Software programs leveraging artificial intelligence to detect vessel occlusions are now widely available to aid in stroke triage. Given their proprietary use, there is a surprising lack of information regarding how the software works, who is using the software, and their performance in an unbiased real-world setting. In this educational review of automated vessel occlusion software, we discuss emerging evidence of their utility, underlying algorithms, real-world diagnostic performance, and limitations. The intended audience includes specialists in stroke care in neurology, emergency medicine, radiology, and neurosurgery. Practical tips for onboarding and utilization of this technology are provided based on the multidisciplinary experience of the authorship team.

Brain aneurysm detection models, both in the literature and in industry, continue to lack generalizability during external validation, limiting clinical adoption. This challenge is largely due to extensive exclusion criteria during training data selection. The authors developed the first model to achieve generalizability using novel methodological approaches. Computed tomography angiography (CTA) scans from 2004 to 2023 at the study institution were used for model training, including untreated unruptured intracranial aneurysms without extensive cerebrovascular disease. External validation used digital subtraction angiography-verified CTAs from an international center, while prospective validation occurred at the internal institution over 9 months. A public web platform was created for further model validation. A total of 2194 CTA scans were used for this study. One thousand five hundred eighty-seven patients and 1920 aneurysms with a mean size of 5.3 ± 3.7 mm were included in the training cohort. The mean age of the patients was 69.7 ± 14.9 years, and 1203 (75.8%) were female. The model achieved a training Dice score of 0.88 and a validation Dice score of 0.76. Prospective internal validation on 304 scans yielded a lesion-level (LL) sensitivity of 82.5% (95% CI: 75.5-87.9) and specificity of 89.6 (95% CI: 84.5-93.2). External validation on 303 scans demonstrated an on-par LL sensitivity and specificity of 83.5% (95% CI: 75.1-89.4) and 92.9% (95% CI: 88.8-95.6), respectively. Radiologist LL sensitivity from the external center was 84.5% (95% CI: 76.2-90.2), and 87.5% of the missed aneurysms were detected by the model. The authors developed the first publicly testable artificial intelligence model for aneurysm detection on CTA scans, demonstrating generalizability and state-of-the-art performance in external validation. The model addresses key limitations of previous efforts and enables broader validation through a web-based platform.

Brain tumor classification is critical for therapeutic applications that benefit from computer-aided diagnostics. Misdiagnosing a brain tumor can significantly reduce a patient's chances of survival, as it may lead to ineffective treatments. This study proposes a novel approach for classifying brain tumors in MRI images using Transfer Learning (TL) with state-of-the-art deep learning models: AlexNet, MobileNetV2, and GoogleNet. Unlike previous studies that often focus on a single model, our work comprehensively compares these architectures, fine-tuned specifically for brain tumor classification. We utilize a publicly available dataset of 4,517 MRI scans, consisting of three prevalent types of brain tumors-glioma (1,129 images), meningioma (1,134 images), and pituitary tumors (1,138 images)-as well as 1,116 images of normal brains (no tumor). Our approach addresses key research gaps, including class imbalance, through data augmentation and model efficiency, leveraging lightweight architectures like MobileNetV2. The GoogleNet model achieves the highest classification accuracy of 99.2%, outperforming previous studies using the same dataset. This demonstrates the potential of our approach to assist physicians in making rapid and precise decisions, thereby improving patient outcomes. The results highlight the effectiveness of TL in medical diagnostics and its potential for real-world clinical deployment. This study advances the field of brain tumor classification and provides a robust framework for future research in medical image analysis.

