A common neurodegenerative disease, Alzheimer's disease requires a precise diagnosis and efficient treatment, particularly in light of escalating healthcare expenses and the expanding use of artificial intelligence in medical diagnostics. Many recent studies shows that the combination of brain Magnetic Resonance Imaging (MRI) and deep neural networks have achieved promising results for diagnosing AD. Using deep convolutional neural networks, this paper introduces a novel deep learning architecture that incorporates multiresidual blocks, specialized spatial attention blocks, grouped query attention, and multi-head attention. The study assessed the model's performance on four publicly accessible datasets and concentrated on identifying binary and multiclass issues across various categories. This paper also takes into account of the explainability of AD's progression and compared with state-of-the-art methods namely Gradient Class Activation Mapping (GradCAM), Score-CAM, Faster Score-CAM, and XGRADCAM. Our methodology consistently outperforms current approaches, achieving 99.66\% accuracy in 4-class classification, 99.63\% in 3-class classification, and 100\% in binary classification using Kaggle datasets. For Open Access Series of Imaging Studies (OASIS) datasets the accuracies are 99.92\%, 99.90\%, and 99.95\% respectively. The Alzheimer's Disease Neuroimaging Initiative-1 (ADNI-1) dataset was used for experiments in three planes (axial, sagittal, and coronal) and a combination of all planes. The study achieved accuracies of 99.08\% for axis, 99.85\% for sagittal, 99.5\% for coronal, and 99.17\% for all axis, and 97.79\% and 8.60\% respectively for ADNI-2. The network's ability to retrieve important information from MRI images is demonstrated by its excellent accuracy in categorizing AD stages.

Most machine learning-based image segmentation models produce pixel-wise confidence scores - typically derived from softmax outputs - that represent the model's predicted probability for each class label at every pixel. While this information can be particularly valuable in high-stakes domains such as medical imaging, these (uncalibrated) scores are heuristic in nature and do not constitute rigorous quantitative uncertainty estimates. Conformal prediction (CP) provides a principled framework for transforming heuristic confidence scores into statistically valid uncertainty estimates. However, applying CP directly to image segmentation ignores the spatial correlations between pixels, a fundamental characteristic of image data. This can result in overly conservative and less interpretable uncertainty estimates. To address this, we propose CONSIGN (Conformal Segmentation Informed by Spatial Groupings via Decomposition), a CP-based method that incorporates spatial correlations to improve uncertainty quantification in image segmentation. Our method generates meaningful prediction sets that come with user-specified, high-probability error guarantees. It is compatible with any pre-trained segmentation model capable of generating multiple sample outputs - such as those using dropout, Bayesian modeling, or ensembles. We evaluate CONSIGN against a standard pixel-wise CP approach across three medical imaging datasets and two COCO dataset subsets, using three different pre-trained segmentation models. Results demonstrate that accounting for spatial structure significantly improves performance across multiple metrics and enhances the quality of uncertainty estimates.

