Prostate cancer (PCa) is one of the most common types of cancer, seriously affecting adult male health. Accurate and automated PCa segmentation is essential for radiologists to confirm the location of cancer, evaluate its severity, and design appropriate treatments. This paper presents PCaSAM, a fully automated PCa segmentation model that allows us to input multi-modal MRI images into the foundation model to improve performance significantly. We collected multi-center datasets to conduct a comprehensive evaluation. The results showed that PCaSAM outperforms the generalist medical foundation model and the other representative segmentation models, with the average DSC of 0.721 and 0.706 in the internal and external datasets, respectively. Furthermore, with the assistance of segmentation, the PI-RADS scoring of PCa lesions was improved significantly, leading to a substantial increase in average AUC by 8.3-8.9% on two external datasets. Besides, PCaSAM achieved superior efficiency, making it highly suitable for real-world deployment scenarios.

Despite advances in endovascular stroke therapy (EST) devices and techniques, many patients are left with substantial disability, even if the final infarct volumes (FIVs) remain small. Here, we evaluate the performance of a machine learning (ML) approach using pre-treatment CT angiography (CTA) to identify this cohort of patients that may benefit from additional interventions. We identified consecutive large vessel occlusion (LVO) acute ischemic stroke (AIS) subjects who underwent EST with successful reperfusion in a multicenter prospective registry cohort. We included only subjects with FIV<30mL and recorded 90-day outcome (modified Rankin scale, mRS). A deep learning model was pre-trained and then fine-tuned to predict 90-day mRS 0-2 using pre-treatment CTA images (DSN-CTA model). The primary outcome was the predictive performance of the DSNCTA model compared to a logistic regression model with clinical variables, measured by the area under the receiver operating characteristic curve (AUROC). The DSN-CTA model was pre-trained on 1,542 subjects and then fine-tuned and cross-validated with 48 subjects, all of whom underwent EST with TICI 2b-3 reperfusion. Of this cohort, 56.2% of subjects had 90-day mRS 3-6 despite successful EST and FIV<30mL. The DSN-CTA model showed significantly better performance than a model with clinical variables alone when predicting good 90-day mRS (AUROC 0.81 vs 0.492, p=0.006). The CTA-based machine learning model was able to more reliably predict unexpected poor functional outcome after successful EST and small FIV for patients with LVO AIS compared to standard clinical variables. ML models may identify <i>a priori</i> patients in whom EST-based LVO reperfusion alone is insufficient to improve clinical outcomes. AIS＝ acute ischemic stroke; AUROC＝ area under the receiver operating characteristic curve; DSN-CTA＝ DeepSymNet-v3 model; EST＝ endovascular stroke therapy; FIV＝ final infarct volume; LVO＝ large vessel occlusion; ML＝ machine learning.

Alzheimer's disease (AD) is a leading cause of death, making early detection critical to improve survival rates. Conventional manual techniques struggle with early diagnosis due to the brain's complex structure, necessitating the use of dependable deep learning (DL) methods. This research proposes a novel RESIGN model is a combination of Res-InceptionSeg for detecting AD utilizing MRI images. The input MRI images were pre-processed using a Non-Local Means (NLM) filter to reduce noise artifacts. A ResNet-LSTM model was used for feature extraction, targeting White Matter (WM), Grey Matter (GM), and Cerebrospinal Fluid (CSF). The extracted features were concatenated and classified into Normal, MCI, and AD categories using an Inception V3-based classifier. Additionally, SegNet was employed for abnormal brain region segmentation. The RESIGN model achieved an accuracy of 99.46%, specificity of 98.68%, precision of 95.63%, recall of 97.10%, and an F1 score of 95.42%. It outperformed ResNet, AlexNet, Dense- Net, and LSTM by 7.87%, 5.65%, 3.92%, and 1.53%, respectively, and further improved accuracy by 25.69%, 5.29%, 2.03%, and 1.71% over ResNet18, CLSTM, VGG19, and CNN, respectively. The integration of spatial-temporal feature extraction, hybrid classification, and deep segmentation makes RESIGN highly reliable in detecting AD. A 5-fold cross-validation proved its robustness, and its performance exceeded that of existing models on the ADNI dataset. However, there are potential limitations related to dataset bias and limited generalizability due to uniform imaging conditions. The proposed RESIGN model demonstrates significant improvement in early AD detection through robust feature extraction and classification by offering a reliable tool for clinical diagnosis.

