To investigate a non-invasive radiomics-based machine learning algorithm to differentiate upper urinary tract urothelial carcinoma (UTUC) from renal cell carcinoma (RCC) prior to surgical intervention. Preoperative computed tomography venous-phase datasets from patients that underwent procedures for histopathologically confirmed UTUC or RCC were retrospectively analyzed. Tumor segmentation was performed manually, and radiomic features were extracted according to the International Image Biomarker Standardization Initiative. Features were normalized using z-scores, and a predictive model was developed using the least absolute shrinkage and selection operator (LASSO). The dataset was split into a training cohort (70%) and a test cohort (30%). A total of 236 patients [30.5% female, median age 70.5 years (IQR: 59.5-77), median tumor size 5.8 cm (range: 4.1-8.2 cm)] were included. For differentiating UTUC from RCC, the model achieved a sensitivity of 88.4% and specificity of 81% (AUC: 0.93, radiomics score cutoff: 0.467) in the training cohort. In the validation cohort, the sensitivity was 80.6% and specificity 80% (AUC: 0.87, radiomics score cutoff: 0.601). Subgroup analysis of the validation cohort demonstrated robust performance, particularly in distinguishing clear cell RCC from high-grade UTUC (sensitivity: 84%, specificity: 73.1%, AUC: 0.84) and high-grade from low-grade UTUC (sensitivity: 57.7%, specificity: 88.9%, AUC: 0.68). Limitations include the need for independent validation in future randomized controlled trials (RCTs). Machine learning-based radiomics models can reliably differentiate between RCC and UTUC in preoperative CT imaging. With a suggested performance benefit compared to conventional imaging, this technology might be added to the current preoperative diagnostic workflow. Local ethics committee no. 20-179.

Deformable liver motion tracking using a single X-ray projection enables real-time motion monitoring and treatment intervention. We introduce a conditional point cloud diffusion model-based framework for accurate and robust liver motion tracking from arbitrarily angled single X-ray projections. We propose a conditional point cloud diffusion model for liver motion tracking (PCD-Liver), which estimates volumetric liver motion by solving deformable vector fields (DVFs) of a prior liver surface point cloud, based on a single X-ray image. It is a patient-specific model of two main components: a rigid alignment model to estimate the liver's overall shifts, and a conditional point cloud diffusion model that further corrects for the liver surface's deformation. Conditioned on the motion-encoded features extracted from a single X-ray projection by a geometry-informed feature pooling layer, the diffusion model iteratively solves detailed liver surface DVFs in a projection angle-agnostic fashion. The liver surface motion solved by PCD-Liver is subsequently fed as the boundary condition into a UNet-based biomechanical model to infer the liver's internal motion to localize liver tumors. A dataset of 10 liver cancer patients was used for evaluation. We used the root mean square error (RMSE) and 95-percentile Hausdorff distance (HD95) metrics to examine the liver point cloud motion estimation accuracy, and the center-of-mass error (COME) to quantify the liver tumor localization error. The mean (±s.d.) RMSE, HD95, and COME of the prior liver or tumor before motion estimation were 8.82 mm (±3.58 mm), 10.84 mm (±4.55 mm), and 9.72 mm (±4.34 mm), respectively. After PCD-Liver's motion estimation, the corresponding values were 3.63 mm (±1.88 mm), 4.29 mm (±1.75 mm), and 3.46 mm (±2.15 mm). Under highly noisy conditions, PCD-Liver maintained stable performance. This study presents an accurate and robust framework for liver deformable motion estimation and tumor localization for image-guided radiotherapy.

To address inter-frame motion artifacts in ultrasound quantitative high-definition microvasculature imaging (qHDMI), we introduced a novel deep learning-based motion correction technique. This approach enables the derivation of more accurate quantitative biomarkers from motion-corrected HDMI images, improving the classification of thyroid nodules. Inter-frame motion, often caused by carotid artery pulsation near the thyroid, can degrade image quality and compromise biomarker reliability, potentially leading to misdiagnosis. Our proposed technique compensates for these motion-induced artifacts, preserving the fine vascular structures critical for accurate biomarker extraction. In this study, we utilized the motion-corrected images obtained through this framework to derive the quantitative biomarkers and evaluated their effectiveness in thyroid nodule classification. We segregated the dataset according to the amount of motion into low and high motion containing cases based on the inter-frame correlation values and performed the thyroid nodule classification for the high motion containing cases and the full dataset. A comprehensive analysis of the biomarker distributions obtained after using the corresponding motion-corrected images demonstrates the significant differences between benign and malignant nodule biomarker characteristics compared to the original motion-containing images. Specifically, the bifurcation angle values derived from the quantitative high-definition microvasculature imaging (qHDMI) become more consistent with the usual trend after motion correction. The classification results demonstrated that sensitivity remained unchanged for groups with less motion, while improved by 9.2% for groups with high motion. These findings highlight that motion correction helps in deriving more accurate biomarkers, which improves the overall classification performance.

