BackgroundHigher-resolution magnetic resonance imaging sequences are needed for the early detection of pancreatic cancer.PurposeTo compare the quality of our novel T2-weighted, high-contrast, thin-slice imaging sequence, with an improved spatial resolution and deep learning-based reconstruction (three-shot turbo spin-echo with deep learning-based reconstruction [3S-TSE-DLR]), for imaging the pancreas with imaging using three conventional sequences (half-Fourier acquisition single-shot turbo spin-echo [HASTE], fat-suppressed 3D T1-weighted [FS-3D-T1W] imaging, and magnetic resonance cholangiopancreatography [MRCP]).Material and MethodsPancreatic images of 50 healthy volunteers acquired with 3S-TSE-DLR, HASTE, FS-3D-T1W imaging, and MRCP were compared by two diagnostic radiologists. A 5-point scale was used for assessing motion artifacts, pancreatic margin sharpness, and the ability to identify the main pancreatic duct (MPD) on 3S-TSE-DLR, HASTE, and FS-3D-T1W imaging, respectively. The ability to identify MPD via MRCP was also evaluated.ResultsArtifact scores (the higher the score, the fewer the artifacts) were significantly higher for 3S-TSE-DLR than for HASTE, and significantly lower for 3S-TSE-DLR than for FS-3D-T1W imaging, for both radiologists. Sharpness scores were significantly higher for 3S-TSE-DLR than for HASTE and FS-3D-T1W imaging, for both radiologists. The rate of identification of MPD was significantly higher for 3S-TSE-DLR than for FS-3D-T1W imaging, for both radiologists, and significantly higher for 3S-TSE-DLR than for HASTE for one radiologist. The rate of identification of MPD was not significantly different between 3S-TSE-DLR and MRCP.Conclusion3S-TSE-DLR provides better image sharpness than conventional sequences, can identify MPD equally as well or better than HASTE, and shows identification performance comparable to that of MRCP.

Medical image segmentation is vital for accurate diagnosis. While U-Net-based models are effective, they struggle to capture long-range dependencies in complex anatomy. We propose GH-UNet, a Group-wise Hybrid Convolution-ViT model within the U-Net framework, to address this limitation. GH-UNet integrates a hybrid convolution-Transformer encoder for both local detail and global context modeling, a Group-wise Dynamic Gating (GDG) module for adaptive feature weighting, and a cascaded decoder for multi-scale integration. Both the encoder and GDG are modular, enabling compatibility with various CNN or ViT backbones. Extensive experiments on five public and one private dataset show GH-UNet consistently achieves superior performance. On ISIC2016, it surpasses H2Former with 1.37% and 1.94% gains in DICE and IOU, respectively, using only 38% of the parameters and 49.61% of the FLOPs. The code is freely accessible via: https://github.com/xiachashuanghua/GH-UNet .

To investigate the value of multi-model based on preoperative CT scans in predicting EGFR/TP53 co-mutation status. We retrospectively included 2171 patients with non-small cell lung cancer (NSCLC) with pre-treatment computed tomography (CT) scans and predicting epidermal growth factor receptor (EGFR) gene sequencing from West China Hospital between January 2013 and April 2024. The deep-learning model was built for predicting EGFR / tumor protein 53 (TP53) co-occurrence status. The model performance was evaluated by area under the curve (AUC) and Kaplan-Meier analysis. We further compared multi-dimension model with three one-dimension models separately, and we explored the value of combining clinical factors with machine-learning factors. Additionally, we investigated 546 patients with 56-panel next-generation sequencing and low-dose computed tomography (LDCT) to explore the biological mechanisms of radiomics. In our cohort of 2171 patients (1,153 males, 1,018 females; median age 60 years), single-dimensional models were developed using data from 1,055 eligible patients. The multi-dimensional model utilizing a Random Forest classifier achieved superior performance, yielding the highest AUC of 0.843 for predicting EGFR/TP53 co-mutations in the test set. The multi-dimensional model demonstrates promising potential for non-invasive prediction of EGFR and TP53 co-mutations, facilitating early and informed clinical decision-making in NSCLC patients at risk of treatment resistance.