The assessment of lymphovascular invasion (LVI) is crucial in the management of rectal cancer; However, accurately evaluating LVI preoperatively using imaging remains challenging. Recent advances in radiomics have created opportunities for developing more accurate diagnostic tools. This study aimed to develop and validate a deep learning model for predicting LVI in rectal cancer patients using preoperative MR imaging. These cases were randomly divided into a training cohort (n = 233) and an validation cohort (n = 101) at a ratio of 7:3. Based on the pathological reports, the patients were classified into positive and negative groups according to their LVI status. Based on the preoperative MRI T2WI axial images, the regions of interest (ROI) were defined from the tumor itself and the edges of the tumor extending outward by 5 pixels, 10 pixels, 15 pixels, and 20 pixels. The 2D and 3D deep learning features were extracted using the DenseNet121 architecture, and the deep learning models were constructed, including a total of ten models: GTV (the tumor itself), GPTV5 (the tumor itself and the tumor extending outward by 5 pixels), GPTV10, GPTV15, and GPTV20. To assess model performance, we utilized the area under the curve (AUC) and conducted DeLong test to compare different models, aiming to identify the optimal model for predicting LVI in rectal cancer. In the 2D deep learning model group, the 2D GPTV10 model demonstrated superior performance with an AUC of 0.891 (95% confidence interval [CI] 0.850-0.933) in the training cohort and an AUC of 0.841 (95% CI 0.767-0.915) in the validation cohort. The difference in AUC between this model and other 2D models was not statistically significant based on DeLong test (p > 0.05); In the group of 3D deep learning models, the 3D GPTV10 model had the highest AUC, with a training cohort AUC of 0.961 (95% CI 0.940-0.982) and a validation cohort AUC of 0.928 (95% CI 0.881-0.976). DeLong test demonstrated that the performance of the 3D GPTV10 model surpassed other 3D models as well as the 2D GPTV10 model (p < 0.05). The study developed a deep learning model, namely 3D GPTV10, utilizing preoperative MRI data to accurately predict the presence of LVI in rectal cancer patients. By training on the tumor itself and its surrounding margin 10 pixels as the region of interest, this model achieved superior performance compared to other deep learning models. These findings have significant implications for clinicians in formulating personalized treatment plans for rectal cancer patients.

The accurate classification of lung nodules is critical to achieving personalized lung cancer treatment and prognosis prediction. The treatment options for lung cancer and the prognosis of patients are closely related to the type of lung nodules, but there are many types of lung nodules, and the distinctions between certain types are subtle, making accurate classification based on traditional medical imaging technology and doctor experience challenging. In this study, a novel method was used to analyze quantitative features in CT images using CT radiomics to reveal the characteristics of pulmonary nodules, and then feature fusion was used to integrate radiomics features and deep learning features to improve the accuracy of classification. This paper proposes a fusion feature pulmonary nodule classification method that fuses radiomics features with deep learning neural network features, aiming to automatically classify different types of pulmonary nodules (such as Malignancy, Calcification, Spiculation, Lobulation, Margin, and Texture). By introducing the Discriminant Correlation Analysis feature fusion algorithm, the method maximizes the complementarity between the two types of features and the differences between different classes. This ensures interaction between the information, effectively utilizing the complementary characteristics of the features. The LIDC-IDRI dataset is used for training, and the fusion feature model has been validated for its advantages and effectiveness in classifying multiple types of pulmonary nodules. The experimental results show that the fusion feature model outperforms the single-feature model in all classification tasks. The AUCs for the tasks of classifying Calcification, Lobulation, Margin, Spiculation, Texture, and Malignancy reached 0.9663, 0.8113, 0.8815, 0.8140, 0.9010, and 0.9316, respectively. In tasks such as nodule calcification and texture classification, the fusion feature model significantly improved the recognition ability of minority classes. The fusion of radiomics features and deep learning neural network features can effectively enhance the overall performance of pulmonary nodule classification models while also improving the recognition of minority classes when there is a significant class imbalance.

The clinical benefits of neoadjuvant chemoimmunotherapy (NACI) are demonstrated in patients with bladder cancer (BCa); however, more than half fail to achieve a pathological complete response (pCR). This study utilizes multi-center cohorts of 2322 patients with pathologically diagnosed BCa, collected between January 1, 2014, and December 31, 2023, to explore the correlation between tumor budding (TB) status and NACI response and disease prognosis. A deep learning model is developed to noninvasively evaluate TB status based on CT images. The deep learning model accurately predicts the TB status, with area under the curve values of 0.932 (95% confidence interval: 0.898-0.965) in the training cohort, 0.944 (0.897-0.991) in the internal validation cohort, 0.882 (0.832-0.933) in external validation cohort 1, 0.944 (0.908-0.981) in the external validation cohort 2, and 0.854 (0.739-0.970) in the NACI validation cohort. Patients predicted to have a high TB status exhibit a worse prognosis (p < 0.05) and a lower pCR rate of 25.9% (7/20) than those predicted to have a low TB status (pCR rate: 73.9% [17/23]; p < 0.001). Hence, this model may be a reliable, noninvasive tool for predicting TB status, aiding clinicians in prognosis assessment and NACI strategy formulation.

