The lack of reliable biomarkers for the early detection and risk stratification of post-COVID-19 pulmonary fibrosis (PCPF) underscores the urgency advanced predictive tools. This study aimed to develop a machine learning-based predictive model integrating quantitative CT (qCT) radiomics and clinical features to assess the risk of lung fibrosis in COVID-19 patients. A total of 204 patients with confirmed COVID-19 pneumonia were included in the study. Of these, 93 patients were assigned to the development cohort (74 for training and 19 for internal validation), while 111 patients from three independent hospitals constituted the external validation cohort. Chest CT images were analyzed using qCT software. Clinical data and laboratory parameters were obtained from electronic health records. Least absolute shrinkage and selection operator (LASSO) regression with 5-fold cross-validation was used to select the most predictive features. Twelve machine learning algorithms were independently trained. Their performances were evaluated by receiver operating characteristic (ROC) curves, area under the curve (AUC) values, sensitivity, and specificity. Seventy-eight features were extracted and reduced to ten features for model development. These included two qCT radiomics signatures: (1) whole lung_reticulation (%) interstitial lung disease (ILD) texture analysis, (2) interstitial lung abnormality (ILA)_Num of lung zones ≥ 5%_whole lung_ILA. Among 12 machine learning algorithms evaluated, the support vector machine (SVM) model demonstrated the best predictive performance, with AUCs of 0.836 (95% CI: 0.830-0.842) in the training cohort, 0.796 (95% CI: 0.777-0.816) in the internal validation cohort, and 0.797 (95% CI: 0.691-0.873) in the external validation cohort. The integration of CT radiomics, clinical and laboratory variables using machine learning provides a robust tool for predicting pulmonary fibrosis progression in COVID-19 patients, facilitating early risk assessment and intervention.

The limited availability of bronchoscopy images makes image synthesis particularly interesting for training deep learning models. Robust image translation across different domains -- virtual bronchoscopy, phantom as well as in-vivo and ex-vivo image data -- is pivotal for clinical applications. This paper proposes BronchoGAN introducing anatomical constraints for image-to-image translation being integrated into a conditional GAN. In particular, we force bronchial orifices to match across input and output images. We further propose to use foundation model-generated depth images as intermediate representation ensuring robustness across a variety of input domains establishing models with substantially less reliance on individual training datasets. Moreover our intermediate depth image representation allows to easily construct paired image data for training. Our experiments showed that input images from different domains (e.g. virtual bronchoscopy, phantoms) can be successfully translated to images mimicking realistic human airway appearance. We demonstrated that anatomical settings (i.e. bronchial orifices) can be robustly preserved with our approach which is shown qualitatively and quantitatively by means of improved FID, SSIM and dice coefficients scores. Our anatomical constraints enabled an improvement in the Dice coefficient of up to 0.43 for synthetic images. Through foundation models for intermediate depth representations, bronchial orifice segmentation integrated as anatomical constraints into conditional GANs we are able to robustly translate images from different bronchoscopy input domains. BronchoGAN allows to incorporate public CT scan data (virtual bronchoscopy) in order to generate large-scale bronchoscopy image datasets with realistic appearance. BronchoGAN enables to bridge the gap of missing public bronchoscopy images.

We present our solution for the Multi-Source COVID-19 Detection Challenge, which classifies chest CT scans from four distinct medical centers. To address multi-source variability, we employ the Spatial-Slice Feature Learning (SSFL) framework with Kernel-Density-based Slice Sampling (KDS). Our preprocessing pipeline combines lung region extraction, quality control, and adaptive slice sampling to select eight representative slices per scan. We compare EfficientNet and Swin Transformer architectures on the validation set. The EfficientNet model achieves an F1-score of 94.68%, compared to the Swin Transformer's 93.34%. The results demonstrate the effectiveness of our KDS-based pipeline on multi-source data and highlight the importance of dataset balance in multi-institutional medical imaging evaluation.