Quantifying diagnostic image quality (IQ) is not straightforward but essential for optimizing the balance between IQ and radiation dose, and for ensuring consistent high-quality images in CT imaging. This review provides a comprehensive overview of advanced objective reference-free IQ assessment methods for CT scans, beyond standard approaches. A literature search was performed in PubMed and Web of Science up to June 2024 to identify studies using advanced objective image quality methods on clinical CT scans. Only reference-free methods, which do not require a predefined reference image, were included. Traditional methods relying on the standard deviation of the Hounsfield units, the signal-to-noise ratio or contrast-to-noise ratio, all within a manually selected region-of-interest, were excluded. Eligible results were categorized by IQ metric (i.e., noise, contrast, spatial resolution and other) and assessment method (manual, automated, and artificial intelligence (AI)-based). Thirty-five studies were included that proposed or employed reference-free IQ methods, identifying 12 noise assessment methods, 4 contrast assessment methods, 14 spatial resolution assessment methods and 7 others, based on manual, automated or AI-based approaches. This review emphasizes the transition from manual to fully automated approaches for IQ assessment, including the potential of AI-based methods, and it provides a reference tool for researchers and radiologists who need to make a well-considered choice in how to evaluate IQ in CT imaging. This review examines the challenge of quantifying diagnostic CT image quality, essential for optimization studies and ensuring consistent high-quality images, by providing an overview of objective reference-free diagnostic image quality assessment methods beyond standard methods. Quantifying diagnostic CT image quality remains a key challenge. This review summarizes objective diagnostic image quality assessment techniques beyond standard metrics. A decision tree is provided to help select optimal image quality assessment techniques.

As increased nuchal translucency (NT) thickness is notably associated with fetal chromosomal abnormalities, structural defects, and genetic syndromes, accurate measurement of NT thickness is crucial for the screening of fetal abnormalities during the first trimester. We aimed to develop a model for quality assessment of ultrasound images for precise measurement of fetal NT thickness. We collected 2140 ultrasound images of midsagittal sections of the fetal face between 11 and 14 weeks of gestation. Several image segmentation models were trained, and the one exhibiting the highest DSC and HD 95 was chosen to automatically segment the ROI. The radiomics features and deep transfer learning (DTL) features were extracted and selected to construct radiomics and DTL models. Feature screening was conducted using the <i>t</i>-test, Mann-Whitney <i>U</i>-test, Spearman’s rank correlation analysis, and LASSO. We also developed early fusion and late fusion models to integrate the advantages of radiomics and DTL models. The optimal model was compared with junior radiologists. We used SHapley Additive exPlanations (SHAP) to investigate the model’s interpretability. The DeepLabV3 ResNet achieved the best segmentation performance (DSC: 98.07 ± 0.02%, HD 95: 0.75 ± 0.15 mm). The feature fusion model demonstrated the optimal performance (AUC: 0.978, 95% CI: 0.965–0.990, accuracy: 93.2%, sensitivity: 93.1%, specificity: 93.4%, PPV: 93.5%, NPV: 93.0%, precision: 93.5%). This model exhibited more reliable performance compared to junior radiologists and significantly improved the capabilities of junior radiologists. The SHAP summary plot showed DTL features were the most important features for feature fusion model. The proposed models innovatively bridge the gaps in previous studies, achieving intelligent quality assessment of ultrasound images for NT measurement and highly accurate automatic segmentation of ROIs. These models are potential tools to enhance quality control for fetal ultrasound examinations, streamline clinical workflows, and improve the professional skills of less-experienced radiologists. The online version contains supplementary material available at 10.1186/s12884-025-07863-y.

Compressive imaging (CI) reconstruction, such as snapshot compressive imaging (SCI) and compressive sensing magnetic resonance imaging (MRI), aims to recover high-dimensional images from low-dimensional compressed measurements. This process critically relies on learning an accurate representation of the underlying high-dimensional image. However, existing unsupervised representations may struggle to achieve a desired balance between representation ability and efficiency. To overcome this limitation, we propose Tensor Decomposed multi-resolution Grid encoding (GridTD), an unsupervised continuous representation framework for CI reconstruction. GridTD optimizes a lightweight neural network and the input tensor decomposition model whose parameters are learned via multi-resolution hash grid encoding. It inherently enjoys the hierarchical modeling ability of multi-resolution grid encoding and the compactness of tensor decomposition, enabling effective and efficient reconstruction of high-dimensional images. Theoretical analyses for the algorithm's Lipschitz property, generalization error bound, and fixed-point convergence reveal the intrinsic superiority of GridTD as compared with existing continuous representation models. Extensive experiments across diverse CI tasks, including video SCI, spectral SCI, and compressive dynamic MRI reconstruction, consistently demonstrate the superiority of GridTD over existing methods, positioning GridTD as a versatile and state-of-the-art CI reconstruction method.

