Synthetic data generation represents a significant advancement in boosting the performance of machine learning (ML) models, particularly in fields where data acquisition is challenging, such as echocardiography. The acquisition and labeling of echocardiograms (echo) for heart assessment, crucial in point-of-care ultrasound (POCUS) settings, often encounter limitations due to the restricted number of echo views available, typically captured by operators with varying levels of experience. This study proposes a novel approach for enhancing clinical diagnosis accuracy by synthetically generating echo views. These views are conditioned on existing, real views of the heart, focusing specifically on the estimation of ejection fraction (EF), a critical parameter traditionally measured from biplane apical views. By integrating a conditional generative model, we demonstrate an improvement in EF estimation accuracy, providing a comparative analysis with traditional methods. Preliminary results indicate that our synthetic echoes, when used to augment existing datasets, not only enhance EF estimation but also show potential in advancing the development of more robust, accurate, and clinically relevant ML models. This approach is anticipated to catalyze further research in synthetic data applications, paving the way for innovative solutions in medical imaging diagnostics.

Explainable Artificial Intelligence (XAI) has become an essential component of medical imaging research, aiming to increase transparency and clinical trust in deep learning models. This study investigates brain hemorrhage diagnosis with a focus on explainability through Class Activation Mapping (CAM) techniques. A pipeline was developed to extract pixellevel segmentation and detection annotations from classification models using nine state-of-the-art CAM algorithms, applied across multiple network stages, and quantitatively evaluated on the Hemorica dataset, which uniquely provides both slice-level labels and high-quality segmentation masks. Metrics including Dice, IoU, and pixel-wise overlap were employed to benchmark CAM variants. Results show that the strongest localization performance occurred at stage 5 of EfficientNetV2S, with HiResCAM yielding the highest bounding-box alignment and AblationCAM achieving the best pixel-level Dice (0.57) and IoU (0.40), representing strong accuracy given that models were trained solely for classification without segmentation supervision. To the best of current knowledge, this is among the f irst works to quantitatively compare CAM methods for brain hemorrhage detection, establishing a reproducible benchmark and underscoring the potential of XAI-driven pipelines for clinically meaningful AI-assisted diagnosis.

Prognostic modeling is essential for forecasting future clinical scores and enabling early detection of Alzheimers disease (AD). While most existing methods focus on predicting the ADAS-Cog global score, they often overlook the predictive value of its 13 sub-scores, which reflect distinct cognitive domains. Some sub-scores may exert greater influence on determining global scores. Assigning higher loss weights to these clinically meaningful sub-scores can guide the model to focus on more relevant cognitive domains, enhancing both predictive accuracy and interpretability. In this study, we propose a weighted Vision Transformer (ViT)-based multi-task learning (MTL) framework to jointly predict the ADAS-Cog global score using baseline MRI scans and its 13 sub-scores at Month 24. Our framework integrates ViT as a feature extractor and systematically investigates the impact of sub-score-specific loss weighting on model performance. Results show that our proposed weighting strategies are group-dependent: strong weighting improves performance for MCI subjects with more heterogeneous MRI patterns, while moderate weighting is more effective for CN subjects with lower variability. Our findings suggest that uniform weighting underutilizes key sub-scores and limits generalization. The proposed framework offers a flexible, interpretable approach to AD prognosis using end-to-end MRI-based learning. (Github repo link will be provided after review)