Low-dose computed tomography (LDCT) imaging employed in lung cancer screening (LCS) programs is increasing in uptake worldwide. LCS programs herald a generational opportunity to simultaneously detect cancer and non-cancer-related early-stage lung disease. Yet these efforts are hampered by a shortage of radiologists to interpret scans at scale. Here, we present TANGERINE, a computationally frugal, open-source vision foundation model for volumetric LDCT analysis. Designed for broad accessibility and rapid adaptation, TANGERINE can be fine-tuned off the shelf for a wide range of disease-specific tasks with limited computational resources and training data. Relative to models trained from scratch, TANGERINE demonstrates fast convergence during fine-tuning, thereby requiring significantly fewer GPU hours, and displays strong label efficiency, achieving comparable or superior performance with a fraction of fine-tuning data. Pretrained using self-supervised learning on over 98,000 thoracic LDCTs, including the UK's largest LCS initiative to date and 27 public datasets, TANGERINE achieves state-of-the-art performance across 14 disease classification tasks, including lung cancer and multiple respiratory diseases, while generalising robustly across diverse clinical centres. By extending a masked autoencoder framework to 3D imaging, TANGERINE offers a scalable solution for LDCT analysis, departing from recent closed, resource-intensive models by combining architectural simplicity, public availability, and modest computational requirements. Its accessible, open-source lightweight design lays the foundation for rapid integration into next-generation medical imaging tools that could transform LCS initiatives, allowing them to pivot from a singular focus on lung cancer detection to comprehensive respiratory disease management in high-risk populations.

Accurate Lung cancer (LC) identification is a big medical problem in the AI-based healthcare systems. Various deep learning-based methods have been proposed for Lung cancer diagnosis. In this study, we proposed a Deep learning techniques-based integrated model (CNN-GRU) for Lung cancer detection. In the proposed model development Convolutional neural networks (CNNs), and gated recurrent units (GRU) models are integrated to design an intelligent model for lung cancer detection. The CNN model extracts spatial features from lung CT images through convolutional and pooling layers. The extracted features from data are embedded in the GRUs model for the final prediction of LC. The model (CNN-GRU) was validated using LC data using the holdout validation technique. Data augmentation techniques such as rotation, and brightness were used to enlarge the data set size for effective training of the model. The optimization techniques Stochastic Gradient Descent(SGD) and Adaptive Moment Estimation(ADAM) were applied during model training for model training parameters optimization. Additionally, evaluation metrics were used to test the model performance. The experimental results of the model presented that the model achieved 99.77% accuracy as compared to previous models. The (CNN-GRU) model is recommended for accurate LC detection in AI-based healthcare systems due to its improved diagnosis accuracy.

Lung cancer remains the leading cause of cancer-related mortality worldwide, necessitating accurate and efficient diagnostic tools to improve patient outcomes. Lung segmentation plays a pivotal role in the diagnostic pipeline, directly impacting the accuracy of disease detection and treatment planning. This study presents an advanced AI-driven framework, optimized through genetic algorithms, for precise lung segmentation in early cancer diagnosis. The proposed model builds upon the UNET3 + architecture and integrates multi-scale feature extraction with enhanced optimization strategies to improve segmentation accuracy while significantly reducing computational complexity. By leveraging genetic algorithms, the framework identifies optimal neural network configurations within a defined search space, ensuring high segmentation performance with minimal parameters. Extensive experiments conducted on publicly available lung segmentation datasets demonstrated superior results, achieving a dice similarity coefficient of 99.17% with only 26% of the parameters required by the baseline UNET3 + model. This substantial reduction in model size and computational cost makes the system highly suitable for resource-constrained environments, including point-of-care diagnostic devices. The proposed approach exemplifies the transformative potential of AI in medical imaging, enabling earlier and more precise lung cancer diagnosis while reducing healthcare disparities in resource-limited settings.

The use of deep learning (DL) in medical image analysis has significantly improved the ability to predict lung cancer. In this study, we introduce a novel deep convolutional neural network (CNN) model, named ResNet+, which is based on the established ResNet framework. This model is specifically designed to improve the prediction of lung cancer and diseases using the images. To address the challenge of missing feature information that occurs during the downsampling process in CNNs, we integrate the ResNet-D module, a variant designed to enhance feature extraction capabilities by modifying the downsampling layers, into the traditional ResNet model. Furthermore, a convolutional attention module was incorporated into the bottleneck layers to enhance model generalization by allowing the network to focus on relevant regions of the input images. We evaluated the proposed model using five public datasets, comprising lung cancer (LC2500 $n$=3183, IQ-OTH/NCCD $n$=1336, and LCC $n$=25000 images) and lung disease (ChestXray $n$=5856, and COVIDx-CT $n$=425024 images). To address class imbalance, we used data augmentation techniques to artificially increase the representation of underrepresented classes in the training dataset. The experimental results show that ResNet+ model demonstrated remarkable accuracy/F1, reaching 98.14/98.14\% on the LC25000 dataset and 99.25/99.13\% on the IQ-OTH/NCCD dataset. Furthermore, the ResNet+ model saved computational cost compared to the original ResNet series in predicting lung cancer images. The proposed model outperformed the baseline models on publicly available datasets, achieving better performance metrics. Our codes are publicly available at https://github.com/AIPMLab/Graduation-2024/tree/main/Peng.

