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Segmentation of coronary calcifications with a domain knowledge-based lightweight 3D convolutional neural network.

Santos R, Castro R, Baeza R, Nunes F, Filipe VM, Renna F, Paredes H, Fontes-Carvalho R, Pedrosa J

pubmed logopapersAug 1 2025
Cardiovascular diseases are the leading cause of death in the world, with coronary artery disease being the most prevalent. Coronary artery calcifications are critical biomarkers for cardiovascular disease, and their quantification via non-contrast computed tomography is a widely accepted and heavily employed technique for risk assessment. Manual segmentation of these calcifications is a time-consuming task, subject to variability. State-of-the-art methods often employ convolutional neural networks for an automated approach. However, there is a lack of studies that perform these segmentations with 3D architectures that can gather important and necessary anatomical context to distinguish the different coronary arteries. This paper proposes a novel and automated approach that uses a lightweight three-dimensional convolutional neural network to perform efficient and accurate segmentations and calcium scoring. Results show that this method achieves Dice score coefficients of 0.93 ± 0.02, 0.93 ± 0.03, 0.84 ± 0.02, 0.63 ± 0.06 and 0.89 ± 0.03 for the foreground, left anterior descending artery (LAD), left circumflex artery (LCX), left main artery (LM) and right coronary artery (RCA) calcifications, respectively, outperforming other state-of-the-art architectures. An external cohort validation also showed the generalization of this method's performance and how it can be applied in different clinical scenarios. In conclusion, the proposed lightweight 3D convolutional neural network demonstrates high efficiency and accuracy, outperforming state-of-the-art methods and showcasing robust generalization potential.

A RF-based end-to-end Breast Cancer Prediction algorithm.

Win KN

pubmed logopapersAug 1 2025
Breast cancer became the primary cause of cancer-related deaths among women year by year. Early detection and accurate prediction of breast cancer play a crucial role in strengthening the quality of human life. Many scientists have concentrated on analyzing and conducting the development of many algorithms and progressing computer-aided diagnosis applications. Whereas many research have been conducted, feature research on cancer diagnosis is rare, especially regarding predicting the desired features by providing and feeding breast cancer features into the system. In this regard, this paper proposed a Breast Cancer Prediction (RF-BCP) algorithm based on Random Forest by taking inputs to predict cancer. For the experiment of the proposed algorithm, two datasets were utilized namely Breast Cancer dataset and a curated mammography dataset, and also compared the accuracy of the proposed algorithm with SVM, Gaussian NB, and KNN algorithms. Experimental results show that the proposed algorithm can predict well and outperform other existing machine learning algorithms to support decision-making.

Cerebral Amyloid Deposition With <sup>18</sup>F-Florbetapir PET Mediates Retinal Vascular Density and Cognitive Impairment in Alzheimer's Disease.

Chen Z, He HL, Qi Z, Bi S, Yang H, Chen X, Xu T, Jin ZB, Yan S, Lu J

pubmed logopapersAug 1 2025
Alzheimer's disease (AD) is accompanied by alterations in retinal vascular density (VD), but the mechanisms remain unclear. This study investigated the relationship among cerebral amyloid-β (Aβ) deposition, VD, and cognitive decline. We enrolled 92 participants, including 47 AD patients and 45 healthy control (HC) participants. VD across retinal subregions was quantified using deep learning-based fundus photography, and cerebral Aβ deposition was measured with <sup>18</sup>F-florbetapir (<sup>18</sup>F-AV45) PET/MRI. Using the minimum bounding circle of the optic disc as the diameter (papilla-diameter, PD), VD (total, 0.5-1.0 PD, 1.0-1.5 PD, 1.5-2.0 PD, 2.0-2.5 PD) was calculated. Standardized uptake value ratio (SUVR) for Aβ deposition was computed for global and regional cortical areas, using the cerebellar cortex as the reference region. Cognitive performance was assessed with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Pearson correlation, multiple linear regression, and mediation analyses were used to explore Aβ deposition, VD, and cognition. AD patients exhibited significantly lower VD in all subregions compared to HC (p < 0.05). Reduced VD correlated with higher SUVR in the global cortex and a decline in cognitive abilities (p < 0.05). Mediation analysis indicated that VD influenced MMSE and MoCA through SUVR in the global cortex, with the most pronounced effects observed in the 1.0-1.5 PD range. Retinal VD is associated with cognitive decline, a relationship primarily mediated by cerebral Aβ deposition measured via <sup>18</sup>F-AV45 PET. These findings highlight the potential of retinal VD as a biomarker for early detection in AD.