Glioblastoma (GBM) is a highly aggressive brain tumor with poor prognosis. This study aimed to construct and validate a radiomics-based machine learning model for predicting overall survival (OS) in IDH-wildtype GBM after maximal safe surgical resection using magnetic resonance imaging. A total of 582 patients were retrospectively enrolled, comprising 301 in the training cohort, 128 in the internal validation cohort, and 153 in the external validation cohort. Volumes of interest (VOIs) from contrast-enhanced T1-weighted imaging (CE-T1WI) were segmented into three regions: contrast-enhancing tumor, necrotic non-enhancing core, and peritumoral edema using an ResNet-based segmentation network. A total of 4,227 radiomic features were extracted and filtered using LASSO-Cox regression to identify signatures. The prognostic model was constructed using the Mime prediction framework, categorizing patients into high- and low-risk groups based on the median OS. Model performance was assessed using the concordance index (CI) and Kaplan-Meier survival analysis. Independent prognostic factors were identified through multivariable Cox regression analysis, and a nomogram was developed for individualized risk assessment. The Step Cox [backward] + RSF model achieved CIs of 0.89, 0.81, and 0.76 in the training, internal and external validation cohorts. Log-rank tests demonstrated significant survival differences between high- and low-risk groups across all cohorts (P < 0.05). Multivariate Cox analysis identified age (HR: 1.022; 95% CI: 0.979, 1.009, P < 0.05), KPS score (HR: 0.970, 95% CI: 0.960, 0.978, P < 0.05), rad-scores of the necrotic non-enhancing core (HR: 8.164; 95% CI: 2.439, 27.331, P < 0.05), and peritumoral edema (HR: 3.748; 95% CI: 1.212, 11.594, P < 0.05) as independent predictors of OS. A nomogram integrating these predictors provided individualized risk assessment. This deep learning segmentation-based radiomics model demonstrated robust performance in predicting OS in GBM after maximal safe surgical resection. By incorporating radiomic signatures and advanced machine learning algorithms, it offers a non-invasive tool for personalized prognostic assessment and supports clinical decision-making.

Deep learning methods provide enormous promise in automating manually intense tasks such as medical image segmentation and provide workflow assistance to clinical experts. Deep neural networks (DNN) require a significant amount of training examples and a variety of expert opinions to capture the nuances and the context, a challenging proposition in oncological studies (H. Wang et al., Nature, vol. 620, no. 7972, pp. 47-60, Aug 2023). Inter-reader variability among clinical experts is a real-world problem that severely impacts the generalization of DNN reproducibility. This study proposes quantifying the variability in DNN performance using expert opinions and exploring strategies to train the network and adapt between expert opinions. We address the inter-reader variability problem in the context of prostate gland segmentation using a well-studied DNN, the 3D U-Net model. Reference data includes magnetic resonance imaging (MRI, T2-weighted) with prostate glandular anatomy annotations from two expert readers (R#1, n = 342 and R#2, n = 204). 3D U-Net was trained and tested with individual expert examples (R#1 and R#2) and had an average Dice coefficient of 0.825 (CI, [0.81 0.84]) and 0.85 (CI, [0.82 0.88]), respectively. Combined training with a representative cohort proportion (R#1, n = 100 and R#2, n = 150) yielded enhanced model reproducibility across readers, achieving an average test Dice coefficient of 0.863 (CI, [0.85 0.87]) for R#1 and 0.869 (CI, [0.87 0.88]) for R#2. We re-evaluated the model performance across the gland volumes (large, small) and found improved performance for large gland size with an average Dice coefficient to be at 0.846 [CI, 0.82 0.87] and 0.872 [CI, 0.86 0.89] for R#1 and R#2, respectively, estimated using fivefold cross-validation. Performance for small gland sizes diminished with average Dice of 0.8 [0.79, 0.82] and 0.8 [0.79, 0.83] for R#1 and R#2, respectively.

