Magnetic Resonance Imaging (MRI) based three-dimensional analysis of knee cartilage has evolved to become fully automatic. However, when implementing these measurements across multiple clinical centers, scanner variability becomes a critical consideration. Our purposes were to quantify and compare same-model variability (between repeated scans on the same MRI system) and cross-model variability (across different MRI systems) in knee cartilage thickness measurements using MRI scanners from five manufacturers, as analyzed with a specific 3D volume analysis software. Ten healthy volunteers (eight males and two females, aged 22-60 years) underwent two scans of their right knee on 3T MRI systems from five manufacturers (Canon, Fujifilm, GE, Philips, and Siemens). The imaging protocol included fat-suppressed spoiled gradient echo and proton density weighted sequences. Cartilage regions were automatically segmented into 7 subregions using a specific deep learning-based 3D volume analysis software. This resulted in 350 measurements for same-model variability and 2,800 measurements for cross-model variability. For same-model variability, 82% of measurements showed variability ≤0.10 mm, and 98% showed variability ≤0.20 mm. For cross-model variability, 51% showed variability ≤0.10 mm, and 84% showed variability ≤0.20 mm. The mean same-model variability (0.06 ± 0.05 mm) was significantly lower than cross-model variability (0.11 ± 0.09 mm) (p < 0.001). This study demonstrates that knee cartilage thickness measurements exhibit significantly higher variability across different MRI systems compared to repeated measurements on the same system, when analyzed using this specific software. This finding has important implications for multi-center studies and longitudinal assessments using different MRI systems and highlights the software-dependent nature of such variability assessments.

Optimizing resource allocation for Parkinson's disease (PD) motor rehabilitation necessitates identifying biomarkers of responsiveness and dynamic neuroplasticity signatures underlying efficacy. A cohort study of 52 early-stage PD patients undergoing 2-week multidisciplinary intensive rehabilitation therapy (MIRT) was conducted, which stratified participants into responders and nonresponders. A multimodal analysis of resting-state electroencephalography (EEG) microstates and functional magnetic resonance imaging (fMRI) coactivation patterns was performed to characterize MIRT-induced spatiotemporal network reorganization. Responders demonstrated clinically meaningful improvement in motor symptoms, exceeding the minimal clinically important difference threshold of 3.25 on the Unified PD Rating Scale part III, alongside significant reductions in bradykinesia and a significant enhancement in quality-of-life scores at the 3-month follow-up. Resting-state EEG in responders showed a significant attenuation in microstate C and a significant enhancement in microstate D occurrences, along with significantly increased transitions from microstate A/B to D, which significantly correlated with motor function, especially in bradykinesia gains. Concurrently, fMRI analyses identified a prolonged dwell time of the dorsal attention network coactivation/ventral attention network deactivation pattern, which was significantly inversely associated with microstate C occurrence and significantly linked to motor improvement. The identified brain spatiotemporal neural markers were validated using machine learning models to assess the efficacy of MIRT in motor rehabilitation for PD patients, achieving an average accuracy rate of 86%. These findings suggest that MIRT may facilitate a shift in neural networks from sensory processing to higher-order cognitive control, with the dynamic reallocation of attentional resources. This preliminary study validates the necessity of integrating cognitive-motor strategies for the motor rehabilitation of PD and identifies novel neural markers for assessing treatment efficacy.

Advancements in medical imaging technology have facilitated the acquisition of high-quality brain images through computed tomography (CT) or magnetic resonance imaging (MRI), enabling professional brain specialists to diagnose brain tumors more effectively. However, manual diagnosis is time-consuming, which has led to the growing importance of automatic detection and classification through brain imaging. Conventional object detection models for brain tumor detection face limitations in brain tumor detection owing to the significant differences between medical images and natural scene images, as well as challenges such as complex backgrounds, noise interference, and blurred boundaries between cancerous and normal tissues. This study investigates the application of deep learning to brain tumor detection, analyzing the effect of three factors, the number of model parameters, input data batch size, and the use of anchor boxes, on detection performance. Experimental results reveal that an excessive number of model parameters or the use of anchor boxes may reduce detection accuracy. However, increasing the number of brain tumor samples improves detection performance. This study, introduces a backbone network built using RepConv and RepC3, along with FGConcat feature map splicing module to optimize the brain tumor detection model. The experimental results show that the proposed RepConv-RepC3-FGConcat Network (RRFNet) can learn underlying semantic information about brain tumors during training stage, while maintaining a low number of parameters during inference, which improves the speed of brain tumor detection. Compared with YOLOv8, RRFNet achieved a higher accuracy in brain tumor detection, with a mAP value of 79.2%. This optimized approach enhances both accuracy and efficiency, which is essential in clinical settings where time and precision are critical.