Rapid review: Growing usage of Multimodal Large Language Models in healthcare.

Gupta P, Zhang Z, Song M, Michalowski M, Hu X, Stiglic G, Topaz M

pubmed logopapersAug 1 2025
Recent advancements in large language models (LLMs) have led to multimodal LLMs (MLLMs), which integrate multiple data modalities beyond text. Although MLLMs show promise, there is a gap in the literature that empirically demonstrates their impact in healthcare. This paper summarizes the applications of MLLMs in healthcare, highlighting their potential to transform health practices. A rapid literature review was conducted in August 2024 using World Health Organization (WHO) rapid-review methodology and PRISMA standards, with searches across four databases (Scopus, Medline, PubMed and ACM Digital Library) and top-tier conferences-including NeurIPS, ICML, AAAI, MICCAI, CVPR, ACL and EMNLP. Articles on MLLMs healthcare applications were included for analysis based on inclusion and exclusion criteria. The search yielded 115 articles, 39 included in the final analysis. Of these, 77% appeared online (preprints and published) in 2024, reflecting the emergence of MLLMs. 80% of studies were from Asia and North America (mainly China and US), with Europe lagging. Studies split evenly between pre-built MLLMs evaluations (60% focused on GPT versions) and custom MLLMs/frameworks development with task-specific customizations. About 81% of studies examined MLLMs for diagnosis and reporting in radiology, pathology, and ophthalmology, with additional applications in education, surgery, and mental health. Prompting strategies, used in 80% of studies, improved performance in nearly half. However, evaluation practices were inconsistent with 67% reported accuracy. Error analysis was mostly anecdotal, with only 18% categorized failure types. Only 13% validated explainability through clinician feedback. Clinical deployment was demonstrated in just 3% of studies, and workflow integration, governance, and safety were rarely addressed. MLLMs offer substantial potential for healthcare transformation through multimodal data integration. Yet, methodological inconsistencies, limited validation, and underdeveloped deployment strategies highlight the need for standardized evaluation metrics, structured error analysis, and human-centered design to support safe, scalable, and trustworthy clinical adoption.

Optimization strategy for fat-suppressed T2-weighted images in liver imaging: The combined application of AI-assisted compressed sensing and respiratory triggering.

Feng M, Li S, Song X, Mao W, Liu Y, Yuan Z

pubmed logopapersAug 1 2025
This study aimed to optimize the imaging time and image quality of T2WI-FS through the integration of Artificial Intelligence-Assisted Compressed Sensing (ACS) and respiratory triggering (RT). A prospective cohort study was conducted on one hundred thirty-four patients (99 males, 35 females; average age: 57.93 ± 9.40 years) undergoing liver MRI between March and July 2024. All patients were scanned using both breath-hold ACS-assisted T2WI (BH-ACS-T2WI) and respiratory-triggered ACS-assisted T2WI (RT-ACS-T2WI) sequences. Two experienced radiologists retrospectively analyzed regions of interest (ROIs), recorded primary lesions, and assessed key metrics including signal intensity (SI), standard deviation (SD), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), motion artifacts, hepatic vessel clarity, liver edge sharpness, lesion conspicuity, and overall image quality. Statistical comparisons were conducted using Mann-Whitney U test, Wilcoxon signed-rank test and intraclass correlation coefficient (ICC). Compared to BH-ACS-T2WI, RT-ACS-T2WI significantly reduced average imaging time from 38 s to 22.91 ± 3.36 s, achieving a 40 % reduction in scan duration. Additionally, RT-ACS-T2WI demonstrated superior performance across multiple parameters, including SI, SD, SNR, CNR, motion artifact reduction, hepatic vessel clarity, liver edge sharpness, lesion conspicuity (≤5 mm), and overall image quality (P < 0.05). Notably, the lesion detection rate was slightly higher with RT-ACS-T2WI (94 %) compared to BH-ACS-T2WI (90 %). The RT-ACS-T2WI sequence not only enhanced image quality but also reduced imaging time to approximately 23 s, making it particularly beneficial for patients unable to perform prolonged breath-holding maneuvers. This approach represents a promising advancement in optimizing liver MRI protocols.

Evaluation of calcaneal inclusion angle in the diagnosis of pes planus with pretrained deep learning networks: An observational study.

