Advances in medical imaging and deep learning have propelled progress in whole slide image (WSI) analysis, with multiple instance learning (MIL) showing promise for efficient and accurate diagnostics. However, conventional MIL models often lack adaptability to evolving datasets, as they rely on static training that cannot incorporate new information without extensive retraining. Applying continual learning (CL) to MIL models is a possible solution, but often sees limited improvements. In this paper, we analyze CL in the context of attention MIL models and find that the model forgetting is mainly concentrated in the attention layers of the MIL model. Using the results of this analysis we propose two components for improving CL on MIL: Attention Knowledge Distillation (AKD) and the Pseudo-Bag Memory Pool (PMP). AKD mitigates catastrophic forgetting by focusing on retaining attention layer knowledge between learning sessions, while PMP reduces the memory footprint by selectively storing only the most informative patches, or ``pseudo-bags'' from WSIs. Experimental evaluations demonstrate that our method significantly improves both accuracy and memory efficiency on diverse WSI datasets, outperforming current state-of-the-art CL methods. This work provides a foundation for CL in large-scale, weakly annotated clinical datasets, paving the way for more adaptable and resilient diagnostic models.

Early identification of individuals who progress from normal cognition (NC) to mild cognitive impairment (MCI) may help prevent cognitive decline. We aimed to build predictive models using radiomic features of the bilateral hippocampus in combination with scores from neuropsychological assessments. We utilized the Alzheimer's Disease Neuroimaging Initiative (ADNI) database to study 175 NC individuals, identifying 50 who progressed to MCI within seven years. Employing the Least Absolute Shrinkage and Selection Operator (LASSO) on T1-weighted images, we extracted and refined hippocampal features. Classification models, including Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), and light gradient boosters (LightGBM), were built based on significant neuropsychological scores. Model validation was conducted using 5-fold cross-validation, and hyperparameters were optimized with Scikit-learn, using an 80:20 data split for training and testing. We found that the LightGBM model achieved an area under the receiver operating characteristic (ROC) curve (AUC) value of 0.89 and an accuracy of 0.79 in the training set, and an AUC value of 0.80 and an accuracy of 0.74 in the test set. The study identified that T1-weighted magnetic resonance imaging radiomic of the hippocampus would be used to predict the progression to MCI at the normal cognitive stage, which might provide a new insight into clinical research.

To assess the agreement between lumbar disc degeneration (DD) grading by the convolutional neural network model SpineNet and radiologist's visual grading. In a 14-year follow-up MRI study involving 19 male volunteers, lumbar DD was assessed by SpineNet and two radiologists using the Pfirrmann classification at baseline (age 37) and after 14 years (age 51). Pfirrmann summary scores (PSS) were calculated by summing individual disc grades. The agreement between the first radiologist and SpineNet was analyzed, with the second radiologist's grading used for inter-observer agreement. Significant differences were observed in the Pfirrmann grades and PSS assigned by the radiologist and SpineNet at both time points. SpineNet assigned Pfirrmann grade 1 to several discs and grade 5 to more discs compared to the radiologists. The concordance correlation coefficients (CCC) of PSS between the radiologist and SpineNet were 0.54 (95% CI: 0.28 to 0.79) at baseline and 0.54 (0.27 to 0.80) at follow-up. The average kappa (κ) values of 0.74 (0.68 to 0.81) at baseline and 0.68 (0.58 to 0.77) at follow-up. CCC of PSS between the radiologists was 0.83 (0.69 to 0.97) at baseline and 0.78 (0.61 to 0.95) at follow-up, with κ values ranging from 0.73 to 0.96. We found fair to substantial agreement in DD grading between SpineNet and the radiologist, albeit with notable discrepancies. These findings indicate that AI-based systems like SpineNet hold promise as complementary tools in radiological evaluation, including in longitudinal studies, but emphasize the need for ongoing refinement of AI algorithms.

Radiotherapy plays a critical role in treating esophageal cancer, but individual responses vary significantly, impacting patient outcomes. This study integrates machine learning-driven multimodal radiomics and transcriptomics to develop predictive models for radiotherapy sensitivity and prognosis in esophageal cancer. We applied the SEResNet101 deep learning model to imaging and transcriptomic data from the UCSC Xena and TCGA databases, identifying prognosis-associated genes such as STUB1, PEX12, and HEXIM2. Using Lasso regression and Cox analysis, we constructed a prognostic risk model that accurately stratifies patients based on survival probability. Notably, STUB1, an E3 ubiquitin ligase, enhances radiotherapy sensitivity by promoting the ubiquitination and degradation of SRC, a key oncogenic protein. In vitro and in vivo experiments confirmed that STUB1 overexpression or SRC silencing significantly improves radiotherapy response in esophageal cancer models. These findings highlight the predictive power of multimodal data integration for individualized radiotherapy planning and underscore STUB1 as a promising therapeutic target for enhancing radiotherapy efficacy in esophageal cancer.

