Accurate, noninvasive diagnosis of compensated advanced chronic liver disease (cACLD) is essential for effective clinical management but remains challenging. This study aimed to develop a deep learning-based radiomics model using international multicenter data and to evaluate its performance by comparing it to the two-dimensional shear wave elastography (2D-SWE) cut-off method covering multiple countries or regions, etiologies, and ultrasound device manufacturers. This retrospective study included 1937 adult patients with chronic liver disease due to hepatitis B, hepatitis C, or metabolic dysfunction-associated steatotic liver disease. All patients underwent 2D-SWE imaging and liver biopsy at 17 centers across China, Japan, and Europe using devices from three manufacturers (SuperSonic Imagine, General Electric, and Mindray). The proposed generalized deep learning radiomics of elastography model integrated both elastographic images and liver stiffness measurements and was trained and tested on stratified internal and external datasets. A total of 1937 patients with 9472 2D-SWE images were included in the statistical analysis. Compared to 2D-SWE, the model achieved a higher area under the receiver operating characteristic curve (AUC) (0.89 vs 0.83, P = 0.025). It also achieved a highly consistent diagnosis across all subanalyses (P values: 0.21-0.91), whereas 2D-SWE exhibited different AUCs in the country or region (P < 0.001) and etiology (P = 0.005) subanalyses but not in the manufacturer subanalysis (P = 0.24). The model demonstrated more accurate and robust performance in noninvasive cACLD diagnosis than 2D-SWE across different countries or regions, etiologies, and manufacturers.

This study evaluates the efficiency, accuracy, and cost-effectiveness of radiology reporting using audio multimodal large language models (LLMs) compared to conventional reporting with speech recognition software. We hypothesized that providing minimal audio input would enable a multimodal LLM to generate complete radiological reports. 480 reports from 80 retrospective multimodal imaging studies were reported by two board-certified radiologists using three workflows: conventional workflow (C-WF) with speech recognition software to generate findings and impressions separately and LLM-based workflow (LLM-WF) using the state-of-the-art LLMs GPT-4o and Claude Sonnet 3.5. Outcome measures included reporting time, corrections and personnel cost per report. Two radiologists assessed formal structure and report quality. Statistical analysis used ANOVA and Tukey's post hoc tests (p < 0.05). LLM-WF significantly reduced reporting time (GPT-4o/Sonnet 3.5: 38.9 s ± 22.7 s vs. C-WF: 88.0 s ± 60.9 s, p < 0.01), required fewer corrections (GPT-4o: 1.0 ± 1.1, Sonnet 3.5: 0.9 ± 1.0 vs. C-WF: 2.4 ± 2.5, p < 0.01), and lowered costs (GPT-4o: $2.3 ± $1.4, Sonnet 3.5: $2.4 ± $1.4 vs. C-WF: $3.0 ± $2.1, p < 0.01). Reports generated with Sonnet 3.5 were rated highest in quality, while GPT-4o and conventional reports showed no difference. Multimodal LLMs can generate high-quality radiology reports based solely on minimal audio input, with greater speed, fewer corrections, and reduced costs compared to conventional speech-based workflows. However, future implementation may involve licensing costs, and generalizability to broader clinical contexts warrants further evaluation. Question Comparing time, accuracy, cost, and report quality of reporting using audio input functionality of GPT-4o and Claude Sonnet 3.5 to conventional reporting with speech recognition. Findings Large language models enable radiological reporting via minimal audio input, reducing turnaround time and costs without quality loss compared to conventional reporting with speech recognition. Clinical relevance Large language model-based reporting from minimal audio input has the potential to improve efficiency and report quality, supporting more streamlined workflows in clinical radiology.

This study aimed to examine the performance of a fine-tuned large language model (LLM) in extracting pretreatment pancreatic cancer according to computed tomography (CT) radiology reports and to compare it with that of readers. This retrospective study included 2690, 886, and 378 CT reports for the training, validation, and test datasets, respectively. Clinical indication, image finding, and imaging diagnosis sections of the radiology report (used as input data) were reviewed and categorized into groups 0 (no pancreatic cancer), 1 (after treatment for pancreatic cancer), and 2 (pretreatment pancreatic cancer present) (used as reference data). A pre-trained Bidirectional Encoder Representation from the Transformers Japanese model was fine-tuned with the training and validation dataset. Group 1 data were undersampled and group 2 data were oversampled in the training dataset due to group imbalance. The best-performing model from the validation set was subsequently assessed using the test dataset for testing purposes. Additionally, three readers (readers 1, 2, and 3) were involved in classifying reports within the test dataset. The fine-tuned LLM and readers 1, 2, and 3 demonstrated an overall accuracy of 0.942, 0.984, 0.979, and 0.947; sensitivity for differentiating groups 0/1/2 of 0.944/0.960/0.921, 0.976/1.000/0.976, 0.984/0.984/0.968, and 1.000/1.000/0.841; and total time required for classification of 49 s, 2689 s, 3496 s, and 4887 s, respectively. Fine-tuned LLM effectively extracted patients with pretreatment pancreatic cancer according to CT radiology reports, and its performance was comparable to that of readers in a shorter time.

