Many Parkinson's disease (PD) patients manifest complications related to treatment called levodopa-induced dyskinesia (LID). Preventing the onset of LID is crucial to the management of PD, but the reasons why some patients develop LID are unclear. The ability to prognosticate predisposition to LID would be valuable for the investigation of mitigation strategies. Thirty rats received 6-hydroxydopamine to induce Parkinsonism-like behaviors before treatment with levodopa (2 mg/kg) daily for 22 days. Fourteen developed LID-like behaviors. Fluorodeoxyglucose PET, T₂-weighted MRI and cerebral perfusion imaging were collected before treatment. Support vector machines were trained to classify prospective LID vs. non-LID animals from treatment-naïve baseline imaging. Volumetric perfusion imaging performed best overall with 86.16% area-under-curve, 86.67% accuracy, 92.86% sensitivity, and 81.25% specificity for classifying animals with LID vs. non-LID in leave-one-out cross-validation. We have demonstrated proof-of-concept for imaging-based classification of susceptibility to LID of a Parkinsonian rat model using perfusion-based imaging and a machine learning model.

This study aims to develop and assess an optimized three-dimensional convolutional neural network model (3D CNN) for predicting major cardiac events from coronary computed tomography angiography (CCTA) images in patients with suspected coronary artery disease. Patients undergoing CCTA with suspected coronary artery disease (CAD) were retrospectively included in this single-center study and split into training and test sets. The endpoint was defined as a composite of all-cause death, myocardial infarction, unstable angina, or revascularization events. Cardiovascular risk assessment relied on Morise score and the extent of CAD (eoCAD). An optimized 3D CNN mimicking the DenseNet architecture was trained on CCTA images to predict the clinical endpoints. The data was unannotated for presence of coronary plaque. A total of 5562 patients were assigned to the training group (66.4% male, median age 61.1 ± 11.2); 714 to the test group (69.3% male, 61.5 ± 11.4). Over a 7.2-year follow-up, the composite endpoint occurred in 760 training group and 83 test group patients. In the test cohort, the CNN achieved an AUC of 0.872 ± 0.020 for predicting the composite endpoint. The predictive performance improved in a stepwise manner: from an AUC of 0.652 ± 0.031 while using Morise score alone to 0.901 ± 0.016 when adding eoCAD and finally to 0.920 ± 0.015 when combining Morise score, eoCAD, and CNN (p < 0.001 and p = 0.012, respectively). Deep learning-based analysis of CCTA images improves prognostic risk stratification when combined with clinical and imaging risk factors in patients with suspected CAD.

Diabetic retinopathy is a leading cause of vision loss, necessitating early, accurate detection. Automated deep learning models show promise but struggle with the complexity of retinal images and limited labeled data. Due to domain differences, traditional transfer learning from datasets like ImageNet often fails in medical imaging. Self-supervised learning (SSL) offers a solution by enabling models to learn directly from medical data, but its success depends on the backbone architecture. Convolutional Neural Networks (CNNs) focus on local features, which can be limiting. To address this, we propose the Multi-scale Self-Supervised Learning (MsSSL) model, combining Vision Transformers (ViTs) for global context and CNNs with a Feature Pyramid Network (FPN) for multi-scale feature extraction. These features are refined through a Deep Learner module, improving spatial resolution and capturing high-level and fine-grained information. The MsSSL model significantly enhances DR grading, outperforming traditional methods, and underscores the value of domain-specific pretraining and advanced model integration in medical imaging.

Carotid atherosclerosis is a key predictor of cardiovascular disease (CVD), necessitating early detection. While foundation models (FMs) show promise in medical imaging, their optimal selection and fine-tuning strategies for classifying carotid atherosclerosis from retinal images remain unclear. Using data from 39,620 individuals, we evaluated four vision FMs with three fine-tuning methods. Performance was evaluated by predictive performance, clinical utility by survival analysis for future CVD mortality, and explainability by Grad-CAM with vessel segmentation. DINOv2 with low-rank adaptation showed the best overall performance (area under the receiver operating characteristic curve = 0.71; sensitivity = 0.87; specificity = 0.44), prognostic relevance (hazard ratio = 2.20, P-trend < 0.05), and vascular alignment. While further external validation on a broader clinical context is necessary to improve the model's generalizability, these findings support the feasibility of opportunistic atherosclerosis and CVD screening using retinal imaging and highlight the importance of a multi-dimensional evaluation framework for optimal FM selection in medical artificial intelligence.

