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Luo X, Wang B, Shi Q, Wang Z, Lai H, Liu H, Qin Y, Chen F, Song X, Ge L, Zhang L, Bian Z, Chen Y

pubmed logopapersJul 18 2025
This study aimed to systematically map the development methods, scope, and limitations of existing artificial intelligence (AI) reporting guidelines in medicine and to explore their applicability to generative AI (GAI) tools, such as large language models (LLMs). We reported a scoping review adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Five information sources were searched, including MEDLINE (via PubMed), EQUATOR Network, CNKI, FAIRsharing, and Google Scholar, from inception to December 31, 2024. Two reviewers independently screened records and extracted data using a predefined Excel template. Data included guideline characteristics (e.g., development methods, target audience, AI domain), adherence to EQUATOR Network recommendations, and consensus methodologies. Discrepancies were resolved by a third reviewer. 68 AI reporting guidelines were included. 48.5% focused on general AI, while only 7.4% addressed GAI/LLMs. Methodological rigor was limited: 39.7% described development processes, 42.6% involved multidisciplinary experts, and 33.8% followed EQUATOR recommendations. Significant overlap existed, particularly in medical imaging (20.6% of guidelines). GAI-specific guidelines (14.7%) lacked comprehensive coverage and methodological transparency. Existing AI reporting guidelines in medicine have suboptimal methodological rigor, redundancy, and insufficient coverage of GAI applications. Future and updated guidelines should prioritize standardized development processes, multidisciplinary collaboration, and expanded focus on emerging AI technologies like LLMs.

Praneeth Namburi, Roger Pallarès-López, Jessica Rosendorf, Duarte Folgado, Brian W. Anthony

arxiv logopreprintJul 18 2025
Ultrasound technology enables safe, non-invasive imaging of dynamic tissue behavior, making it a valuable tool in medicine, biomechanics, and sports science. However, accurately tracking tissue motion in B-mode ultrasound remains challenging due to speckle noise, low edge contrast, and out-of-plane movement. These challenges complicate the task of tracking anatomical landmarks over time, which is essential for quantifying tissue dynamics in many clinical and research applications. This manuscript introduces DUSTrack (Deep learning and optical flow-based toolkit for UltraSound Tracking), a semi-automated framework for tracking arbitrary points in B-mode ultrasound videos. We combine deep learning with optical flow to deliver high-quality and robust tracking across diverse anatomical structures and motion patterns. The toolkit includes a graphical user interface that streamlines the generation of high-quality training data and supports iterative model refinement. It also implements a novel optical-flow-based filtering technique that reduces high-frequency frame-to-frame noise while preserving rapid tissue motion. DUSTrack demonstrates superior accuracy compared to contemporary zero-shot point trackers and performs on par with specialized methods, establishing its potential as a general and foundational tool for clinical and biomechanical research. We demonstrate DUSTrack's versatility through three use cases: cardiac wall motion tracking in echocardiograms, muscle deformation analysis during reaching tasks, and fascicle tracking during ankle plantarflexion. As an open-source solution, DUSTrack offers a powerful, flexible framework for point tracking to quantify tissue motion from ultrasound videos. DUSTrack is available at https://github.com/praneethnamburi/DUSTrack.

Shravan Venkatraman, Pavan Kumar S, Rakesh Raj Madavan, Chandrakala S

arxiv logopreprintJul 18 2025
Accurate classification of computed tomography (CT) images is essential for diagnosis and treatment planning, but existing methods often struggle with the subtle and spatially diverse nature of pathological features. Current approaches typically process images uniformly, limiting their ability to detect localized abnormalities that require focused analysis. We introduce UGPL, an uncertainty-guided progressive learning framework that performs a global-to-local analysis by first identifying regions of diagnostic ambiguity and then conducting detailed examination of these critical areas. Our approach employs evidential deep learning to quantify predictive uncertainty, guiding the extraction of informative patches through a non-maximum suppression mechanism that maintains spatial diversity. This progressive refinement strategy, combined with an adaptive fusion mechanism, enables UGPL to integrate both contextual information and fine-grained details. Experiments across three CT datasets demonstrate that UGPL consistently outperforms state-of-the-art methods, achieving improvements of 3.29%, 2.46%, and 8.08% in accuracy for kidney abnormality, lung cancer, and COVID-19 detection, respectively. Our analysis shows that the uncertainty-guided component provides substantial benefits, with performance dramatically increasing when the full progressive learning pipeline is implemented. Our code is available at: https://github.com/shravan-18/UGPL

