The aim of this study was to evaluate the performance of the YOLOv8 deep learning model for detecting zygomatic fractures. Computed tomography scans with zygomatic fractures were collected, with all slices annotated to identify fracture lines across seven categories: zygomaticomaxillary suture, zygomatic arch, zygomaticofrontal suture, sphenozygomatic suture, orbital floor, zygomatic body, and maxillary sinus wall. The images were divided into training, validation, and test datasets in a 6:2:2 ratio. Performance metrics were calculated for each category. A total of 13,988 axial and 14,107 coronal slices were retrieved. The trained algorithm achieved accuracy of 94.2-97.9%. Recall exceeded 90% across all categories, with sphenozygomatic suture fractures having the highest value (96.6%). Average precision was highest for zygomatic arch fractures (0.827) and lowest for zygomatic body fractures (0.692). The highest F1 score was 96.7% for zygomaticomaxillary suture fractures, and the lowest was 82.1% for zygomatic body fractures. Area under the curve (AUC) values were also highest for zygomaticomaxillary suture (0.943) and lowest for zygomatic body fractures (0.876). The YOLOv8 model demonstrated promising results in the automated detection of zygomatic fractures, achieving the highest performance in identifying fractures of the zygomaticomaxillary suture and zygomatic arch.

<b><i>Objective:</i></b> Cardiovascular risk stratification based on traditional risk factors lacks precision at the individual level. While coronary artery calcium (CAC) scoring enhances risk prediction by detecting calcified atherosclerotic plaques, it may underestimate risk in individuals with noncalcified plaques-a pattern common in younger type 1 diabetes (T1D) patients. Understanding the prevalence of noncalcified atherosclerosis in T1D is crucial for developing more effective screening strategies. Therefore, this study aimed to assess the burden of clinically significant atherosclerosis in T1D patients with CAC <100 using artificial intelligence (AI)-guided quantitative coronary computed tomographic angiography (AI-QCT). <b><i>Methods:</i></b> This study enrolled T1D patients aged ≥30 years with disease duration ≥10 years and no manifest or symptomatic atherosclerotic cardiovascular disease (ASCVD). CAC and carotid ultrasound were assessed in all participants. AI-QCT was performed in patients with CAC 0 and at least one plaque in the carotid arteries or those with CAC 1-99. <b><i>Results:</i></b> Among the 167 participants (mean age 52 ± 10 years; 44% women; T1D duration 29 ± 11 years), 93 (56%) had CAC = 0, 46 (28%) had CAC 1-99, 8 (5%) had CAC 100-299, and 20 (12%) had CAC ≥300. AI-QCT was performed in a subset of 52 patients. Only 11 (21%) had no evidence of coronary artery disease. Significant coronary stenosis was identified in 17% of patients, and 30 (73%) presented with at least one high-risk plaque. Compared with CAC-based risk categories, AI-QCT reclassified 58% of patients, and 21% compared with the STENO1 risk categories. There was only fair agreement between AI-QCT and CAC (κ = 0.25), and a slight agreement between AI-QCT and STENO1 risk categories (κ = 0.02). <b><i>Conclusion:</i></b> AI-QCT may reveal subclinical atherosclerotic burden and high-risk features that remain undetected by traditional risk models or CAC. These findings challenge the assumption that a low CAC score equates to a low cardiovascular risk in T1D.

Efficient and accurate preoperative assessment of the right-sided heart structural complex (RSHSc) is crucial for planning transcatheter tricuspid valve replacement (TTVR). However, current manual methods remain time-consuming and inconsistent. To address this unmet clinical need, this study aimed to develop and validate TRI-PLAN, the first fully automated, deep learning (DL)-based framework for pre-TTVR assessment. A total of 140 preprocedural computed tomography angiography (CTA) scans (63,962 slices) from patients with severe tricuspid regurgitation (TR) at two high-volume cardiac centers in China were retrospectively included. The patients were divided into a training cohort (n = 100), an internal validation cohort (n = 20), and an external validation cohort (n = 20). TRI-PLAN was developed by a dual-stage right heart assessment network (DRA-Net) to segment the RSHSc and localize the tricuspid annulus (TA), followed by automated measurement of key anatomical parameters and right ventricular ejection fraction (RVEF). Performance was comprehensively evaluated in terms of accuracy, interobserver benchmark comparison, clinical usability, and workflow efficiency. TRI-PLAN achieved expert-level segmentation accuracy (volumetric Dice 0.952/0.955; surface Dice 0.934/0.940), precise localization (standard deviation 1.18/1.14 mm), excellent measurement agreement (ICC 0.984/0.979) and reliable RVEF evaluation (R = 0.97, bias<5 %) across internal and external cohorts. In addition, TRI-PLAN obtained a direct acceptance rate of 80 % and reduced total assessment time from 30 min manually to under 2 min (>95 % time saving). TRI-PLAN provides an accurate, efficient, and clinically applicable solution for pre-TTVR assessment, with strong potential to streamline TTVR planning and enhance procedural outcomes.