The rapid evolution of deepfake technology poses critical challenges to healthcare systems, particularly in safeguarding the integrity of medical imaging, electronic health records (EHR), and telemedicine platforms. As autonomous AI becomes increasingly integrated into smart healthcare, the potential misuse of deepfakes to manipulate sensitive healthcare data or impersonate medical professionals highlights the urgent need for robust and adaptive detection mechanisms. In this work, we propose DProm, a dynamic deepfake detection framework leveraging visual prompt tuning (VPT) with a pre-trained Swin Transformer. Unlike traditional static detection models, which struggle to adapt to rapidly evolving deepfake techniques, DProm fine-tunes a small set of visual prompts to efficiently adapt to new data distributions with minimal computational and storage requirements. Comprehensive experiments demonstrate that DProm achieves state-of-the-art performance in both static cross-dataset evaluations and dynamic scenarios, ensuring robust detection across diverse data distributions. By addressing the challenges of scalability, adaptability, and resource efficiency, DProm offers a transformative solution for enhancing the security and trustworthiness of autonomous AI systems in healthcare, paving the way for safer and more reliable smart healthcare applications.

When applying machine learning to medical image classification, data leakage is a critical issue. Previous methods, such as adding noise to gradients for differential privacy, work well on large datasets like MNIST and CIFAR-100, but fail on small, imbalanced medical datasets like HAM10000. This is because the imbalanced distribution causes gradients from minority classes to be clipped and lose crucial information, while majority classes dominate. This leads the model to fall into suboptimal solutions early. To address this, we propose SAD-DPSGD, which uses a linear decaying mechanism for noise and clipping thresholds. By allocating more privacy budget and using higher clipping thresholds in the initial training phases, the model avoids suboptimal solutions and enhances performance. Experiments show that SAD-DPSGD outperforms Auto-DPSGD on HAM10000, improving accuracy by 2.15% under $\epsilon = 3.0$ , $\delta = 10^{-3}$.

Manual annotation of airway regions in computed tomography images is a time-consuming and expertise-dependent task. Automatic airway segmentation is therefore a prerequisite for enabling rapid bronchoscopic navigation and the clinical deployment of bronchoscopic robotic systems. Although convolutional neural network methods have gained considerable attention in airway segmentation, the unique tree-like structure of airways poses challenges for conventional and deformable convolutions, which often fail to focus on fine airway structures, leading to missed segments and discontinuities. To address this issue, this study proposes a novel tubular feature extraction network, named TfeNet. TfeNet introduces a novel direction-aware convolution operation that first applies spatial rotation transformations to adjust the sampling positions of linear convolution kernels. The deformed kernels are then represented as line segments or polylines in 3D space. Furthermore, a tubular feature fusion module (TFFM) is designed based on asymmetric convolution and residual connection strategies, enhancing the network's focus on subtle airway structures. Extensive experiments conducted on one public dataset and two datasets used in airway segmentation challenges demonstrate that the proposed TfeNet achieves more accuracy and continuous airway structure predictions compared with existing methods. In particular, TfeNet achieves the highest overall score of 94.95% on the current largest airway segmentation dataset, Airway Tree Modeling(ATM22), and demonstrates advanced performance on the lung fibrosis dataset(AIIB23). The code is available at https://github.com/QibiaoWu/TfeNet.

We present 4KAgent, a unified agentic super-resolution generalist system designed to universally upscale any image to 4K resolution (and even higher, if applied iteratively). Our system can transform images from extremely low resolutions with severe degradations, for example, highly distorted inputs at 256x256, into crystal-clear, photorealistic 4K outputs. 4KAgent comprises three core components: (1) Profiling, a module that customizes the 4KAgent pipeline based on bespoke use cases; (2) A Perception Agent, which leverages vision-language models alongside image quality assessment experts to analyze the input image and make a tailored restoration plan; and (3) A Restoration Agent, which executes the plan, following a recursive execution-reflection paradigm, guided by a quality-driven mixture-of-expert policy to select the optimal output for each step. Additionally, 4KAgent embeds a specialized face restoration pipeline, significantly enhancing facial details in portrait and selfie photos. We rigorously evaluate our 4KAgent across 11 distinct task categories encompassing a total of 26 diverse benchmarks, setting new state-of-the-art on a broad spectrum of imaging domains. Our evaluations cover natural images, portrait photos, AI-generated content, satellite imagery, fluorescence microscopy, and medical imaging like fundoscopy, ultrasound, and X-ray, demonstrating superior performance in terms of both perceptual (e.g., NIQE, MUSIQ) and fidelity (e.g., PSNR) metrics. By establishing a novel agentic paradigm for low-level vision tasks, we aim to catalyze broader interest and innovation within vision-centric autonomous agents across diverse research communities. We will release all the code, models, and results at: https://4kagent.github.io.