BackgroundRetinal fundus images provide a noninvasive window into systemic health, offering opportunities for early detection of metabolic disorders such as metabolic syndrome (METS). ObjectiveThis study aimed to develop a deep learning model to predict METS from fundus images obtained during routine health checkups, leveraging a multi-task learning approach. MethodsWe retrospectively analyzed 5,000 fundus images from Japanese health checkup participants. Convolutional neural network (CNN) models were trained to classify METS status, incorporating fundus-specific data augmentation strategies and auxiliary regression tasks targeting clinical parameters such as abdominal circumference (AC). Model performance was evaluated using validation accuracy, test accuracy, and the area under the receiver operating characteristic curve (AUC). ResultsModels employing fundus-specific augmentation demonstrated more stable convergence and superior validation accuracy compared to general-purpose augmentation. Incorporating AC as an auxiliary task further enhanced performance across architectures. The final ensemble model with test-time augmentation achieved a test accuracy of 0.696 and an AUC of 0.73178. ConclusionCombining multi-task learning, fundus-specific data augmentation, and ensemble prediction substantially improves deep learning-based METS classification from fundus images. This approach may offer a practical, noninvasive screening tool for metabolic syndrome in general health checkup settings.

This study aimed to establish and validate a prediction model based on machine learning methods and SHAP algorithm to predict response to anti-vascular endothelial growth factor (VEGF) therapy in neovascular age-related macular degeneration (AMD). In this retrospective study, we extracted data including demographic characteristics, laboratory test results, and imaging features from optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Eight machine learning methods, including Logistic Regression, Gradient Boosting Decision Tree, Random Forest, CatBoost, Support Vector Machine, XGboost, LightGBM, K Nearest Neighbors were employed to develop the predictive model. The machine learning method with optimal performance was selected for further interpretation. Finally, the SHAP algorithm was applied to explain the model's predictions. The study included 145 patients with neovascular AMD. Among the eight models developed, the Random Forest model demonstrated general optimal performance, achieving a high accuracy of 75.86% and the highest area under the receiver operating characteristic curve (AUC) value of 0.91. In this model, important features identified as significant contributors to the response to anti-VEGF therapy in neovascular AMD patients included fractal dimension, total number of end points, total number of junctions, total vessels length, vessels area, average lacunarity, choroidal neovascularization (CNV) type, age, duration and logMAR BCVA. SHAP analysis and visualization provided interpretation at both the factor level and individual level. The Random Forest model for predicting response to anti-VEGF therapy in neovascular AMD using SHAP algorithm proved to be feasible and effective. OCTA imaging features, such as fractal dimension, total number of end points et al, were the most effective predictive factors.

This dataset provides the first annotated, openly available MRI-based imaging dataset for investigations of tongue musculature, including multi-contrast and multi-site MRI data from non-disease participants. The present dataset includes 47 participants collated from three studies: BeLong (four participants; T2-weighted images), EATT4MND (19 participants; T2-weighted images), and BMC (24 participants; T1-weighted images). We provide manually corrected segmentations of five key tongue muscles: the superior longitudinal, combined transverse/vertical, genioglossus, and inferior longitudinal muscles. Other phenotypic measures, including age, sex, weight, height, and tongue muscle volume, are also available for use. This dataset will benefit researchers across domains interested in the structure and function of the tongue in health and disease. For instance, researchers can use this data to train new machine learning models for tongue segmentation, which can be leveraged for segmentation and tracking of different tongue muscles engaged in speech formation in health and disease. Altogether, this dataset provides the means to the scientific community for investigation of the intricate tongue musculature and its role in physiological processes and speech production.

Currently, cervical anesthesia is performed using three main approaches: superficial cervical plexus block, deep cervical plexus block, and intermediate plexus nerve block. However, each technique carries inherent risks and demands significant clinical expertise. Ultrasound imaging, known for its real-time visualization capabilities and accessibility, is widely used in both diagnostic and interventional procedures. Nevertheless, accurate segmentation of small and irregularly shaped structures such as the cervical and brachial plexuses remains challenging due to image noise, complex anatomical morphology, and limited annotated training data. This study introduces DEMAC-Net-a dual-encoder, multiattention collaborative network-to significantly improve the segmentation accuracy of these neural structures. By precisely identifying the cervical nerve pathway (CNP) and adjacent anatomical tissues, DEMAC-Net aims to assist clinicians, especially those less experienced, in effectively guiding anesthesia procedures and accurately identifying optimal needle insertion points. Consequently, this improvement is expected to enhance clinical safety, reduce procedural risks, and streamline decision-making efficiency during ultrasound-guided regional anesthesia. DEMAC-Net combines a dual-encoder architecture with the Spatial Understanding Convolution Kernel (SUCK) and the Spatial-Channel Attention Module (SCAM) to extract multi-scale features effectively. Additionally, a Global Attention Gate (GAG) and inter-layer fusion modules refine relevant features while suppressing noise. A novel dataset, Neck Ultrasound Dataset (NUSD), was introduced, containing 1,500 annotated ultrasound images across seven anatomical regions. Extensive experiments were conducted on both NUSD and the BUSI public dataset, comparing DEMAC-Net to state-of-the-art models using metrics such as Dice Similarity Coefficient (DSC) and Intersection over Union (IoU). On the NUSD dataset, DEMAC-Net achieved a mean DSC of 93.3%, outperforming existing models. For external validation on the BUSI dataset, it demonstrated superior generalization, achieving a DSC of 87.2% and a mean IoU of 77.4%, surpassing other advanced methods. Notably, DEMAC-Net displayed consistent segmentation stability across all tested structures. The proposed DEMAC-Net significantly improves segmentation accuracy for small nerves and complex anatomical structures in ultrasound images, outperforming existing methods in terms of accuracy and computational efficiency. This framework holds great potential for enhancing ultrasound-guided procedures, such as peripheral nerve blocks, by providing more precise anatomical localization, ultimately improving clinical outcomes.