Assessing body composition using computed tomography (CT) can help predict the clinical outcomes of cancer patients, including surgical complications, chemotherapy toxicity, and survival. However, manual segmentation of CT images is labor-intensive and can lead to significant inter-observer variability. In this study, we validate the accuracy and reliability of automatic CT-based segmentation using the Data Analysis Facilitation Suite (DAFS) Express software package, which rapidly segments single CT slices. The study analyzed single-slice images at the third lumbar vertebra (L3) level (n = 5973) of patients diagnosed with non-metastatic colorectal (n = 3098) and breast cancer (n = 2875) at Kaiser Permanente Northern California. Manual segmentation used SliceOmatic with Alberta protocol HU ranges; automated segmentation used DAFS Express with identical HU limits. The accuracy of the automated segmentation was evaluated using the DICE index, the reliability was assessed by intra-class correlation coefficients (ICC) with 95% CI, and the agreement between automatic and manual segmentations was assessed by Bland-Altman analysis. DICE scores below 20% and 70% were considered failed and poor segmentations, respectively, and underwent additional review. The mortality risk associated with each tissue's area was generated using Cox proportional hazard ratios (HR) with 95% CI, adjusted for patient-specific variables including age, sex, race/ethnicity, cancer stage and grade, treatment receipt, and smoking status. A blinded review process categorized images with various characteristics for sensitivity analysis. The mean (standard deviation, SD) ages of the colorectal and breast cancer patients were 62.6 (11.4) and 56 (11.8), respectively. Automatic segmentation showed high accuracy vs. manual segmentation, with mean DICE scores above 96% for skeletal muscle (SKM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT), and above 77% for intermuscular adipose tissue (IMAT), with three failures, representing 0.05% of the cohort. Bland-Altman analysis of 5,973 measurements showed mean cross-sectional area differences of -5.73, -0.84, -2.82, and -1.02 cm² for SKM, VAT, SAT and IMAT, respectively, indicating good agreement, with slight underestimation in SKM and SAT. Reliability Coefficients ranged from 0.88-1.00 for colorectal and 0.95-1.00 for breast cancer, with Simple Kappa values of 0.65-0.99 and 0.67-0.97, respectively. Additionally, mortality associations for automated and manual segmentations were similar, with comparable hazard ratios, confidence intervals, and p-values. Kaplan-Meier survival estimates showed mortality differences below 2.14%. DAFS Express enables rapid, accurate body composition analysis by automating segmentation, reducing expert time and computational burden. This rapid analysis of body composition is a prerequisite to large-scale research that could potentially enable use in the clinical setting. Automated CT segmentations may be utilized to assess markers of sarcopenia, muscle loss, and adiposity and predict clinical outcomes.

Accurate and automated segmentation of 3D biomedical images is a sophisticated imperative in clinical diagnosis, imaging-guided surgery, and prognosis judgment. Although the burgeoning of deep learning technologies has fostered smart segmentators, the successive and simultaneous garnering global and local features still remains challenging, which is essential for an exact and efficient imageological assay. To this end, a segmentation solution dubbed the mixed parallel shunted transformer (MPSTrans) is developed here, highlighting 3D-MPST blocks in a U-form framework. It enabled not only comprehensive characteristic capture and multiscale slice synchronization but also deep supervision in the decoder to facilitate the fetching of hierarchical representations. Performing on an unpublished colon cancer data set, this model achieved an impressive increase in dice similarity coefficient (DSC) and a 1.718 mm decease in Hausdorff distance at 95% (HD95), alongside a substantial shrink of computational load of 56.7% in giga floating-point operations per second (GFLOPs). Meanwhile, MPSTrans outperforms other mainstream methods (Swin UNETR, UNETR, nnU-Net, PHTrans, and 3D U-Net) on three public multiorgan (aorta, gallbladder, kidney, liver, pancreas, spleen, stomach, etc.) and multimodal (CT, PET-CT, and MRI) data sets of medical segmentation decathlon (MSD) brain tumor, multiatlas labeling beyond cranial vault (BCV), and automated cardiac diagnosis challenge (ACDC), accentuating its adaptability. These results reflect the potential of MPSTrans to advance the state-of-the-art in biomedical imaging analysis, which would offer a robust tool for enhanced diagnostic capacity.

Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition, and accurate prediction of functional outcomes is critical for optimizing patient management within the initial 3 days of presentation. However, existing clinical scoring systems and imaging assessments do not fully capture clinical variability in predicting outcomes. We developed a deep learning model integrating pre- and postoperative noncontrast CT (NCCT) imaging with clinical data to predict 3-month modified Rankin Scale (mRS) scores in aSAH patients. Using data from 1850 patients across four hospitals, we constructed and validated five models: preoperative, postoperative, stacking imaging, clinical, and fusion models. The fusion model significantly outperformed the others (all p<0.001), achieving a mean absolute error of 0.79 and an area under the curve of 0.92 in the external test. These findings demonstrate that this integrated deep learning model enables accurate prediction of 3-month outcomes and may serve as a prognostic support tool early in aSAH care.

