This study was undertaken to develop and validate an automatic, artificial intelligence-enhanced software tool for hippocampal sclerosis (HS) detection, using a variety of standard magnetic resonance imaging (MRI) protocols from different MRI scanners for routine clinical practice. First, MRI scans of 36 epilepsy patients with unilateral HS and 36 control patients with epilepsy of other etiologies were analyzed. MRI features, including hippocampal subfield volumes from three-dimensional (3D) magnetization-prepared rapid acquisition gradient echo (MPRAGE) scans and fluid-attenuated inversion recovery (FLAIR) intensities, were calculated. Hippocampal subfield volumes were corrected for total brain volume and z-scored using a dataset of 256 healthy controls. Hippocampal subfield FLAIR intensities were z-scored in relation to each subject's mean cortical FLAIR signal. Additionally, left-right ratios of FLAIR intensities and volume features were obtained. Support vector classifiers were trained on the above features to predict HS presence and laterality. In a second step, the algorithm was validated using two independent, external cohorts, including 118 patients and 116 controls in sum, scanned with different MRI scanners and acquisition protocols. Classifiers demonstrated high accuracy in HS detection and lateralization, with slight variations depending on the input image availability. The best cross-validation accuracy was achieved using both 3D MPRAGE and 3D FLAIR scans (mean accuracy = 1.0, confidence interval [CI] = .939-1.0). External validation of trained classifiers in two independent cohorts yielded accuracies of .951 (CI = .902-.980) and .889 (CI = .805-.945), respectively. In both validation cohorts, the additional use of FLAIR scans led to significantly better classification performance than the use of MPRAGE data alone (p = .016 and p = .031, respectively). A further model was trained on both validation cohorts and tested on the former training cohort, providing additional evidence for good validation performance. Comparison to a previously published algorithm showed no significant difference in performance (p = 1). The method presented achieves accurate automated HS detection using standard clinical MRI protocols. It is robust and flexible and requires no image processing expertise.

Advances in biomarkers and pathophysiology of vascular contributions to cognitive impairment and dementia (VCID) are expected to bring greater mechanistic insights, more targeted treatments, and potentially disease-modifying therapies. The 2025 Annual Workshop of the Albert Research Institute for White Matter and Cognition, sponsored by the Leo and Anne Albert Charitable Trust since 2015, focused on novel biomarkers for VCID. The meeting highlighted the complexity of dementia, emphasizing that the majority of cases involve multiple brain pathologies, with vascular pathology typically present. Potential novel approaches to diagnosis of disease processes and progression that may result in VCID included measures of microglial senescence and retinal changes, as well as artificial intelligence (AI) integration of multimodal datasets. Proteomic studies identified plasma proteins associated with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL; a rare genetic disorder affecting brain vessels) and age-related vascular pathology that suggested potential therapeutic targets. Blood-based microglial and brain-derived extracellular vesicles are promising tools for early detection of brain inflammation and other changes that have been associated with cognitive decline. Imaging measures of blood perfusion, oxygen extraction, and cerebrospinal fluid (CSF) flow were discussed as potential VCID biomarkers, in part because of correlations with classic pathological Alzheimer's disease (AD) biomarkers. MRI-visible perivascular spaces, which may be a novel imaging biomarker of sleep-driven glymphatic waste clearance dysfunction, are associated with vascular risk factors, lower cognitive function, and various brain pathologies including Alzheimer's, Parkinson's and cerebral amyloid angiopathy (CAA). People with Down syndrome are at high risk for dementia. Individuals with Down syndrome who develop dementia almost universally experience mixed brain pathologies, with AD pathology and cerebrovascular pathology being the most common. This follows the pattern in the general population where mixed pathologies are also predominant in the brains of people clinically diagnosed with dementia, including AD dementia. Intimate partner violence-related brain injury, hypertension's impact on dementia risk, and the promise of remote ischemic conditioning for treating VCID were additional themes.

In brain gliomas, non-invasive biomarkers reflecting tumor cellularity would be useful to guide supramarginal resections and to plan stereotactic biopsies. We aim to validate a previously-trained machine learning algorithm that generates cellularity prediction maps (CPM) from multiparametric MRI data to an independent, retrospective external cohort of gliomas undergoing image-guided biopsies, and to compare the performance of CPM and diffusion MRI apparent diffusion coefficient (ADC) in predicting cellularity. A cohort of patients with treatment-naïve or recurrent gliomas were prospectively studied. All patients underwent pre-surgical MRI according to the standardized brain tumor imaging protocol. The surgical sampling site was planned based on image-guided biopsy targets and tissue was stained with hematoxylin-eosin for cell density count. The correlation between MRI-derived CPM values and histological cellularity, and between ADC and histological cellularity, was evaluated both assuming independent observations and accounting for non-independent observations. Sixty-six samples from twenty-seven patients were collected. Thirteen patients had treatment-naïve tumors and fourteen had recurrent lesions. CPM value accurately predicted histological cellularity in treatment-naïve patients (b = 1.4, R² = 0.2, p = 0.009, rho = 0.41, p = 0.016, RMSE = 1503 cell/mm²), but not in the recurrent sub-cohort. Similarly, ADC values showed a significant association with histological cellularity only in treatment-naive patients (b = 1.3, R² = 0.22, p = 0.007; rho = -0.37, p = 0.03), not statistically different from the CPM correlation. These findings were confirmed with statistical tests accounting for non-independent observations. MRI-derived machine learning generated cellularity prediction maps (CPM) enabled a non-invasive evaluation of tumor cellularity in treatment-naïve glioma patients, although CPM did not clearly outperform ADC alone in this cohort.