Šimon Kubov, Simon Klíčník, Jakub Dandár, Zdeněk Straka, Karolína Kvaková, Daniel Kvak

arxiv logopreprintJul 18 2025
Scoliosis affects roughly 2 to 4 percent of adolescents, and treatment decisions depend on precise Cobb angle measurement. Manual assessment is time consuming and subject to inter observer variation. We conducted a retrospective, multi centre evaluation of a fully automated deep learning software (Carebot AI Bones, Spine Measurement functionality; Carebot s.r.o.) on 103 standing anteroposterior whole spine radiographs collected from ten hospitals. Two musculoskeletal radiologists independently measured each study and served as reference readers. Agreement between the AI and each radiologist was assessed with Bland Altman analysis, mean absolute error (MAE), root mean squared error (RMSE), Pearson correlation coefficient, and Cohen kappa for four grade severity classification. Against Radiologist 1 the AI achieved an MAE of 3.89 degrees (RMSE 4.77 degrees) with a bias of 0.70 degrees and limits of agreement from minus 8.59 to plus 9.99 degrees. Against Radiologist 2 the AI achieved an MAE of 3.90 degrees (RMSE 5.68 degrees) with a bias of 2.14 degrees and limits from minus 8.23 to plus 12.50 degrees. Pearson correlations were r equals 0.906 and r equals 0.880 (inter reader r equals 0.928), while Cohen kappa for severity grading reached 0.51 and 0.64 (inter reader kappa 0.59). These results demonstrate that the proposed software reproduces expert level Cobb angle measurements and categorical grading across multiple centres, suggesting its utility for streamlining scoliosis reporting and triage in clinical workflows.

Ningyong Wu, Jinzhi Wang, Wenhong Zhao, Chenzhan Yu, Zhigang Xiu, Duwei Dai

arxiv logopreprintJul 18 2025
The growing volume of medical imaging data has increased the need for automated diagnostic tools, especially for musculoskeletal injuries like rib fractures, commonly detected via CT scans. Manual interpretation is time-consuming and error-prone. We propose OrthoInsight, a multi-modal deep learning framework for rib fracture diagnosis and report generation. It integrates a YOLOv9 model for fracture detection, a medical knowledge graph for retrieving clinical context, and a fine-tuned LLaVA language model for generating diagnostic reports. OrthoInsight combines visual features from CT images with expert textual data to deliver clinically useful outputs. Evaluated on 28,675 annotated CT images and expert reports, it achieves high performance across Diagnostic Accuracy, Content Completeness, Logical Coherence, and Clinical Guidance Value, with an average score of 4.28, outperforming models like GPT-4 and Claude-3. This study demonstrates the potential of multi-modal learning in transforming medical image analysis and providing effective support for radiologists.

Yutao Jin, Haowen Xiao, Jielei Chu, Fengmao Lv, Yuxiao Li, Tianrui Li

arxiv logopreprintJul 18 2025
Mild Cognitive Impairment (MCI) serves as a prodromal stage of Alzheimer's Disease (AD), where early identification and intervention can effectively slow the progression to dementia. However, diagnosing AD remains a significant challenge in neurology due to the confounders caused mainly by the selection bias of multimodal data and the complex relationships between variables. To address these issues, we propose a novel visual-language causal intervention framework named Alzheimer's Disease Prediction with Cross-modal Causal Intervention (ADPC) for diagnostic assistance. Our ADPC employs large language model (LLM) to summarize clinical data under strict templates, maintaining structured text outputs even with incomplete or unevenly distributed datasets. The ADPC model utilizes Magnetic Resonance Imaging (MRI), functional MRI (fMRI) images and textual data generated by LLM to classify participants into Cognitively Normal (CN), MCI, and AD categories. Because of the presence of confounders, such as neuroimaging artifacts and age-related biomarkers, non-causal models are likely to capture spurious input-output correlations, generating less reliable results. Our framework implicitly eliminates confounders through causal intervention. Experimental results demonstrate the outstanding performance of our method in distinguishing CN/MCI/AD cases, achieving state-of-the-art (SOTA) metrics across most evaluation metrics. The study showcases the potential of integrating causal reasoning with multi-modal learning for neurological disease diagnosis.

