This study aimed to develop and validate a multi-temporal magnetic resonance imaging (MRI)-based delta-radiomics model to accurately predict severe acute radiation enteritis risk in patients undergoing total neoadjuvant therapy (TNT) for locally advanced rectal cancer (LARC). A retrospective analysis was conducted on the data from 92 patients with LARC who received TNT. All patients underwent pelvic MRI at baseline (pre-treatment) and after neoadjuvant radiotherapy (post-RT). Radiomic features of the primary tumor region were extracted from T2-weighted images at both timepoints. Four delta feature strategies were defined (absolute difference, percent change, ratio, and feature fusion) by concatenating pre- and post-RT features. Severe acute radiation enteritis (SARE) was defined as a composite CTCAE-based symptom score of ≥ 3 within the first 2 weeks of radiotherapy. Features were selected via statistical evaluation and least absolute shrinkage and selection operator regression. Support vector machine (SVM) classifiers were trained using baseline, post-RT, delta, and combined radiomic and clinical features. Model performance was evaluated in an independent test set based on the area under the curve (AUC) value and other metrics. Only the delta-fusion strategy retained stable radiomic features after selection, and outperformed the difference, percent, and ratio definitions in terms of feature stability and model performance. The SVM model, based on combined delta-fusion radiomics and clinical variables, demonstrated the best predictive performance and generalizability. In the independent test cohort, this combined model demonstrated an AUC value of 0.711, sensitivity of 88.9%, and F1-score of 0.696; these values surpassed those of models built with baseline-only or delta difference features. Integrating multi-temporal radiomic features via delta-fusion with clinical factors markedly improved early prediction of SARE in LARC. The delta-fusion approach outperformed conventional delta calculations, and demonstrated superior predictive performance. This highlights its potential in guiding individualized TNT sequencing and proactive toxicity management. NA.

Radiation-induced xerostomia is a common sequela in patients who undergo head and neck radiation therapy. This study aims to develop a three-dimensional deep learning model to predict xerostomia by fusing data from the gross tumor volume primary (GTVp) channel and parotid glands (PGs) channel. Retrospective data were collected from 180 head and neck cancer patients. Xerostomia was defined as xerostomia of grade ≥ 2 occurring in the 6th month of radiation therapy. The dataset was split into 137 cases (58.4% xerostomia, 41.6% non-xerostomia) for training and 43 (55.8% xerostomia, 44.2% non-xerostomia) for testing. XeroNet was composed of GNet, PNet, and a Naive Bayes decision fusion layer. GNet processed data from the GTVp channel (CT, dose distributions corresponding and the GTVp contours). PNet processed data from the PGs channel (CT, dose distributions and the PGs contours). The Naive Bayes decision fusion layer was used to integrate the results from GNet and PNet. Model performance was evaluated using accuracy, F-score, sensitivity, specificity, and area under the receiver operator characteristic curve (AUC). The proposed model achieved promising prediction results. The accuracy, AUC, F-score, sensitivity and specificity were 0.779, 0.858, 0.797, 0.777, and 0.782, respectively. Features extracted from the CT and dose distributions in the GTVp and PGs regions were used to construct machine learning models. However, the performance of these models was inferior to our method. Compared with recent studies on xerostomia prediction, our method also showed better performance. The proposed model could effectively extract features from the GTVp and PGs channels, achieving good performance in xerostomia prediction.

This systematic review and meta-analysis aimed to summarize and evaluate the available information regarding the performance of deep learning methods for tooth detection and segmentation in orthopantomographies. Electronic databases (Medline, Embase and Cochrane) were searched up to September 2023 for relevant observational studies and both, randomized and controlled clinical trials. Two reviewers independently conducted the study selection, data extraction, and quality assessments. GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) assessment was adopted for collective grading of the overall body of evidence. From the 2,207 records identified, 20 studies were included in the analysis. Meta-analysis was conducted for the comparison of mesiodens detection and segmentation (n = 6) using sensitivity and specificity as the two main diagnostic parameters. A graphical summary of the analysis was also plotted and a Hierarchical Summary Receiver Operating Characteristic curve, prediction region, summary point, and confidence region were illustrated. The included studies quantitative analysis showed pooled sensitivity, specificity, positive LR, negative LR, and diagnostic odds ratio of 0.92 (95% confidence interval [CI], 0.84-0.96), 0.94 (95% CI, 0.89-0.97), 15.7 (95% CI, 7.6-32.2), 0.08 (95% CI, 0.04-0.18), and 186 (95% CI, 44-793), respectively. A graphical summary of the meta-analysis was plotted based on sensitivity and specificity. Hierarchical Summary Receiver Operating Characteristic curves showed a positive correlation between logit-transformed sensitivity and specificity (r = 0.886). Based on the results of the meta-analysis and GRADE assessment, a moderate recommendation is advised to dental operators when relying on AI-based tools for tooth detection and segmentation in panoramic radiographs.