This study considers the application of ultrasound placental image texture analysis for the prediction of hypertensive disorders of pregnancy (HDP) using deep learning (DL) algorithm. In this prospective observational study, placental ultrasound images were taken serially at 11-14 weeks (T1), 20-24 weeks (T2), and 28-32 weeks (T3). Pregnant women with blood pressure at or above 140/90 mmHg on two occasions 4 h apart were considered to have HDP. The image data of women with HDP were compared with those with a normal outcome using DL techniques such as convolutional neural networks (CNN), transfer learning, and a Vision Transformer (ViT) with a TabNet classifier. The accuracy and the Cohen kappa scores of the different DL techniques were compared. A total of 600/1008 (59.5%) subjects had a normal outcome, and 143/1008 (14.2%) had HDP; the reminder, 265/1008 (26.3%), had other adverse outcomes. In the basic CNN model, the accuracy was 81.6% for T1, 80% for T2, and 82.8% for T3. Using the Efficient Net B0 transfer learning model, the accuracy was 87.7%, 85.3%, and 90.3% for T1, T2, and T3, respectively. Using a TabNet classifier with a ViT, the accuracy and area under the receiver operating characteristic curve scores were 91.4% and 0.915 for T1, 90.2% and 0.904 for T2, and 90.3% and 0.907 for T3. The sensitivity and specificity for HDP prediction using ViT were 89.1% and 91.7% for T1, 86.6% and 93.7% for T2, and 85.6% and 94.6% for T3. Ultrasound placental image texture analysis using DL could differentiate women with a normal outcome and those with HDP with excellent accuracy and could open new avenues for research in this field.

Glial tumors and especially glioblastoma present a major challenge in neuro-oncology due to their infiltrative growth, resistance to therapy, and poor overall survival-despite aggressive treatments such as maximal safe resection and chemoradiotherapy. These tumors typically manifest through neurological symptoms such as seizures, headaches, and signs of increased intracranial pressure, prompting urgent neuroimaging. At initial diagnosis, MRI plays a central role in differentiating true neoplasms from tumor mimics, including inflammatory or infectious conditions. Advanced techniques such as perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI) enhance diagnostic specificity and may prevent unnecessary surgical intervention. In the preoperative phase, MRI contributes to surgical planning through the use of functional MRI (fMRI) and diffusion tensor imaging (DTI), enabling localization of eloquent cortex and white matter tracts. These modalities support safer resections by informing trajectory planning and risk assessment. Emerging MR techniques, including magnetic resonance spectroscopy, amide proton transfer imaging, and 2HG quantification, offer further potential in delineating tumor infiltration beyond contrast-enhancing margins. Postoperatively, MRI is important for evaluating residual tumor, detecting surgical complications, and guiding radiotherapy planning. During treatment surveillance, MRI assists in distinguishing true progression from pseudoprogression or radiation necrosis, thereby guiding decisions on additional surgery, changes in systemic therapy, or inclusion into clinical trials. The continued evolution of MRI hardware, software, and image analysis-particularly with the integration of machine learning-will be critical for supporting precision neurosurgical oncology. This review highlights how advanced MRI techniques can inform clinical decision-making at each stage of care in patients with high-grade gliomas.

Diseases underlying osteolytic lesions in jaws are characterized by the absorption of bone tissue and are often asymptomatic, delaying their diagnosis. Well-defined lesions (benign cyst-like lesions) and ill-defined lesions (osteomyelitis or malignancy) can be detected early in a panoramic radiograph (PR) by an experienced examiner, but most dentists lack appropriate training. To support dentists, this study aimed to develop and evaluate deep learning models for the detection of osteolytic lesions in PRs. A dataset of 676 PRs (165 well-defined, 181 ill-defined, 330 control) was collected from the Department of Oral and Maxillofacial Surgery at Charité Berlin, Germany. The osteolytic lesions were pixel-wise segmented and labeled as well-defined or ill-defined. Four model architectures for instance segmentation (Mask R-CNN with a Swin-Tiny or ResNet-50 backbone, Mask DINO, and YOLOv5) were employed with five-fold cross-validation. Their effectiveness was evaluated with sensitivity, specificity, F1-score, and AUC and failure cases were shown. Mask R-CNN with a Swin-Tiny backbone was most effective (well-defined F1 = 0.784, AUC = 0.881; ill-defined F1 = 0.904, AUC = 0.971) and the model architectures including vision transformer components were more effective than those without. Model mistakes were observed around the maxillary sinus, at tooth extraction sites, and for radiolucent bands. Promising deep learning models were developed for the detection of osteolytic lesions in PRs, particularly those with vision transformer components (Mask R-CNN with Swin-Tiny and Mask DINO). These results underline the potential of vision transformers for enhancing the automated detection of osteolytic lesions, offering a significant improvement over traditional deep learning models.

