Current lung cancer screening guidelines recommend annual low-dose computed tomography (LDCT) for high-risk individuals. However, the effectiveness of LDCT in non-high-risk individuals remains inadequately explored. With the incidence of lung cancer steadily increasing among non-high-risk individuals, this study aims to assess the risk of lung cancer in non-high-risk individuals and evaluate the potential of thin-section LDCT reconstruction combined with artificial intelligence (LDCT-TRAI) as a screening tool. A real-world cohort study on lung cancer screening was conducted at the West China Hospital of Sichuan University from January 2010 to July 2021. Participants were screened using either LDCT-TRAI or traditional thick-section LDCT without AI (traditional LDCT) . The AI system employed was the uAI-ChestCare software. Lung cancer diagnoses were confirmed through pathological examination. Among the 259 121 enrolled non-high-risk participants, 87 260 (33.7%) had positive screening results. Within 1 year, 728 (0.3%) participants were diagnosed with lung cancer, of whom 87.1% (634/728) were never-smokers, and 92.7% (675/728) presented with stage I disease. Compared with traditional LDCT, LDCT-TRAI demonstrated a higher lung cancer detection rate (0.3% vs. 0.2%, <i>P</i> < 0.001), particularly for stage I cancers (94.4% vs. 83.2%, <i>P</i> < 0.001), and was associated with improved survival outcomes (5-year overall survival rate: 95.4% vs. 81.3%, <i>P</i> < 0.0001). These findings highlight the importance of expanding lung cancer screening to non-high-risk populations, especially never-smokers. LDCT-TRAI outperformed traditional LDCT in detecting early-stage cancers and improving survival outcomes, underscoring its potential as a more effective screening tool for early lung cancer detection in this population.

Brain Tumor Segmentation (BraTS) plays a critical role in clinical diagnosis, treatment planning, and monitoring the progression of brain tumors. However, due to the variability in tumor appearance, size, and intensity across different MRI modalities, automated segmentation remains a challenging task. In this study, we propose a novel Transformer-based framework, multiPI-TransBTS, which integrates multi-physical information to enhance segmentation accuracy. The model leverages spatial information, semantic information, and multi-modal imaging data, addressing the inherent heterogeneity in brain tumor characteristics. The multiPI-TransBTS framework consists of an encoder, an Adaptive Feature Fusion (AFF) module, and a multi-source, multi-scale feature decoder. The encoder incorporates a multi-branch architecture to separately extract modality-specific features from different MRI sequences. The AFF module fuses information from multiple sources using channel-wise and element-wise attention, ensuring effective feature recalibration. The decoder combines both common and task-specific features through a Task-Specific Feature Introduction (TSFI) strategy, producing accurate segmentation outputs for Whole Tumor (WT), Tumor Core (TC), and Enhancing Tumor (ET) regions. Comprehensive evaluations on the BraTS2019 and BraTS2020 datasets demonstrate the superiority of multiPI-TransBTS over the state-of-the-art methods. The model consistently achieves better Dice coefficients, Hausdorff distances, and Sensitivity scores, highlighting its effectiveness in addressing the BraTS challenges. Our results also indicate the need for further exploration of the balance between precision and recall in the ET segmentation task. The proposed framework represents a significant advancement in BraTS, with potential implications for improving clinical outcomes for brain tumor patients.

To explore the feasibility of using a diagnostic model constructed with deep learning-radiomics (DLR) features extracted from chest computed tomography (CT) images to predict the gender-age-physiology (GAP) stage of patients with connective tissue disease-associated interstitial lung disease (CTD-ILD). The data of 264 CTD-ILD patients were retrospectively collected. GAP Stage I, II, III patients are 195, 56, 13 cases respectively. The latter two stages were combined into one group. The patients were randomized into a training set and a validation set. Single-input models were separately constructed using the selected radiomics and DL features, while DLR model was constructed from both sets of features. For all models, the support vector machine (SVM) and logistic regression (LR) algorithms were used for construction. The nomogram models were generated by integrating age, gender, and DLR features. The DLR model outperformed the radiomics and DL models in both the training set and the validation set. The predictive performance of the DLR model based on the LR algorithm was the best among all the feature-based models (AUC = 0.923). The comprehensive models had even greater performance in predicting the GAP stage of CTD-ILD patients. The comprehensive model using the SVM algorithm had the best performance of the two models (AUC = 0.951). The DLR model extracted from CT images can assist in the clinical prediction of the GAP stage of CTD-ILD patients. A nomogram showed even greater performance in predicting the GAP stage of CTD-ILD patients.