To determine whether a machine learning model of voxel level [¹⁸f]fluorodeoxyglucose positron emission tomography (PET) data could predict progressive supranuclear palsy (PSP) pathology, as well as outperform currently available biomarkers. One hundred and thirty-seven autopsied patients with PSP (n = 42) and other neurodegenerative diseases (n = 95) who underwent antemortem [¹⁸f]fluorodeoxyglucose PET and 3.0 Tesla magnetic resonance imaging (MRI) scans were analyzed. A linear support vector machine was applied to differentiate pathological groups with sensitivity analyses performed to assess the influence of voxel size and region removal. A radial basis function was also prepared to create a secondary model using the most important voxels. The models were optimized on the main dataset (n = 104), and their performance was compared with the magnetic resonance parkinsonism index measured on MRI in the independent test dataset (n = 33). The model had the highest accuracy (0.91) and F-score (0.86) when voxel size was 6mm. In this optimized model, important voxels for differentiating the groups were observed in the thalamus, midbrain, and cerebellar dentate. The secondary models found the combination of thalamus and dentate to have the highest accuracy (0.89) and F-score (0.81). The optimized secondary model showed the highest accuracy (0.91) and F-scores (0.86) in the test dataset and outperformed the magnetic resonance parkinsonism index (0.81 and 0.70, respectively). The results suggest that glucose hypometabolism in the thalamus and cerebellar dentate have the highest potential for predicting PSP pathology. Our optimized machine learning model outperformed the best currently available biomarker to predict PSP pathology. ANN NEUROL 2025.

Accurate measurement of hallux valgus angle (HVA) and intermetatarsal angle (IMA) is essential for diagnosing hallux valgus and determining appropriate treatment strategies. Traditional manual measurement methods, while standardized, are time-consuming, labor-intensive, and subject to evaluator bias. Recent advancements in deep learning have been applied to hallux valgus angle estimation, but the development of effective algorithms requires large, well-annotated datasets. Existing X-ray datasets are typically limited to cropped foot regions images, and only one dataset containing very few samples is publicly available. To address these challenges, we introduce HVAngleEst, the first large-scale, open-access dataset specifically designed for hallux valgus angle estimation. HVAngleEst comprises 1,382 X-ray images from 1,150 patients and includes comprehensive annotations, such as foot localization, hallux valgus angles, and line segments for each phalanx. This dataset enables fully automated, end-to-end hallux valgus angle estimation, reducing manual labor and eliminating evaluator bias.

Mammographic breast cancer detection depends on high-quality positioning, which is traditionally assessed and monitored subjectively. This study used artificial intelligence (AI) to evaluate mammography positioning on digital screening mammograms to identify and quantify unmet mammography positioning quality (MPQ). Data were collected within an IRB-approved collaboration. In total, 126 367 digital mammography studies (553 339 images) were processed. Unmet MPQ criteria, including exaggeration, portion cutoff, posterior tissue missing, nipple not in profile, too high on image receptor, inadequate pectoralis length, sagging, and posterior nipple line (PNL) length difference, were evaluated using MPQ AI algorithms. The similarity of unmet MPQ occurrence and rank order was compared for each health system. Altogether, 163 759 and 219 785 unmet MPQ criteria were identified, respectively, at the health systems. The rank order and the probability distribution of the unmet MPQ criteria were not statistically significantly different between health systems (P = .844 and P = .92, respectively). The 3 most-common unmet MPQ criteria were: short PNL length on the craniocaudal (CC) view, inadequate pectoralis muscle, and excessive exaggeration on the CC view. The percentages of unmet positioning criteria out of the total potential unmet positioning criteria at health system 1 and health system 2 were 8.4% (163 759/1 949 922) and 7.3% (219 785/3 030 129), respectively. Artificial intelligence identified a similar distribution of unmet MPQ criteria in 2 health systems' daily work. Knowledge of current commonly unmet MPQ criteria can facilitate the improvement of mammography quality through tailored education strategies.

Cone-beam computed tomography (CBCT) imaging plays a crucial role in dentistry, with automatic prediction of anatomical structures on CBCT images potentially enhancing diagnostic and planning procedures. This study aims to predict anatomical structures automatically on CBCT images using a deep learning algorithm. CBCT images from 70 patients were analyzed. Anatomical structures were annotated using a regional segmentation tool within an annotation software by two dentomaxillofacial radiologists. Each volumetric dataset comprised 405 slices, with relevant anatomical structures marked in each slice. Seventy DICOM images were converted to Nifti format, with seven reserved for testing and the remaining sixty-three used for training. The training utilized nnUNetv2 with an initial learning rate of 0.01, decreasing by 0.00001 at each epoch, and was conducted for 1000 epochs. Statistical analysis included accuracy, Dice score, precision, and recall results. The segmentation model achieved an accuracy of 0.99 for nasal fossa, maxillary sinus, nasopalatine canal, mandibular canal, foramen mentale, and foramen mandible, with corresponding Dice scores of 0.85, 0.98, 0.79, 0.73, 0.78, and 0.74, respectively. Precision values ranged from 0.73 to 0.98. Maxillary sinus segmentation exhibited the highest performance, while mandibular canal segmentation showed the lowest performance. The results demonstrate high accuracy and precision across most structures, with varying Dice scores indicating the consistency of segmentation. Overall, our segmentation model exhibits robust performance in delineating anatomical features in CBCT images, promising potential applications in dental diagnostics and treatment planning.

