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AI-driven preclinical disease risk assessment using imaging in UK biobank.

Seletkov D, Starck S, Mueller TT, Zhang Y, Steinhelfer L, Rueckert D, Braren R

pubmed logopapersJul 26 2025
Identifying disease risk and detecting disease before clinical symptoms appear are essential for early intervention and improving patient outcomes. In this context, the integration of medical imaging in a clinical workflow offers a unique advantage by capturing detailed structural and functional information. Unlike non-image data, such as lifestyle, sociodemographic, or prior medical conditions, which often rely on self-reported information susceptible to recall biases and subjective perceptions, imaging offers more objective and reliable insights. Although the use of medical imaging in artificial intelligence (AI)-driven risk assessment is growing, its full potential remains underutilized. In this work, we demonstrate how imaging can be integrated into routine screening workflows, in particular by taking advantage of neck-to-knee whole-body magnetic resonance imaging (MRI) data available in the large prospective study UK Biobank. Our analysis focuses on three-year risk assessment for a broad spectrum of diseases, including cardiovascular, digestive, metabolic, inflammatory, degenerative, and oncologic conditions. We evaluate AI-based pipelines for processing whole-body MRI and demonstrate that using image-derived radiomics features provides the best prediction performance, interpretability, and integration capability with non-image data.

Contextual structured annotations on PACS: a futuristic vision for reporting routine oncologic imaging studies and its potential to transform clinical work and research.

Wong VK, Wang MX, Bethi E, Nagarakanti S, Morani AC, Marcal LP, Rauch GM, Brown JJ, Yedururi S

pubmed logopapersJul 26 2025
Radiologists currently have very limited and time-consuming options to annotate findings on the images and are mostly limited to arrows, calipers and lines to annotate any type of findings on most PACS systems. We propose a framework placing encoded, transferable, highly contextual structured text annotations directly on PACS images indicating the type of lesion, level of suspicion, location, lesion measurement, and TNM status for malignant lesions, along with automated integration of this information into the radiology report. This approach offers a one-stop solution to generate radiology reports that are easily understood by other radiologists, patient care providers, patients, and machines while reducing the effort needed to dictate a detailed radiology report and minimizing speech recognition errors. It also provides a framework for automated generation of large volume high quality annotated data sets for machine learning algorithms from daily work of radiologists. Enabling voice dictation of these contextual annotations directly into PACS similar to voice enabled Google search will further enhance the user experience. Wider adaptation of contextualized structured annotations in the future can facilitate studies understanding the temporal evolution of different tumor lesions across multiple lines of treatment and early detection of asynchronous response/areas of treatment failure. We present a futuristic vision, and solution with the potential to transform clinical work and research in oncologic imaging.

A novel hybrid deep learning approach combining deep feature attention and statistical validation for enhanced thyroid ultrasound segmentation.

Banerjee T, Singh DP, Swain D, Mahajan S, Kadry S, Kim J

pubmed logopapersJul 26 2025
An effective diagnosis system and suitable treatment planning require the precise segmentation of thyroid nodules in ultrasound imaging. The advancement of imaging technologies has not resolved traditional imaging challenges, which include noise issues, limited contrast, and dependency on operator choices, thus highlighting the need for automated, reliable solutions. The researchers developed TATHA, an innovative deep learning architecture dedicated to improving thyroid ultrasound image segmentation accuracy. The model is evaluated using the digital database of thyroid ultrasound images, which includes 99 cases across three subsets containing 134 labelled images for training, validation, and testing. It incorporates data pre-treatment procedures that reduce speckle noise and enhance contrast, while edge detection provides high-quality input for segmentation. TATHA outperforms U-Net, PSPNet, and Vision Transformers across various datasets and cross-validation folds, achieving superior Dice scores, accuracy, and AUC results. The distributed thyroid segmentation framework generates reliable predictions by combining results from multiple feature extraction units. The findings confirm that these advancements make TATHA an essential tool for clinicians and researchers in thyroid imaging and clinical applications.

A triple pronged approach for ulcerative colitis severity classification using multimodal, meta, and transformer based learning.

Ahmed MN, Neogi D, Kabir MR, Rahman S, Momen S, Mohammed N

pubmed logopapersJul 26 2025
Ulcerative colitis (UC) is a chronic inflammatory disorder necessitating precise severity stratification to facilitate optimal therapeutic interventions. This study harnesses a triple-pronged deep learning methodology-including multimodal inference pipelines that eliminate domain-specific training, few-shot meta-learning, and Vision Transformer (ViT)-based ensembling-to classify UC severity within the HyperKvasir dataset. We systematically evaluate multiple vision transformer architectures, discovering that a Swin-Base model achieves an accuracy of 90%, while a soft-voting ensemble of diverse ViT backbones boosts performance to 93%. In parallel, we leverage multimodal pre-trained frameworks (e.g., CLIP, BLIP, FLAVA) integrated with conventional machine learning algorithms, yielding an accuracy of 83%. To address limited annotated data, we deploy few-shot meta-learning approaches (e.g., Matching Networks), attaining 83% accuracy in a 5-shot context. Furthermore, interpretability is enhanced via SHapley Additive exPlanations (SHAP), which interpret both local and global model behaviors, thereby fostering clinical trust in the model's inferences. These findings underscore the potential of contemporary representation learning and ensemble strategies for robust UC severity classification, highlighting the pivotal role of model transparency in facilitating medical image analysis.