Alzheimer's disease (AD) is a heterogeneous neurodegenerative disorder in which tau neurofibrillary tangles are a pathological hallmark closely associated with cognitive dysfunction and neurodegeneration. In this study, we used brain tau data to investigate AD heterogeneity by identifying and characterizing the subpopulations among patients. We included 615 cognitively normal and 159 AD brain ¹⁸F-flortaucipr PET scans, along with T1-weighted MRI from the Alzheimer Disease Neuroimaging Initiative database. A three dimensional-convolutional neural network model was employed for AD detection using standardized uptake value ratio (SUVR) images. The model-derived saliency maps were generated and employed as informative image features for clustering AD participants. Among the identified subpopulations, statistical analysis of demographics, neuropsychological measures, and SUVR were compared. Correlations between neuropsychological measures and regional SUVRs were assessed. A generalized linear model was utilized to investigate the sex and APOE ε4 interaction effect on regional SUVRs. Two distinct subpopulations of AD patients were revealed, denoted as S_Hi and S_Lo. Compared to the S_Lo group, the S_Hi group exhibited a significantly higher global tau burden in the brain, but both groups showed similar cognition distribution levels. In the S_Hi group, the associations between the neuropsychological measurements and regional tau deposition were weakened. Moreover, a significant interaction effect of sex and APOE ε4 on tau deposition was observed in the S_Lo group, but no such effect was found in the S_Hi group. Our results suggest that tau tangles, as shown by SUVR, continue to accumulate even when cognitive function plateaus in AD patients, highlighting the advantages of PET in later disease stages. The differing relationships between cognition and tau deposition, and between gender, APOE4, and tau deposition, provide potential for subtype-specific treatments. Targeting gender-specific and genetic factors influencing tau deposition, as well as interventions aimed at tau's impact on cognition, may be effective.

Multiple sclerosis (MS) diagnosis and monitoring rely heavily on accurate assessment of brain MRI biomarkers, particularly white matter hyperintensities (WMHs) and ventricular changes. Current segmentation approaches suffer from several limitations: they typically segment these structures independently despite their pathophysiological relationship, struggle to differentiate between normal and pathological hyperintensities, and are poorly optimized for anisotropic clinical MRI data. We propose a novel 2D pix2pix-based deep learning framework for simultaneous segmentation of ventricles and WMHs with the unique capability to distinguish between normal periventricular hyperintensities and pathological MS lesions. Our method was developed and validated on FLAIR MRI scans from 300 MS patients. Compared to established methods (SynthSeg, Atlas Matching, BIANCA, LST-LPA, LST-LGA, and WMH-SynthSeg), our approach achieved superior performance for both ventricle segmentation (Dice: 0.801+/-0.025, HD95: 18.46+/-7.1mm) and WMH segmentation (Dice: 0.624+/-0.061, precision: 0.755+/-0.161). Furthermore, our method successfully differentiated between normal and abnormal hyperintensities with a Dice coefficient of 0.647. Notably, our approach demonstrated exceptional computational efficiency, completing end-to-end processing in approximately 4 seconds per case, up to 36 times faster than baseline methods, while maintaining minimal resource requirements. This combination of improved accuracy, clinically relevant differentiation capability, and computational efficiency addresses critical limitations in current neuroimaging analysis, potentially enabling integration into routine clinical workflows and enhancing MS diagnosis and monitoring.

MRI, as a mature diagnostic method in clinical application, is favored by doctors and patients, there are also insurmountable bottleneck problems. AI strategies such as multimodal imaging integration and machine learning are used to build an intelligent multimodal imaging system based on MRI data to solve the unmet clinical needs in various medical environments. This review systematically discusses the development of MRI-guided multimodal imaging systems and the application of intelligent multimodal imaging systems integrated with artificial intelligence in the early diagnosis of brain and cardiovascular diseases. The safe and effective deployment of AI in clinical diagnostic equipment can help enhance early accurate diagnosis and personalized patient care.

Brain tumors, regardless of being benign or malignant, pose considerable health risks, with malignant tumors being more perilous due to their swift and uncontrolled proliferation, resulting in malignancy. Timely identification is crucial for enhancing patient outcomes, particularly in nations such as Bangladesh, where healthcare infrastructure is constrained. Manual MRI analysis is arduous and susceptible to inaccuracies, rendering it inefficient for prompt diagnosis. This research sought to tackle these problems by creating an automated brain tumor classification system utilizing MRI data obtained from many hospitals in Bangladesh. Advanced deep learning models, including VGG16, VGG19, and ResNet50, were utilized to classify glioma, meningioma, and various brain cancers. Explainable AI (XAI) methodologies, such as Grad-CAM and Grad-CAM++, were employed to improve model interpretability by emphasizing the critical areas in MRI scans that influenced the categorization. VGG16 achieved the most accuracy, attaining 99.17%. The integration of XAI enhanced the system's transparency and stability, rendering it more appropriate for clinical application in resource-limited environments such as Bangladesh. This study highlights the capability of deep learning models, in conjunction with explainable artificial intelligence (XAI), to enhance brain tumor detection and identification in areas with restricted access to advanced medical technologies.