In the world, Alzheimer's disease (AD) is the utmost public reason for dementia. AD causes memory loss and disturbing mental function impairment in aging people. The loss of memory and disturbing mental function brings a significant load on patients as well as on society. So far, there is no actual treatment that can cure AD; however, early diagnosis can slow down this disease. Deep learning has shown substantial success in diagnosing AZ disease. However, challenges remain due to limited data, improper model selection, and extraction of irrelevant features. In this work, we proposed a fully automated framework based on the fusion of a vision transformer and a novel inverted residual bottleneck with self-attention (IRBwSA) for AD diagnosis. In the first step, data augmentation was performed to balance the selected dataset. After that, the vision model is designed and modified according to the dataset. Similarly, a new inverted bottleneck self-attention model is developed. The designed models are trained on the augmented dataset, and extracted features are fused using a novel search-based approach. Moreover, the designed models are interpreted using an explainable artificial intelligence technique named LIME. The fused features are finally classified using a shallow wide neural network and other classifiers. The experimental process was conducted on an augmented MRI dataset, and 96.1% accuracy and 96.05% precision rate were obtained. Comparison with a few recent techniques shows the proposed framework's better performance.

Mammogram visual question answering (VQA) integrates image interpretation with clinical reasoning and has potential to support breast cancer screening. We systematically evaluated the GPT-5 family and GPT-4o model on four public mammography datasets (EMBED, InBreast, CMMD, CBIS-DDSM) for BI-RADS assessment, abnormality detection, and malignancy classification tasks. GPT-5 consistently was the best performing model but lagged behind both human experts and domain-specific fine-tuned models. On EMBED, GPT-5 achieved the highest scores among GPT variants in density (56.8%), distortion (52.5%), mass (64.5%), calcification (63.5%), and malignancy (52.8%) classification. On InBreast, it attained 36.9% BI-RADS accuracy, 45.9% abnormality detection, and 35.0% malignancy classification. On CMMD, GPT-5 reached 32.3% abnormality detection and 55.0% malignancy accuracy. On CBIS-DDSM, it achieved 69.3% BI-RADS accuracy, 66.0% abnormality detection, and 58.2% malignancy accuracy. Compared with human expert estimations, GPT-5 exhibited lower sensitivity (63.5%) and specificity (52.3%). While GPT-5 exhibits promising capabilities for screening tasks, its performance remains insufficient for high-stakes clinical imaging applications without targeted domain adaptation and optimization. However, the tremendous improvements in performance from GPT-4o to GPT-5 show a promising trend in the potential for general large language models (LLMs) to assist with mammography VQA tasks.

Computed tomography (CT) is a cornerstone imaging modality for non-invasive, high-resolution visualization of internal anatomical structures. However, when the scanned object exceeds the scanner's field of view (FOV), projection data are truncated, resulting in incomplete reconstructions and pronounced artifacts near FOV boundaries. Conventional reconstruction algorithms struggle to recover accurate anatomy from such data, limiting clinical reliability. Deep learning approaches have been explored for FOV extension, with diffusion generative models representing the latest advances in image synthesis. Yet, conventional diffusion models are computationally demanding and slow at inference due to their iterative sampling process. To address these limitations, we propose an efficient CT FOV extension framework based on the image-to-image Schr\"odinger Bridge (I$^2$SB) diffusion model. Unlike traditional diffusion models that synthesize images from pure Gaussian noise, I$^2$SB learns a direct stochastic mapping between paired limited-FOV and extended-FOV images. This direct correspondence yields a more interpretable and traceable generative process, enhancing anatomical consistency and structural fidelity in reconstructions. I$^2$SB achieves superior quantitative performance, with root-mean-square error (RMSE) values of 49.8\,HU on simulated noisy data and 152.0HU on real data, outperforming state-of-the-art diffusion models such as conditional denoising diffusion probabilistic models (cDDPM) and patch-based diffusion methods. Moreover, its one-step inference enables reconstruction in just 0.19s per 2D slice, representing over a 700-fold speedup compared to cDDPM (135s) and surpassing diffusionGAN (0.58s), the second fastest. This combination of accuracy and efficiency makes I$^2$SB highly suitable for real-time or clinical deployment.

Model-based reconstruction plays a key role in compressed sensing (CS) MRI, as it incorporates effective image regularizers to improve the quality of reconstruction. The Plug-and-Play and Regularization-by-Denoising frameworks leverage advanced denoisers (e.g., convolutional neural network (CNN)-based denoisers) and have demonstrated strong empirical performance. However, their theoretical guarantees remain limited, as practical CNNs often violate key assumptions. In contrast, gradient-driven denoisers achieve competitive performance, and the required assumptions for theoretical analysis are easily satisfied. However, solving the associated optimization problem remains computationally demanding. To address this challenge, we propose a generalized Krylov subspace method (GKSM) to solve the optimization problem efficiently. Moreover, we also establish rigorous convergence guarantees for GKSM in nonconvex settings. Numerical experiments on CS MRI reconstruction with spiral and radial acquisitions validate both the computational efficiency of GKSM and the accuracy of the theoretical predictions. The proposed optimization method is applicable to any linear inverse problem.

