Accurate segmentation of pheochromocytoma (PCC) in abdominal CT scans is essential for tumor burden estimation, prognosis, and treatment planning. It may also help infer genetic clusters, reducing reliance on expensive testing. This study systematically evaluates anatomical priors to identify configurations that improve deep learning-based PCC segmentation. We employed the nnU-Net framework to evaluate eleven annotation strategies for accurate 3D segmentation of pheochromocytoma, introducing a set of novel multi-class schemes based on organ-specific anatomical priors. These priors were derived from adjacent organs commonly surrounding adrenal tumors (e.g., liver, spleen, kidney, aorta, adrenal gland, and pancreas), and were compared against a broad body-region prior used in previous work. The framework was trained and tested on 105 contrast-enhanced CT scans from 91 patients at the NIH Clinical Center. Performance was measured using Dice Similarity Coefficient (DSC), Normalized Surface Distance (NSD), and instance-wise F1 score. Among all strategies, the Tumor + Kidney + Aorta (TKA) annotation achieved the highest segmentation accuracy, significantly outperforming the previously used Tumor + Body (TB) annotation across DSC (p = 0.0097), NSD (p = 0.0110), and F1 score (25.84% improvement at an IoU threshold of 0.5), measured on a 70-30 train-test split. The TKA model also showed superior tumor burden quantification (R^2 = 0.968) and strong segmentation across all genetic subtypes. In five-fold cross-validation, TKA consistently outperformed TB across IoU thresholds (0.1 to 0.5), reinforcing its robustness and generalizability. These findings highlight the value of incorporating relevant anatomical context in deep learning models to achieve precise PCC segmentation, supporting clinical assessment and longitudinal monitoring.

Medical image segmentation suffers from data scarcity, particularly in polyp detection where annotation requires specialized expertise. We present SynDiff, a framework combining text-guided synthetic data generation with efficient diffusion-based segmentation. Our approach employs latent diffusion models to generate clinically realistic synthetic polyps through text-conditioned inpainting, augmenting limited training data with semantically diverse samples. Unlike traditional diffusion methods requiring iterative denoising, we introduce direct latent estimation enabling single-step inference with T x computational speedup. On CVC-ClinicDB, SynDiff achieves 96.0% Dice and 92.9% IoU while maintaining real-time capability suitable for clinical deployment. The framework demonstrates that controlled synthetic augmentation improves segmentation robustness without distribution shift. SynDiff bridges the gap between data-hungry deep learning models and clinical constraints, offering an efficient solution for deployment in resourcelimited medical settings.

To compare the trueness of artificial intelligence (AI)-based, manual, and global segmentation protocols by superimposing the resulting segmented 3D models onto reference gold standard surface scan models. Twelve dry human mandibles were used. A cone beam computed tomography (CBCT) scanner was used to scan the mandibles, and the acquired digital imaging and communications in medicine (DICOM) files were segmented using three protocols: global thresholding, manual, and AI-based segmentation (Diagnocat; Diagnocat, San Francisco, CA). The segmented files were exported as study 3D models. A structured light surface scanner (GoSCAN Spark; Creaform 3D, Levis, Canada) was used to scan all mandibles, and the resulting reference 3D models were exported. The study 3D models were compared with the respective reference 3D models by using a mesh comparison software (Geomagic Design X; 3D Systems Inc, Rock Hill, SC). Root mean square (RMS) error values were recorded to measure the magnitude of deviation (trueness), and color maps were obtained to visualize the differences. Comparisons of the trueness of three segmentation methods for differences in RMS were made using repeated measures analysis of variance (ANOVA). A two-sided 5% significance level was used for all tests in the software program. AI-based segmentations had significantly higher RMS values than manual segmentations for the entire mandible (p < 0.001), alveolar process (p < 0.001), and body of the mandible (p < 0.001). AI-based segmentations had significantly lower RMS values than manual segmentations for the condyles (p = 0.018) and ramus (p = 0.013). No significant differences were found between the AI-based and manual segmentations for the coronoid process (p = 0.275), symphysis (p = 0.346), and angle of the mandible (p = 0.344). Global thresholding had significantly higher RMS values than manual segmentations for the alveolus (p < 0.001), angle of the mandible (p < 0.001), body of the mandible (p < 0.001), condyles (p < 0.001), coronoid (p = 0.002), entire mandible (p < 0.001), ramus (p < 0.001), and symphysis (p < 0.001). Global thresholding had significantly higher RMS values than AI-based segmentation for the alveolar process (p = 0.002), angle of the mandible (p < 0.001), body of the mandible (p < 0.001), condyles (p < 0.001), coronoid (p = 0.017), mandible (p < 0.001), ramus (p < 0.001), and symphysis (p < 0.001). AI-based segmentations produced lower RMS values, indicating truer 3D models, compared to global thresholding, and showed no significant differences in some areas compared to manual segmentation. Thus, AI-based segmentation offers a level of segmentation trueness acceptable for use as an alternative to manual or global thresholding segmentation protocols.