Aktas E, Ceylan N, Yaltirik Bilgin E, Bilgin E, Ince L

pubmed logopapersAug 1 2025
Pes planus is a common postural deformity related to the medial longitudinal arch of the foot. Radiographic examinations are important for reproducibility and objectivity; the most commonly used methods are the calcaneal inclusion angle and Mery angle. However, there may be variations in radiographic measurements due to human error and inexperience. In this study, a deep learning (DL)-based solution is proposed to solve this problem. Lateral radiographs of the right and left foot of 289 patients were taken and saved. The study population is a homogeneous group in terms of age and gender, and does not provide sufficient heterogeneity to represent the general population. These radiography (X-ray) images were measured by 2 different experts and the measurements were recorded. According to these measurements, each X-ray image is labeled as pes planus or non-pes planus. These images were then filtered and resized using Gaussian blurring and median filtering methods. As a result of these processes, 2 separate data sets were created. Generally accepted DL models (AlexNet, GoogleNet, SqueezeNet) were reconstructed to classify these images. The 2-category (pes planus/no pes planus) data in the 2 preprocessed and resized datasets were classified by fine-tuning these reconstructed transfer learning networks. The GoogleNet and SqueezeNet models achieved 100% accuracy, while AlexNet achieved 92.98% accuracy. These results show that the predictions of the models and the measurements of expert radiologists overlap to a large extent. DL-based diagnostic methods can be used as a decision support system in the diagnosis of pes planus. DL algorithms enhance the consistency of the diagnostic process by reducing measurement variations between different observers. DL systems accelerate diagnosis by automatically performing angle measurements from X-ray images, which is particularly beneficial in busy clinical settings by saving time. DL models integrated with smartphone cameras can facilitate the diagnosis of pes planus and serve as a screening tool, especially in regions with limited access to healthcare.

Light Convolutional Neural Network to Detect Chronic Obstructive Pulmonary Disease (COPDxNet): A Multicenter Model Development and External Validation Study.

Rabby ASA, Chaudhary MFA, Saha P, Sthanam V, Nakhmani A, Zhang C, Barr RG, Bon J, Cooper CB, Curtis JL, Hoffman EA, Paine R, Puliyakote AK, Schroeder JD, Sieren JC, Smith BM, Woodruff PG, Reinhardt JM, Bhatt SP, Bodduluri S

pubmed logopapersAug 1 2025
Approximately 70% of adults with chronic obstructive pulmonary disease (COPD) remain undiagnosed. Opportunistic screening using chest computed tomography (CT) scans, commonly acquired in clinical practice, may be used to improve COPD detection through simple, clinically applicable deep-learning models. We developed a lightweight, convolutional neural network (COPDxNet) that utilizes minimally processed chest CT scans to detect COPD. We analyzed 13,043 inspiratory chest CT scans from the COPDGene participants, (9,675 standard-dose and 3,368 low-dose scans), which we randomly split into training (70%) and test (30%) sets at the participant level to no individual contributed to both sets. COPD was defined by postbronchodilator FEV /FVC < 0.70. We constructed a simple, four-block convolutional model that was trained on pooled data and validated on the held-out standard- and low-dose test sets. External validation was performed using standard-dose CT scans from 2,890 SPIROMICS participants and low-dose CT scans from 7,893 participants in the National Lung Screening Trial (NLST). We evaluated performance using the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, Brier scores, and calibration curves. On COPDGene standard-dose CT scans, COPDxNet achieved an AUC of 0.92 (95% CI: 0.91 to 0.93), sensitivity of 80.2%, and specificity of 89.4%. On low-dose scans, AUC was 0.88 (95% CI: 0.86 to 0.90). When the COPDxNet model was applied to external validation datasets, it showed an AUC of 0.92 (95% CI: 0.91 to 0.93) in SPIROMICS and 0.82 (95% CI: 0.81 to 0.83) on NLST. The model was well-calibrated, with Brier scores of 0.11 for standard- dose and 0.13 for low-dose CT scans in COPDGene, 0.12 in SPIROMICS, and 0.17 in NLST. COPDxNet demonstrates high discriminative accuracy and generalizability for detecting COPD on standard- and low-dose chest CT scans, supporting its potential for clinical and screening applications across diverse populations.

MR-AIV reveals <i>in vivo</i> brain-wide fluid flow with physics-informed AI.

