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Deep learning NTCP model for late dysphagia after radiotherapy for head and neck cancer patients based on 3D dose, CT and segmentations

de Vette, S. P., Neh, H., van der Hoek, L., MacRae, D. C., Chu, H., Gawryszuk, A., Steenbakkers, R. J., van Ooijen, P. M., Fuller, C. D., Hutcheson, K. A., Langendijk, J. A., Sijtsema, N. M., van Dijk, L. V.

medrxiv logopreprintJun 20 2025
Background & purposeLate radiation-associated dysphagia after head and neck cancer (HNC) significantly impacts patients health and quality of life. Conventional normal tissue complication probability (NTCP) models use discrete dose parameters to predict toxicity risk but fail to fully capture the complexity of this side effect. Deep learning (DL) offers potential improvements by incorporating 3D dose data for all anatomical structures involved in swallowing. This study aims to enhance dysphagia prediction with 3D DL NTCP models compared to conventional NTCP models. Materials & methodsA multi-institutional cohort of 1484 HNC patients was used to train and validate a 3D DL model (Residual Network) incorporating 3D dose distributions, organ-at-risk segmentations, and CT scans, with or without patient- or treatment-related data. Predictions of grade [≥]2 dysphagia (CTCAEv4) at six months post-treatment were evaluated using area under the curve (AUC) and calibration curves. Results were compared to a conventional NTCP model based on pre-treatment dysphagia, tumour location, and mean dose to swallowing organs. Attention maps highlighting regions of interest for individual patients were assessed. ResultsDL models outperformed the conventional NTCP model in both the independent test set (AUC=0.80-0.84 versus 0.76) and external test set (AUC=0.73-0.74 versus 0.63) in AUC and calibration. Attention maps showed a focus on the oral cavity and superior pharyngeal constrictor muscle. ConclusionDL NTCP models performed better than the conventional NTCP model, suggesting the benefit of using 3D-input over the conventional discrete dose parameters. Attention maps highlighted relevant regions linked to dysphagia, supporting the utility of DL for improved predictions.

Artificial Intelligence for Early Detection and Prognosis Prediction of Diabetic Retinopathy

Budi Susilo, Y. K., Yuliana, D., Mahadi, M., Abdul Rahman, S., Ariffin, A. E.

medrxiv logopreprintJun 20 2025
This review explores the transformative role of artificial intelligence (AI) in the early detection and prognosis prediction of diabetic retinopathy (DR), a leading cause of vision loss in diabetic patients. AI, particularly deep learning and convolutional neural networks (CNNs), has demonstrated remarkable accuracy in analyzing retinal images, identifying early-stage DR with high sensitivity and specificity. These advancements address critical challenges such as intergrader variability in manual screening and the limited availability of specialists, especially in underserved regions. The integration of AI with telemedicine has further enhanced accessibility, enabling remote screening through portable devices and smartphone-based imaging. Economically, AI-based systems reduce healthcare costs by optimizing resource allocation and minimizing unnecessary referrals. Key findings highlight the dominance of Medicine (819 documents) and Computer Science (613 documents) in research output, reflecting the interdisciplinary nature of this field. Geographically, China, the United States, and India lead in contributions, underscoring global efforts to combat DR. Despite these successes, challenges such as algorithmic bias, data privacy, and the need for explainable AI (XAI) remain. Future research should focus on multi-center validation, diverse AI methodologies, and clinician-friendly tools to ensure equitable adoption. By addressing these gaps, AI can revolutionize DR management, reducing the global burden of diabetes-related blindness through early intervention and scalable solutions.

Research hotspots and development trends in molecular imaging of glioma (2014-2024): A bibliometric review.