The therapeutic management of neoplasm employs high level energy beam to ablate malignant cells, which can cause collateral damage to adjacent normal tissue. Furthermore, respiration-induced organ motion, during radiotherapy can lead to significant displacement of neoplasms. In this work, a non-invasive ultrasound-based deep learning algorithm for respiratory motion compensation system (RMCS) was developed to mitigate the effect of respiratory motion induced neoplasm movement in radiotherapy. The deep learning algorithm generated based on modified YOLOv8n (You Only Look Once), by incorporating squeeze and excitation blocks for channel wise recalibration and enhanced attention mechanisms for spatial channel focus (SE-ATT-YOLO) to cope up with enhanced ultrasound image detection in real time scenario. The trained model was inferred with ultrasound movement of human diaphragm and tracked the bounding box coordinates using BoT-Sort, which drives the RMCS. The SE-ATT-YOLO model achieved mean average precision (mAP) of 0.88 which outperforms YOLOv8n with the value of 0.85. The root mean square error (RMSE) obtained from prerecorded respiratory signals with the compensated RMCS signal was calculated. The model achieved an inference speed of approximately 50 FPS. The RMSE values recorded were 4.342 for baseline shift, 3.105 for sinusoidal signal, 1.778 for deep breath, and 1.667 for slow signal. The SE-ATT-YOLO model outperformed all the results of previous models. The loss function uncertainty in YOLOv8n model was rectified in SE-ATT YOLO depicting the stability of the model. The model' stability, speed and accuracy of the model optimized the performance of the RMCS.

To develop a radiomics risk-predictive model for differentiating the different stages of Hashimoto's thyroiditis (HT). Data from patients with HT who underwent definitive surgical pathology between January 2018 and December 2023 were retrospectively collected and categorized into early HT (HT patients with simple positive antibodies or simultaneously accompanied by elevated thyroid hormones) and late HT (HT patients with positive antibodies and beginning to present subclinical hypothyroidism or developing hypothyroidism). Ultrasound images and five clinical and 12 laboratory indicators were obtained. Six classifiers were used to construct radiomics models. The gradient boosting decision tree (GBDT) classifier was used to screen for the best features to explore the main risk factors for differentiating early HT. The performance of each model was evaluated by receiver operating characteristic (ROC) curve. The model was validated using one internal and two external test cohorts. A total of 785 patients were enrolled. Extreme gradient boosting (XGBOOST) showed best performance in the training cohort, with an AUC of 0.999 (0.998, 1), and AUC values of 0.993 (0.98, 1), 0.947 (0.866, 1), and 0.98 (0.939, 1), respectively, in the internal test, first external, and second external cohorts. Ultrasound radiomic features contributed to 78.6% (11/14) of the model. The first-order feature of traverse section of thyroid ultrasound image, texture feature gray-level run length matrix (GLRLM) of longitudinal section of thyroid ultrasound image and free thyroxine showed the greatest contributions in the model. Our study developed and tested a risk-predictive model that effectively differentiated HT stages to more precisely and actively manage patients with HT at an earlier stage.

LLMs have demonstrated significant potential in Medical Report Generation (MRG), yet their development requires large amounts of medical image-report pairs, which are commonly scattered across multiple centers. Centralizing these data is exceptionally challenging due to privacy regulations, thereby impeding model development and broader adoption of LLM-driven MRG models. To address this challenge, we present FedMRG, the first framework that leverages Federated Learning (FL) to enable privacy-preserving, multi-center development of LLM-driven MRG models, specifically designed to overcome the critical challenge of communication-efficient LLM training under multi-modal data heterogeneity. To start with, our framework tackles the fundamental challenge of communication overhead in FL-LLM tuning by employing low-rank factorization to efficiently decompose parameter updates, significantly reducing gradient transmission costs and making LLM-driven MRG feasible in bandwidth-constrained FL settings. Furthermore, we observed the dual heterogeneity in MRG under the FL scenario: varying image characteristics across medical centers, as well as diverse reporting styles and terminology preferences. To address this, we further enhance FedMRG with (1) client-aware contrastive learning in the MRG encoder, coupled with diagnosis-driven prompts, which capture both globally generalizable and locally distinctive features while maintaining diagnostic accuracy; and (2) a dual-adapter mutual boosting mechanism in the MRG decoder that harmonizes generic and specialized adapters to address variations in reporting styles and terminology. Through extensive evaluation of our established FL-MRG benchmark, we demonstrate the generalizability and adaptability of FedMRG, underscoring its potential in harnessing multi-center data and generating clinically accurate reports while maintaining communication efficiency.