COVID-19 and pneumonia through medical imaging is critical for effective patient management. This study aims to develop a robust framework that integrates synthetic image augmentation with advanced deep learning (DL) models to address dataset imbalance, improve diagnostic accuracy, and enhance trust in artificial intelligence (AI)-driven diagnoses through Explainable AI (XAI) techniques. The proposed framework benchmarks state-of-the-art models (InceptionV3, DenseNet, ResNet) for initial performance evaluation. Synthetic images are generated using Feature Interpolation through Linear Mapping and principal component analysis to enrich dataset diversity and balance class distribution. YOLOv8 and InceptionV3 models, fine-tuned via transfer learning, are trained on the augmented dataset. Grad-CAM is used for model explainability, while large language models (LLMs) support visualization analysis to enhance interpretability. YOLOv8 achieved superior performance with 97% accuracy, precision, recall, and F1-score, outperforming benchmark models. Synthetic data generation effectively reduced class imbalance and improved recall for underrepresented classes. Comparative analysis demonstrated significant advancements over existing methodologies. XAI visualizations (Grad-CAM heatmaps) highlighted anatomically plausible focus areas aligned with clinical markers of COVID-19 and pneumonia, thereby validating the model's decision-making process. The integration of synthetic data generation, advanced DL, and XAI significantly enhances the detection of COVID-19 and pneumonia while fostering trust in AI systems. YOLOv8's high accuracy, coupled with interpretable Grad-CAM visualizations and LLM-driven analysis, promotes transparency crucial for clinical adoption. Future research will focus on developing a clinically viable, human-in-the-loop diagnostic workflow, further optimizing performance through the integration of transformer-based language models to improve interpretability and decision-making.

In recent times, appropriate diagnosis of brain tumour is a crucial task in medical system. Therefore, identification of a potential brain tumour is challenging owing to the complex behaviour and structure of the human brain. To address this issue, a deep learning-driven framework consisting of four pre-trained models viz DenseNet169, VGG-19, Xception, and EfficientNetV2B2 is developed to classify potential brain tumours from medical resonance images. At first, the deep learning models are trained and fine-tuned on the training dataset, obtained validation scores of trained models are considered as model-wise weights. Then, trained models are subsequently evaluated on the test dataset to generate model-specific predictions. In the weight-aware decision module, the class-bucket of a probable output class is updated with the weights of deep models when their predictions match the class. Finally, the bucket with the highest aggregated value is selected as the final output class for the input image. A novel weight-aware decision mechanism is a key feature of this framework, which effectively deals tie situations in multi-class classification compared to conventional majority-based techniques. The developed framework has obtained promising results of 98.7%, 97.52%, and 94.94% accuracy on three different datasets. The entire framework is seamlessly integrated into an end-to-end web-application for user convenience. The source code, dataset and other particulars are publicly released at https://github.com/SaiSanthosh1508/Brain-Tumour-Image-classification-app [Rishik Sai Santhosh, "Brain Tumour Image Classification Application," https://github.com/SaiSanthosh1508/Brain-Tumour-Image-classification-app] for academic, research and other non-commercial usage.

Artificial intelligence (AI) methods have established themselves in cardiovascular magnetic resonance (CMR) as automated quantification tools for ventricular volumes, function, and myocardial tissue characterization. Quality assurance approaches focus on measuring and controlling AI-expert differences but there is a need for tools that better communicate reliability and agreement. This study introduces the Verity plot, a novel statistical visualization that communicates the reliability of quantitative parameters (QP) with clear agreement criteria and descriptive statistics. Tolerance ranges for the acceptability of the bias and variance of AI-expert differences were derived from intra- and interreader evaluations. AI-expert agreement was defined by bias confidence and variance tolerance intervals being within bias and variance tolerance ranges. A reliability plot was designed to communicate this statistical test for agreement. Verity plots merge reliability plots with density and a scatter plot to illustrate AI-expert differences. Their utility was compared against Correlation, Box and Bland-Altman plots. Bias and variance tolerance ranges were established for volume, function, and myocardial tissue characterization QPs. Verity plots provided insights into statstistcal properties, outlier detection, and parametric test assumptions, outperforming Correlation, Box and Bland-Altman plots. Additionally, they offered a framework for determining the acceptability of AI-expert bias and variance. Verity plots offer markers for bias, variance, trends and outliers, in addition to deciding AI quantification acceptability. The plots were successfully applied to various AI methods in CMR and decisively communicated AI-expert agreement.

Tuberculous meningitis (TBM) leads to high mortality, especially amongst individuals with HIV. Predicting the incidence of disease-related complications is challenging, for which purpose the value of brain magnetic resonance imaging (MRI) has not been well investigated. We used a convolutional neural network (CNN) to explore the complementary contribution of brain MRI to the conventional prognostic determinants. We pooled data from two randomised control trials of HIV-positive and HIV-negative adults with clinical TBM in Vietnam to predict the occurrence of death or new neurological complications in the first two months after the subject's first MRI session. We developed and compared three models: a logistic regression with clinical, demographic and laboratory data as reference, a CNN that utilised only T1-weighted MRI volumes, and a model that fused all available information. All models were fine-tuned using two repetitions of 5-fold cross-validation. The final evaluation was based on a random 70/30 training/test split, stratified by the outcome and HIV status. Based on the selected model, we explored the interpretability maps derived from the models. 215 patients were included, with an event prevalence of 22.3%. On the test set our non-imaging model had higher AUC (71.2% [Formula: see text] 1.1%) than the imaging-only model (67.3% [Formula: see text] 2.6%). The fused model was superior to both, with an average AUC = 77.3% [Formula: see text] 4.0% in the test set. The non-imaging variables were more informative in the HIV-positive group, while the imaging features were more predictive in the HIV-negative group. All three models performed better in the HIV-negative cohort. The interpretability maps show the model's focus on the lateral fissures, the corpus callosum, the midbrain, and peri-ventricular tissues. Imaging information can provide added value to predict unwanted outcomes of TBM. However, to confirm this finding, a larger dataset is needed.