Zhou H, Luo Y, Li S, Zhang G, Zeng X

pubmed logopapersJun 20 2025
This study aims to explore research hotspots and development trends in molecular imaging of glioma from 2014 to 2024. A total of 2957 publications indexed in the web of science core collection (WoSCC) were analyzed using bibliometric techniques. To visualize the research landscape, co-citation clustering, keyword analysis, and technological trend mapping were performed using CiteSpace and Excel. Publication output peaked in 2021. Emerging research trends included the integration of radiomics and artificial intelligence and the application of novel imaging modalities such as positron emission tomography and magnetic resonance spectroscopy. Significant progress was observed in blood-brain barrier disruption techniques and the development of molecular probes, especially those targeting IDH and MGMT mutations. Molecular imaging has been pivotal in advancing glioma research, contributing to improved diagnostic accuracy and personalized treatment strategies. However, challenges such as clinical translation and standardization remain. Future studies should focus on integrating advanced technologies into routine clinical practice to enhance patient care.

DSA-NRP: No-Reflow Prediction from Angiographic Perfusion Dynamics in Stroke EVT

Shreeram Athreya, Carlos Olivares, Ameera Ismail, Kambiz Nael, William Speier, Corey Arnold

arxiv logopreprintJun 20 2025
Following successful large-vessel recanalization via endovascular thrombectomy (EVT) for acute ischemic stroke (AIS), some patients experience a complication known as no-reflow, defined by persistent microvascular hypoperfusion that undermines tissue recovery and worsens clinical outcomes. Although prompt identification is crucial, standard clinical practice relies on perfusion magnetic resonance imaging (MRI) within 24 hours post-procedure, delaying intervention. In this work, we introduce the first-ever machine learning (ML) framework to predict no-reflow immediately after EVT by leveraging previously unexplored intra-procedural digital subtraction angiography (DSA) sequences and clinical variables. Our retrospective analysis included AIS patients treated at UCLA Medical Center (2011-2024) who achieved favorable mTICI scores (2b-3) and underwent pre- and post-procedure MRI. No-reflow was defined as persistent hypoperfusion (Tmax > 6 s) on post-procedural imaging. From DSA sequences (AP and lateral views), we extracted statistical and temporal perfusion features from the target downstream territory to train ML classifiers for predicting no-reflow. Our novel method significantly outperformed a clinical-features baseline(AUC: 0.7703 $\pm$ 0.12 vs. 0.5728 $\pm$ 0.12; accuracy: 0.8125 $\pm$ 0.10 vs. 0.6331 $\pm$ 0.09), demonstrating that real-time DSA perfusion dynamics encode critical insights into microvascular integrity. This approach establishes a foundation for immediate, accurate no-reflow prediction, enabling clinicians to proactively manage high-risk patients without reliance on delayed imaging.

MVKD-Trans: A Multi-View Knowledge Distillation Vision Transformer Architecture for Breast Cancer Classification Based on Ultrasound Images.

Ling D, Jiao X

pubmed logopapersJun 20 2025
Breast cancer is the leading cancer threatening women's health. In recent years, deep neural networks have outperformed traditional methods in terms of both accuracy and efficiency for breast cancer classification. However, most ultrasound-based breast cancer classification methods rely on single-perspective information, which may lead to higher misdiagnosis rates. In this study, we propose a multi-view knowledge distillation vision transformer architecture (MVKD-Trans) for the classification of benign and malignant breast tumors. We utilize multi-view ultrasound images of the same tumor to capture diverse features. Additionally, we employ a shuffle module for feature fusion, extracting channel and spatial dual-attention information to improve the model's representational capability. Given the limited computational capacity of ultrasound devices, we also utilize knowledge distillation (KD) techniques to compress the multi-view network into a single-view network. The results show that the accuracy, area under the ROC curve (AUC), sensitivity, specificity, precision, and F1 score of the model are 88.15%, 91.23%, 81.41%, 90.73%, 78.29%, and 79.69%, respectively. The superior performance of our approach, compared to several existing models, highlights its potential to significantly enhance the understanding and classification of breast cancer.