To create a Python-based toolbox to simulate commonly occurring artifacts for single voxel gamma-aminobutyric acid (GABA)-edited MRS data. The toolbox was designed to maximize user flexibility and contains artifact, applied, input/output (I/O), and support functions. The artifact functions can produce spurious echoes, eddy currents, nuisance peaks, line broadening, baseline contamination, linear frequency drifts, and frequency and phase shift artifacts. Applied functions combine or apply specific parameter values to produce recognizable effects such as lipid peak and motion contamination. I/O and support functions provide additional functionality to accommodate different kinds of input data (MATLAB FID-A.mat files, NIfTI-MRS files), which vary by domain (time vs. frequency), MRS data type (e.g., edited vs. non-edited) and scale. A frequency and phase correction machine learning model experiment trained on corrupted simulated data and validated on in vivo data is shown to highlight the utility of our toolbox. Data simulated from the toolbox are complementary for research applications, as demonstrated by training a frequency and phase correction deep learning model that is applied to in vivo data containing artifacts. Visual assessment also confirms the resemblance of simulated artifacts compared to artifacts found in in vivo data. Our easy to install Python artifact simulated toolbox SMART_MRS is useful to enhance the diversity and quality of existing simulated edited-MRS data and is complementary to existing MRS simulation software.

Alzheimer's Disease (AD) as one of the most prevalent neurodegenerative disorders worldwide, characterized by significant memory and cognitive decline in its later stages, severely impacting daily lives. Consequently, early diagnosis and accurate assessment are crucial for delaying disease progression. In recent years, multimodal imaging has gained widespread adoption in AD diagnosis and research, particularly the combined use of Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET). The complementarity of these modalities in structural and metabolic information offers a unique advantage for comprehensive disease understanding and precise diagnosis. With the rapid advancement of deep learning techniques, efficient fusion of MRI and PET multimodal data has emerged as a prominent research focus. This review systematically surveys the latest advancements in deep learning-based multimodal fusion of MRI and PET images for AD research, with a particular focus on studies published in the past five years (2021-2025). It first introduces the main sources of AD-related data, along with data preprocessing and feature extraction methods. Then, it summarizes performance metrics and multimodal fusion techniques. Next, it explores the application of various deep learning models and their variants in multimodal fusion tasks. Finally, it analyzes the key challenges currently faced in the field, including data scarcity and imbalance, inter-institutional data heterogeneity, etc., and discusses potential solutions and future research directions. This review aims to provide systematic guidance for researchers in the field of MRI and PET multimodal fusion, with the ultimate goal of advancing the development of early AD diagnosis and intervention strategies.

The accurate and timely diagnosis of brain tumors is of paramount clinical significance for effective treatment planning and improved patient outcomes. While deep learning has advanced medical image analysis, concurrently achieving high classification accuracy, robust generalization, and computational efficiency remains a formidable challenge. This is often due to the difficulty in optimally capturing both fine-grained local tumor features and their broader global contextual cues without incurring substantial computational costs. This paper introduces NeXtBrain, a novel hybrid architecture meticulously designed to overcome these limitations. NeXtBrain's core innovations, the NeXt Convolutional Block (NCB) and the NeXt Transformer Block (NTB), synergistically enhance feature learning: NCB leverages Multi-Head Convolutional Attention and a SwiGLU-based MLP to precisely extract subtle local tumor morphologies and detailed textures, while NTB integrates self-attention with convolutional attention and a SwiGLU MLP to effectively model long-range spatial dependencies and global contextual relationships, crucial for differentiating complex tumor characteristics. Evaluated on two publicly available benchmark datasets, Figshare and Kaggle, NeXtBrain was rigorously compared against 17 state-of-the-art (SOTA) models. On Figshare, it achieved 99.78 % accuracy and a 99.77 % F1-score. On Kaggle, it attained 99.78 % accuracy and a 99.81 % F1-score, surpassing leading SOTA ViT, CNN, and hybrid models. Critically, NeXtBrain demonstrates exceptional computational efficiency, achieving these SOTA results with only 23.91 million parameters, requiring just 10.32 GFLOPs, and exhibiting a rapid inference time of 0.007 ms. This efficiency allows it to outperform significantly larger models such as DeiT3-Base with 85.82 M parameters, Swin-Base with 86.75 M parameters in both accuracy and computational demand.