This study evaluated the performance of a multi-stage Segmentation Residual Network (SegResNet)-based deep learning (DL) model for the automatic segmentation of cone-beam computed tomography (CBCT) images of patients with stage III and IV periodontitis. Seventy pre-processed CBCT scans from patients undergoing periodontal rehabilitation were used for training and validation. The model was tested on 10 CBCT scans independent from the training dataset by comparing results with semi-automatic (SA) segmentations. Segmentation accuracy was assessed using the Dice similarity coefficient (DSC), Intersection over Union (IoU), and Hausdorff distance 95^th percentile (HD95). Linear periodontal measurements were performed on four tooth surfaces to assess the validity of the DL segmentation in the periodontal region. The DL model achieved a mean DSC of 0.9650 ± 0.0097, with an IoU of 0.9340 ± 0.0180 and HD95 of 0.4820 mm ± 0.1269 mm, showing strong agreement with SA segmentation. Linear measurements revealed high statistical correlations between the mesial, distal, and lingual surfaces, with intraclass correlation coefficients (ICC) of 0.9442 (p<0.0001), 0.9232 (p<0.0001), and 0.9598(p<0.0001), respectively, while buccal measurements revealed lower consistency, with an ICC of 0.7481 (p<0.0001). The DL method reduced the segmentation time by 47 times compared to the SA method. Acquired 3D models may enable precise treatment planning in cases where conventional diagnostic modalities are insufficient. However, the robustness of the model must be increased to improve its general reliability and consistency at the buccal aspect of the periodontal region. This study presents a DL model for the CBCT-based segmentation of periodontal defects, demonstrating high accuracy and a 47-fold time reduction compared to SA methods, thus improving the feasibility of 3D diagnostics for advanced periodontitis.

Propagation-based imaging (one method of X-ray phase contrast imaging) with microcomputed tomography (PBI-µCT) offers the potential to visualise low-density materials, such as soft tissues and hydrogel constructs, which are difficult to be identified by conventional absorption-based contrast µCT. Conventional µCT reconstruction produces edge-enhanced contrast (EEC) images which preserve sharp boundaries but are susceptible to noise and do not provide consistent grey value representation for the same material. Meanwhile, phase retrieval (PR) algorithms can convert edge enhanced contrast to area contrast to improve signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) but usually results to over-smoothing, thus creating inaccuracies in quantitative analysis. To alleviate these problems, this study developed a deep learning-based method called edge view enhanced phase retrieval (EVEPR), by strategically integrating the complementary spatial features of denoised EEC and PR images, and further applied this method to segment the hydrogel constructs in vivo and ex vivo. EVEPR used paired denoised EEC and PR images to train a deep convolutional neural network (CNN) on a dataset-to-dataset basis. The CNN had been trained on important high-frequency details, for example, edges and boundaries from the EEC image and area contrast from PR images. The CNN predicted result showed enhanced area contrast beyond conventional PR algorithms while improving SNR and CNR. The enhanced CNR especially allowed for the image to be segmented with greater efficiency. EVEPR was applied to in vitro and ex vivo PBI-µCT images of low-density hydrogel constructs. The enhanced visibility and consistency of hydrogel constructs was essential for segmenting such material which usually exhibit extremely poor contrast. The EVEPR images allowed for more accurate segmentation with reduced manual adjustments. The efficiency in segmentation allowed for the generation of a sizeable database of segmented hydrogel scaffolds which were used in conventional data-driven segmentation applications. EVEPR was demonstrated to be a robust post-image processing method capable of significantly enhancing image quality by training a CNN on paired denoised EEC and PR images. This method not only addressed the common issues of over-smoothing and noise susceptibility in conventional PBI-µCT image processing but also allowed for efficient and accurate in vitro and ex vivo image processing applications of low-density materials.

