Limited DXA access hinders osteoporosis screening. This proof-of-concept study proposes using widely available knee X-rays for opportunistic Bone Mineral Density (BMD) estimation via deep learning, emphasizing robust uncertainty quantification essential for clinical use. An EfficientNet model was trained on the OAI dataset to predict BMD from bilateral knee radiographs. Two Test-Time Augmentation (TTA) methods were compared: traditional averaging and a multi-sample approach. Crucially, Split Conformal Prediction was implemented to provide statistically rigorous, patient-specific prediction intervals with guaranteed coverage. Results showed a Pearson correlation of 0.68 (traditional TTA). While traditional TTA yielded better point predictions, the multi-sample approach produced slightly tighter confidence intervals (90%, 95%, 99%) while maintaining coverage. The framework appropriately expressed higher uncertainty for challenging cases. Although anatomical mismatch between knee X-rays and standard DXA limits immediate clinical use, this method establishes a foundation for trustworthy AI-assisted BMD screening using routine radiographs, potentially improving early osteoporosis detection.

We propose a cascaded 3D diffusion model framework to synthesize high-fidelity 3D PET/CT volumes directly from demographic variables, addressing the growing need for realistic digital twins in oncologic imaging, virtual trials, and AI-driven data augmentation. Unlike deterministic phantoms, which rely on predefined anatomical and metabolic templates, our method employs a two-stage generative process. An initial score-based diffusion model synthesizes low-resolution PET/CT volumes from demographic variables alone, providing global anatomical structures and approximate metabolic activity. This is followed by a super-resolution residual diffusion model that refines spatial resolution. Our framework was trained on 18-F FDG PET/CT scans from the AutoPET dataset and evaluated using organ-wise volume and standardized uptake value (SUV) distributions, comparing synthetic and real data between demographic subgroups. The organ-wise comparison demonstrated strong concordance between synthetic and real images. In particular, most deviations in metabolic uptake values remained within 3-5% of the ground truth in subgroup analysis. These findings highlight the potential of cascaded 3D diffusion models to generate anatomically and metabolically accurate PET/CT images, offering a robust alternative to traditional phantoms and enabling scalable, population-informed synthetic imaging for clinical and research applications.

Although Alzheimer's disease detection via MRIs has advanced significantly thanks to contemporary deep learning models, challenges such as class imbalance, protocol variations, and limited dataset diversity often hinder their generalization capacity. To address this issue, this article focuses on the single domain generalization setting, where given the data of one domain, a model is designed and developed with maximal performance w.r.t. an unseen domain of distinct distribution. Since brain morphology is known to play a crucial role in Alzheimer's diagnosis, we propose the use of learnable pseudo-morphological modules aimed at producing shape-aware, anatomically meaningful class-specific augmentations in combination with a supervised contrastive learning module to extract robust class-specific representations. Experiments conducted across three datasets show improved performance and generalization capacity, especially under class imbalance and imaging protocol variations. The source code will be made available upon acceptance at https://github.com/zobia111/SDG-Alzheimer.

Alzheimer's detection efforts aim to develop accurate models for early disease diagnosis. Significant advances have been achieved with convolutional neural networks and vision transformer based approaches. However, medical datasets suffer heavily from class imbalance, variations in imaging protocols, and limited dataset diversity, which hinder model generalization. To overcome these challenges, this study focuses on single-domain generalization by extending the well-known mixup method. The key idea is to compute the distance transform of MRI scans, separate them spatially into multiple layers and then combine layers stemming from distinct samples to produce augmented images. The proposed approach generates diverse data while preserving the brain's structure. Experimental results show generalization performance improvement across both ADNI and AIBL datasets.