Glioblastoma multiforme (GBM) is the most aggressive type of brain cancer, making effective treatments essential to improve patient survival. To advance the understanding of GBM and develop more effective therapies, preclinical studies commonly use mouse models due to their genetic and physiological similarities to humans. In particular, the GL261 mouse glioma model is employed for its reproducible tumor growth and ability to mimic key aspects of human gliomas. Ultrasound imaging is a valuable modality in preclinical studies, offering real-time, non-invasive tumor monitoring and facilitating treatment response assessment. Furthermore, its potential therapeutic applications, such as in tumor ablation, expand its utility in preclinical studies. However, real-time segmentation of GL261 tumors during surgery introduces significant complexities, such as precise tumor boundary delineation and maintaining processing efficiency. Automated segmentation offers a solution, but its success relies on high-quality datasets with precise labeling. Our study introduces the first publicly available ultrasound dataset specifically developed to improve tumor segmentation in GL261 glioblastomas, providing 1,856 annotated images to support AI model development in preclinical research. This dataset bridges preclinical insights and clinical practice, laying the foundation for developing more accurate and effective tumor resection techniques.

Neoadjuvant therapy plays a pivotal role in breast cancer treatment, particularly for patients aiming to conserve their breast by reducing tumor size pre-surgery. The ultimate goal of this treatment is achieving a pathologic complete response (pCR), which signifies the complete eradication of cancer cells, thereby lowering the likelihood of recurrence. This study introduces a novel predictive approach to identify patients likely to achieve pCR using radiomic features extracted from MR images, enhanced by the InceptionV3 model and cutting-edge validation methodologies. In our study, we gathered data from 255 unique Patient IDs sourced from the -SPY 2 MRI database with the goal of classifying pCR (pathological complete response). Our research introduced two key areas of novelty.Firstly, we explored the extraction of advanced features from the dcom series such as Area, Perimeter, Entropy, Intensity of the places where the intensity is more than the average intensity of the image. These features provided deeper insights into the characteristics of the MRI data and enhanced the discriminative power of our classification model.Secondly, we applied these extracted features along with combine pixel array of the dcom series of each patient to the numerous deep learning model along with InceptionV3 (GoogleNet) model which provides the best accuracy. To optimize the model's performance, we experimented with different combinations of loss functions, optimizer functions, and activation functions. Lastly, our classification results were subjected to validation using accuracy, AUC, Sensitivity, Specificity and F1 Score. These evaluation metrics provided a robust assessment of the model's performance and ensured the reliability of our findings. The successful combination of advanced feature extraction, utilization of the InceptionV3 model with tailored hyperparameters, and thorough validation using cutting-edge techniques significantly enhanced the accuracy and reliability of our pCR classification study. By adopting a collaborative approach that involved both radiologists and the computer-aided system, we achieved superior predictive performance for pCR, as evidenced by the impressive values obtained for the area under the curve (AUC) at 0.91 having an accuracy of .92. Overall, the combination of advanced feature extraction, leveraging the InceptionV3 model with customized hyperparameters, and rigorous validation using state-of-the-art techniques contributed to the accuracy and credibility of our pCR classification study.

High-resolution CT (HR-CT) cannot image trabecular bone due to insufficient spatial resolution. Ultra-high-resolution CT may be a valuable alternative. We aimed to describe the accuracy of Canon Medical HR, super-high-resolution (SHR), and ultra-high-resolution (UHR)-CT in measuring trabecular bone microarchitectural parameters using micro-CT as a reference. Sixteen cadaveric distal tibial epiphyses were enrolled in this pre-clinical study. Images were acquired with HR-CT (i.e., 0.5 mm slice thickness/512² matrix) and SHR-CT (i.e., 0.25 mm slice thickness and 1024² matrix) with and without deep learning reconstruction (DLR) and UHR-CT (i.e., 0.25 mm slice thickness/2048² matrix) without DLR. Trabecular bone parameters were compared. Trabecular thickness was closest with UHR-CT but remained 1.37 times that of micro-CT (P < 0.001). With SHR-CT without and with DLR, it was 1.75 and 1.79 times that of micro-CT, respectively (P < 0.001), and 3.58 and 3.68 times that of micro-CT with HR-CT without and with DLR, respectively (P < 0.001). Trabecular separation was 0.7 times that of micro-CT with UHR-CT (P < 0.001), 0.93 and 0.94 times that of micro-CT with SHR-CT without and with DLR (P = 0.36 and 0.79, respectively), and 1.52 and 1.36 times that of micro-CT with HR-CT without and with DLR (P < 0.001). Bone volume/total volume was overestimated (i.e., 1.66 to 1.92 times that of micro-CT) by all techniques (P < 0.001). However, HR-CT values were superior to UHR-CT values (P = 0.03 and 0.01, without and with DLR, respectively). UHR and SHR-CT were the closest techniques to micro-CT and surpassed HR-CT.