This study aimed to explore whether an artificial intelligence iterative reconstruction (AIIR) algorithm combined with low-dose aortic computed tomography angiography (CTA) demonstrates clinical effectiveness in assessing preoperative access for transcatheter aortic valve implantation (TAVI). A total of 109 patients were prospectively recruited for aortic CTA scans and divided into two groups: group A (n = 51) with standard-dose CT examinations (SDCT) and group B (n = 58) with low-dose CT examinations (LDCT). Group B was further subdivided into groups B1 and B2. Groups A and B2 used the hybrid iterative algorithm (HIR: Karl 3D), whereas Group B1 used the AIIR algorithm. CT attenuation and noise of different vessel segments were measured, and the contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were calculated. Two radiologists, who were blinded to the study details, rated the subjective image quality on a 5-point scale. The effective radiation doses were also recorded for groups A and B. Group B1 demonstrated the highest CT attenuation, SNR, and CNR and the lowest image noise among the three groups (p < 0.05). The scores of subjective image noise, vessel and non-calcified plaque edge sharpness, and overall image quality in Group B1 were higher than those in groups A and B2 (p < 0.001). Group B2 had the highest artifacts scores compared with groups A and B1 (p < 0.05). The radiation dose in group B was reduced by 50.33% compared with that in group A (p < 0.001). The AIIR algorithm combined with low-dose CTA yielded better diagnostic images before TAVI than the Karl 3D algorithm.

This study aimed to develop a simple, interpretable model using routinely available data for predicting COVID-19 mortality at admission, addressing limitations of complex models, and to provide a statistically robust framework for controlled clinical use, managing model uncertainty for responsible healthcare application. Data from Belgium's first COVID-19 wave (UZ Brussel, n = 252) were used for model development. External validation utilized data from unvaccinated patients during the late second and early third waves (AZ Delta, n = 175). Various machine learning methods were trained and compared for diagnostic performance after data preprocessing and feature selection. The final model, the M3-score, incorporated three features: age, white blood cell (WBC) count, and AI-derived total lung involvement (TOTAL_AI) quantified from CT scans using Icolung software. The M3-score demonstrated strong classification performance in the training cohort (AUC 0.903) and clinically useful performance in the external validation dataset (AUC 0.826), indicating generalizability potential. To enhance clinical utility and interpretability, predicted probabilities were categorized into actionable likelihood ratio (LR) intervals: highly unlikely (LR 0.0), unlikely (LR 0.13), gray zone (LR 0.85), more likely (LR 2.14), and likely (LR 8.19) based on the training cohort. External validation suggested temporal and geographical robustness, though some variability in AUC and LR performance was observed, as anticipated in real-world settings. The parsimonious M3-score, integrating AI-based CT quantification with clinical and laboratory data, offers an interpretable tool for predicting in-hospital COVID-19 mortality, showing robust training performance. Observed performance variations in external validation underscore the need for careful interpretation and further extensive validation across international cohorts to confirm wider applicability and robustness before widespread clinical adoption.

Integration of AI and XR in TAVR is revolutionizing the management of severe aortic stenosis by enhancing diagnostic accuracy, risk stratification, and pre-procedural planning. Advanced algorithms now facilitate precise electrocardiographic, echocardiographic, and CT-based assessments that reduce observer variability and enable patient-specific risk prediction. Immersive XR technologies, including augmented, virtual, and mixed reality, improve spatial visualization of complex cardiac anatomy and support real-time procedural guidance. Despite these advancements, standardized protocols, regulatory frameworks, and ethical safeguards remain necessary for widespread clinical adoption.

The distance between the mandibular third molar (M3) and the mandibular canal (MC) is a key factor in assessing the risk of injury to the inferior alveolar nerve (IAN). However, existing deep learning systems have not yet been able to accurately quantify the M3-MC distance in 3D space. The aim of this study was to develop and validate a deep learning-based system for accurate measurement of M3-MC spatial relationships in cone-beam computed tomography (CBCT) images and to evaluate its accuracy against conventional methods. We propose an innovative approach for low-resource environments, using DeeplabV3 + for semantic segmentation of CBCT-extracted 2D images, followed by multi-category 3D reconstruction and visualization. Based on the reconstruction model, we applied the KD-Tree algorithm to measure the spatial minimum distance between M3 and MC. Through internal validation with randomly selected CBCT images, we compared the differences between the AI system, conventional measurement methods on the CBCT, and the gold standard measured by senior experts. Statistical analysis was performed using one-way ANOVA with Tukey HSD post-hoc tests (p < 0.05), employing multiple error metrics for comprehensive evaluation. One-way ANOVA revealed significant differences among measurement methods. Subsequent Tukey HSD post-hoc tests showed significant differences between the AI reconstruction model and conventional methods. The measurement accuracy of the AI system compared to the gold standard was 0.19 for mean error (ME), 0.18 for mean absolute error (MAE), 0.69 for mean square error (MSE), 0.83 for root mean square error (RMSE), and 0.96 for coefficient of determination (R²) (p < 0.01). These results indicate that the proposed AI system is highly accurate and reliable in M3-MC distance measurement and provides a powerful tool for preoperative risk assessment of M3 extraction.

