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Optimized AI-based Neural Decoding from BOLD fMRI Signal for Analyzing Visual and Semantic ROIs in the Human Visual System.

Veronese L, Moglia A, Pecco N, Della Rosa P, Scifo P, Mainardi LT, Cerveri P

pubmed logopapersAug 14 2025
AI-based neural decoding reconstructs visual perception by leveraging generative models to map brain activity measured through functional MRI (fMRI) into the observed visual stimulus. Traditionally, ridge linear models transform fMRI into a latent space, which is then decoded using variational autoencoders (VAE) or latent diffusion models (LDM). Owing to the complexity and noisiness of fMRI data, newer approaches split the reconstruction into two sequential stages, the first one providing a rough visual approximation using a VAE, the second one incorporating semantic information through the adoption of LDM guided by contrastive language-image pre-training (CLIP) embeddings. This work addressed some key scientific and technical gaps of the two-stage neural decoding by: 1) implementing a gated recurrent unit (GRU)-based architecture to establish a non-linear mapping between the fMRI signal and the VAE latent space, 2) optimizing the dimensionality of the VAE latent space, 3) systematically evaluating the contribution of the first reconstruction stage, and 4) analyzing the impact of different brain regions of interest (ROIs) on reconstruction quality. Experiments on the Natural Scenes Dataset, containing 73,000 unique natural images, along with fMRI of eight subjects, demonstrated that the proposed architecture maintained competitive performance while reducing the complexity of its first stage by 85%. The sensitivity analysis showcased that the first reconstruction stage is essential for preserving high structural similarity in the final reconstructions. Restricting analysis to semantic ROIs, while excluding early visual areas, diminished visual coherence, preserving semantics though. The inter-subject repeatability across ROIs was about 92 and 98% for visual and sematic metrics, respectively. This study represents a key step toward optimized neural decoding architectures leveraging non-linear models for stimulus prediction. Sensitivity analysis highlighted the interplay between the two reconstruction stages, while ROI-based analysis provided strong evidence that the two-stage AI model reflects the brain's hierarchical processing of visual information.

Severity Classification of Pediatric Spinal Cord Injuries Using Structural MRI Measures and Deep Learning: A Comprehensive Analysis across All Vertebral Levels.

Sadeghi-Adl Z, Naghizadehkashani S, Middleton D, Krisa L, Alizadeh M, Flanders AE, Faro SH, Wang Z, Mohamed FB

pubmed logopapersAug 14 2025
Spinal cord injury (SCI) in the pediatric population presents a unique challenge in diagnosis and prognosis due to the complexity of performing clinical assessments on children. Accurate evaluation of structural changes in the spinal cord is essential for effective treatment planning. This study aims to evaluate structural characteristics in pediatric patients with SCI by comparing cross-sectional area (CSA), anterior-posterior (AP) width, and right-left (RL) width across all vertebral levels of the spinal cord between typically developing (TD) and participants with SCI. We employed deep learning techniques to utilize these measures for detecting SCI cases and determining their injury severity. Sixty-one pediatric participants (ages 6-18), including 20 with chronic SCI and 41 TD, were enrolled and scanned by using a 3T MRI scanner. All SCI participants underwent the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) test to assess their neurologic function and determine their American Spinal Injury Association (ASIA) Impairment Scale (AIS) category. T2-weighted MRI scans were utilized to measure CSA, AP width, and RL widths along the entire cervical and thoracic cord. These measures were automatically extracted at every vertebral level of the spinal cord by using the spinal cord toolbox. Deep convolutional neural networks (CNNs) were utilized to classify participants into SCI or TD groups and determine their AIS classification based on structural parameters and demographic factors such as age and height. Significant differences (<i>P</i> < .05) were found in CSA, AP width, and RL width between SCI and TD participants, indicating notable structural alterations due to SCI. The CNN-based models demonstrated high performance, achieving 96.59% accuracy in distinguishing SCI from TD participants. Furthermore, the models determined AIS category classification with 94.92% accuracy. The study demonstrates the effectiveness of integrating cross-sectional structural imaging measures with deep learning methods for classification and severity assessment of pediatric SCI. The deep learning approach outperforms traditional machine learning models in diagnostic accuracy, offering potential improvements in patient care in pediatric SCI management.