Recent advancements in multimodal Large Language Models (LLMs) have significantly enhanced the automation of medical image analysis, particularly in generating radiology reports from chest X-rays (CXR). However, these models still suffer from hallucinations and clinically significant errors, limiting their reliability in real-world applications. In this study, we propose Look & Mark (L&M), a novel grounding fixation strategy that integrates radiologist eye fixations (Look) and bounding box annotations (Mark) into the LLM prompting framework. Unlike conventional fine-tuning, L&M leverages in-context learning to achieve substantial performance gains without retraining. When evaluated across multiple domain-specific and general-purpose models, L&M demonstrates significant gains, including a 1.2% improvement in overall metrics (A.AVG) for CXR-LLaVA compared to baseline prompting and a remarkable 9.2% boost for LLaVA-Med. General-purpose models also benefit from L&M combined with in-context learning, with LLaVA-OV achieving an 87.3% clinical average performance (C.AVG)-the highest among all models, even surpassing those explicitly trained for CXR report generation. Expert evaluations further confirm that L&M reduces clinically significant errors (by 0.43 average errors per report), such as false predictions and omissions, enhancing both accuracy and reliability. These findings highlight L&M's potential as a scalable and efficient solution for AI-assisted radiology, paving the way for improved diagnostic workflows in low-resource clinical settings.

Three-dimensional ultrasound enables real-time volumetric visualization of anatomical structures. Unlike traditional 2D ultrasound, 3D imaging reduces the reliance on precise probe orientation, potentially making ultrasound more accessible to clinicians with varying levels of experience and improving automated measurements and post-exam analysis. However, achieving both high volume rates and high image quality remains a significant challenge. While 3D diverging waves can provide high volume rates, they suffer from limited tissue harmonic generation and increased multipath effects, which degrade image quality. One compromise is to retain the focusing in elevation while leveraging unfocused diverging waves in the lateral direction to reduce the number of transmissions per elevation plane. Reaching the volume rates achieved by full 3D diverging waves, however, requires dramatically undersampling the number of elevation planes. Subsequently, to render the full volume, simple interpolation techniques are applied. This paper introduces a novel approach to 3D ultrasound reconstruction from a reduced set of elevation planes by employing diffusion models (DMs) to achieve increased spatial and temporal resolution. We compare both traditional and supervised deep learning-based interpolation methods on a 3D cardiac ultrasound dataset. Our results show that DM-based reconstruction consistently outperforms the baselines in image quality and downstream task performance. Additionally, we accelerate inference by leveraging the temporal consistency inherent to ultrasound sequences. Finally, we explore the robustness of the proposed method by exploiting the probabilistic nature of diffusion posterior sampling to quantify reconstruction uncertainty and demonstrate improved recall on out-of-distribution data with synthetic anomalies under strong subsampling.

Dynamic MRI plays a vital role in clinical practice by capturing both spatial details and dynamic motion, but its high spatiotemporal resolution is often limited by long scan times. Deep learning (DL)-based methods have shown promising performance in accelerating dynamic MRI. However, most existing algorithms rely on large fully-sampled datasets for training, which are difficult to acquire. Recently, implicit neural representation (INR) has emerged as a powerful scan-specific paradigm for accelerated MRI, which models signals as a continuous function over spatiotemporal coordinates. Although this approach achieves efficient continuous modeling of dynamic images and robust reconstruction, it faces challenges in recovering fine details and increasing computational demands for high dimensional data representation. To enhance both efficiency and reconstruction quality, we propose TenF-INR, a novel patch-based unsupervised framework that employs INR to model bases of tensor decomposition, enabling efficient and accurate modeling of dynamic MR images with learnable tensor functions. By exploiting strong correlations in similar spatial image patches and in the temporal direction, TenF-INR enforces multidimensional low-rankness and implements patch-based reconstruction with the benefits of continuous modeling. We compare TenF-INR with state-of-the-art methods, including supervised DL methods and unsupervised approaches. Experimental results demonstrate that TenF-INR achieves high acceleration factors up to 21, outperforming all comparison methods in image quality, temporal fidelity, and quantitative metrics, even surpassing the supervised methods.