Interval breast cancers (IBCs) are detected between regular mammographic screenings after an initially negative result. Studies have shown that the prognosis of IBCs is similar to that of unscreened symptomatic cancers and is hence a surrogate used to assess the effectiveness of screening programs. This systematic review consolidates the current literature available on strategies to reduce the rates of IBC. Following PRISMA guidelines, three databases were searched from inception till October 29, 2023 to identify papers, which reported IBC rates. Key search terms included "interval breast cancer", "mammogram", "tomosynthesis" and "screening". A total of 32 articles were included. Fourteen studies discussed the use of digital breast tomosynthesis (DBT) as an alternative screening modality to mammograms. Six studies discussed the use of artificial intelligence (AI) on mammograms, five studies discussed the use of supplemental modalities including ultrasonography (US) in addition to mammograms, five studies discussed varying screening intervals and two studies discussed tamoxifen use. The trajectory of IBCs can be altered by early detection when they are more amenable to treatment, through advanced screening techniques, adjusting inter-screening intervals and modifiable risk factors. The goal is to create a screening protocol that is economically effective and accessible to various populations.

Acute ischemic stroke (AIS) has a poor prognosis and a high recurrence rate. Predicting the outcomes of AIS patients in the early stages of the disease is therefore important. The establishment of intracerebral collateral circulation significantly improves the survival of brain cells and the outcomes of AIS patients. However, no machine learning method has been applied to investigate the correlation between the dynamic evolution of intracerebral venous collateral circulation and AIS prognosis. Therefore, we employed a support vector machine (SVM) algorithm to analyze asymmetrically prominent cortical veins (APCVs) and deep medullary veins (DMVs) to establish a radiomic model for predicting the prognosis of AIS by combining clinical indicators. The magnetic resonance imaging (MRI) data and clinical indicators of 150 AIS patients were retrospectively analyzed. Regions of interest corresponding to the DMVs and APCVs were delineated, and least absolute shrinkage and selection operator (LASSO) regression was used to select features extracted from these regions. An APCV-DMV radiomic model was created via the SVM algorithm, and independent clinical risk factors associated with AIS were combined with the radiomic model to generate a joint model. The SVM algorithm was selected because of its proven efficacy in handling high-dimensional radiomic data compared with alternative classifiers (<i>e.g.</i>, random forest) in pilot experiments. Nine radiomic features associated with AIS patient outcomes were ultimately selected. In the internal training test set, the AUCs of the clinical, DMV-APCV radiomic and joint models were 0.816, 0.976 and 0.996, respectively. The DeLong test revealed that the predictive performance of the joint model was better than that of the individual models, with a test set AUC of 0.996, sensitivity of 0.905, and specificity of 1.000 (<i>P</i> < 0.05). Using radiomic methods, we propose a novel joint predictive model that combines the imaging histologic features of the APCV and DMV with clinical indicators. This model quantitatively characterizes the morphological and functional attributes of venous collateral circulation, elucidating its important role in accurately evaluating the prognosis of patients with AIS and providing a noninvasive and highly accurate imaging tool for early prognostic prediction.

<b>Background:</b> No robust biomarkers have been identified to predict the efficacy of programmed cell death protein 1 (PD-1) inhibitors in patients with locoregionally advanced nasopharyngeal carcinoma (LANPC). We aimed to develop radiomic models using pre-immunotherapy MRI to predict the response to PD-1 inhibitors and the patient prognosis. <b>Methods:</b> This study included 246 LANPC patients (training cohort, <i>n</i> = 117; external test cohort, <i>n</i> = 129) from 10 centers. The best-performing machine learning classifier was employed to create the radiomic models. A combined model was constructed by integrating clinical and radiomic data. A radiomic interpretability study was performed with whole slide images (WSIs) stained with hematoxylin and eosin (H&E) and immunohistochemistry (IHC). A total of 150 patient-level nuclear morphological features (NMFs) and 12 cell spatial distribution features (CSDFs) were extracted from WSIs. The correlation between the radiomic and pathological features was assessed using Spearman correlation analysis. <b>Results:</b> The radiomic model outperformed the clinical and combined models in predicting treatment response (area under the curve: 0.760 vs. 0.559 vs. 0.652). For overall survival estimation, the combined model performed comparably to the radiomic model but outperformed the clinical model (concordance index: 0.858 vs. 0.812 vs. 0.664). Six treatment response-related radiomic features correlated with 50 H&E-derived (146 pairs, |<i>r</i>|= 0.31 to 0.46) and 2 to 26 IHC-derived NMF, particularly for CD45RO (69 pairs, |<i>r</i>|= 0.31 to 0.48), CD8 (84, |<i>r</i>|= 0.30 to 0.59), PD-L1 (73, |<i>r</i>|= 0.32 to 0.48), and CD163 (53, |<i>r</i>| = 0.32 to 0.59). Eight prognostic radiomic features correlated with 11 H&E-derived (16 pairs, |<i>r</i>|= 0.48 to 0.61) and 2 to 31 IHC-derived NMF, particularly for PD-L1 (80 pairs, |<i>r</i>|= 0.44 to 0.64), CD45RO (65, |<i>r</i>|= 0.42 to 0.67), CD19 (35, |<i>r</i>|= 0.44 to 0.58), CD66b (61, |<i>r</i>| = 0.42 to 0.67), and FOXP3 (21, |<i>r</i>| = 0.41 to 0.71). In contrast, fewer CSDFs exhibited correlations with specific radiomic features. <b>Conclusion:</b> The radiomic model and combined model are feasible in predicting immunotherapy response and outcomes in LANPC patients. The radiology-pathology correlation suggests a potential biological basis for the predictive models.