To construct an artificial intelligence (AI)-assisted model for identifying the infraorbital posterior ethmoid cells (IPECs) based on deep learning using sagittal CT images. Sagittal CT images of 277 samples with and 142 samples without IPECs were retrospectively collected. An experienced radiologist engaged in the relevant aspects picked a sagittal CT image that best showed IPECs. The images were randomly assigned to the training and test sets, with 541 sides in the training set and 97 sides in the test set. The training set was used to perform a five-fold cross-validation, and the results of each fold were used to predict the test set. The model was built using nnUNet, and its performance was evaluated using Dice and standard classification metrics. The model achieved a Dice coefficient of 0.900 in the training set and 0.891 in the additional set. Precision was 0.965 for the training set and 1.000 for the additional set, while sensitivity was 0.981 and 0.967, respectively. A comparison of the diagnostic efficacy between manual outlining by a less-experienced radiologist and AI-assisted outlining showed a significant improvement in detection efficiency (P < 0.05). The AI model aided correctly in identifying and outlining all IPECs, including 12 sides that the radiologist should improve portraying. AI models can help radiologists identify the IPECs, which can further prompt relevant clinical interventions.

The specific role of lysophospholipids (LysoPLs) in the pathogenesis of chronic obstructive pulmonary disease (COPD) is not yet fully understood. We determined serum LysoPLs in 20 patients with stable COPD and 20 healthy smokers using liquid chromatography-mass spectrometry (LC-MS) and matching with the lipidIMMS library, and integrated these data with spirometry, systemic inflammation markers, and quantitative chest CT generated by an automated 3D-U-Net artificial intelligence algorithm model. Our findings identified three differential LysoPLs, lysophosphatidylcholine (LPC) (18:0), LPC (18:1), and LPC (18:2), which were significantly lower in the COPD group than in healthy smokers. Significant negative correlations were observed between these LPCs and the inflammatory markers C-reactive protein and Interleukin-6. LPC (18:0) and (18:2) correlated with higher post-bronchodilator FEV1, and the latter also correlated with FEV1% predicted, forced vital capacity (FVC), and FEV1/FVC ratio. Additionally, these three LPCs were negatively correlated with the volume and percentage of low attenuation areas (LAA), high-attenuation areas (HAA), honeycombing, reticular patterns, ground-glass opacities (GGO), and consolidation on CT imaging. In the patients with COPD, the three LPCs were most significantly associated with HAA and GGO. In conclusion, patients with stable COPD exhibited a unique LysoPL metabolism profile, with LPC (18:0), LPC (18:1), and LPC (18:2) being the most significantly altered lipid molecules. The reduction in these three LPCs was associated with impaired pulmonary function and were also linked to a greater extent of emphysema and interstitial lung abnormalities.

Small animal models are crucial for investigating idiopathic pulmonary fibrosis (IPF) and developing preclinical therapeutic strategies. However, there are several limitations to the quantitative measurements used in the longitudinal assessment of experimental lung fibrosis, e.g., histological or biochemical analyses introduce inter-individual variability, while image-derived biomarker has yet to directly and accurately quantify the severity of lung fibrosis. This study investigates artificial intelligence (AI)-assisted, end-to-end, semi-quantitative measurement of lung fibrosis using in vivo micro-CT. Based on the bleomycin (BLM)-induced lung fibrosis mouse model, the AI model predicts histopathological scores from in vivo micro-CT images, directly correlating these images with the severity of lung fibrosis in mice. Fibrosis severity was graded by the Ashcroft scale: none (0), mild (1-3), moderate (4-5), severe (≥6).The overall accuracy, precision, recall, and F1 scores of the lung fibrosis severity-stratified 3-fold cross validation on 225 micro-CT images for the proposed AI model were 92.9%, 90.9%, 91.6%, and 91.0%. The overall area under the receiver operating characteristic curve (AUROC) was 0.990 (95% CI: 0.977, 1.000), with AUROC values of 1.000 for none (100 images, 95% CI: 0.997, 1.000), 0.969 for mild (43 images, 95% CI: 0.918, 1.000), 0.992 for moderate (36 images, 95% CI: 0.962, 1.000), and 0.992 for severe (46 images, 95% CI: 0.967, 1.000). Preliminary results indicate that AI-assisted, in vivo micro-CT-based semi-quantitative measurements of murine are feasible and likely accurate. This novel method holds promise as a tool to improve the reproducibility of experimental studies in animal models of IPF.

The aim of this study was to evaluate the benefit of a volumetric AI-based body composition analysis (BCA) algorithm in multiple myeloma (MM). Therefore, a retrospective monocentric cohort of 91 MM patients was analyzed. The BCA algorithm, powered by a convolutional neural network, quantified tissue compartments and bone density based on routine CT scans. Correlations between BCA data and demographic/clinical parameters were investigated. BCA-endotypes were identified and survival rates were compared between BCA-derived patient clusters. Patients with high-risk cytogenetics exhibited elevated cardiac marker index values. Across Revised-International Staging System (R-ISS) categories, BCA parameters did not show significant differences. However, both subcutaneous and total adipose tissue volumes were significantly lower in patients with progressive disease or death during follow-up compared to patients without progression. Cluster analysis revealed two distinct BCA-endotypes, with one group displaying significantly better survival. Furthermore, a combined model composed of clinical parameters and BCA data demonstrated a higher predictive capability for disease progression compared to models based solely on high-risk cytogenetics or R-ISS. These findings underscore the potential of BCA to improve patient stratification and refining prognostic models in MM.