Tuberous breast deformity (TBD) is a congenital condition characterized by constriction of the breast base, parenchymal hypoplasia, and areolar herniation. The absence of a universally accepted classification system complicates diagnosis and surgical planning, leading to variability in clinical outcomes. Artificial intelligence (AI) has emerged as a powerful adjunct in medical imaging, enabling objective, reproducible, and data-driven diagnostic assessments. This study introduces an AI-driven diagnostic tool for tuberous breast deformity (TBD) classification using a Siamese Network trained on paired frontal and lateral images. Additionally, the model generates a continuous Tuberosity Score (ranging from 0 to 1) based on embedding vector distances, offering an objective measure to enhance surgical planning and improved clinical outcomes. A dataset of 200 expertly classified frontal and lateral breast images (100 tuberous, 100 non-tuberous) was used to train a Siamese Network with contrastive loss. The model extracted high-dimensional feature embeddings to differentiate tuberous from non-tuberous breasts. Five-fold cross-validation ensured robust performance evaluation. Performance metrics included accuracy, precision, recall, and F1-score. Visualization techniques, such as t-SNE clustering and occlusion sensitivity mapping, were employed to interpret model decisions. The model achieved an average accuracy of 96.2% ± 5.5%, with balanced precision and recall. The Tuberosity Score, derived from the Euclidean distance between embeddings, provided a continuous measure of deformity severity, correlating well with clinical assessments. This AI-based framework offers an objective, high-accuracy classification system for TBD. The Tuberosity Score enhances diagnostic precision, potentially aiding in surgical planning and improving patient outcomes.

Cone-Beam Computed Tomography (CBCT) is essential in medical imaging, and the Feldkamp-Davis-Kress (FDK) algorithm is a popular choice for reconstruction due to its efficiency. However, FDK is susceptible to noise and artifacts. While recent deep learning methods offer improved image quality, they often increase computational complexity and lack the interpretability of traditional methods. In this paper, we introduce an enhanced FDK-based neural network that maintains the classical algorithm's interpretability by selectively integrating trainable elements into the cosine weighting and filtering stages. Recognizing the challenge of a large parameter space inherent in 3D CBCT data, we leverage wavelet transformations to create sparse representations of the cosine weights and filters. This strategic sparsification reduces the parameter count by $93.75\%$ without compromising performance, accelerates convergence, and importantly, maintains the inference computational cost equivalent to the classical FDK algorithm. Our method not only ensures volumetric consistency and boosts robustness to noise, but is also designed for straightforward integration into existing CT reconstruction pipelines. This presents a pragmatic enhancement that can benefit clinical applications, particularly in environments with computational limitations.

This study aims to develop and validate a novel radiomics model utilizing magnetic resonance imaging (MRI) to predict progression-free survival (PFS) in patients with unresectable hepatocellular carcinoma (uHCC) who are receiving a combination of immune checkpoint inhibitors (ICIs) and antiangiogenic agents. This is an area that has not been previously explored using MRI-based radiomics. 111 patients with uHCC were enrolled in this study. After performing univariate cox regression and the least absolute shrinkage and selection operator (LASSO) algorithms to extract radiological features, the Rad-score was calculated through a Cox proportional hazards regression model and a random survival forest (RSF) model. The optimal calculation method was selected by comparing the Harrell's concordance index (C-index) values. The Rad-score was then combined with independent clinical risk factors to create a nomogram. C-index, time-dependent receiver operating characteristics (ROC) curves, calibration curves, and decision curve analysis were employed to assess the forecast ability of the risk models. The combined nomogram incorporated independent clinical factors and Rad-score calculated by RSF demonstrated better prognosis prediction for PFS, with C-index of 0.846, 0.845, separately in the training and the validation cohorts. This indicates that our model performs well and has the potential to enable more precise patient stratification and personalized treatment strategies. Based on the risk level, the participants were classified into two distinct groups: the high-risk signature (HRS) group and the low-risk signature (LRS) group, with a significant difference between the groups (P < 0.01). The effective clinical-radiomics nomogram based on MRI imaging is a promising tool in predicting the prognosis in uHCC patients receiving ICIs combined with anti-angiogenic agents, potentially leading to more effective clinical outcomes.