Lung cancer is a major cause of cancer-related deaths, and early diagnosis and treatment are crucial for improving patients' survival outcomes. In this paper, we propose to employ convolutional neural networks to model the non-linear relationship between the risk of lung cancer and the lungs' morphology revealed in the CT images. We apply a mini-batched loss that extends the Cox proportional hazards model to handle the non-convexity induced by neural networks, which also enables the training of large data sets. Additionally, we propose to combine mini-batched loss and binary cross-entropy to predict both lung cancer occurrence and the risk of mortality. Simulation results demonstrate the effectiveness of both the mini-batched loss with and without the censoring mechanism, as well as its combination with binary cross-entropy. We evaluate our approach on the National Lung Screening Trial data set with several 3D convolutional neural network architectures, achieving high AUC and C-index scores for lung cancer classification and survival prediction. These results, obtained from simulations and real data experiments, highlight the potential of our approach to improving the diagnosis and treatment of lung cancer.

Machine learning (ML) algorithms play a crucial role in the early and accurate diagnosis of Alzheimer's Disease (AD), which is essential for effective treatment planning. However, existing methods are not well-suited for identifying Mild Cognitive Impairment (MCI), a critical transitional stage between normal aging and AD. This inadequacy is primarily due to label imbalance and bias from different sensitve attributes in MCI classification. To overcome these challenges, we have designed an end-to-end fairness-aware approach for label-imbalanced classification, tailored specifically for neuroimaging data. This method, built on the recently developed FACIMS framework, integrates into STREAMLINE, an automated ML environment. We evaluated our approach against nine other ML algorithms and found that it achieves comparable balanced accuracy to other methods while prioritizing fairness in classifications with five different sensitive attributes. This analysis contributes to the development of equitable and reliable ML diagnostics for MCI detection.

The use of artificial intelligence (AI) in medicine has shown promise to improve the quality of healthcare decisions. However, AI can be biased in a manner that produces unfair predictions for certain demographic subgroups. In MIMIC-CXR, a publicly available dataset of over 300,000 chest X-ray images, diagnostic AI has been shown to have a higher false negative rate for racial minorities. We evaluated the capacity of synthetic data augmentation, oversampling, and demographic-based corrections to enhance the fairness of AI predictions. We show that adjusting unfair predictions for demographic attributes, such as race, is ineffective at improving fairness or predictive performance. However, using oversampling and synthetic data augmentation to modify disease prevalence reduced such disparities by 74.7% and 10.6%, respectively. Moreover, such fairness gains were accomplished without reduction in performance (95% CI AUC: [0.816, 0.820] versus [0.810, 0.819] versus [0.817, 0.821] for baseline, oversampling, and augmentation, respectively).

Artificial intelligence (AI) shows promise in clinical tasks, yet its integration into workflows remains underexplored. This study proposes an AI-aided same-day diagnostic imaging workup to reduce recall rates following abnormal screening mammograms and alleviate patient anxiety while waiting for the diagnostic examinations. Using discrete simulation, we found minimal disruption to the workflow (a 4% reduction in daily patient volume or a 2% increase in operating time) under specific conditions: operation from 9 am to 12 pm with all radiologists managing all patient types (screenings, diagnostics, and biopsies). Costs specific to the AI-aided same-day diagnostic workup include AI software expenses and potential losses from unused pre-reserved slots for same-day diagnostic workups. These simulation findings can inform the implementation of an AI-aided same-day diagnostic workup, with future research focusing on its potential benefits, including improved patient satisfaction, reduced anxiety, lower recall rates, and shorter time to cancer diagnoses and treatment.