Toscano JD, Guo Y, Wang Z, Vaezi M, Mori Y, Karniadakis GE, Boster KAS, Kelley DH

pubmed logopapersAug 1 2025
The circulation of cerebrospinal and interstitial fluid plays a vital role in clearing metabolic waste from the brain, and its disruption has been linked to neurological disorders. However, directly measuring brain-wide fluid transport-especially in the deep brain-has remained elusive. Here, we introduce magnetic resonance artificial intelligence velocimetry (MR-AIV), a framework featuring a specialized physics-informed architecture and optimization method that reconstructs three-dimensional fluid velocity fields from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). MR-AIV unveils brain-wide velocity maps while providing estimates of tissue permeability and pressure fields-quantities inaccessible to other methods. Applied to the brain, MR-AIV reveals a functional landscape of interstitial and perivascular flow, quantitatively distinguishing slow diffusion-driven transport (∼ 0.1 µm/s) from rapid advective flow (∼ 3 µm/s). This approach enables new investigations into brain clearance mechanisms and fluid dynamics in health and disease, with broad potential applications to other porous media systems, from geophysics to tissue mechanics.

Enhanced Detection, Using Deep Learning Technology, of Medial Meniscal Posterior Horn Ramp Lesions in Patients with ACL Injury.

Park HJ, Ham S, Shim E, Suh DH, Kim JG

pubmed logopapersJul 31 2025
Meniscal ramp lesions can impact knee stability, particularly when associated with anterior cruciate ligament (ACL) injuries. Although magnetic resonance imaging (MRI) is the primary diagnostic tool, its diagnostic accuracy remains suboptimal. We aimed to determine whether deep learning technology could enhance MRI-based ramp lesion detection. We reviewed the records of 236 patients who underwent arthroscopic procedures documenting ACL injuries and the status of the medial meniscal posterior horn. A deep learning model was developed using MRI data for ramp lesion detection. Ramp lesion risk factors among patients who underwent ACL reconstruction were analyzed using logistic regression, extreme gradient boosting (XGBoost), and random forest models and were integrated into a final prediction model using Swin Transformer Large architecture. The deep learning model using MRI data demonstrated superior overall diagnostic performance to the clinicians' assessment (accuracy of 73.3% compared with 68.1%, specificity of 78.0% compared with 62.9%, and sensitivity of 64.7% compared with 76.4%). Incorporating risk factors (age, posteromedial tibial bone marrow edema, and lateral meniscal tears) improved the model's accuracy to 80.7%, with a sensitivity of 81.8% and a specificity of 80.9%. Integrating deep learning with MRI data and risk factors significantly enhanced diagnostic accuracy for ramp lesions, surpassing that of the model using MRI alone and that of clinicians. This study highlights the potential of artificial intelligence to provide clinicians with more accurate diagnostic tools for detecting ramp lesions, potentially enhancing treatment and patient outcomes. Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

SAM-Med3D: A Vision Foundation Model for General-Purpose Segmentation on Volumetric Medical Images.

Wang H, Guo S, Ye J, Deng Z, Cheng J, Li T, Chen J, Su Y, Huang Z, Shen Y, zzzzFu B, Zhang S, He J

pubmed logopapersJul 31 2025
Existing volumetric medical image segmentation models are typically task-specific, excelling at specific targets but struggling to generalize across anatomical structures or modalities. This limitation restricts their broader clinical use. In this article, we introduce segment anything model (SAM)-Med3D, a vision foundation model (VFM) for general-purpose segmentation on volumetric medical images. Given only a few 3-D prompt points, SAM-Med3D can accurately segment diverse anatomical structures and lesions across various modalities. To achieve this, we gather and preprocess a large-scale 3-D medical image segmentation dataset, SA-Med3D-140K, from 70 public datasets and 8K licensed private cases from hospitals. This dataset includes 22K 3-D images and 143K corresponding masks. SAM-Med3D, a promptable segmentation model characterized by its fully learnable 3-D structure, is trained on this dataset using a two-stage procedure and exhibits impressive performance on both seen and unseen segmentation targets. We comprehensively evaluate SAM-Med3D on 16 datasets covering diverse medical scenarios, including different anatomical structures, modalities, targets, and zero-shot transferability to new/unseen tasks. The evaluation demonstrates the efficiency and efficacy of SAM-Med3D, as well as its promising application to diverse downstream tasks as a pretrained model. Our approach illustrates that substantial medical resources can be harnessed to develop a general-purpose medical AI for various potential applications. Our dataset, code, and models are available at: https://github.com/uni-medical/SAM-Med3D.
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