CBCT has become an essential tool in orthodontics, although its use must remain judicious and evidence-based. This study provides an updated analysis of international recommendations concerning the use of CBCT in orthodontics, with a particular focus on clinical indications, radiation dose reduction, and recent technological advancements. A systematic review of guidelines published between 2015 and 2025 was conducted following the PRISMA methodology. Inclusion criteria comprised official directives from recognized scientific societies and clinical studies evaluating low dose protocols in orthodontics. The analysis of the 19 retained recommendations reveals a consensus regarding the primary indications for CBCT in orthodontics, particularly for impacted teeth, skeletal anomalies, periodontal and upper airways assessment. Dose optimization and the integration of artificial intelligence emerge as major advancements, enabling significant radiation reduction while preserving diagnostic accuracy. The development of low dose protocols and advanced reconstruction algorithms presents promising perspectives for safer and more efficient imaging, increasingly replacing conventional 2D radiographic techniques. However, an international harmonization of recommendations for these new imaging sequences is imperative to standardize clinical practices and enhance patient radioprotection.

Biochemical recurrence (BCR) after radical prostatectomy exhibits heterogeneous prognostic implications. Recent advancements in imaging and biomarkers have high potential for personalizing care. Prostate-specific membrane antigen imaging (PSMA)-PET/CT has revolutionized the BCR management in prostate cancer by detecting microscopic lesions earlier than conventional staging, leading to improved cancer control outcomes and changes in treatment plans in approximately two-thirds of cases. Salvage radiotherapy, often combined with androgen deprivation therapy, remains the standard treatment for high-risk BCR postprostatectomy, with PSMA-PET/CT guiding treatment adjustments, such as the radiation field, and improving progression-free survival. Advancements in biomarkers, genomic classifiers, and artificial intelligence-based models have enhanced risk stratification and personalized treatment planning, resulting in both treatment intensification and de-escalation. While conventional risk grouping relying on Gleason score and PSA level and kinetics remain the foundation for BCR management, PSMA-PET/CT, novel biomarkers, and artificial intelligence may enable more personalized treatment strategies.

This paper addresses the problem of detecting possible serious bacterial infection (pSBI) of infancy, i.e. a clinical presentation consistent with bacterial sepsis in newborn infants using cranial ultrasound (cUS) images. The captured image set for each patient enables multiview imagery: coronal and sagittal, with geometric overlap. To exploit this geometric relation, we develop a new learning framework, called the intersection-guided Crossview Local- and Image-level Fusion Network (CLIF-Net). Our technique employs two distinct convolutional neural network branches to extract features from coronal and sagittal images with newly developed multi-level fusion blocks. Specifically, we leverage the spatial position of these images to locate the intersecting region. We then identify and enhance the semantic features from this region across multiple levels using cross-attention modules, facilitating the acquisition of mutually beneficial and more representative features from both views. The final enhanced features from the two views are then integrated and projected through the image-level fusion layer, outputting pSBI and non-pSBI class probabilities. We contend that our method of exploiting multi-view cUS images enables a first of its kind, robust 3D representation tailored for pSBI detection. When evaluated on a dataset of 302 cUS scans from Mbale Regional Referral Hospital in Uganda, CLIF-Net demonstrates substantially enhanced performance, surpassing the prevailing state-of-the-art infection detection techniques.