Robust Training with Data Augmentation for Medical Imaging Classification

Josué Martínez-Martínez, Olivia Brown, Mostafa Karami, Sheida Nabavi

arxiv logopreprintJun 20 2025
Deep neural networks are increasingly being used to detect and diagnose medical conditions using medical imaging. Despite their utility, these models are highly vulnerable to adversarial attacks and distribution shifts, which can affect diagnostic reliability and undermine trust among healthcare professionals. In this study, we propose a robust training algorithm with data augmentation (RTDA) to mitigate these vulnerabilities in medical image classification. We benchmark classifier robustness against adversarial perturbations and natural variations of RTDA and six competing baseline techniques, including adversarial training and data augmentation approaches in isolation and combination, using experimental data sets with three different imaging technologies (mammograms, X-rays, and ultrasound). We demonstrate that RTDA achieves superior robustness against adversarial attacks and improved generalization performance in the presence of distribution shift in each image classification task while maintaining high clean accuracy.

Proportional Sensitivity in Generative Adversarial Network (GAN)-Augmented Brain Tumor Classification Using Convolutional Neural Network

Mahin Montasir Afif, Abdullah Al Noman, K. M. Tahsin Kabir, Md. Mortuza Ahmmed, Md. Mostafizur Rahman, Mufti Mahmud, Md. Ashraful Babu

arxiv logopreprintJun 20 2025
Generative Adversarial Networks (GAN) have shown potential in expanding limited medical imaging datasets. This study explores how different ratios of GAN-generated and real brain tumor MRI images impact the performance of a CNN in classifying healthy vs. tumorous scans. A DCGAN was used to create synthetic images which were mixed with real ones at various ratios to train a custom CNN. The CNN was then evaluated on a separate real-world test set. Our results indicate that the model maintains high sensitivity and precision in tumor classification, even when trained predominantly on synthetic data. When only a small portion of GAN data was added, such as 900 real images and 100 GAN images, the model achieved excellent performance, with test accuracy reaching 95.2%, and precision, recall, and F1-score all exceeding 95%. However, as the proportion of GAN images increased further, performance gradually declined. This study suggests that while GANs are useful for augmenting limited datasets especially when real data is scarce, too much synthetic data can introduce artifacts that affect the model's ability to generalize to real world cases.

PMFF-Net: A deep learning-based image classification model for UIP, NSIP, and OP.

Xu MW, Zhang ZH, Wang X, Li CT, Yang HY, Liao ZH, Zhang JQ

pubmed logopapersJun 19 2025
High-resolution computed tomography (HRCT) is helpful for diagnosing interstitial lung diseases (ILD), but it largely depends on the experience of physicians. Herein, our study aims to develop a deep-learning-based classification model to differentiate the three common types of ILD, so as to provide a reference to help physicians make the diagnosis and improve the accuracy of ILD diagnosis. Patients were selected from four tertiary Grade A hospitals in Kunming based on inclusion and exclusion criteria. HRCT scans of 130 patients were included. The imaging manifestations were usual interstitial pneumonia (UIP), non-specific interstitial pneumonia (NSIP), and organizing pneumonia (OP). Additionally, 50 chest HRCT cases without imaging abnormalities during the same period were selected.Construct a data set. Conduct the training, validation, and testing of the Parallel Multi-scale Feature Fusion Network (PMFF-Net) deep learning model. Utilize Python software to generate data and charts pertaining to model performance. Assess the model's accuracy, precision, recall, and F1-score, and juxtapose its diagnostic efficacy against that of physicians across various hospital levels, with differing levels of seniority, and from various departments. The PMFF -Net deep learning model is capable of classifying imaging types such as UIP, NSIP, and OP, as well as normal imaging. In a mere 105 s, it makes the diagnosis for 18 HRCT images with a diagnostic accuracy of 92.84 %, precision of 91.88 %, recall of 91.95 %, and an F1 score of 0.9171. The diagnostic accuracy of senior radiologists (83.33 %) and pulmonologists (77.77 %) from tertiary hospitals is higher than that of internists from secondary hospitals (33.33 %). Meanwhile, the diagnostic accuracy of middle-aged radiologists (61.11 %) and pulmonologists (66.66 %) are higher than junior radiologists (38.88 %) and pulmonologists (44.44 %) in tertiary hospitals, whereas junior and middle-aged internists at secondary hospitals were unable to complete the tests. This study found that the PMFF-Net model can effectively classify UIP, NSIP, OP imaging types, and normal imaging, which can help doctors of different hospital levels and departments make clinical decisions quickly and effectively.