Polyps, like a silent time bomb in the gut, are always lurking and can explode into deadly colorectal cancer at any time. Many methods are attempted to maximize the early detection of colon polyps by screening, however, there are still face some challenges: (i) the scarcity of per-pixel annotation data and clinical features such as the blurred boundary and low contrast of polyps result in poor performance. (ii) existing weakly semi-supervised methods directly using pseudo-labels to supervise student tend to ignore the value brought by intermediate features in the teacher. To adapt the point-prompt teacher model to the challenging scenarios of complex medical images and limited annotation data, we creatively leverage the diverse inductive biases of CNN and Transformer to extract robust and complementary representation of polyp features (boundary and context). At the same time, a novel designed teacher-student intermediate feature distillation method is introduced rather than just using pseudo-labels to guide student learning. Comprehensive experiments demonstrate that our proposed method effectively handles scenarios with limited annotations and exhibits good segmentation performance. All code is available at https://github.com/dxqllp/WSS-Polyp.

The COVID-19 pandemic has significantly strained healthcare systems, highlighting the need for early diagnosis to isolate positive cases and prevent the spread. This study combines machine learning, deep learning, and transfer learning techniques to automatically diagnose COVID-19 and other pulmonary conditions from radiographic images. First, we used Convolutional Neural Networks (CNNs) and a Support Vector Machine (SVM) classifier on a dataset of 21,165 chest X-ray images. Our model achieved an accuracy of 86.18 %. This approach aids medical experts in rapidly and accurateky detecting lung diseases. Next, we applied transfer learning using ResNet18 combined with SVM on a dataset comprising normal, COVID-19, lung opacity, and viral pneumonia images. This model outperformed traditional methods, with classification rates of 98 % with Stochastic Gradient Descent (SGD), 97 % with Adam, 96 % with RMSProp, and 94 % with Adagrad optimizers. Additionally, we incorporated two additional transfer learning models, EfficientNet-CNN and Xception-CNN, which achieved classification accuracies of 99.20 % and 98.80 %, respectively. However, we observed limitations in dataset diversity and representativeness, which may affect model generalization. Future work will focus on implementing advanced data augmentation techniques and collaborations with medical experts to enhance model performance.This research demonstrates the potential of cutting-edge deep learning techniques to improve diagnostic accuracy and efficiency in medical imaging applications.

Research in the cross-modal medical image translation domain has been very productive over the past few years in tackling the scarce availability of large curated multi-modality datasets with the promising performance of GAN-based architectures. However, only a few of these studies assessed task-based related performance of these synthetic data, especially for the training of deep models. We design and compare different GAN-based frameworks for generating synthetic brain[18F]fluorodeoxyglucose (FDG) PET images from T1 weighted MRI data. We first perform standard qualitative and quantitative visual quality evaluation. Then, we explore further impact of using these fake PET data in the training of a deep unsupervised anomaly detection (UAD) model designed to detect subtle epilepsy lesions in T1 MRI and FDG PET images. We introduce novel diagnostic task-oriented quality metrics of the synthetic FDG PET data tailored to our unsupervised detection task, then use these fake data to train a use case UAD model combining a deep representation learning based on siamese autoencoders with a OC-SVM density support estimation model. This model is trained on normal subjects only and allows the detection of any variation from the pattern of the normal population. We compare the detection performance of models trained on 35 paired real MR T1 of normal subjects paired either on 35 true PET images or on 35 synthetic PET images generated from the best performing generative models. Performance analysis is conducted on 17 exams of epilepsy patients undergoing surgery. The best performing GAN-based models allow generating realistic fake PET images of control subject with SSIM and PSNR values around 0.9 and 23.8, respectively and in distribution (ID) with regard to the true control dataset. The best UAD model trained on these synthetic normative PET data allows reaching 74% sensitivity. Our results confirm that GAN-based models are the best suited for MR T1 to FDG PET translation, outperforming transformer or diffusion models. We also demonstrate the diagnostic value of these synthetic data for the training of UAD models and evaluation on clinical exams of epilepsy patients. Our code and the normative image dataset are available.

To assess the performance of a Deep Neural Network (DNN)-based prototype algorithm for automated PE detection on CTPA scans. Patients who had previously undergone CTPA with three different systems (SOMATOM Force, go.Top, and Definition AS; Siemens Healthineers, Forchheim, Germany) because of suspected PE from September 2022 to January 2023 were retrospectively enrolled in this study (n = 1,000, 58.8 % women). For detailed evaluation, all PE were divided into three location-based subgroups: central arteries, lobar branches, and peripheral regions. Clinical reports served as ground truth. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were determined to evaluate the performance of DNN-based PE detection. Cases were excluded due to incomplete data (n = 32), inconclusive report (n = 17), insufficient contrast detected in the pulmonary trunk (n = 40), or failure of the preprocessing algorithms (n = 8). Therefore, the final cohort included 903 cases with a PE prevalence of 12 % (n = 110). The model achieved a sensitivity, specificity, PPV, and NPV of 84.6, 95.1, 70.5, and 97.8 %, respectively, and delivered an overall accuracy of 93.8 %. Among the false positive cases (n = 39), common sources of error included lung masses, pneumonia, and contrast flow artifacts. Common sources of false negatives (n = 17) included chronic and subsegmental PEs. The proposed DNN-based algorithm provides excellent performance for the detection of PE, suggesting its potential utility to support radiologists in clinical reading and exam prioritization.