GNN-based Unified Deep Learning

Furkan Pala, Islem Rekik

arxiv logopreprintAug 14 2025
Deep learning models often struggle to maintain generalizability in medical imaging, particularly under domain-fracture scenarios where distribution shifts arise from varying imaging techniques, acquisition protocols, patient populations, demographics, and equipment. In practice, each hospital may need to train distinct models - differing in learning task, width, and depth - to match local data. For example, one hospital may use Euclidean architectures such as MLPs and CNNs for tabular or grid-like image data, while another may require non-Euclidean architectures such as graph neural networks (GNNs) for irregular data like brain connectomes. How to train such heterogeneous models coherently across datasets, while enhancing each model's generalizability, remains an open problem. We propose unified learning, a new paradigm that encodes each model into a graph representation, enabling unification in a shared graph learning space. A GNN then guides optimization of these unified models. By decoupling parameters of individual models and controlling them through a unified GNN (uGNN), our method supports parameter sharing and knowledge transfer across varying architectures (MLPs, CNNs, GNNs) and distributions, improving generalizability. Evaluations on MorphoMNIST and two MedMNIST benchmarks - PneumoniaMNIST and BreastMNIST - show that unified learning boosts performance when models are trained on unique distributions and tested on mixed ones, demonstrating strong robustness to unseen data with large distribution shifts. Code and benchmarks: https://github.com/basiralab/uGNN

Healthcare and cutting-edge technology: Advancements, challenges, and future prospects.

Singhal V, R S, Singhal S, Tiwari A, Mangal D

pubmed logopapersAug 14 2025
The high-level integration of technology in health care has radically changed the process of patient care, diagnosis, treatment, and health outcomes. This paper discusses significant technological advances: AI for medical imaging to detect early disease stages; robotic surgery with precision and minimally invasive techniques; telemedicine for remote monitoring and virtual consultation; personalized medicine through genomic analysis; and blockchain in secure and transparent handling of health data. Every section in the paper discusses the underlying principles, advantages, and disadvantages associated with such technologies, supported by appropriate case studies like deploying AI in radiology to enhance cancer diagnosis or robotic surgery to enhance accuracy in surgery and blockchain technology in electronic health records to enable data integrity and security. The paper also discusses key ethical issues, including risks to data privacy, algorithmic bias in AI-based diagnosis, patient consent problems in genomic medicine, and regulatory issues blocking the large-scale adoption of digital health solutions. The article also includes some recommended avenues of future research in the spaces where interdisciplinary cooperation, effective cybersecurity frameworks, and policy transformations are urgently required to ensure that new healthcare technology adoption is ethical and responsible. The work is aimed at delivering important information for policymakers and researchers who are interested in the changing roles of technology to improve healthcare provision and patient outcomes, as well as healthcare practitioners.

Performance of GPT-5 in Brain Tumor MRI Reasoning

Mojtaba Safari, Shansong Wang, Mingzhe Hu, Zach Eidex, Qiang Li, Xiaofeng Yang

arxiv logopreprintAug 14 2025
Accurate differentiation of brain tumor types on magnetic resonance imaging (MRI) is critical for guiding treatment planning in neuro-oncology. Recent advances in large language models (LLMs) have enabled visual question answering (VQA) approaches that integrate image interpretation with natural language reasoning. In this study, we evaluated GPT-4o, GPT-5-nano, GPT-5-mini, and GPT-5 on a curated brain tumor VQA benchmark derived from 3 Brain Tumor Segmentation (BraTS) datasets - glioblastoma (GLI), meningioma (MEN), and brain metastases (MET). Each case included multi-sequence MRI triplanar mosaics and structured clinical features transformed into standardized VQA items. Models were assessed in a zero-shot chain-of-thought setting for accuracy on both visual and reasoning tasks. Results showed that GPT-5-mini achieved the highest macro-average accuracy (44.19%), followed by GPT-5 (43.71%), GPT-4o (41.49%), and GPT-5-nano (35.85%). Performance varied by tumor subtype, with no single model dominating across all cohorts. These findings suggest that GPT-5 family models can achieve moderate accuracy in structured neuro-oncological VQA tasks, but not at a level acceptable for clinical use.

Deep Learning-Based Automated Segmentation of Uterine Myomas

Tausifa Jan Saleem, Mohammad Yaqub

arxiv logopreprintAug 14 2025
Uterine fibroids (myomas) are the most common benign tumors of the female reproductive system, particularly among women of childbearing age. With a prevalence exceeding 70%, they pose a significant burden on female reproductive health. Clinical symptoms such as abnormal uterine bleeding, infertility, pelvic pain, and pressure-related discomfort play a crucial role in guiding treatment decisions, which are largely influenced by the size, number, and anatomical location of the fibroids. Magnetic Resonance Imaging (MRI) is a non-invasive and highly accurate imaging modality commonly used by clinicians for the diagnosis of uterine fibroids. Segmenting uterine fibroids requires a precise assessment of both the uterus and fibroids on MRI scans, including measurements of volume, shape, and spatial location. However, this process is labor intensive and time consuming and subjected to variability due to intra- and inter-expert differences at both pre- and post-treatment stages. As a result, there is a critical need for an accurate and automated segmentation method for uterine fibroids. In recent years, deep learning algorithms have shown re-markable improvements in medical image segmentation, outperforming traditional methods. These approaches offer the potential for fully automated segmentation. Several studies have explored the use of deep learning models to achieve automated segmentation of uterine fibroids. However, most of the previous work has been conducted using private datasets, which poses challenges for validation and comparison between studies. In this study, we leverage the publicly available Uterine Myoma MRI Dataset (UMD) to establish a baseline for automated segmentation of uterine fibroids, enabling standardized evaluation and facilitating future research in this domain.