Machine learning-based MRI radiomics predict IL18 expression and overall survival of low-grade glioma patients.

Zhang Z, Xiao Y, Liu J, Xiao F, Zeng J, Zhu H, Tu W, Guo H

pubmed logopapersJun 19 2025
Interleukin-18 has broad immune regulatory functions. Genomic data and enhanced Magnetic Resonance Imaging data related to LGG patients were downloaded from The Cancer Genome Atlas and Cancer Imaging Archive, and the constructed model was externally validated using hospital MRI enhanced images and clinical pathological features. Radiomic feature extraction was performed using "PyRadiomics", feature selection was conducted using Maximum Relevance Minimum Redundancy and Recursive Feature Elimination methods, and a model was built using the Gradient Boosting Machine algorithm to predict the expression status of IL18. The constructed radiomics model achieved areas under the receiver operating characteristic curve of 0.861, 0.788, and 0.762 in the TCIA training dataset (n = 98), TCIA validation dataset (n = 41), and external validation dataset (n = 50). Calibration curves and decision curve analysis demonstrated the calibration and high clinical utility of the model. The radiomics model based on enhanced MRI can effectively predict the expression status of IL18 and the prognosis of LGG.

A fusion-based deep-learning algorithm predicts PDAC metastasis based on primary tumour CT images: a multinational study.

Xue N, Sabroso-Lasa S, Merino X, Munzo-Beltran M, Schuurmans M, Olano M, Estudillo L, Ledesma-Carbayo MJ, Liu J, Fan R, Hermans JJ, van Eijck C, Malats N

pubmed logopapersJun 19 2025
Diagnosing the presence of metastasis of pancreatic cancer is pivotal for patient management and treatment, with contrast-enhanced CT scans (CECT) as the cornerstone of diagnostic evaluation. However, this diagnostic modality requires a multifaceted approach. To develop a convolutional neural network (CNN)-based model (PMPD, Pancreatic cancer Metastasis Prediction Deep-learning algorithm) to predict the presence of metastases based on CECT images of the primary tumour. CECT images in the portal venous phase of 335 patients with pancreatic ductal adenocarcinoma (PDAC) from the PanGenEU study and The First Affiliated Hospital of Zhengzhou University (ZZU) were randomly divided into training and internal validation sets by applying fivefold cross-validation. Two independent external validation datasets of 143 patients from the Radboud University Medical Center (RUMC), included in the PANCAIM study (RUMC-PANCAIM) and 183 patients from the PREOPANC trial of the Dutch Pancreatic Cancer Group (PREOPANC-DPCG) were used to evaluate the results. The area under the receiver operating characteristic curve (AUROC) for the internally tested model was 0.895 (0.853-0.937) and 0.779 (0.741-0.817) in the PanGenEU and ZZU sets, respectively. In the external validation sets, the mean AUROC was 0.806 (0.787-0.826) for the RUMC-PANCAIM and 0.761 (0.717-0.804) for the PREOPANC-DPCG. When stratified by the different metastasis sites, the PMPD model achieved the average AUROC between 0.901-0.927 in PanGenEU, 0.782-0.807 in ZZU and 0.761-0.820 in PREOPANC-DPCG sets. A PMPD-derived Metastasis Risk Score (MRS) (HR: 2.77, 95% CI 1.99 to 3.86, p=1.59e-09) outperformed the Resectability status from the National Comprehensive Cancer Network guideline and the CA19-9 biomarker in predicting overall survival. Meanwhile, the MRS could potentially predict developed metastasis (AUROC: 0.716 for within 3 months, 0.645 for within 6 months). This study represents a pioneering utilisation of a high-performance deep-learning model to predict extrapancreatic organ metastasis in patients with PDAC.
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