FaRMamba: Frequency-based learning and Reconstruction aided Mamba for Medical Segmentation

Ze Rong, ZiYue Zhao, Zhaoxin Wang, Lei Ma

arxiv logopreprintJul 26 2025
Accurate medical image segmentation remains challenging due to blurred lesion boundaries (LBA), loss of high-frequency details (LHD), and difficulty in modeling long-range anatomical structures (DC-LRSS). Vision Mamba employs one-dimensional causal state-space recurrence to efficiently model global dependencies, thereby substantially mitigating DC-LRSS. However, its patch tokenization and 1D serialization disrupt local pixel adjacency and impose a low-pass filtering effect, resulting in Local High-frequency Information Capture Deficiency (LHICD) and two-dimensional Spatial Structure Degradation (2D-SSD), which in turn exacerbate LBA and LHD. In this work, we propose FaRMamba, a novel extension that explicitly addresses LHICD and 2D-SSD through two complementary modules. A Multi-Scale Frequency Transform Module (MSFM) restores attenuated high-frequency cues by isolating and reconstructing multi-band spectra via wavelet, cosine, and Fourier transforms. A Self-Supervised Reconstruction Auxiliary Encoder (SSRAE) enforces pixel-level reconstruction on the shared Mamba encoder to recover full 2D spatial correlations, enhancing both fine textures and global context. Extensive evaluations on CAMUS echocardiography, MRI-based Mouse-cochlea, and Kvasir-Seg endoscopy demonstrate that FaRMamba consistently outperforms competitive CNN-Transformer hybrids and existing Mamba variants, delivering superior boundary accuracy, detail preservation, and global coherence without prohibitive computational overhead. This work provides a flexible frequency-aware framework for future segmentation models that directly mitigates core challenges in medical imaging.

Leveraging Fine-Tuned Large Language Models for Interpretable Pancreatic Cystic Lesion Feature Extraction and Risk Categorization

Ebrahim Rasromani, Stella K. Kang, Yanqi Xu, Beisong Liu, Garvit Luhadia, Wan Fung Chui, Felicia L. Pasadyn, Yu Chih Hung, Julie Y. An, Edwin Mathieu, Zehui Gu, Carlos Fernandez-Granda, Ammar A. Javed, Greg D. Sacks, Tamas Gonda, Chenchan Huang, Yiqiu Shen

arxiv logopreprintJul 26 2025
Background: Manual extraction of pancreatic cystic lesion (PCL) features from radiology reports is labor-intensive, limiting large-scale studies needed to advance PCL research. Purpose: To develop and evaluate large language models (LLMs) that automatically extract PCL features from MRI/CT reports and assign risk categories based on guidelines. Materials and Methods: We curated a training dataset of 6,000 abdominal MRI/CT reports (2005-2024) from 5,134 patients that described PCLs. Labels were generated by GPT-4o using chain-of-thought (CoT) prompting to extract PCL and main pancreatic duct features. Two open-source LLMs were fine-tuned using QLoRA on GPT-4o-generated CoT data. Features were mapped to risk categories per institutional guideline based on the 2017 ACR White Paper. Evaluation was performed on 285 held-out human-annotated reports. Model outputs for 100 cases were independently reviewed by three radiologists. Feature extraction was evaluated using exact match accuracy, risk categorization with macro-averaged F1 score, and radiologist-model agreement with Fleiss' Kappa. Results: CoT fine-tuning improved feature extraction accuracy for LLaMA (80% to 97%) and DeepSeek (79% to 98%), matching GPT-4o (97%). Risk categorization F1 scores also improved (LLaMA: 0.95; DeepSeek: 0.94), closely matching GPT-4o (0.97), with no statistically significant differences. Radiologist inter-reader agreement was high (Fleiss' Kappa = 0.888) and showed no statistically significant difference with the addition of DeepSeek-FT-CoT (Fleiss' Kappa = 0.893) or GPT-CoT (Fleiss' Kappa = 0.897), indicating that both models achieved agreement levels on par with radiologists. Conclusion: Fine-tuned open-source LLMs with CoT supervision enable accurate, interpretable, and efficient phenotyping for large-scale PCL research, achieving performance comparable to GPT-4o.