Medical imaging constitutes critical information in the diagnostic and prognostic evaluation of patients, as it serves to uncover a broad spectrum of pathologies and deviances. Clinical practitioners who carry out medical image screening are primarily reliant on their knowledge and experience for disease diagnosis. Convolutional Neural Networks (CNNs) hold the potential to serve as a formidable decision-support tool in the realm of medical image analysis due to their high capacity to extract hierarchical features and effectuate direct classification and segmentation from image data. However, CNNs contain a myriad of hyperparameters and optimizing these hyperparameters poses a major obstacle to the effective implementation of CNNs. In this work, a two-phase Bayesian Optimization-derived Scheduling (BOS) approach is proposed for hyperparameter optimization for the head and cancerous tissue segmentation tasks. We proposed this two-phase BOS approach to incorporate both rapid convergences in the first training phase and slower (but without overfitting) improvements in the last training phase. Furthermore, we found that batch size and learning rate have a significant impact on the training process, but optimizing them separately can lead to sub-optimal hyperparameter combinations. Therefore, batch size and learning rate have been coupled as the batch size to learning rate (B2L) ratio and utilized in the optimization process to optimize both simultaneously. The optimized hyperparameters have been tested for a three-dimensional V-Net model with computed tomography (CT) and positron emission tomography (PET) scans to segment and classify cancerous and noncancerous tissues. The results of 10-fold cross-validation indicate that the optimal batch size to learning rate (B2L) ratio for each phase of the training method can improve the overall medical image segmentation performance.

Radiogenomics holds promise in identifying molecular alterations in nonsmall cell lung cancer (NSCLC) using imaging features. Previously, we developed a radiogenomics model to predict epidermal growth factor receptor (EGFR) mutations based on contrast-enhanced computed tomography (CECT) in NSCLC patients. The current study aimed to externally validate this model using a publicly available National Institutes of Health (NIH)-based NSCLC dataset and assess the effect of EGFR mutation prevalence on model performance through synthetic minority oversampling technique (SMOTE). The original radiogenomics model was validated on an independent NIH cohort (n=140). For assessing the influence of disease prevalence, six SMOTE-augmented datasets were created, simulating EGFR mutation prevalence from 25% to 50%. Seven models were developed (one from original data, six SMOTE-augmented), each undergoing rigorous cross-validation, feature selection, and logistic regression modeling. Models were tested against the NIH cohort. Performance was compared using area under the receiver operating characteristic curve (Area Under the Curve [AUC]), and differences between radiomic-only, clinical-only, and combined models were statistically assessed. External validation revealed poor diagnostic performance for both our model and a previously published EGFR radiomics model (AUC ∼0.5). The clinical model alone achieved higher diagnostic accuracy (AUC 0.74). SMOTE-augmented models showed increased sensitivity but did not improve overall AUC compared to the clinical-only model. Changing EGFR mutation prevalence had minimal impact on AUC, challenging previous assumptions about the influence of sample imbalance on model performance. External validation failed to reproduce prior radiogenomics model performance, while clinical variables alone retained strong predictive value. SMOTE-based oversampling did not improve diagnostic accuracy, suggesting that, in EGFR prediction, radiomics may offer limited value beyond clinical data. Emphasis on robust external validation and data-sharing is essential for future clinical implementation of radiogenomic models.

PCOS (Poly-Cystic Ovary Syndrome) is a multifaceted disorder that often affects the ovarian morphology of women of their reproductive age, resulting in the development of numerous cysts on the ovaries. Ultrasound imaging typically diagnoses PCOS, which helps clinicians assess the size, shape, and existence of cysts in the ovaries. Nevertheless, manual ultrasound image analysis is often challenging and time-consuming, resulting in inter-observer variability. To effectively treat PCOS and prevent its long-term effects, prompt and accurate diagnosis is crucial. In such cases, a prediction model based on deep learning can help physicians by streamlining the diagnosis procedure, reducing time and potential errors. This article proposes a novel integrated approach, QEI-SAM (Quality Enhanced Image - Segment Anything Model), for enhancing image quality and ovarian cyst segmentation for accurate prediction. GAN (Generative Adversarial Networks) and CNN (Convolutional Neural Networks) are the most recent cutting-edge innovations that have supported the system in attaining the expected result. The proposed QEI-SAM model used Enhanced Super Resolution Generative Adversarial Networks (ESRGAN) for image enhancement to increase the resolution, sharpening the edges and restoring the finer structure of the ultrasound ovary images and achieved a better SSIM of 0.938, PSNR value of 38.60 and LPIPS value of 0.0859. Then, it incorporates the Segment Anything Model (SAM) to segment ovarian cysts and achieve the highest Dice coefficient of 0.9501 and IoU score of 0.9050. Furthermore, Convolutional Neural Network - ResNet 50, ResNet 101, VGG 16, VGG 19, AlexNet and Inception v3 have been implemented to diagnose PCOS promptly. Finally, VGG 19 has achieved the highest accuracy of 99.31%.