Conventional approaches to material decomposition in spectral CT face challenges related to precise algorithm calibration across imaged conditions and low signal quality caused by variable object size and reduced dose. In this proof-of-principle study, a deep learning approach to multi-material decomposition was developed to quantify iodine, gadolinium, and calcium in spectral CT. A dual-phase network architecture was trained using synthetic datasets containing computational models of cylindrical and virtual patient phantoms. Classification and quantification performance was evaluated across a range of patient size and dose parameters. The model was found to accurately classify (accuracy: cylinders - 98%, virtual patients - 97%) and quantify materials (mean absolute percentage difference: cylinders - 8-10%, virtual patients - 10-15%) in both datasets. Performance in virtual patient phantoms improved as the hybrid training dataset included a larger contingent of virtual patient phantoms (accuracy: 48% with 0 virtual patients to 97% with 8 virtual patients). For both datasets, the algorithm was able to maintain strong performance under challenging conditions of large patient size and reduced dose. This study shows the validity of a deep-learning based approach to multi-material decomposition trained with in-silico images that can overcome the limitations of conventional material decomposition approaches.

Interstitial lung disease (ILD) prognostication incorporates clinical history, pulmonary function testing (PFTs), and chest CT pattern classifications. The machine learning classifier, Fibresolve, includes a model to help detect CT patterns associated with idiopathic pulmonary fibrosis (IPF). We developed and tested new Fibresolve software to predict outcomes in patients with ILD. Fibresolve uses a transformer (ViT) algorithm to analyze CT imaging that additionally embeds PFTs, age, and sex to produce an overall risk score. The model was trained to optimize risk score in a dataset of 602 subjects designed to maximize predictive performance via Cox proportional hazards. Validation was completed with the first hazard ratio assessment dataset, then tested in a second datatest set. 61 % of 220 subjects died in the validation set's study period, whereas 40 % of the 407 subjects died in the second dataset's. The validation dataset's mortality hazard ratio (HR) was 3.66 (95 % CI: 2.09-6.42) and 4.66 (CI: 2.47-8.77) for the moderate and high-risk groups. In the second dataset, Fibresolve was a predictor of mortality at initial visit, with a HR of 2.79 (1.73-4.49) and 5.82 (3.53-9.60) in the moderate and high-risk groups. Similar predictive performance was seen at follow-up visits, as well as with changes in the Fibresolve scores over sequential visits. Fibresolve predicts mortality by automatically assessing combined CT, PFTs, age, and sex into a ViT model. The new software algorithm affords accurate prognostication and demonstrates the ability to detect clinical changes over time.

Intracerebral hemorrhage (ICH) is a life-threatening condition caused by bleeding in the brain, with high mortality rates, particularly in the acute phase. Accurate diagnosis through medical image segmentation plays a crucial role in early intervention and treatment. However, existing segmentation methods, such as region-growing, clustering, and deep learning, face significant limitations when applied to complex images like ICH, especially in multi-threshold image segmentation (MTIS). As the number of thresholds increases, these methods often become computationally expensive and exhibit degraded segmentation performance. To address these challenges, this paper proposes an Elite-Adaptive-Turbulent Hiking Optimization Algorithm (EATHOA), an enhanced version of the Hiking Optimization Algorithm (HOA), specifically designed for high-dimensional and multimodal optimization problems like ICH image segmentation. EATHOA integrates three novel strategies including Elite Opposition-Based Learning (EOBL) for improving population diversity and exploration, Adaptive k-Average-Best Mutation (AKAB) for dynamically balancing exploration and exploitation, and a Turbulent Operator (TO) for escaping local optima and enhancing the convergence rate. Extensive experiments were conducted on the CEC2017 and CEC2022 benchmark functions to evaluate EATHOA's global optimization performance, where it consistently outperformed other state-of-the-art algorithms. The proposed EATHOA was then applied to solve the MTIS problem in ICH images at six different threshold levels. EATHOA achieved peak values of PSNR (34.4671), FSIM (0.9710), and SSIM (0.8816), outperforming recent methods in segmentation accuracy and computational efficiency. These results demonstrate the superior performance of EATHOA and its potential as a powerful tool for medical image analysis, offering an effective and computationally efficient solution for the complex challenges of ICH image segmentation.