Endobronchial ultrasound (EBUS) is a widely used imaging modality for evaluating thoracic lymph nodes (LNs), particularly in the staging of lung cancer. Artificial intelligence (AI)-assisted EBUS has emerged as a promising tool to enhance diagnostic accuracy. However, its effectiveness in differentiating benign from malignant thoracic LNs remains uncertain. This meta-analysis aimed to evaluate the diagnostic performance of AI-assisted EBUS compared to the pathological reference standards. A systematic search was conducted across PubMed, Embase, and Web of Science for studies assessing AI-assisted EBUS in differentiating benign and malignant thoracic LNs. The reference standard included pathological confirmation via EBUS-guided transbronchial needle aspiration, surgical resection, or other histological/cytological validation methods. Sensitivity, specificity, diagnostic likelihood ratios, and diagnostic odds ratio (OR) were pooled using a random-effects model. The area under the receiver operating characteristic curve (AUROC) was summarized to evaluate diagnostic accuracy. Subgroup analyses were conducted by study design, lymph node location, and AI model type. Twelve studies with a total of 6,090 thoracic LNs were included. AI-assisted EBUS showed a pooled sensitivity of 0.75 (95% confidence interval [CI]: 0.60-0.86, I² = 97%) and specificity of 0.88 (95% CI: 0.83-0.92, I² = 96%). The positive and negative likelihood ratios were 6.34 (95% CI: 4.41-9.08) and 0.28 (95% CI: 0.17-0.47), respectively. The pooled diagnostic OR was 22.38 (95% CI: 11.03-45.38), and the AUROC was 0.90 (95% CI: 0.88-0.93). The subgroup analysis showed higher sensitivity but lower specificity in retrospective studies compared to prospective ones (sensitivity: 0.87 vs. 0.42; specificity: 0.80 vs. 0.93; both p < 0.001). No significant differences were found by lymph node location or AI model type. AI-assisted EBUS shows promise in differentiating benign from malignant thoracic LNs, particularly those with high specificity. However, substantial heterogeneity and moderate sensitivity highlight the need for cautious interpretation and further validation. PROSPERO CRD42025637964.

This study aims to assess the feasibility of "double-low," low radiation dosage and low contrast media dosage, CT pulmonary angiography (CTPA) based on deep-learning image reconstruction (DLIR) algorithms. One hundred consecutive patients (41 females; average age 60.9 years, range 18-90) were prospectively scanned on multi-detector CT systems. Fifty patients in the conventional-dose group (CD group) underwent CTPA with 100 kV protocol using the traditional iterative reconstruction algorithm, and 50 patients in the low-dose group (LD group) underwent CTPA with a 70 kVp DLIR protocol. Radiation and contrast agent doses were recorded and compared between groups. Objective parameters were measured and compared. Two radiologists evaluated images for overall image quality, artifacts, and image contrast separately on a 5-point scale. The furthest visible branches were compared between groups. Compared to the control group, the study group reduced the dose-length product by 80.3% (p < 0.01) and the contrast media dose by 33.3%. CT values, SD values, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) showed no statistically significant differences (all p > 0.05) between the LD and CD groups. The overall image quality scores were comparable between the LD and CD groups (p > 0.05), with good in-reader agreement (k = 0.75). More peripheral pulmonary vessels could be assessed in the LD group compared with the CD group. 70 kVp combined with DLIR reconstruction for CTPA can further reduce radiation and contrast agent dose while maintaining image quality and increasing the visibility on the pulmonary artery distal branches. Question Elevated radiation exposure and substantial doses of contrast media during CT pulmonary angiography (CTPA) augment patient risks. Findings The "double-low" CT pulmonary angiography protocol can diminish radiation doses by 80.3% and minimize contrast doses by one-third while maintaining image quality. Clinical relevance With deep learning algorithms, we confirmed that CTPA images maintained excellent quality despite reduced radiation and contrast dosages, helping to reduce radiation exposure and kidney burden on patients. The "double-low" CTPA protocol, complemented by deep learning image reconstruction, prioritizes patient safety.