Data-Driven Abdominal Phenotypes of Type 2 Diabetes in Lean, Overweight, and Obese Cohorts

Lucas W. Remedios, Chloe Choe, Trent M. Schwartz, Dingjie Su, Gaurav Rudravaram, Chenyu Gao, Aravind R. Krishnan, Adam M. Saunders, Michael E. Kim, Shunxing Bao, Alvin C. Powers, Bennett A. Landman, John Virostko

arxiv logopreprintAug 14 2025
Purpose: Although elevated BMI is a well-known risk factor for type 2 diabetes, the disease's presence in some lean adults and absence in others with obesity suggests that detailed body composition may uncover abdominal phenotypes of type 2 diabetes. With AI, we can now extract detailed measurements of size, shape, and fat content from abdominal structures in 3D clinical imaging at scale. This creates an opportunity to empirically define body composition signatures linked to type 2 diabetes risk and protection using large-scale clinical data. Approach: To uncover BMI-specific diabetic abdominal patterns from clinical CT, we applied our design four times: once on the full cohort (n = 1,728) and once on lean (n = 497), overweight (n = 611), and obese (n = 620) subgroups separately. Briefly, our experimental design transforms abdominal scans into collections of explainable measurements through segmentation, classifies type 2 diabetes through a cross-validated random forest, measures how features contribute to model-estimated risk or protection through SHAP analysis, groups scans by shared model decision patterns (clustering from SHAP) and links back to anatomical differences (classification). Results: The random-forests achieved mean AUCs of 0.72-0.74. There were shared type 2 diabetes signatures in each group; fatty skeletal muscle, older age, greater visceral and subcutaneous fat, and a smaller or fat-laden pancreas. Univariate logistic regression confirmed the direction of 14-18 of the top 20 predictors within each subgroup (p < 0.05). Conclusions: Our findings suggest that abdominal drivers of type 2 diabetes may be consistent across weight classes.

Comparative evaluation of supervised and unsupervised deep learning strategies for denoising hyperpolarized <sup>129</sup>Xe lung MRI.

Bdaiwi AS, Willmering MM, Hussain R, Hysinger E, Woods JC, Walkup LL, Cleveland ZI

pubmed logopapersAug 14 2025
Reduced signal-to-noise ratio (SNR) in hyperpolarized <sup>129</sup>Xe MR images can affect accurate quantification for research and diagnostic evaluations. Thus, this study explores the application of supervised deep learning (DL) denoising, traditional (Trad) and Noise2Noise (N2N) and unsupervised Noise2void (N2V) approaches for <sup>129</sup>Xe MR imaging. The DL denoising frameworks were trained and tested on 952 <sup>129</sup>Xe MRI data sets (421 ventilation, 125 diffusion-weighted, and 406 gas-exchange acquisitions) from healthy subjects and participants with cardiopulmonary conditions and compared with the block matching 3D denoising technique. Evaluation involved mean signal, noise standard deviation (SD), SNR, and sharpness. Ventilation defect percentage (VDP), apparent diffusion coefficient (ADC), membrane uptake, red blood cell (RBC) transfer, and RBC:Membrane were also evaluated for ventilation, diffusion, and gas-exchange images, respectively. Denoising methods significantly reduced noise SDs and enhanced SNR (p < 0.05) across all imaging types. Traditional ventilation model (Trad<sub>vent</sub>) improved sharpness in ventilation images but underestimated VDP (bias = -1.37%) relative to raw images, whereas N2N<sub>vent</sub> overestimated VDP (bias = +1.88%). Block matching 3D and N2V<sub>vent</sub> showed minimal VDP bias (≤ 0.35%). Denoising significantly reduced ADC mean and SD (p < 0.05, bias ≤ - 0.63 × 10<sup>-2</sup>). The values of Trad<sub>vent</sub> and N2N<sub>vent</sub> increased mean membrane and RBC (p < 0.001) with no change in RBC:Membrane. Denoising also reduced SDs of all gas-exchange metrics (p < 0.01). Low SNR may impair the potential of <sup>129</sup>Xe MRI for clinical diagnosis and lung function assessment. The evaluation of supervised and unsupervised DL denoising methods enhanced <sup>129</sup>Xe imaging quality, offering promise for improved clinical interpretation and diagnosis.