To develop an interpretable machine learning (ML) model using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) radiomic data, dosimetric parameters, and clinical data for predicting radiation-induced hepatic toxicity (RIHT) in patients with hepatocellular carcinoma (HCC) following intensity-modulated radiation therapy (IMRT). A retrospective analysis of 150 HCC patients was performed, with a 7:3 ratio used to divide the data into training and validation cohorts. Radiomic features from the original MRI sequences and Delta-radiomic features were extracted. Seven ML models based on radiomics were developed: logistic regression (LR), random forest (RF), support vector machine (SVM), eXtreme Gradient Boosting (XGBoost), adaptive boosting (AdaBoost), decision tree (DT), and artificial neural network (ANN). The predictive performance of the models was evaluated using receiver operating characteristic (ROC) curve analysis and calibration curves. Shapley additive explanations (SHAP) were employed to interpret the contribution of each variable and its risk threshold. Original radiomic features and Delta-radiomic features were extracted from DCE-MRI images and filtered to generate Radiomics-scores and Delta-Radiomics-scores. These were then combined with independent risk factors (Body Mass Index (BMI), V5, and pre-Child-Pugh score(pre-CP)) identified through univariate and multivariate logistic regression and Spearman correlation analysis to construct the ML models. In the training cohort, the AUC values were 0.8651 for LR, 0.7004 for RF, 0.6349 for SVM, 0.6706 for XGBoost, 0.7341 for AdaBoost, 0.6806 for Decision Tree, and 0.6786 for ANN. The corresponding accuracies were 84.4%, 65.6%, 75.0%, 65.6%, 71.9%, 68.8%, and 71.9%, respectively. The validation cohort further confirmed the superiority of the LR model, which was selected as the optimal model. SHAP analysis revealed that Delta-radiomics made a substantial positive contribution to the model. The interpretable ML model based on radiomics provides a non-invasive tool for predicting RIHT in patients with HCC, demonstrating satisfactory discriminative performance.

Lung cancer imaging plays a crucial role in early diagnosis and treatment, where machine learning and deep learning have significantly advanced the accuracy and efficiency of disease classification. This study introduces the Explainable and Lightweight Lung Cancer Net (XLLC-Net), a streamlined convolutional neural network designed for classifying lung cancer from histopathological images. Using the LC25000 dataset, which includes three lung cancer classes and two colon cancer classes, we focused solely on the three lung cancer classes for this study. XLLC-Net effectively discerns complex disease patterns within these classes. The model consists of four convolutional layers and contains merely 3 million parameters, considerably reducing its computational footprint compared to existing deep learning models. This compact architecture facilitates efficient training, completing each epoch in just 60 seconds. Remarkably, XLLC-Net achieves a classification accuracy of 99.62% [Formula: see text] 0.16%, with precision, recall, and F1 score of 99.33% [Formula: see text] 0.30%, 99.67% [Formula: see text] 0.30%, and 99.70% [Formula: see text] 0.30%, respectively. Furthermore, the integration of Explainable AI techniques, such as Saliency Map and GRAD-CAM, enhances the interpretability of the model, offering clear visual insights into its decision-making process. Our results underscore the potential of lightweight DL models in medical imaging, providing high accuracy and rapid training while ensuring model transparency and reliability.

Volumetric atlases are an invaluable tool in neuroscience and otolaryngology, greatly aiding experiment planning and surgical interventions, as well as the interpretation of experimental and clinical data. The rat is a major animal model for hearing and balance studies, and a detailed volumetric atlas for the rat central auditory system (Waxholm) is available. However, the Waxholm rat atlas only contains a low-resolution inner ear featuring five structures. In the present work, we segmented and annotated 34 structures in the rat inner ear, yielding a detailed volumetric inner ear atlas which can be integrated with the Waxholm rat brain atlas. We performed iodine-enhanced microCT and iDISCO+-based clearing and fluorescence lightsheet microscopy imaging on a sample of rat temporal bones. Image stacks were segmented in a semiautomated way, and 34 inner ear volumes were reconstructed from five samples. Using geometrical morphometry, high-resolution segmentations obtained from lightsheet and microCT stacks were registered into the coordinate system of the Waxholm rat atlas. Cleared sample autofluorescence was used for the reconstruction of most inner ear structures, including fluid-filled compartments, nerves and sensory epithelia, blood vessels, and connective tissue structures. Image resolution allowed reconstruction of thin ducts (reuniting, saccular and endolymphatic), and the utriculoendolymphatic valve. The vestibulocochlear artery coursing through bone was found to be associated to the reuniting duct, and to be visible both in cleared and microCT samples, thus allowing to infer duct location from microCT scans. Cleared labyrinths showed minimal shape distortions, as shown by alignment with microCT and Waxholm labyrinths. However, membranous labyrinths could display variable collapse of the superior division, especially the roof of canal ampullae, whereas the inferior division (saccule and cochlea) was well preserved, with the exception of Reissner's membrane that could display ruptures in the second cochlear turn. As an example of atlas use, the volumes reconstructed from segmentations were used to separate macrophage populations from the spiral ganglion, auditory neuron dendrites, and Organ of Corti. We have reconstructed 34 structures from the rat temporal bone, which are available as both image stacks and printable 3D objects in a shared repository for download. These can be used for teaching, localizing cells or other features within the ear, modeling auditory and vestibular sensory physiology and training of automated segmentation machine learning tools.

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.