In functional MRI, a hemodynamic response function (HRF) describes how neural events are translated into a blood oxygenation response detected through imaging. The HRF has the potential to quantify neurovascular mechanisms by which cardiovascular risks modify brain health, but relationships among HRF characteristics, brain health, and cardiovascular modifiers of brain health have not been well studied to date. One hundred and thirty-seven middle-aged participants (mean age: 53.6±4.7, female (62%), 78% White American participants and 22% African American participants) in the exploratory analysis from Bogalusa Heart Study completed clinical evaluations from childhood to midlife and an adaptive Stroop task during fMRI in midlife. The HRFs of each participant within seventeen brain regions of interest (ROIs) previously identified as activated by this task were calculated using a convolutional neural network approach. Faster and more efficient neurovascular functioning was characterized in terms of five HRF characteristics: faster time to peak (TTP), shorter full width at half maximum (FWHM), smaller peak magnitude (PM), smaller trough magnitude (TM), and smaller area under the HRF curve (AUHRF). The composite HRF summary characteristics over all ROIs were calculated for multivariable and simple linear regression analyses. In multivariable models, faster and more efficient HRF characteristic was found in non-smoker compared to smokers (AUHRF, p = 0.029). Faster and more efficient HRF characteristics were associated with lower systolic and diastolic blood pressures (FWHM, TM, and AUHRF, p = 0.030, 0.042, and 0.032) and cerebral amyloid burden (FWHM, p-value = 0.027) in midlife; as well as greater response rate on the Stroop task (FWHM, p = 0.042) in midlife. In simple linear regression models, faster and more efficient HRF characteristics were found in women compared to men (TM, p = 0.019); in White American participants compared to African American participants (AUHRF, p = 0.044); and in non-smokers compared to smokers (TTP and AUHRF, p = 0.019 and 0.010). Faster and more efficient HRF characteristics were associated with lower systolic and diastolic blood pressures (FWHM and TM, p = 0.019 and 0.029), and lower BMI (FWHM and AUHRF, p = 0.025 and 0.017), in childhood and adolescence; and lower BMI (TTP, p = 0.049), cerebral amyloid burden (FWHM, p = 0.002), and white matter hyperintensity burden (FWHM, p = 0.046) in midlife; as well as greater accuracy on the Stroop task (AUHRF, p = 0.037) in midlife. In a diverse middle-aged community sample, HRF-based indicators of faster and more efficient neurovascular functioning were associated with better brain health and cognitive function, as well as better lifespan cardiovascular health.

Deformable image registration is a fundamental task in medical image analysis, which is crucial in enabling early detection and accurate disease diagnosis. Although transformer-based architectures have demonstrated strong potential through attention mechanisms, challenges remain in ineffective feature extraction and spatial alignment, particularly within hierarchical attention frameworks. To address these limitations, we propose a novel registration framework that integrates hierarchical feature encoding in the encoder and an adaptive cascaded refinement strategy in the decoder. The model employs hierarchical cross-attention between fixed and moving images at multiple scales, enabling more precise alignment and improved registration accuracy. The decoder incorporates the Adaptive Cascaded Module (ACM), facilitating progressive deformation field refinement across multiple resolution levels. This approach captures coarse global transformations and acceptable local variations, resulting in smooth and anatomically consistent alignment. However, rather than relying solely on the final decoder output, our framework leverages intermediate representations at each stage of the network, enhancing the robustness and precision of the registration process. Our method achieves superior accuracy and adaptability by integrating deformations across all scales. Comprehensive experiments on two widely used 3D brain MRI datasets, OASIS and LPBA40, demonstrate that the proposed framework consistently outperforms existing state-of-the-art approaches across multiple evaluation metrics regarding accuracy, robustness, and generalizability.