The decision to treat unruptured intracranial aneurysms remains a clinical dilemma. Middle cerebral artery (MCA) aneurysms represent a prevalent subtype of intracranial aneurysms. This study aims to develop a multimodal fusion deep learning model for stratifying rupture risk in MCA aneurysms. We retrospectively enrolled internal cohort and two external validation datasets with 578 and 51 MCA aneurysms, respectively. Multivariate logistic regression analysis was performed to identify independent predictors of rupture. Aneurysm morphological parameters were quantified using reconstructed CT angiography (CTA) images. Radiomics features of aneurysms were extracted through computational analysis. We developed MCANet - a multimodal data-driven classification model integrating raw CTA images, radiomics features, clinical parameters, and morphological characteristics - to establish an aneurysm rupture risk assessment framework. External validation was conducted using datasets from two independent medical centers to evaluate model generalizability and small-sample robustness. Four key metrics, including accuracy, F1-score, precision, and recall, were employed to assess model performance. In the internal cohort, 369 aneurysms were ruptured. Independent predictors of rupture included: the presence of multiple aneurysms, aneurysm location, aneurysm angle, presence of daughter-sac aneurysm, and height-width ratio. MCANet demonstrated satisfactory predictive performance with 91.38% accuracy, 96.33% sensitivity, 90.52% precision, and 93.33% F1-score. External validation maintained good discriminative ability across both independent cohorts. The MCANet model effectively integrates multimodal heterogeneous data for MCA aneurysm rupture risk prediction, demonstrating clinical applicability even in data-constrained scenarios. This model shows potential to optimize therapeutic decision-making and mitigate patient anxiety through individualized risk assessment.

To investigate lumbar vertebral volumetric bone mineral density (vBMD) from ex vivo opportunistic multi-detector computed tomography (MDCT) scans using different protocols, and compare it to dedicated quantitative CT (QCT) values from the same specimens. Cadavers from two female donors (ages 62 and 68 years) were scanned (L1-L5) using six different MDCT protocols and one dedicated QCT scan. Opportunistic vBMD was extracted using an artificial intelligence-based algorithm. The vBMD measurements from the six MDCT protocols, which varied in peak tube voltage (80-140 kVp), tube load (72-200 mAs), slice thickness (0.75-1 mm), and/or slice increment (0.5-0.75 mm), were compared to those obtained from dedicated QCT. A strong positive correlation was observed between vBMD from opportunistic MDCT and reference QCT (ρ = 0.869, p < 0.01). Agreement between vBMD measurements from MDCT protocols and the QCT reference standard according to the intraclass correlation coefficient (ICC) was 0.992 (95% confidence interval [CI]: 0.982-0.998). Bland-Altman analysis showed biases ranging from - 12.66 to 8.00 mg/cm³ across the six MDCT protocols, with all data points falling within the respective limits of agreement (LOA) for both cadavers. Opportunistic vBMD measurements of lumbar vertebrae demonstrated reliable consistency ex vivo across various scan parameters when compared to dedicated QCT.

Accurate segmentation of pheochromocytoma (PCC) in abdominal CT scans is essential for tumor burden estimation, prognosis, and treatment planning. It may also help infer genetic clusters, reducing reliance on expensive testing. This study systematically evaluates anatomical priors to identify configurations that improve deep learning-based PCC segmentation. We employed the nnU-Net framework to evaluate eleven annotation strategies for accurate 3D segmentation of pheochromocytoma, introducing a set of novel multi-class schemes based on organ-specific anatomical priors. These priors were derived from adjacent organs commonly surrounding adrenal tumors (e.g., liver, spleen, kidney, aorta, adrenal gland, and pancreas), and were compared against a broad body-region prior used in previous work. The framework was trained and tested on 105 contrast-enhanced CT scans from 91 patients at the NIH Clinical Center. Performance was measured using Dice Similarity Coefficient (DSC), Normalized Surface Distance (NSD), and instance-wise F1 score. Among all strategies, the Tumor + Kidney + Aorta (TKA) annotation achieved the highest segmentation accuracy, significantly outperforming the previously used Tumor + Body (TB) annotation across DSC (p = 0.0097), NSD (p = 0.0110), and F1 score (25.84% improvement at an IoU threshold of 0.5), measured on a 70-30 train-test split. The TKA model also showed superior tumor burden quantification (R^2 = 0.968) and strong segmentation across all genetic subtypes. In five-fold cross-validation, TKA consistently outperformed TB across IoU thresholds (0.1 to 0.5), reinforcing its robustness and generalizability. These findings highlight the value of incorporating relevant anatomical context into deep learning models to achieve precise PCC segmentation, offering a valuable tool to support clinical assessment and longitudinal disease monitoring in PCC patients.