The Bosniak classification system is widely used to assess malignancy risk in renal cystic lesions, yet inter-observer variability poses significant challenges. Large language models (LLMs) may offer a standardized approach to classification when provided with textual descriptions, such as those found in radiology reports. This study evaluated the performance of five LLMs-GPT‑4 (ChatGPT), Gemini, Copilot, Perplexity, and NotebookLM-in classifying renal cysts based on synthetic textual descriptions mimicking CT report content. A synthetic dataset of 100 diagnostic scenarios (20 cases per Bosniak category) was constructed using established radiological criteria. Each LLM was evaluated using zero-shot and few-shot prompting strategies, while NotebookLM employed retrieval-augmented generation (RAG). Performance metrics included accuracy, sensitivity, and specificity. Statistical significance was assessed using McNemar's and chi-squared tests. GPT‑4 achieved the highest accuracy (87% zero-shot, 99% few-shot), followed by Copilot (81-86%), Gemini (55-69%), and Perplexity (43-69%). NotebookLM, tested only under RAG conditions, reached 87% accuracy. Few-shot learning significantly improved performance (p < 0.05). Classification of Bosniak IIF lesions remained challenging across models. When provided with well-structured textual descriptions, LLMs can accurately classify renal cysts. Few-shot prompting significantly enhances performance. However, persistent difficulties in classifying borderline lesions such as Bosniak IIF highlight the need for further refinement and real-world validation.

Brain tumors show significant health challenges due to their potential to cause critical neurological functions. Early and accurate diagnosis is crucial for effective treatment. In this research, we propose ResLink, a novel deep learning architecture for brain tumor classification using CT scan images. ResLink integrates novel area attention mechanisms with residual connections to enhance feature learning and spatial understanding for spatially rich image classification tasks. The model employs a multi-stage convolutional pipeline, incorporating dropout, regularization, and downsampling, followed by a final attention-based refinement for classification. Trained on a balanced dataset, ResLink achieves a high accuracy of 95% and demonstrates strong generalizability. This research demonstrates the potential of ResLink in improving brain tumor classification, offering a robust and efficient technique for medical imaging applications.

Magnetic Resonance Imaging (MRI) is indispensable in clinical practice but remains constrained by fragmented, multi-stage workflows encompassing acquisition, reconstruction, segmentation, detection, diagnosis, and reporting. While deep learning has achieved progress in individual tasks, existing approaches are often anatomy- or application-specific and lack generalizability across diverse clinical settings. Moreover, current pipelines rarely integrate imaging data with complementary language information that radiologists rely on in routine practice. Here, we introduce OmniMRI, a unified vision-language foundation model designed to generalize across the entire MRI workflow. OmniMRI is trained on a large-scale, heterogeneous corpus curated from 60 public datasets, over 220,000 MRI volumes and 19 million MRI slices, incorporating image-only data, paired vision-text data, and instruction-response data. Its multi-stage training paradigm, comprising self-supervised vision pretraining, vision-language alignment, multimodal pretraining, and multi-task instruction tuning, progressively equips the model with transferable visual representations, cross-modal reasoning, and robust instruction-following capabilities. Qualitative results demonstrate OmniMRI's ability to perform diverse tasks within a single architecture, including MRI reconstruction, anatomical and pathological segmentation, abnormality detection, diagnostic suggestion, and radiology report generation. These findings highlight OmniMRI's potential to consolidate fragmented pipelines into a scalable, generalist framework, paving the way toward foundation models that unify imaging and clinical language for comprehensive, end-to-end MRI interpretation.

Low-dose computed tomography (CT) denoising is crucial for reduced radiation exposure while ensuring diagnostically acceptable image quality. Despite significant advancements driven by deep learning (DL) in recent years, existing DL-based methods, typically trained on a specific dose level and anatomical region, struggle to handle diverse noise characteristics and anatomical heterogeneity during varied scanning conditions, limiting their generalizability and robustness in clinical scenarios. In this paper, we propose FoundDiff, a foundational diffusion model for unified and generalizable LDCT denoising across various dose levels and anatomical regions. FoundDiff employs a two-stage strategy: (i) dose-anatomy perception and (ii) adaptive denoising. First, we develop a dose- and anatomy-aware contrastive language image pre-training model (DA-CLIP) to achieve robust dose and anatomy perception by leveraging specialized contrastive learning strategies to learn continuous representations that quantify ordinal dose variations and identify salient anatomical regions. Second, we design a dose- and anatomy-aware diffusion model (DA-Diff) to perform adaptive and generalizable denoising by synergistically integrating the learned dose and anatomy embeddings from DACLIP into diffusion process via a novel dose and anatomy conditional block (DACB) based on Mamba. Extensive experiments on two public LDCT datasets encompassing eight dose levels and three anatomical regions demonstrate superior denoising performance of FoundDiff over existing state-of-the-art methods and the remarkable generalization to unseen dose levels. The codes and models are available at https://github.com/hao1635/FoundDiff.