Accurate preoperative detection and analysis of lymph node metastasis (LNM) in head and neck squamous cell carcinoma (HNSCC) is essential for the surgical planning and execution of a neck dissection and may directly affect the morbidity and prognosis of patients. Additionally, predicting extranodal extension (ENE) using pre-operative imaging could be particularly valuable in oropharyngeal HPV-positive squamous cell carcinoma, enabling more accurate patient counseling, allowing the decision to favor primary chemoradiotherapy over immediate neck dissection when appropriate. Currently, radiological images are evaluated by radiologists and head and neck oncologists; and automated image interpretation is not part of the current standard of care. Therefore, the value of preoperative image recognition by artificial intelligence (AI) with the large language model (LLM) ChatGPT-4 V was evaluated in this exploratory study based on neck computed tomography (CT) images of HNSCC patients with cervical LNM, and corresponding images without LNM. The objective of this study was to firstly assess the preoperative rater accuracy by comparing clinician assessments of imaging-detected extranodal extension (iENE) and the extent of neck dissection to AI predictions, and secondly to evaluate the pathology-based accuracy by comparing AI predictions to final histopathological outcomes. 45 preoperative CT scans were retrospectively analyzed in this study: 15 cases in which a selective neck dissection (sND) was performed, 15 cases with ensuing radical neck dissection (mrND), and 15 cases without LNM (sND). Of note, image analysis was based on three single images provided to both ChatGPT-4 V and the head and neck surgeons as reviewers. Final pathological characteristics were available in all cases as HNSCC patients had undergone surgery. ChatGPT-4 V was tasked with providing the extent of LNM in the preoperative CT scans and with providing a recommendation for the extent of neck dissection and the detection of iENE. The diagnostic performance of ChatGPT-4 V was reviewed independently by two head and neck surgeons with its accuracy, sensitivity, and specificity being assessed. In this study, ChatGPT-4 V reached a sensitivity of 100% and a specificity of 34.09% in identifying the need for a radical neck dissection based on neck CT images. The sensitivity and specificity of detecting iENE was 100% and 34.15%, respectively. Both human reviewers achieved higher specificity. Notably, ChatGPT-4 V also recommended a mrND and detected iENE on CT images without any cervical LNM. In this exploratory study of 45 preoperative CT Neck scans before a neck dissection, ChatGPT-4 V substantially overestimated the degree and severity of lymph node metastasis in head and neck cancer. While these results suggest that ChatGPT-4 V may not yet be a tool providing added value for surgical planning in head and neck cancer, the unparalleled speed of analysis and well-founded reasoning provided suggests that AI tools may provide added value in the future.

Liver diseases are among the top global health burdens. Recently, there has been an increasing significance of diagnostics without discomfort to the patient; among them, ultrasound is the most used. Deep learning, in particular convolutional neural networks, has revolutionized the classification of liver diseases by automatically performing some specific analyses of difficult images. This review summarizes the progress that has been made in deep learning techniques for the classification of liver diseases using ultrasound imaging. It evaluates various models from CNNs to their hybrid versions, such as CNN-Transformer, for detecting fatty liver, fibrosis, and liver cancer, among others. Several challenges in the generalization of data and models across a different clinical environment are also discussed. Deep learning has great prospects for automatic diagnosis of liver diseases. Most of the models have performed with high accuracy in different clinical studies. Despite this promise, challenges relating to generalization have remained. Future hardware developments and access to quality clinical data continue to further improve the performance of these models and ensure their vital role in the diagnosis of liver diseases.

Artificial intelligence (AI) in breast imaging has garnered significant attention given the numerous reports of improved efficiency, accuracy, and the potential to bridge the gap of expanded volume in the face of limited physician resources. While AI models are developed with specific data points, on specific equipment, and in specific populations, the real-world clinical environment is dynamic, and patient populations are diverse, which can impact generalizability and widespread adoption of AI in clinical practice. Implementation of AI models into clinical practice requires focused attention on the potential of AI bias impacting outcomes. The following review presents the concept, sources, and types of AI bias to be considered when implementing AI models and offers suggestions on strategies to mitigate AI bias in practice.