Medical image segmentation methods generally assume that the process from medical image to segmentation is unbiased, and use neural networks to establish conditional probability models to complete the segmentation task. This assumption does not consider confusion factors, which can affect medical images, such as complex anatomical variations and imaging modality limitations. Confusion factors obfuscate the relevance and causality of medical image segmentation, leading to unsatisfactory segmentation results. To address this issue, we propose a multi-causal aware modeling backdoor-intervention optimization (MAMBO-NET) network for medical image segmentation. Drawing insights from causal inference, MAMBO-NET utilizes self-modeling with multi-Gaussian distributions to fit the confusion factors and introduce causal intervention into the segmentation process. Moreover, we design appropriate posterior probability constraints to effectively train the distributions of confusion factors. For the distributions to effectively guide the segmentation and mitigate and eliminate the Impact of confusion factors on the segmentation, we introduce classical backdoor intervention techniques and analyze their feasibility in the segmentation task. To evaluate the effectiveness of our approach, we conducted extensive experiments on five medical image datasets. The results demonstrate that our method significantly reduces the influence of confusion factors, leading to enhanced segmentation accuracy.

Deformable image registration (DIR) is an enabling technology in many diagnostic and therapeutic tasks. Despite this, DIR algorithms have limited clinical use, largely due to a lack of benchmark datasets for quality assurance during development. DIRs of intra-patient abdominal CTs are among the most challenging registration scenarios due to significant organ deformations and inconsistent image content. To support future algorithm development, here we introduce our first-of-its-kind abdominal CT DIR benchmark dataset, comprising large numbers of highly accurate landmark pairs on matching blood vessel bifurcations. Abdominal CT image pairs of 30 patients were acquired from several publicly available repositories as well as the authors' institution with IRB approval. The two CTs of each pair were originally acquired for the same patient but on different days. An image processing workflow was developed and applied to each CT image pair: (1) Abdominal organs were segmented with a deep learning model, and image intensity within organ masks was overwritten. (2) Matching image patches were manually identified between two CTs of each image pair. (3) Vessel bifurcation landmarks were labeled on one image of each image patch pair. (4) Image patches were deformably registered, and landmarks were projected onto the second image. (5) Landmark pair locations were refined manually or with an automated process. This workflow resulted in 1895 total landmark pairs, or 63 per case on average. Estimates of the landmark pair accuracy using digital phantoms were 0.7 mm ± 1.2 mm. The data are published in Zenodo at https://doi.org/10.5281/zenodo.14362785. Instructions for use can be found at https://github.com/deshanyang/Abdominal-DIR-QA. This dataset is a first-of-its-kind for abdominal DIR validation. The number, accuracy, and distribution of landmark pairs will allow for robust validation of DIR algorithms with precision beyond what is currently available.

To assess the predictive performance, risk stratification capabilities, and auxiliary diagnostic utility of radiomics, deep learning, and fusion models in identifying visceral pleural invasion (VPI) in lung adenocarcinoma. A total of 449 patients (female:male, 263:186; 59.8 ± 10.5 years) diagnosed with clinical IA stage lung adenocarcinoma (LAC) from two distinct hospitals were enrolled in the study and divided into a training cohort (n = 289) and an external test cohort (n = 160). The fusion models were constructed from the feature level and the decision level respectively. A comprehensive analysis was conducted to assess the prediction ability and prognostic value of radiomics, deep learning, and fusion models. The diagnostic performance of radiologists of varying seniority with and without the assistance of the optimal model was compared. The late fusion model demonstrated superior diagnostic performance (AUC = 0.812) compared to clinical (AUC = 0.650), radiomics (AUC = 0.710), deep learning (AUC = 0.770), and the early fusion models (AUC = 0.586) in the external test cohort. The multivariate Cox regression analysis showed that the VPI status predicted by the late fusion model were independently associated with patient disease-free survival (DFS) (p = 0.044). Furthermore, model assistance significantly improved radiologist performance, particularly for junior radiologists; the AUC increased by 0.133 (p < 0.001) reaching levels comparable to the senior radiologist without model assistance (AUC: 0.745 vs. 0.730, p = 0.790). The proposed decision-level (late fusion) model significantly reducing the risk of overfitting and demonstrating excellent robustness in multicenter external validation, which can predict VPI status in LAC, aid in prognostic stratification, and assist radiologists in achieving higher diagnostic performance.