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A Comprehensive Study on Medical Image Segmentation using Deep Neural Networks

Loan Dao, Ngoc Quoc Ly

arxiv logopreprintJun 4 2025
Over the past decade, Medical Image Segmentation (MIS) using Deep Neural Networks (DNNs) has achieved significant performance improvements and holds great promise for future developments. This paper presents a comprehensive study on MIS based on DNNs. Intelligent Vision Systems are often evaluated based on their output levels, such as Data, Information, Knowledge, Intelligence, and Wisdom (DIKIW),and the state-of-the-art solutions in MIS at these levels are the focus of research. Additionally, Explainable Artificial Intelligence (XAI) has become an important research direction, as it aims to uncover the "black box" nature of previous DNN architectures to meet the requirements of transparency and ethics. The study emphasizes the importance of MIS in disease diagnosis and early detection, particularly for increasing the survival rate of cancer patients through timely diagnosis. XAI and early prediction are considered two important steps in the journey from "intelligence" to "wisdom." Additionally, the paper addresses existing challenges and proposes potential solutions to enhance the efficiency of implementing DNN-based MIS.

Retrieval-Augmented Generation with Large Language Models in Radiology: From Theory to Practice.

Fink A, Rau A, Reisert M, Bamberg F, Russe MF

pubmed logopapersJun 4 2025
<i>"Just Accepted" papers have undergone full peer review and have been accepted for publication in <i>Radiology: Artificial Intelligence</i>. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content.</i> Large language models (LLMs) hold substantial promise in addressing the growing workload in radiology, but recent studies also reveal limitations, such as hallucinations and opacity in sources for LLM responses. Retrieval-augmented Generation (RAG) based LLMs offer a promising approach to streamline radiology workflows by integrating reliable, verifiable, and customizable information. Ongoing refinement is critical to enable RAG models to manage large amounts of input data and to engage in complex multiagent dialogues. This report provides an overview of recent advances in LLM architecture, including few-shot and zero-shot learning, RAG integration, multistep reasoning, and agentic RAG, and identifies future research directions. Exemplary cases demonstrate the practical application of these techniques in radiology practice. ©RSNA, 2025.

Artificial intelligence in bone metastasis analysis: Current advancements, opportunities and challenges.

Afnouch M, Bougourzi F, Gaddour O, Dornaika F, Ahmed AT

pubmed logopapersJun 3 2025
Artificial Intelligence is transforming medical imaging, particularly in the analysis of bone metastases (BM), a serious complication of advanced cancers. Machine learning and deep learning techniques offer new opportunities to improve detection, recognition, and segmentation of bone metastasis. Yet, challenges such as limited data, interpretability, and clinical validation remain. Following PRISMA guidelines, we reviewed artificial intelligence methods and applications for bone metastasis analysis across major imaging modalities including CT, MRI, PET, SPECT, and bone scintigraphy. The survey includes traditional machine learning models and modern deep learning architectures such as CNNs and transformers. We also examined available datasets and their effect in developing artificial intelligence in this field. Artificial intelligence models have achieved strong performance across tasks and modalities, with Convolutional Neural Network (CNN) and Transformer architectures showing particularly efficient performance across different tasks. However, limitations persist, including data imbalance, overfitting risks, and the need for greater transparency. Clinical translation is also challenged by regulatory and validation hurdles. Artificial intelligence holds strong potential to improve BM diagnosis and streamline radiology workflows. To reach clinical maturity, future work must address data diversity, model explainability, and large-scale validation, which are critical steps for being trusted to be integrated into the oncology care routines.

Evaluating the performance and potential bias of predictive models for the detection of transthyretin cardiac amyloidosis

Hourmozdi, J., Easton, N., Benigeri, S., Thomas, J. D., Narang, A., Ouyang, D., Duffy, G., Upton, R., Hawkes, W., Akerman, A., Okwuosa, I., Kline, A., Kho, A. N., Luo, Y., Shah, S. J., Ahmad, F. S.

medrxiv logopreprintJun 2 2025
BackgroundDelays in the diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) contribute to the significant morbidity of the condition, especially in the era of disease-modifying therapies. Screening for ATTR-CM with AI and other algorithms may improve timely diagnosis, but these algorithms have not been directly compared. ObjectivesThe aim of this study was to compare the performance of four algorithms for ATTR-CM detection in a heart failure population and assess the risk for harms due to model bias. MethodsWe identified patients in an integrated health system from 2010-2022 with ATTR-CM and age- and sex-matched them to controls with heart failure to target 5% prevalence. We compared the performance of a claims-based random forest model (Huda et al. model), a regression-based score (Mayo ATTR-CM), and two deep learning echo models (EchoNet-LVH and EchoGo(R) Amyloidosis). We evaluated for bias using standard fairness metrics. ResultsThe analytical cohort included 176 confirmed cases of ATTR-CM and 3192 control patients with 79.2% self-identified as White and 9.0% as Black. The Huda et al. model performed poorly (AUC 0.49). Both deep learning echo models had a higher AUC when compared to the Mayo ATTR-CM Score (EchoNet-LVH 0.88; EchoGo Amyloidosis 0.92; Mayo ATTR-CM Score 0.79; DeLong P<0.001 for both). Bias auditing met fairness criteria for equal opportunity among patients who identified as Black. ConclusionsDeep learning, echo-based models to detect ATTR-CM demonstrated best overall discrimination when compared to two other models in external validation with low risk of harms due to racial bias.