Lei Xu, Torkel B Brismar

arxiv logopreprintJul 18 2025
We have developed a novel CT image analysis package named AnatomyArchive, built on top of the recent full body segmentation model TotalSegmentator. It provides automatic target volume selection and deselection capabilities according to user-configured anatomies for volumetric upper- and lower-bounds. It has a knowledge graph-based and time efficient tool for anatomy segmentation mask management and medical image database maintenance. AnatomyArchive enables automatic body volume cropping, as well as automatic arm-detection and exclusion, for more precise body composition analysis in both 2D and 3D formats. It provides robust voxel-based radiomic feature extraction, feature visualization, and an integrated toolchain for statistical tests and analysis. A python-based GPU-accelerated nearly photo-realistic segmentation-integrated composite cinematic rendering is also included. We present here its software architecture design, illustrate its workflow and working principle of algorithms as well provide a few examples on how the software can be used to assist development of modern machine learning models. Open-source codes will be released at https://github.com/lxu-medai/AnatomyArchive for only research and educational purposes.

Maximilian Rokuss, Benjamin Hamm, Yannick Kirchhoff, Klaus Maier-Hein

arxiv logopreprintJul 18 2025
We introduce the first publicly available breast MRI dataset with explicit left and right breast segmentation labels, encompassing more than 13,000 annotated cases. Alongside this dataset, we provide a robust deep-learning model trained for left-right breast segmentation. This work addresses a critical gap in breast MRI analysis and offers a valuable resource for the development of advanced tools in women's health. The dataset and trained model are publicly available at: www.github.com/MIC-DKFZ/BreastDivider

Kyriakos Flouris, Moritz Halter, Yolanne Y. R. Lee, Samuel Castonguay, Luuk Jacobs, Pietro Dirix, Jonathan Nestmann, Sebastian Kozerke, Ender Konukoglu

arxiv logopreprintJul 18 2025
Hemodynamic analysis is essential for predicting aneurysm rupture and guiding treatment. While magnetic resonance flow imaging enables time-resolved volumetric blood velocity measurements, its low spatiotemporal resolution and signal-to-noise ratio limit its diagnostic utility. To address this, we propose the Localized Fourier Neural Operator (LoFNO), a novel 3D architecture that enhances both spatial and temporal resolution with the ability to predict wall shear stress (WSS) directly from clinical imaging data. LoFNO integrates Laplacian eigenvectors as geometric priors for improved structural awareness on irregular, unseen geometries and employs an Enhanced Deep Super-Resolution Network (EDSR) layer for robust upsampling. By combining geometric priors with neural operator frameworks, LoFNO de-noises and spatiotemporally upsamples flow data, achieving superior velocity and WSS predictions compared to interpolation and alternative deep learning methods, enabling more precise cerebrovascular diagnostics.

Malo Gicquel, Ruoyi Zhao, Anika Wuestefeld, Nicola Spotorno, Olof Strandberg, Kalle Åström, Yu Xiao, Laura EM Wisse, Danielle van Westen, Rik Ossenkoppele, Niklas Mattsson-Carlgren, David Berron, Oskar Hansson, Gabrielle Flood, Jacob Vogel

arxiv logopreprintJul 18 2025
Ultra-high resolution 7 tesla (7T) magnetic resonance imaging (MRI) provides detailed anatomical views, offering better signal-to-noise ratio, resolution and tissue contrast than 3T MRI, though at the cost of accessibility. We present an advanced deep learning model for synthesizing 7T brain MRI from 3T brain MRI. Paired 7T and 3T T1-weighted images were acquired from 172 participants (124 cognitively unimpaired, 48 impaired) from the Swedish BioFINDER-2 study. To synthesize 7T MRI from 3T images, we trained two models: a specialized U-Net, and a U-Net integrated with a generative adversarial network (GAN U-Net). Our models outperformed two additional state-of-the-art 3T-to-7T models in image-based evaluation metrics. Four blinded MRI professionals judged our synthetic 7T images as comparable in detail to real 7T images, and superior in subjective visual quality to 7T images, apparently due to the reduction of artifacts. Importantly, automated segmentations of the amygdalae of synthetic GAN U-Net 7T images were more similar to manually segmented amygdalae (n=20), than automated segmentations from the 3T images that were used to synthesize the 7T images. Finally, synthetic 7T images showed similar performance to real 3T images in downstream prediction of cognitive status using MRI derivatives (n=3,168). In all, we show that synthetic T1-weighted brain images approaching 7T quality can be generated from 3T images, which may improve image quality and segmentation, without compromising performance in downstream tasks. Future directions, possible clinical use cases, and limitations are discussed.
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