Medical image analysis using deep learning algorithms has become a basis of modern healthcare, enabling early detection, diagnosis, treatment planning, and disease monitoring. However, sharing sensitive raw medical data with third parties for analysis raises significant privacy concerns. This paper presents a privacy-preserving machine learning (PPML) framework using a Fully Connected Neural Network (FCNN) for secure medical image analysis using the MedMNIST dataset. The proposed PPML framework leverages a torus-based fully homomorphic encryption (TFHE) to ensure data privacy during inference, maintain patient confidentiality, and ensure compliance with privacy regulations. The FCNN model is trained in a plaintext environment for FHE compatibility using Quantization-Aware Training to optimize weights and activations. The quantized FCNN model is then validated under FHE constraints through simulation and compiled into an FHE-compatible circuit for encrypted inference on sensitive data. The proposed framework is evaluated on the MedMNIST datasets to assess its accuracy and inference time in both plaintext and encrypted environments. Experimental results reveal that the PPML framework achieves a prediction accuracy of 88.2% in the plaintext setting and 87.5% during encrypted inference, with an average inference time of 150 milliseconds per image. This shows that FCNN models paired with TFHE-based encryption achieve high prediction accuracy on MedMNIST datasets with minimal performance degradation compared to unencrypted inference.

Brain tumors (BT) can cause fatal outcomes by affecting body functions, making precise early detection via magnetic resonance imaging (MRI) examinations critical. The complex variations found in cells of BT may pose challenges in identifying the type of tumor and selecting the most suitable treatment strategy, potentially resulting in different assessments by doctors. As a result, in recent years, AI-powered diagnostic systems have been created to accurately and efficiently identify different types of BT using MRI images. Notably, state-of-the-art deep learning architectures, which have demonstrated efficacy in diverse domains, are now being employed effectively for classifying of brain MRI images. This research presents a hybrid model that integrates spatial attention mechanism (SAM) with ConvNeXt to classify three types of BT: meningioma, pituitary, and glioma. The hybrid model integrates ConvNeXt to enhance the receptive field, capturing information from a broader spatial context, crucial for recognizing tumor patterns spanning multiple pixels. SAM is applied after ConvNeXt, enabling the network to selectively focus on informative regions, thereby improving the model's ability to distinguish BT types and capture complex spatial relationships. Tested on BSF and Figshare datasets, the proposed model achieves a remarkable accuracy of 99.39% and 98.86%, respectively, outperforming the results of recent studies by achieving these results in fewer training periods. This hybrid model marks a major step forward in the automatic classification of BT, demonstrating superior performance in accuracy with efficient training.

The purpose of this study was to create and validate an ultrasound-based graph convolutional network (US-based GCN) model for the prediction of axillary lymph node metastasis (ALNM) in patients with breast cancer. A total of 820 eligible patients with breast cancer who underwent preoperative breast ultrasonography (US) between April 2016 and June 2022 were retrospectively enrolled. The training cohort consisted of 621 patients, whereas validation cohort 1 included 112 patients, and validation cohort 2 included 87 patients. A US-based GCN model was built using US deep learning features. In validation cohort 1, the US-based GCN model performed satisfactorily, with an AUC of 0.88 and an accuracy of 0.76. In validation cohort 2, the US-based GCN model performed satisfactorily, with an AUC of 0.84 and an accuracy of 0.75. This approach has the potential to help guide optimal ALNM management in breast cancer patients, particularly by preventing overtreatment. In conclusion, we developed a US-based GCN model to assess the ALN status of breast cancer patients prior to surgery. The US-based GCN model can provide a possible noninvasive method for detecting ALNM and aid in clinical decision-making. High-level evidence for clinical use in later studies is anticipated to be obtained through prospective studies.

The advent of anti-amyloid therapies (AATs) for Alzheimer's disease (AD) has elevated the importance of MRI surveillance for amyloidrelated imaging abnormalities (ARIA) such as microhemorrhages and siderosis (ARIA-H) and edema (ARIA-E). We report a literature review and early quality assurance experience with an FDA-cleared assistive AI tool intended for detection of ARIA in MRI clinical workflows. The AI system improved sensitivity for detection of subtle ARIA-E and ARIA-H lesions but at the cost of a reduction in specificity. We propose a tiered workflow combining protocol harmonization and expert interpretation with AI overlay review. AI-assisted ARIA detection is a paradigm shift that offers great promise to enhance patient safety as disease-modifying therapies for AD gain broader clinical use; however, some pitfalls need to be considered.ABBREVIATIONS: AAT＝ anti-amyloid therapy; ARIA＝ amyloid-related imaging abnormalities, ARIA-H = amyloid-related imaging abnormality-hemorrhage, ARIA-E = amyloid-related imaging abnormality-edema.