Few-shot learning alleviates the heavy dependence of medical image segmentation on large-scale labeled data, but it shows strong performance gaps when dealing with new tasks compared with traditional deep learning. Existing methods mainly learn the class knowledge of a few known (support) samples and extend it to unknown (query) samples. However, the large distribution differences between the support image and the query image lead to serious deviations in the transfer of class knowledge, which can be specifically summarized as two segmentation challenges: Intra-class inconsistency and Inter-class similarity, blurred and confused boundaries. In this paper, we propose a new interactive prototype learning and self-learning network to solve the above challenges. First, we propose a deep encoding-decoding module to learn the high-level features of the support and query images to build peak prototypes with the greatest semantic information and provide semantic guidance for segmentation. Then, we propose an interactive prototype learning module to improve intra-class feature consistency and reduce inter-class feature similarity by conducting mid-level features-based mean prototype interaction and high-level features-based peak prototype interaction. Last, we propose a query features-guided self-learning module to separate foreground and background at the feature level and combine low-level feature maps to complement boundary information. Our model achieves competitive segmentation performance on benchmark datasets and shows substantial improvement in generalization ability.

Peripheral Nerves (PNs) are traditionally evaluated using US or MRI, allowing radiologists to identify and classify them as normal or pathological based on imaging findings, symptoms, and electrophysiological tests. However, the anatomical complexity of PNs, coupled with their proximity to surrounding structures like vessels and muscles, presents significant challenges. Advanced imaging techniques, including MR-neurography and Diffusion-Weighted Imaging (DWI) neurography, have shown promise but are hindered by steep learning curves, operator dependency, and limited accessibility. Discrepancies between imaging findings and patient symptoms further complicate the evaluation of PNs, particularly in cases where imaging appears normal despite clinical indications of pathology. Additionally, demographic and clinical factors such as age, sex, comorbidities, and physical activity influence PN health but remain unquantifiable with current imaging methods. Artificial Intelligence (AI) solutions have emerged as a transformative tool in PN evaluation. AI-based algorithms offer the potential to transition from qualitative to quantitative assessments, enabling precise segmentation, characterization, and threshold determination to distinguish healthy from pathological nerves. These advances could improve diagnostic accuracy and treatment monitoring. This review highlights the latest advances in AI applications for PN imaging, discussing their potential to overcome the current limitations and opportunities to improve their integration into routine radiological practice.

This study explores a multi-modal deep learning approach that integrates pre-intervention neuroimaging and clinical data to predict endovascular therapy (EVT) outcomes in acute ischemic stroke patients. To this end, consecutive stroke patients undergoing EVT were included in the study, including patients with suspected Intracranial Atherosclerosis-related Large Vessel Occlusion ICAD-LVO and other refractory occlusions. A retrospective, single-center cohort of patients with anterior circulation LVO who underwent EVT between 2017-2023 was analyzed. Refractory LVO (rLVO) defined class, comprised patients who presented any of the following: final angiographic stenosis > 50 %, unsuccessful recanalization (eTICI 0-2a) or required rescue treatments (angioplasty +/- stenting). Neuroimaging data included non-contrast CT and CTA volumes, automated vascular segmentation, and CT perfusion parameters. Clinical data included demographics, comorbidities and stroke severity. Imaging features were encoded using convolutional neural networks and fused with clinical data using a DAFT module. Data were split 80 % for training (with four-fold cross-validation) and 20 % for testing. Explainability methods were used to analyze the contribution of clinical variables and regions of interest in the images. The final sample comprised 599 patients; 481 for training the model (77, 16.0 % rLVO), and 118 for testing (16, 13.6 % rLVO). The best model predicting rLVO using just imaging achieved an AUC of 0.53 ± 0.02 and F1 of 0.19 ± 0.05 while the proposed multimodal model achieved an AUC of 0.70 ± 0.02 and F1 of 0.39 ± 0.02 in testing. Combining vascular segmentation, clinical variables, and imaging data improved prediction performance over single-source models. This approach offers an early alert to procedural complexity, potentially guiding more tailored, timely intervention strategies in the EVT workflow.