Alzheimer's Disease is a condition that affects the brain and causes changes in behavior and memory loss while making it hard to carry out tasks properly. It's vital to spot the illness early, for effective treatment. MRI technology has advanced in detecting Alzheimer's by using machine learning and deep learning models. These models use neural networks to analyze brain MRI results automatically and identify key indicators of Alzheimer's disease. In this study, we used MRI data to train a CNN for diagnosing and categorizing the four stages of Alzheimer's disease with deep learning techniques, offering significant advantages in identifying patterns in medical imaging for this neurodegenerative condition compared to using a CNN exclusively trained for this purpose. They evaluated ResNet50, InceptionResNetv2 as well as a CNN specifically trained for their study and found that combining the models led to highly accurate results. The accuracy rates for the trained CNN model stood at 90.76%, InceptionResNetv2 at 86.84%, and ResNet50 at 90.27%. In this trial run of the experiment conducted by combining all three models collaboratively resulted in an accuracy rate of 94.27% compared to the accuracy rates of each model working individually.

Decisions regarding veno-venous extracorporeal membrane oxygenation (vv-ECMO) in patients with acute respiratory distress syndrome (ARDS) are often based solely on clinical and physiological parameters, which may insufficiently reflect severity and heterogeneity of lung injury. This study aimed to develop a predictive model integrating machine learning-derived quantitative features from admission chest computed tomography (CT) with selected clinical variables to support early individualized decision-making regarding vv-ECMO therapy. In this retrospective single-center cohort study, 375 consecutive patients with COVID-19-associated ARDS admitted to the ICU between March 2020 and April 2022 were included. Lung segmentation from initial CTs was performed using a convolutional neural network (CNN) to generate high-resolution, anatomically accurate masks of the lungs. Subsequently, 592 radiomic features, quantifying lung aeration, density and morphology, were extracted. Four clinical parameters - age, mean airway pressure, lactate, and C-reactive protein, were selected on the basis of clinical relevance. Three logistic regression models were developed: (1) Imaging Model, (2) Clinical Model, and (3) Combined Model integrating different features. Predictive performance was assessed via the area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, and specificity. A total of 375 patients were included: 172 in the training and 203 in the validation cohort. In the training cohort, the AUROCs were 0.743 (Imaging), 0.828 (Clinical), and 0.842 (Combined). In the validation cohort, the Combined Model achieved the highest AUROC (0.705), outperforming the Clinical (0.674) and Imaging (0.639) Models. Overall accuracy in the validation cohort was 64.0% (Combined), 66.5% (Clinical), and 59.1% (Imaging). The Combined Model showed 68.1% sensitivity and 58.9% specificity. Kaplan-Meier analysis confirmed a significantly greater cumulative incidence of ECMO therapy in patients predicted as high risk (p < 0.001), underscoring its potential to support individualized, timely ECMO decisions in ARDS by providing clinicians with objective data-driven risk estimates. Quantitative CT features based on machine learning-derived lung segmentation allow early individualized prediction of the need for vv-ECMO in ARDS. While clinical data remain essential, radiomic markers enhance prognostic accuracy. The Combined Model demonstrates considerable potential to support timely and evidence-based ECMO initiation, facilitating individualized critical care in both specialized and general ICU environments.Trial registration: The study is registered with the German Clinical Trials Register under the number DRKS00027856. Registered 18.01.2022, retrospectively registered due to retrospective design of the study.

Parkinson's disease (PD) is a chronic neurodegenerative disorder characterized by progressive loss of dopaminergic neurons in substantia nigra, resulting in both motor impairments and cognitive decline. Traditional PD classification methods are expert-dependent and time-intensive, while existing deep learning (DL) models often suffer from inconsistent accuracy, limited interpretability, and inability to fully capture PD's clinical heterogeneity. This study proposes a novel framework Enhanced EfficientNet-Extended Multimodal PD Classification with Hybrid Particle Swarm and Grey Wolf Optimizer (EEFN-XM-PDC-HybPS-GWO) to overcome these challenges. The model integrates T1-weighted MRI, DaTscan images, and gait scores from NTUA and PhysioNet repository respectively. Denoising is achieved via Multiscale Attention Variational Autoencoders (MSA-VAE), and critical regions are segmented using Semantic Invariant Multi-View Clustering (SIMVC). The Enhanced EfficientNet-Extended Multimodal (EEFN-XM) model extracts and fuses image and gait features, while HybPS-GWO optimizes classification weights. The system classifies subjects into early-stage PD, advanced-stage PD, and healthy controls (HCs). Ablation analysis confirms the hybrid optimizer's contribution to performance gains. The proposed model achieved 99.2% accuracy with stratified 5-fold cross-validation, outperforming DMFEN-PDC, MMT-CA-PDC, and LSTM-PDD-GS by 7.3%, 15.97%, and 10.43%, respectively, and reduced execution time by 33.33%. EEFN-XM-PDC-HybPS-GWO demonstrates superior accuracy, computational efficiency, and clinical relevance, particularly in early-stage diagnosis and PD classification.