Out-of-distribution (OOD) detection is essential for ensuring the reliability of deep learning models in medical imaging applications. This work is motivated by the observation that class activation maps (CAMs) for in-distribution (ID) data typically emphasize regions that are highly relevant to the model's predictions, whereas OOD data often lacks such focused activations. By masking input images with inverted CAMs, the feature representations of ID data undergo more substantial changes compared to those of OOD data, offering a robust criterion for differentiation. In this paper, we introduce a novel unsupervised OOD detection framework, Multi-Exit Class Activation Map (MECAM), which leverages multi-exit CAMs and feature masking. By utilizing mult-exit networks that combine CAMs from varying resolutions and depths, our method captures both global and local feature representations, thereby enhancing the robustness of OOD detection. We evaluate MECAM on multiple ID datasets, including ISIC19 and PathMNIST, and test its performance against three medical OOD datasets, RSNA Pneumonia, COVID-19, and HeadCT, and one natural image OOD dataset, iSUN. Comprehensive comparisons with state-of-the-art OOD detection methods validate the effectiveness of our approach. Our findings emphasize the potential of multi-exit networks and feature masking for advancing unsupervised OOD detection in medical imaging, paving the way for more reliable and interpretable models in clinical practice.

Solving non-convex regularized inverse problems is challenging due to their complex optimization landscapes and multiple local minima. However, these models remain widely studied as they often yield high-quality, task-oriented solutions, particularly in medical imaging, where the goal is to enhance clinically relevant features rather than merely minimizing global error. We propose incDG, a hybrid framework that integrates deep learning with incremental model-based optimization to efficiently approximate the $\ell_0$-optimal solution of imaging inverse problems. Built on the Deep Guess strategy, incDG exploits a deep neural network to generate effective initializations for a non-convex variational solver, which refines the reconstruction through regularized incremental iterations. This design combines the efficiency of Artificial Intelligence (AI) tools with the theoretical guarantees of model-based optimization, ensuring robustness and stability. We validate incDG on TpV-regularized optimization tasks, demonstrating its effectiveness in medical image deblurring and tomographic reconstruction across diverse datasets, including synthetic images, brain CT slices, and chest-abdomen scans. Results show that incDG outperforms both conventional iterative solvers and deep learning-based methods, achieving superior accuracy and stability. Moreover, we confirm that training incDG without ground truth does not significantly degrade performance, making it a practical and powerful tool for solving non-convex inverse problems in imaging and beyond.

To develop a convolutional neural network (CNN) model to diagnose thyroid cartilage invasion by laryngeal and hypopharyngeal cancers observed on computed tomography (CT) images and evaluate the model's diagnostic performance. We retrospectively analyzed 91 cases of laryngeal or hypopharyngeal cancer treated surgically at our hospital during the period April 2010 through May 2023, and we divided the cases into datasets for training (n = 61) and testing (n = 30). We reviewed the CT images and pathological diagnoses in all cases to determine the invasion positive- or negative-status as a ground truth. We trained the new CNN model to classify thyroid cartilage invasion-positive or -negative status from the pre-treatment axial CT images by transfer learning from Residual Network 101 (ResNet101), using the training dataset. We then used the test dataset to evaluate the model's performance. Two radiologists, one with extensive head and neck imaging experience (senior reader) and the other with less experience (junior reader) reviewed the CT images of the test dataset to determine whether thyroid cartilage invasion was present. The following were obtained by the CNN model with the test dataset: area under the curve (AUC), 0.82; 90 % accuracy, 80 % sensitivity, and 95 % specificity. The CNN model showed a significant difference in AUCs compared to the junior reader (p = 0.035) but not the senior reader (p = 0.61). The CNN-based diagnostic model can be a useful supportive tool for the assessment of thyroid cartilage invasion in patients with laryngeal or hypopharyngeal cancer.

To evaluate deep learning (DL)-based models for detecting periapical bone rarefaction (PBRs) in panoramic radiographs (PRs), analyzing their feasibility and performance in dental practice. A search was conducted across seven databases and partial grey literature up to November 15, 2024, using Medical Subject Headings and entry terms related to DL, PBRs, and PRs. Studies assessing DL-based models for detecting and classifying PBRs in conventional PRs were included, while those using non-PR imaging or focusing solely on non-PBR lesions were excluded. Two independent reviewers performed screening, data extraction, and quality assessment using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, with conflicts resolved by a third reviewer. Twelve studies met the inclusion criteria, mostly from Asia (58.3%). The risk of bias was moderate in 10 studies (83.3%) and high in 2 (16.7%). DL models showed moderate to high performance in PBR detection (sensitivity: 26-100%; specificity: 51-100%), with U-NET and YOLO being the most used algorithms. Only one study (8.3%) distinguished Periapical Granuloma from Periapical Cysts, revealing a classification gap. Key challenges included limited generalization due to small datasets, anatomical superimpositions in PRs, and variability in reported metrics, compromising models comparison. This review underscores that DL-based has the potential to become a valuable tool in dental image diagnostics, but it cannot yet be considered a definitive practice. Multicenter collaboration is needed to diversify data and democratize those tools. Standardized performance reporting is critical for fair comparability between different models.