$\textbf{Objective:}$ Brain-predicted age difference (BrainAGE) is a neuroimaging biomarker reflecting brain health. However, training robust BrainAGE models requires large datasets, often restricted by privacy concerns. This study evaluates the performance of federated learning (FL) for BrainAGE estimation in ischemic stroke patients treated with mechanical thrombectomy, and investigates its association with clinical phenotypes and functional outcomes. $\textbf{Methods:}$ We used FLAIR brain images from 1674 stroke patients across 16 hospital centers. We implemented standard machine learning and deep learning models for BrainAGE estimates under three data management strategies: centralized learning (pooled data), FL (local training at each site), and single-site learning. We reported prediction errors and examined associations between BrainAGE and vascular risk factors (e.g., diabetes mellitus, hypertension, smoking), as well as functional outcomes at three months post-stroke. Logistic regression evaluated BrainAGE's predictive value for these outcomes, adjusting for age, sex, vascular risk factors, stroke severity, time between MRI and arterial puncture, prior intravenous thrombolysis, and recanalisation outcome. $\textbf{Results:}$ While centralized learning yielded the most accurate predictions, FL consistently outperformed single-site models. BrainAGE was significantly higher in patients with diabetes mellitus across all models. Comparisons between patients with good and poor functional outcomes, and multivariate predictions of these outcomes showed the significance of the association between BrainAGE and post-stroke recovery. $\textbf{Conclusion:}$ FL enables accurate age predictions without data centralization. The strong association between BrainAGE, vascular risk factors, and post-stroke recovery highlights its potential for prognostic modeling in stroke care.

Objective: Our study aimed to evaluate and validate PanSegNet, a deep learning (DL) algorithm for pediatric pancreas segmentation on MRI in children with acute pancreatitis (AP), chronic pancreatitis (CP), and healthy controls. Methods: With IRB approval, we retrospectively collected 84 MRI scans (1.5T/3T Siemens Aera/Verio) from children aged 2-19 years at Gazi University (2015-2024). The dataset includes healthy children as well as patients diagnosed with AP or CP based on clinical criteria. Pediatric and general radiologists manually segmented the pancreas, then confirmed by a senior pediatric radiologist. PanSegNet-generated segmentations were assessed using Dice Similarity Coefficient (DSC) and 95th percentile Hausdorff distance (HD95). Cohen's kappa measured observer agreement. Results: Pancreas MRI T2W scans were obtained from 42 children with AP/CP (mean age: 11.73 +/- 3.9 years) and 42 healthy children (mean age: 11.19 +/- 4.88 years). PanSegNet achieved DSC scores of 88% (controls), 81% (AP), and 80% (CP), with HD95 values of 3.98 mm (controls), 9.85 mm (AP), and 15.67 mm (CP). Inter-observer kappa was 0.86 (controls), 0.82 (pancreatitis), and intra-observer agreement reached 0.88 and 0.81. Strong agreement was observed between automated and manual volumes (R^2 = 0.85 in controls, 0.77 in diseased), demonstrating clinical reliability. Conclusion: PanSegNet represents the first validated deep learning solution for pancreatic MRI segmentation, achieving expert-level performance across healthy and diseased states. This tool, algorithm, along with our annotated dataset, are freely available on GitHub and OSF, advancing accessible, radiation-free pediatric pancreatic imaging and fostering collaborative research in this underserved domain.