Bone metastases, affecting more than 4.8% of patients with cancer annually, and particularly spinal metastases require urgent intervention to prevent neurological complications. However, the current process of manually reviewing radiological reports leads to potential delays in specialist referrals. We hypothesized that natural language processing (NLP) review of routine radiology reports could automate the referral process for timely multidisciplinary care of spinal metastases. We assessed 3 NLP models-a rule-based regular expression (RegEx) model, GPT-4, and a specialized Bidirectional Encoder Representations from Transformers (BERT) model (NYUTron)-for automated detection and referral of bone metastases. Study inclusion criteria targeted patients with active cancer diagnoses who underwent advanced imaging (computed tomography, MRI, or positron emission tomography) without previous specialist referral. We defined 2 separate tasks: task of identifying clinically significant bone metastatic terms (lexical detection), and identifying cases needing a specialist follow-up (clinical referral). Models were developed using 3754 hand-labeled advanced imaging studies in 2 phases: phase 1 focused on spine metastases, and phase 2 generalized to bone metastases. Standard McRae's line performance metrics were evaluated and compared across all stages and tasks. In the lexical detection, a simple RegEx achieved the highest performance (sensitivity 98.4%, specificity 97.6%, F1 = 0.965), followed by NYUTron (sensitivity 96.8%, specificity 89.9%, and F1 = 0.787). For the clinical referral task, RegEx also demonstrated superior performance (sensitivity 92.3%, specificity 87.5%, and F1 = 0.936), followed by a fine-tuned NYUTron model (sensitivity 90.0%, specificity 66.7%, and F1 = 0.750). An NLP-based automated referral system can accurately identify patients with bone metastases requiring specialist evaluation. A simple RegEx model excels in syntax-based identification and expert-informed rule generation for efficient referral patient recommendation in comparison with advanced NLP models. This system could significantly reduce missed follow-ups and enhance timely intervention for patients with bone metastases.

Existing deep learning models for functional MRI-based classification have limitations in network architecture determination (relying on experience) and feature space fusion (mostly simple concatenation, lacking mutual learning). Inspired by the human brain's mechanism of updating neural connections through learning and decision-making, we proposed a novel BRain-Inspired feature Fusion (BRIEF) framework, which is able to optimize network architecture automatically by incorporating an improved neural network connection search (NCS) strategy and a Transformer-based multi-feature fusion module. Specifically, we first extracted 4 types of fMRI temporal representations, i.e., time series (TCs), static/dynamic functional connection (FNC/dFNC), and multi-scale dispersion entropy (MsDE), to construct four encoders. Within each encoder, we employed a modified Q-learning to dynamically optimize the NCS to extract high-level feature vectors, where the NCS is formulated as a Markov Decision Process. Then, all feature vectors were fused via a Transformer, leveraging both stable/time-varying connections and multi-scale dependencies across different brain regions to achieve the final classification. Additionally, an attention module was embedded to improve interpretability. The classification performance of our proposed BRIEF was compared with 21 state-of-the-art models by discriminating two mental disorders from healthy controls: schizophrenia (SZ, n=1100) and autism spectrum disorder (ASD, n=1550). BRIEF demonstrated significant improvements of 2.2% to 12.1% compared to 21 algorithms, reaching an AUC of 91.5% - 0.6% for SZ and 78.4% - 0.5% for ASD, respectively. This is the first attempt to incorporate a brain-inspired, reinforcement learning strategy to optimize fMRI-based mental disorder classification, showing significant potential for identifying precise neuroimaging biomarkers.

Dentocraniofacial hard tissue defects profoundly affect patients' physiological functions, facial aesthetics, and psychological well-being, posing significant challenges for precise reconstruction. Current deep learning models are limited to single-tissue scenarios and modality-specific imaging inputs, resulting in poor generalizability and trade-offs between anatomical fidelity, computational efficiency, and cross-tissue adaptability. Here we introduce UniDCF, a unified framework capable of reconstructing multiple dentocraniofacial hard tissues through multimodal fusion encoding of point clouds and multi-view images. By leveraging the complementary strengths of each modality and incorporating a score-based denoising module to refine surface smoothness, UniDCF overcomes the limitations of prior single-modality approaches. We curated the largest multimodal dataset, comprising intraoral scans, CBCT, and CT from 6,609 patients, resulting in 54,555 annotated instances. Evaluations demonstrate that UniDCF outperforms existing state-of-the-art methods in terms of geometric precision, structural completeness, and spatial accuracy. Clinical simulations indicate UniDCF reduces reconstruction design time by 99% and achieves clinician-rated acceptability exceeding 94%. Overall, UniDCF enables rapid, automated, and high-fidelity reconstruction, supporting personalized and precise restorative treatments, streamlining clinical workflows, and enhancing patient outcomes.