The diagnostic accuracy and subjectivity of existing Knee Osteoarthritis (OA) ordinal grading systems has been a subject of on-going debate and concern. Existing automated solutions are trained to emulate these imperfect systems, whilst also being reliant on large annotated databases for fully-supervised training. This work proposes a three stage approach for automated continuous grading of knee OA that is built upon the principles of Anomaly Detection (AD); learning a robust representation of healthy knee X-rays and grading disease severity based on its distance to the centre of normality. In the first stage, SS-FewSOME is proposed, a self-supervised AD technique that learns the 'normal' representation, requiring only examples of healthy subjects and <3% of the labels that existing methods require. In the second stage, this model is used to pseudo label a subset of unlabelled data as 'normal' or 'anomalous', followed by denoising of pseudo labels with CLIP. The final stage involves retraining on labelled and pseudo labelled data using the proposed Dual Centre Representation Learning (DCRL) which learns the centres of two representation spaces; normal and anomalous. Disease severity is then graded based on the distance to the learned centres. The proposed methodology outperforms existing techniques by margins of up to 24% in terms of OA detection and the disease severity scores correlate with the Kellgren-Lawrence grading system at the same level as human expert performance. Code available at https://github.com/niamhbelton/SS-FewSOME_Disease_Severity_Knee_Osteoarthritis.

Although Alzheimer's disease detection via MRIs has advanced significantly thanks to contemporary deep learning models, challenges such as class imbalance, protocol variations, and limited dataset diversity often hinder their generalization capacity. To address this issue, this article focuses on the single domain generalization setting, where given the data of one domain, a model is designed and developed with maximal performance w.r.t. an unseen domain of distinct distribution. Since brain morphology is known to play a crucial role in Alzheimer's diagnosis, we propose the use of learnable pseudo-morphological modules aimed at producing shape-aware, anatomically meaningful class-specific augmentations in combination with a supervised contrastive learning module to extract robust class-specific representations. Experiments conducted across three datasets show improved performance and generalization capacity, especially under class imbalance and imaging protocol variations. The source code will be made available upon acceptance at https://github.com/zobia111/SDG-Alzheimer.

Artificial Intelligence (AI) research needs to be clinician led; however, expertise typically lies outside their skill set. Collaborations exist but are often commercially driven. Free and open-source computational algorithms and software expertise are required for meaningful clinically driven AI medical research. Deep learning algorithms automate segmenting regions of interest for analysis and clinical translation. Numerous studies have automatically segmented paranasal sinus computed tomography (CT) scans; however, openly accessible algorithms capturing the sinonasal cavity remain scarce. The purpose of this study was to validate and provide an open-source segmentation algorithm for paranasal sinus CTs for the otolaryngology research community. A cross-sectional comparative study was conducted with a deep learning algorithm, UNet++, modified for automatic segmentation of paranasal sinuses CTs and "ground-truth" manual segmentations. A dataset of 100 paranasal sinuses scans was manually segmented, with an 80/20 training/testing split. The algorithm is available at https://github.com/rheadkaul/SinusSegment. Primary outcomes included the Dice similarity coefficient (DSC) score, Intersection over Union (IoU), Hausdorff distance (HD), sensitivity, specificity, and visual similarity grading. Twenty scans representing 7300 slices were assessed. The mean DSC was 0.87 and IoU 0.80, with HD 33.61 mm. The mean sensitivity was 83.98% and specificity 99.81%. The median visual similarity grading score was 3 (good). There were no statistically significant differences in outcomes with normal or diseased paranasal sinus CTs. Automatic segmentation of CT paranasal sinuses yields good results when compared with manual segmentation. This study provides an open-source segmentation algorithm as a foundation and gateway for more complex AI-based analysis of large datasets.

Recent vision-language foundation models deliver state-of-the-art results on natural image classification but falter on medical images due to pronounced domain shifts. At the same time, training a medical foundation model requires substantial resources, including extensive annotated data and high computational capacity. To bridge this gap with minimal overhead, we introduce MedBridge, a lightweight multimodal adaptation framework that re-purposes pretrained VLMs for accurate medical image diagnosis. MedBridge comprises three key components. First, a Focal Sampling module that extracts high-resolution local regions to capture subtle pathological features and compensate for the limited input resolution of general-purpose VLMs. Second, a Query Encoder (QEncoder) injects a small set of learnable queries that attend to the frozen feature maps of VLM, aligning them with medical semantics without retraining the entire backbone. Third, a Mixture of Experts mechanism, driven by learnable queries, harnesses the complementary strength of diverse VLMs to maximize diagnostic performance. We evaluate MedBridge on five medical imaging benchmarks across three key adaptation tasks, demonstrating its superior performance in both cross-domain and in-domain adaptation settings, even under varying levels of training data availability. Notably, MedBridge achieved over 6-15% improvement in AUC compared to state-of-the-art VLM adaptation methods in multi-label thoracic disease diagnosis, underscoring its effectiveness in leveraging foundation models for accurate and data-efficient medical diagnosis. Our code is available at https://github.com/ai-med/MedBridge.