Machine Learning-Driven Radiomic Profiling of Thalamus-Amygdala Nuclei for Prediction of Postoperative Delirium After STN-DBS in Parkinson's Disease Patients: A Pilot Study.

Radziunas A, Davidavicius G, Reinyte K, Pranckeviciene A, Fedaravicius A, Kucinskas V, Laucius O, Tamasauskas A, Deltuva V, Saudargiene A

pubmed logopapersAug 13 2025
Postoperative delirium is a common complication following sub-thalamic nucleus deep brain stimulation surgery in Parkinson's disease patients. Postoperative delirium has been shown to prolong hospital stays, harm cognitive function, and negatively impact outcomes. Utilizing radiomics as a predictive tool for identifying patients at risk of delirium is a novel and personalized approach. This pilot study analyzed preoperative T1-weighted and T2-weighted magnetic resonance images from 34 Parkinson's disease patients, which were used to segment the thalamus, amygdala, and hippocampus, resulting in 10,680 extracted radiomic features. Feature selection using the minimum redundancy maximal relevance method identified the 20 most informative features, which were input into eight different machine learning algorithms. A high predictive accuracy of postoperative delirium was achieved by applying regularized binary logistic regression and linear discriminant analysis and using 10 most informative radiomic features. Regularized logistic regression resulted in 96.97% (±6.20) balanced accuracy, 99.5% (±4.97) sensitivity, 94.43% (±10.70) specificity, and area under the receiver operating characteristic curve of 0.97 (±0.06). Linear discriminant analysis showed 98.42% (±6.57) balanced accuracy, 98.00% (±9.80) sensitivity, 98.83% (±4.63) specificity, and area under the receiver operating characteristic curve of 0.98 (±0.07). The feed-forward neural network also demonstrated strong predictive capacity, achieving 96.17% (±10.40) balanced accuracy, 94.5% (±19.87) sensitivity, 97.83% (±7.87) specificity, and an area under the receiver operating characteristic curve of 0.96 (±0.10). However, when the feature set was extended to 20 features, both logistic regression and linear discriminant analysis showed reduced performance, while the feed-forward neural network achieved the highest predictive accuracy of 99.28% (±2.71), with 100.0% (±0.00) sensitivity, 98.57% (±5.42) specificity, and an area under the receiver operating characteristic curve of 0.99 (±0.03). Selected radiomic features might indicate network dysfunction between thalamic laterodorsal, reuniens medial ventral, and amygdala basal nuclei with hippocampus cornu ammonis 4 in these patients. This finding expands previous research suggesting the importance of the thalamic-hippocampal-amygdala network for postoperative delirium due to alterations in neuronal activity.

A stacking ensemble framework integrating radiomics and deep learning for prognostic prediction in head and neck cancer.

Wang B, Liu J, Zhang X, Lin J, Li S, Wang Z, Cao Z, Wen D, Liu T, Ramli HRH, Harith HH, Hasan WZW, Dong X

pubmed logopapersAug 13 2025
Radiomics models frequently face challenges related to reproducibility and robustness. To address these issues, we propose a multimodal, multi-model fusion framework utilizing stacking ensemble learning for prognostic prediction in head and neck cancer (HNC). This approach seeks to improve the accuracy and reliability of survival predictions. A total of 806 cases from nine centers were collected; 143 cases from two centers were assigned as the external validation cohort, while the remaining 663 were stratified and randomly split into training (n = 530) and internal validation (n = 133) sets. Radiomics features were extracted according to IBSI standards, and deep learning features were obtained using a 3D DenseNet-121 model. Following feature selection, the selected features were input into Cox, SVM, RSF, DeepCox, and DeepSurv models. A stacking fusion strategy was employed to develop the prognostic model. Model performance was evaluated using Kaplan-Meier survival curves and time-dependent ROC curves. On the external validation set, the model using combined PET and CT radiomics features achieved superior performance compared to single-modality models, with the RSF model obtaining the highest concordance index (C-index) of 0.7302. When using deep features extracted by 3D DenseNet-121, the PET + CT-based models demonstrated significantly improved prognostic accuracy, with Deepsurv and DeepCox achieving C-indices of 0.9217 and 0.9208, respectively. In stacking models, the PET + CT model using only radiomics features reached a C-index of 0.7324, while the deep feature-based stacking model achieved 0.9319. The best performance was obtained by the multi-feature fusion model, which integrated both radiomics and deep learning features from PET and CT, yielding a C-index of 0.9345. Kaplan-Meier survival analysis further confirmed the fusion model's ability to distinguish between high-risk and low-risk groups. The stacking-based ensemble model demonstrates superior performance compared to individual machine learning models, markedly improving the robustness of prognostic predictions.
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