Pancreatic cancer is one of the most aggressive and lethal malignancies of the digestive system and is characterized by an extremely low five-year survival rate. The perineural invasion (PNI) status in patients with pancreatic cancer is positively correlated with adverse prognoses, including overall survival and recurrence-free survival. Emerging radiomic methods can reveal subtle variations in tumor structure by analyzing preoperative contrast-enhanced computed tomography (CECT) imaging data. Therefore, we propose the development of a preoperative CECT-based radiomic model to predict the risk of PNI in patients with pancreatic cancer. This study enrolled patients with pancreatic malignancies who underwent radical resection. Computerized tools were employed to extract radiomic features from tumor regions of interest (ROIs). The optimal radiomic features associated with PNI were selected to construct a radiomic score (RadScore). The model's reliability was comprehensively evaluated by integrating clinical and follow-up information, with SHapley Additive exPlanations (SHAP)-based visualization to interpret the decision-making processes. A total of 167 patients with pancreatic malignancies were included. From the CECT images, 851 radiomic features were extracted, 22 of which were identified as most strongly correlated with PNI. These 22 features were evaluated using seven machine learning methods. We ultimately selected the Gaussian naive Bayes model, which demonstrated robust predictive performance in both the training and validation cohorts, and achieved area under the ROC curve (AUC) values of 0.899 and 0.813, respectively. Among the clinical features, maximum tumor diameter, CA-199 level, blood glucose concentration, and lymph node metastasis were found to be independent risk factors for PNI. The integrated model yielded AUCs of 0.945 (training cohort) and 0.881 (validation cohort). Decision curve analysis confirmed the clinical utility of the ensemble model to predict perineural invasion. The combined model integrating clinical and radiomic features exhibited excellent performance in predicting the probability of perineural invasion in patients with pancreatic cancer. This approach has significant potential to optimize therapeutic decision-making and prognostic evaluation in patients with PNI.

Rheumatic heart disease (RHD) represents a significant global health challenge, disproportionately affecting over 40 million people in low- and middle-income countries. Early detection through color Doppler echocardiography is crucial for treating RHD, but it requires specialized physicians who are often scarce in resource-limited settings. To address this disparity, artificial intelligence (AI)-driven tools for RHD screening can provide scalable, autonomous solutions to improve access to critical healthcare services in underserved regions. This paper introduces RADAR (Rapid AI-Assisted Echocardiography Detection and Analysis of RHD), a novel and generalizable AI approach for end-to-end spatiotemporal analysis of color Doppler echocardiograms, aimed at detecting early RHD in resource-limited settings. RADAR identifies key imaging views and employs convolutional neural networks to analyze diagnostically relevant phases of the cardiac cycle. It also localizes essential anatomical regions and examines blood flow patterns. It then integrates all findings into a cohesive analytical framework. RADAR was trained and validated on 1,022 echocardiogram videos from 511 Ugandan children, acquired using standard portable ultrasound devices. An independent set of 318 cases, acquired using a handheld ultrasound device with diverse imaging characteristics, was also tested. On the validation set, RADAR outperformed existing methods, achieving an average accuracy of 0.92, sensitivity of 0.94, and specificity of 0.90. In independent testing, it maintained high, clinically acceptable performance, with an average accuracy of 0.79, sensitivity of 0.87, and specificity of 0.70. These results highlight RADAR's potential to improve RHD detection and promote health equity for vulnerable children by enhancing timely, accurate diagnoses in underserved regions.

Osteoporosis is an under-screened musculoskeletal disorder that results in diminished quality of life and significant burden to the healthcare system. We aimed to evaluate the ability of Rho, an artificial intelligence (AI) tool, to prospectively identify patients at-risk for low bone mineral density (BMD) from standard x-rays, its adoption rate by radiologists, and acceptance by primary care providers (PCPs). Patients ≥50 years were recruited when undergoing an x-ray of a Rho-eligible body part for any clinical indication. Questionnaires were completed at baseline and 6-month follow-up, and PCPs of "Rho-Positive" patients (those likely to have low BMD) were asked for feedback. Positive predictive value (PPV) was calculated in patients who returned within 6 months for a DXA. Of 1145 patients consented, 987 had x-rays screened by Rho, and 655 were flagged as Rho-Positive. Radiologists included this finding in 524 (80%) of reports. Of all Rho-Positive patients, 125 had a DXA within 6 months; Rho had a 74% PPV for DXA T-Score <-1. From 51 PCP responses, 78% found Rho beneficial. Of 389 patients with follow-up questionnaire data, a greater proportion of Rho-Positive versus -negative patients had discussed bone health with their PCP since study start (36% vs 18%, <i>P</i> < .001), or were newly diagnosed with osteoporosis (11% vs 5%; <i>P</i> = .03). By identifying patients at-risk of low BMD, with acceptability of reporting by radiologists and generally positive feedback from PCPs, Rho has the potential to improve low screening rates for osteoporosis by leveraging existing x-ray data.