Artificial Intelligence-Driven Innovations in Diabetes Care and Monitoring

Abdul Rahman, S., Mahadi, M., Yuliana, D., Budi Susilo, Y. K., Ariffin, A. E., Amgain, K.

medrxiv logopreprintJun 2 2025
This study explores Artificial Intelligence (AI)s transformative role in diabetes care and monitoring, focusing on innovations that optimize patient outcomes. AI, particularly machine learning and deep learning, significantly enhances early detection of complications like diabetic retinopathy and improves screening efficacy. The methodology employs a bibliometric analysis using Scopus, VOSviewer, and Publish or Perish, analyzing 235 articles from 2023-2025. Results indicate a strong interdisciplinary focus, with Computer Science and Medicine being dominant subject areas (36.9% and 12.9% respectively). Bibliographic coupling reveals robust international collaborations led by the U.S. (1558.52 link strength), UK, and China, with key influential documents by Zhu (2023c) and Annuzzi (2023). This research highlights AIs impact on enhancing monitoring, personalized treatment, and proactive care, while acknowledging challenges in data privacy and ethical deployment. Future work should bridge technological advancements with real-world implementation to create equitable and efficient diabetes care systems.

American College of Veterinary Radiology and European College of Veterinary Diagnostic Imaging position statement on artificial intelligence.

Appleby RB, Difazio M, Cassel N, Hennessey R, Basran PS

pubmed logopapersJun 1 2025
The American College of Veterinary Radiology (ACVR) and the European College of Veterinary Diagnostic Imaging (ECVDI) recognize the transformative potential of AI in veterinary diagnostic imaging and radiation oncology. This position statement outlines the guiding principles for the ethical development and integration of AI technologies to ensure patient safety and clinical effectiveness. Artificial intelligence systems must adhere to good machine learning practices, emphasizing transparency, error reporting, and the involvement of clinical experts throughout development. These tools should also include robust mechanisms for secure patient data handling and postimplementation monitoring. The position highlights the critical importance of maintaining a veterinarian in the loop, preferably a board-certified radiologist or radiation oncologist, to interpret AI outputs and safeguard diagnostic quality. Currently, no commercially available AI products for veterinary diagnostic imaging meet the required standards for transparency, validation, or safety. The ACVR and ECVDI advocate for rigorous peer-reviewed research, unbiased third-party evaluations, and interdisciplinary collaboration to establish evidence-based benchmarks for AI applications. Additionally, the statement calls for enhanced education on AI for veterinary professionals, from foundational training in curricula to continuing education for practitioners. Veterinarians are encouraged to disclose AI usage to pet owners and provide alternative diagnostic options as needed. Regulatory bodies should establish guidelines to prevent misuse and protect the profession and patients. The ACVR and ECVDI stress the need for a cautious, informed approach to AI adoption, ensuring these technologies augment, rather than compromise, veterinary care.

[Applications of artificial intelligence in cardiovascular imaging: advantages, limitations, and future challenges].

Fortuni F, Petrina SM, Nicolosi GL

pubmed logopapersJun 1 2025
Artificial intelligence (AI) is rapidly transforming cardiovascular imaging, offering innovative solutions to enhance diagnostic precision, prognostic accuracy, and therapeutic decision-making. This review explores the role of AI in cardiovascular imaging, highlighting its applications, advantages, limitations, and future challenges. The discussion is structured by imaging modalities, including echocardiography, cardiac and coronary computed tomography, cardiac magnetic resonance, and nuclear cardiology. For each modality, we examine AI's contributions across the patient care continuum: from patient selection and image acquisition to quantitative and qualitative analysis, interpretation support, prognostic stratification, therapeutic guidance, and integration with other clinical data. AI applications demonstrate significant potential to streamline workflows, improve diagnostic accuracy, and provide advanced insights for complex clinical scenarios. However, several limitations must be addressed. Many AI algorithms are developed using data from single, high-expertise centers, raising concerns about their generalizability to routine clinical practice. In some cases, these algorithms may even produce misleading results. Additionally, the "black box" nature of certain AI systems poses challenges for cardiologists, making discrepancies difficult to interpret or rectify. Importantly, AI should be seen as a complementary tool rather than a replacement for cardiologists, designed to expedite routine tasks and allow clinicians to focus on complex cases. Future challenges include fostering clinician involvement in algorithm development and extending AI implementation to peripheral healthcare centers. This approach aims to enhance accessibility, understanding, and applicability of AI in everyday clinical practice, ultimately democratizing its benefits and ensuring equitable integration into healthcare systems.