Predicting the risk of developing breast cancer is an important clinical tool to guide early intervention and tailoring personalized screening strategies. Early risk models have limited performance and recently machine learning-based analysis of mammogram images showed encouraging risk prediction effects. These models however are limited to the use of a single exam or tend to overlook nuanced breast tissue evolvement in spatial and temporal details of longitudinal imaging exams that are indicative of breast cancer risk. In this paper, we propose STA-Risk (Spatial and Temporal Asymmetry-based Risk Prediction), a novel Transformer-based model that captures fine-grained mammographic imaging evolution simultaneously from bilateral and longitudinal asymmetries for breast cancer risk prediction. STA-Risk is innovative by the side encoding and temporal encoding to learn spatial-temporal asymmetries, regulated by a customized asymmetry loss. We performed extensive experiments with two independent mammogram datasets and achieved superior performance than four representative SOTA models for 1- to 5-year future risk prediction. Source codes will be released upon publishing of the paper.

DeepInverse is an open-source PyTorch-based library for solving imaging inverse problems. The library covers all crucial steps in image reconstruction from the efficient implementation of forward operators (e.g., optics, MRI, tomography), to the definition and resolution of variational problems and the design and training of advanced neural network architectures. In this paper, we describe the main functionality of the library and discuss the main design choices.

In contrast to vision transformers, which model long-range dependencies through global self-attention, large kernel convolutions provide a more efficient and scalable alternative, particularly in high-resolution 3D volumetric settings. However, naively increasing kernel size often leads to optimization instability and degradation in performance. Motivated by the spatial bias observed in effective receptive fields (ERFs), we hypothesize that different kernel elements converge at variable rates during training. To support this, we derive a theoretical connection between element-wise gradients and first-order optimization, showing that structurally re-parameterized convolution blocks inherently induce spatially varying learning rates. Building on this insight, we introduce Rep3D, a 3D convolutional framework that incorporates a learnable spatial prior into large kernel training. A lightweight two-stage modulation network generates a receptive-biased scaling mask, adaptively re-weighting kernel updates and enabling local-to-global convergence behavior. Rep3D adopts a plain encoder design with large depthwise convolutions, avoiding the architectural complexity of multi-branch compositions. We evaluate Rep3D on five challenging 3D segmentation benchmarks and demonstrate consistent improvements over state-of-the-art baselines, including transformer-based and fixed-prior re-parameterization methods. By unifying spatial inductive bias with optimization-aware learning, Rep3D offers an interpretable, and scalable solution for 3D medical image analysis. The source code is publicly available at https://github.com/leeh43/Rep3D.

Due to the association with higher incidence of left ventricular dysfunction and complications, segmentation of left ventricle and related pathological tissues: microvascular obstruction and myocardial infarction from late gadolinium enhancement cardiac magnetic resonance images is crucially important. However, lack of datasets, diverse shapes and locations, extreme imbalanced class, severe intensity distribution overlapping are the main challenges. We first release a late gadolinium enhancement cardiac magnetic resonance benchmark dataset LGE-LVP containing 140 patients with left ventricle myocardial infarction and concomitant microvascular obstruction. Then, a progressive deep learning model LVPSegNet is proposed to segment the left ventricle and its pathologies via adaptive region of interest extraction, sample augmentation, curriculum learning, and multiple receptive field fusion in dealing with the challenges. Comprehensive comparisons with state-of-the-art models on the internal and external datasets demonstrate that the proposed model performs the best on both geometric and clinical metrics and it most closely matched the clinician's performance. Overall, the released LGE-LVP dataset alongside the LVPSegNet we proposed offer a practical solution for automated left ventricular and its pathologies segmentation by providing data support and facilitating effective segmentation. The dataset and source codes will be released via https://github.com/DFLAG-NEU/LVPSegNet.

Deep learning has become an invaluable tool for bioimage analysis but, while open-source cell annotation software such as cellpose are widely used, an equivalent tool for three-dimensional (3D) vascular annotation does not exist. With the vascular system being directly impacted by a broad range of diseases, there is significant medical interest in quantitative analysis for vascular imaging. However, existing deep learning approaches for this task are specialised to particular tissue types or imaging modalities. We present a new deep learning model for segmentation of vasculature that is generalisable across tissues, modalities, scales and pathologies. To create a generalisable model, a 3D convolutional neural network was trained using data from multiple modalities including optical imaging, computational tomography and photoacoustic imaging. Through this varied training set, the model was forced to learn common features of vessels cross-modality and scale. Following this, the general model was fine-tuned to different applications with a minimal amount of manually labelled ground truth data. It was found that the general model could be specialised to segment new datasets, with a high degree of accuracy, using as little as 0.3% of the volume of that dataset for fine-tuning. As such, this model enables users to produce accurate segmentations of 3D vascular networks without the need to label large amounts of training data.

Using massive datasets, foundation models are large-scale, pre-trained models that perform a wide range of tasks. These models have shown consistently improved results with the introduction of new methods. It is crucial to analyze how these trends impact the medical field and determine whether these advancements can drive meaningful change. This study investigates the application of recent state-of-the-art foundation models, DINOv2, MAE, VMamba, CoCa, SAM2, and AIMv2, for medical image classification. We explore their effectiveness on datasets including CBIS-DDSM for mammography, ISIC2019 for skin lesions, APTOS2019 for diabetic retinopathy, and CHEXPERT for chest radiographs. By fine-tuning these models and evaluating their configurations, we aim to understand the potential of these advancements in medical image classification. The results indicate that these advanced models significantly enhance classification outcomes, demonstrating robust performance despite limited labeled data. Based on our results, AIMv2, DINOv2, and SAM2 models outperformed others, demonstrating that progress in natural domain training has positively impacted the medical domain and improved classification outcomes. Our code is publicly available at: https://github.com/sajjad-sh33/Medical-Transfer-Learning.