MambaVesselNet++: A Hybrid CNN-Mamba Architecture for Medical Image Segmentation

Qing Xu, Yanming Chen, Yue Li, Ziyu Liu, Zhenye Lou, Yixuan Zhang, Xiangjian He

arxiv logopreprintJul 26 2025
Medical image segmentation plays an important role in computer-aided diagnosis. Traditional convolution-based U-shape segmentation architectures are usually limited by the local receptive field. Existing vision transformers have been widely applied to diverse medical segmentation frameworks due to their superior capabilities of capturing global contexts. Despite the advantage, the real-world application of vision transformers is challenged by their non-linear self-attention mechanism, requiring huge computational costs. To address this issue, the selective state space model (SSM) Mamba has gained recognition for its adeptness in modeling long-range dependencies in sequential data, particularly noted for its efficient memory costs. In this paper, we propose MambaVesselNet++, a Hybrid CNN-Mamba framework for medical image segmentation. Our MambaVesselNet++ is comprised of a hybrid image encoder (Hi-Encoder) and a bifocal fusion decoder (BF-Decoder). In Hi-Encoder, we first devise the texture-aware layer to capture low-level semantic features by leveraging convolutions. Then, we utilize Mamba to effectively model long-range dependencies with linear complexity. The Bi-Decoder adopts skip connections to combine local and global information of the Hi-Encoder for the accurate generation of segmentation masks. Extensive experiments demonstrate that MambaVesselNet++ outperforms current convolution-based, transformer-based, and Mamba-based state-of-the-arts across diverse medical 2D, 3D, and instance segmentation tasks. The code is available at https://github.com/CC0117/MambaVesselNet.

Hybrid Deep Learning and Handcrafted Feature Fusion for Mammographic Breast Cancer Classification

Maximilian Tschuchnig, Michael Gadermayr, Khalifa Djemal

arxiv logopreprintJul 26 2025
Automated breast cancer classification from mammography remains a significant challenge due to subtle distinctions between benign and malignant tissue. In this work, we present a hybrid framework combining deep convolutional features from a ResNet-50 backbone with handcrafted descriptors and transformer-based embeddings. Using the CBIS-DDSM dataset, we benchmark our ResNet-50 baseline (AUC: 78.1%) and demonstrate that fusing handcrafted features with deep ResNet-50 and DINOv2 features improves AUC to 79.6% (setup d1), with a peak recall of 80.5% (setup d1) and highest F1 score of 67.4% (setup d1). Our experiments show that handcrafted features not only complement deep representations but also enhance performance beyond transformer-based embeddings. This hybrid fusion approach achieves results comparable to state-of-the-art methods while maintaining architectural simplicity and computational efficiency, making it a practical and effective solution for clinical decision support.

A Metabolic-Imaging Integrated Model for Prognostic Prediction in Colorectal Liver Metastases

Qinlong Li, Pu Sun, Guanlin Zhu, Tianjiao Liang, Honggang QI

arxiv logopreprintJul 26 2025
Prognostic evaluation in patients with colorectal liver metastases (CRLM) remains challenging due to suboptimal accuracy of conventional clinical models. This study developed and validated a robust machine learning model for predicting postoperative recurrence risk. Preliminary ensemble models achieved exceptionally high performance (AUC $>$ 0.98) but incorporated postoperative features, introducing data leakage risks. To enhance clinical applicability, we restricted input variables to preoperative baseline clinical parameters and radiomic features from contrast-enhanced CT imaging, specifically targeting recurrence prediction at 3, 6, and 12 months postoperatively. The 3-month recurrence prediction model demonstrated optimal performance with an AUC of 0.723 in cross-validation. Decision curve analysis revealed that across threshold probabilities of 0.55-0.95, the model consistently provided greater net benefit than "treat-all" or "treat-none" strategies, supporting its utility in postoperative surveillance and therapeutic decision-making. This study successfully developed a robust predictive model for early CRLM recurrence with confirmed clinical utility. Importantly, it highlights the critical risk of data leakage in clinical prognostic modeling and proposes a rigorous framework to mitigate this issue, enhancing model reliability and translational value in real-world settings.

All-in-One Medical Image Restoration with Latent Diffusion-Enhanced Vector-Quantized Codebook Prior

Haowei Chen, Zhiwen Yang, Haotian Hou, Hui Zhang, Bingzheng Wei, Gang Zhou, Yan Xu

arxiv logopreprintJul 26 2025
All-in-one medical image restoration (MedIR) aims to address multiple MedIR tasks using a unified model, concurrently recovering various high-quality (HQ) medical images (e.g., MRI, CT, and PET) from low-quality (LQ) counterparts. However, all-in-one MedIR presents significant challenges due to the heterogeneity across different tasks. Each task involves distinct degradations, leading to diverse information losses in LQ images. Existing methods struggle to handle these diverse information losses associated with different tasks. To address these challenges, we propose a latent diffusion-enhanced vector-quantized codebook prior and develop \textbf{DiffCode}, a novel framework leveraging this prior for all-in-one MedIR. Specifically, to compensate for diverse information losses associated with different tasks, DiffCode constructs a task-adaptive codebook bank to integrate task-specific HQ prior features across tasks, capturing a comprehensive prior. Furthermore, to enhance prior retrieval from the codebook bank, DiffCode introduces a latent diffusion strategy that utilizes the diffusion model's powerful mapping capabilities to iteratively refine the latent feature distribution, estimating more accurate HQ prior features during restoration. With the help of the task-adaptive codebook bank and latent diffusion strategy, DiffCode achieves superior performance in both quantitative metrics and visual quality across three MedIR tasks: MRI super-resolution, CT denoising, and PET synthesis.
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