Artificial intelligence in fetal brain imaging: Advancements, challenges, and multimodal approaches for biometric and structural analysis.

Wang L, Fatemi M, Alizad A

pubmed logopapersJun 1 2025
Artificial intelligence (AI) is transforming fetal brain imaging by addressing key challenges in diagnostic accuracy, efficiency, and data integration in prenatal care. This review explores AI's application in enhancing fetal brain imaging through ultrasound (US) and magnetic resonance imaging (MRI), with a particular focus on multimodal integration to leverage their complementary strengths. By critically analyzing state-of-the-art AI methodologies, including deep learning frameworks and attention-based architectures, this study highlights significant advancements alongside persistent challenges. Notable barriers include the scarcity of diverse and high-quality datasets, computational inefficiencies, and ethical concerns surrounding data privacy and security. Special attention is given to multimodal approaches that integrate US and MRI, combining the accessibility and real-time imaging of US with the superior soft tissue contrast of MRI to improve diagnostic precision. Furthermore, this review emphasizes the transformative potential of AI in fostering clinical adoption through innovations such as real-time diagnostic tools and human-AI collaboration frameworks. By providing a comprehensive roadmap for future research and implementation, this study underscores AI's potential to redefine fetal imaging practices, enhance diagnostic accuracy, and ultimately improve perinatal care outcomes.

Driving Knowledge to Action: Building a Better Future With Artificial Intelligence-Enabled Multidisciplinary Oncology.

Loaiza-Bonilla A, Thaker N, Chung C, Parikh RB, Stapleton S, Borkowski P

pubmed logopapersJun 1 2025
Artificial intelligence (AI) is transforming multidisciplinary oncology at an unprecedented pace, redefining how clinicians detect, classify, and treat cancer. From earlier and more accurate diagnoses to personalized treatment planning, AI's impact is evident across radiology, pathology, radiation oncology, and medical oncology. By leveraging vast and diverse data-including imaging, genomic, clinical, and real-world evidence-AI algorithms can uncover complex patterns, accelerate drug discovery, and help identify optimal treatment regimens for each patient. However, realizing the full potential of AI also necessitates addressing concerns regarding data quality, algorithmic bias, explainability, privacy, and regulatory oversight-especially in low- and middle-income countries (LMICs), where disparities in cancer care are particularly pronounced. This study provides a comprehensive overview of how AI is reshaping cancer care, reviews its benefits and challenges, and outlines ethical and policy implications in line with ASCO's 2025 theme, <i>Driving Knowledge to Action.</i> We offer concrete calls to action for clinicians, researchers, industry stakeholders, and policymakers to ensure that AI-driven, patient-centric oncology is accessible, equitable, and sustainable worldwide.

Quantifying the Unknowns of Plaque Morphology: The Role of Topological Uncertainty in Coronary Artery Disease.

Singh Y, Hathaway QA, Dinakar K, Shaw LJ, Erickson B, Lopez-Jimenez F, Bhatt DL

pubmed logopapersJun 1 2025
This article aimed to explore topological uncertainty in medical imaging, particularly in assessing coronary artery calcification using artificial intelligence (AI). Topological uncertainty refers to ambiguities in spatial and structural characteristics of medical features, which can impact the interpretation of coronary plaques. The article discusses the challenges of integrating AI with topological considerations and the need for specialized methodologies beyond traditional performance metrics. It highlights advancements in quantifying topological uncertainty, including the use of persistent homology and topological data analysis techniques. The importance of standardization in methodologies and ethical considerations in AI deployment are emphasized. It also outlines various types of uncertainty in topological frameworks for coronary plaques, categorizing them as quantifiable and controllable or quantifiable and not controllable. Future directions include developing AI algorithms that incorporate topological insights, establishing standardized protocols, and exploring ethical implications to revolutionize cardiovascular care through personalized treatment plans guided by sophisticated topological analysis. Recognizing and quantifying topological uncertainty in medical imaging as AI emerges is critical. Exploring topological uncertainty in coronary artery disease will revolutionize cardiovascular care, promising enhanced precision and personalization in diagnostics and treatment for millions affected by cardiovascular diseases.
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