Glioblastoma (GBM), primary central nervous system lymphoma (PCNSL), and brain metastases (BM) are common malignant brain tumors with similar radiological features, while the accurate and non-invasive dialgnosis is essential for selecting appropriate treatment plans. This study develops a deep learning model, FoTNet, to improve the automatic diagnosis accuracy of these tumors, particularly for the relatively rare PCNSL tumor. The model integrates a frequency-based channel attention layer and the focal loss to address the class imbalance issue caused by the limited samples of PCNSL. A multi-center MRI dataset was constructed by collecting and integrating data from Sir Run Run Shaw Hospital, along with public datasets from UPENN and TCGA. The dataset includes T1-weighted contrast-enhanced (T1-CE) MRI images from 58 GBM, 82 PCNSL, and 269 BM cases, which were divided into training and testing sets with a 5:2 ratio. FoTNet achieved a classification accuracy of 92.5 % and an average AUC of 0.9754 on the test set, significantly outperforming existing machine learning and deep learning methods in distinguishing among GBM, PCNSL, and BM. Through multiple validations, FoTNet has proven to be an effective and robust tool for accurately classifying these brain tumors, providing strong support for preoperative diagnosis and assisting clinicians in making more informed treatment decisions.

Computer-aided diagnosis systems based on deep neural networks heavily rely on datasets with high-quality labels. However, manual annotation for lesion diagnosis relies on image features, often requiring professional experience and complex image analysis process. This inevitably introduces noisy labels, which can misguide the training of classification models. Our goal is to design an effective method to address the challenges posed by label noise in medical images. we propose a novel noise-tolerant medical image classification framework consisting of two phases: fore-training correction and progressive hard-sample enhanced learning. In the first phase, we design a dual-branch sample partition detection scheme that effectively classifies each instance into one of three subsets: clean, hard, or noisy. Simultaneously, we propose a hard-sample label refinement strategy based on class prototypes with confidence-perception weighting and an effective joint correction method for noisy samples, enabling the acquisition of higher-quality training data. In the second phase, we design a progressive hard-sample reinforcement learning method to enhance the model's ability to learn discriminative feature representations. This approach accounts for sample difficulty and mitigates the effects of label noise in medical datasets. Our framework achieves an accuracy of 82.39% on the pneumoconiosis dataset collected by our laboratory. On a five-class skin disease dataset with six different levels of label noise (0, 0.05, 0.1, 0.2, 0.3, and 0.4), the average accuracy over the last ten epochs reaches 88.51%, 86.64%, 85.02%, 83.01%, 81.95%, 77.89%, respectively; For binary polyp classification under noise rates of 0.2, 0.3, and 0.4, the average accuracy over the last ten epochs is 97.90%, 93.77%, 89.33%, respectively. The effectiveness of our proposed framework is demonstrated through its performance on three challenging datasets with both real and synthetic noise. Experimental results further demonstrate the robustness of our method across varying noise rates.

Patients with metastatic bone disease are at risk of pathological femoral fractures and may require prophylactic surgical fixation. Current clinical decision support tools often overestimate fracture risk, leading to overtreatment. While novel scores integrating femoral strength assessment via finite element (FE) models show promise, they require 3D imaging, extensive computation, and are difficult to automate. Predicting femoral strength directly from single 2D radiographic projections using convolutional neural networks (CNNs) could address these limitations, but this approach has not yet been explored for femora with metastatic lesions. This study aimed to test whether CNNs can accurately predict strength of femora with metastatic lesions from single 2D radiographic projections. CNNs with various architectures were developed and trained using an FE model generated training dataset. This training dataset was based on 36,000 modified computed tomography (CT) scans, created by randomly inserting artificial lytic lesions into the CT scans of 36 intact anatomical femoral specimens. From each modified CT scan, an anterior-posterior 2D projection was generated and femoral strength in one-legged stance was determined using nonlinear FE models. Following training, the CNN performance was evaluated on an independent experimental test dataset consisting of 31 anatomical femoral specimens (16 intact, 15 with artificial lytic lesions). 2D projections of each specimen were created from corresponding CT scans and femoral strength was assessed in mechanical tests. The CNNs' performance was evaluated using linear regression analysis and compared to 2D densitometric predictors (bone mineral density and content) and CT-based 3D FE models. All CNNs accurately predicted the experimentally measured strength in femora with and without metastatic lesions of the test dataset (R²≥0.80, CCC≥0.81). In femora with metastatic lesions, the performance of the CNNs (best: R²=0.84, CCC=0.86) was considerably superior to 2D densitometric predictors (R²≤0.07) and slightly inferior to 3D FE models (R²=0.90, CCC=0.94). CNNs, trained on a large dataset generated via FE models, predicted experimentally measured strength of femora with artificial metastatic lesions with accuracy comparable to 3D FE models. By eliminating the need for 3D imaging and reducing computational demands, this novel approach demonstrates potential for application in a clinical setting.