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Artificial intelligence in imaging diagnosis of liver tumors: current status and future prospects.

Hori M, Suzuki Y, Sofue K, Sato J, Nishigaki D, Tomiyama M, Nakamoto A, Murakami T, Tomiyama N

pubmed logopapersJun 19 2025
Liver cancer remains a significant global health concern, ranking as the sixth most common malignancy and the third leading cause of cancer-related deaths worldwide. Medical imaging plays a vital role in managing liver tumors, particularly hepatocellular carcinoma (HCC) and metastatic lesions. However, the large volume and complexity of imaging data can make accurate and efficient interpretation challenging. Artificial intelligence (AI) is recognized as a promising tool to address these challenges. Therefore, this review aims to explore the recent advances in AI applications in liver tumor imaging, focusing on key areas such as image reconstruction, image quality enhancement, lesion detection, tumor characterization, segmentation, and radiomics. Among these, AI-based image reconstruction has already been widely integrated into clinical workflows, helping to enhance image quality while reducing radiation exposure. While the adoption of AI-assisted diagnostic tools in liver imaging has lagged behind other fields, such as chest imaging, recent developments are driving their increasing integration into clinical practice. In the future, AI is expected to play a central role in various aspects of liver cancer care, including comprehensive image analysis, treatment planning, response evaluation, and prognosis prediction. This review offers a comprehensive overview of the status and prospects of AI applications in liver tumor imaging.

CLAIM: Clinically-Guided LGE Augmentation for Realistic and Diverse Myocardial Scar Synthesis and Segmentation

Farheen Ramzan, Yusuf Kiberu, Nikesh Jathanna, Shahnaz Jamil-Copley, Richard H. Clayton, Chen, Chen

arxiv logopreprintJun 18 2025
Deep learning-based myocardial scar segmentation from late gadolinium enhancement (LGE) cardiac MRI has shown great potential for accurate and timely diagnosis and treatment planning for structural cardiac diseases. However, the limited availability and variability of LGE images with high-quality scar labels restrict the development of robust segmentation models. To address this, we introduce CLAIM: \textbf{C}linically-Guided \textbf{L}GE \textbf{A}ugmentation for Real\textbf{i}stic and Diverse \textbf{M}yocardial Scar Synthesis and Segmentation framework, a framework for anatomically grounded scar generation and segmentation. At its core is the SMILE module (Scar Mask generation guided by cLinical knowledgE), which conditions a diffusion-based generator on the clinically adopted AHA 17-segment model to synthesize images with anatomically consistent and spatially diverse scar patterns. In addition, CLAIM employs a joint training strategy in which the scar segmentation network is optimized alongside the generator, aiming to enhance both the realism of synthesized scars and the accuracy of the scar segmentation performance. Experimental results show that CLAIM produces anatomically coherent scar patterns and achieves higher Dice similarity with real scar distributions compared to baseline models. Our approach enables controllable and realistic myocardial scar synthesis and has demonstrated utility for downstream medical imaging task.

Federated Learning for MRI-based BrainAGE: a multicenter study on post-stroke functional outcome prediction

Vincent Roca, Marc Tommasi, Paul Andrey, Aurélien Bellet, Markus D. Schirmer, Hilde Henon, Laurent Puy, Julien Ramon, Grégory Kuchcinski, Martin Bretzner, Renaud Lopes

arxiv logopreprintJun 18 2025
$\textbf{Objective:}$ Brain-predicted age difference (BrainAGE) is a neuroimaging biomarker reflecting brain health. However, training robust BrainAGE models requires large datasets, often restricted by privacy concerns. This study evaluates the performance of federated learning (FL) for BrainAGE estimation in ischemic stroke patients treated with mechanical thrombectomy, and investigates its association with clinical phenotypes and functional outcomes. $\textbf{Methods:}$ We used FLAIR brain images from 1674 stroke patients across 16 hospital centers. We implemented standard machine learning and deep learning models for BrainAGE estimates under three data management strategies: centralized learning (pooled data), FL (local training at each site), and single-site learning. We reported prediction errors and examined associations between BrainAGE and vascular risk factors (e.g., diabetes mellitus, hypertension, smoking), as well as functional outcomes at three months post-stroke. Logistic regression evaluated BrainAGE's predictive value for these outcomes, adjusting for age, sex, vascular risk factors, stroke severity, time between MRI and arterial puncture, prior intravenous thrombolysis, and recanalisation outcome. $\textbf{Results:}$ While centralized learning yielded the most accurate predictions, FL consistently outperformed single-site models. BrainAGE was significantly higher in patients with diabetes mellitus across all models. Comparisons between patients with good and poor functional outcomes, and multivariate predictions of these outcomes showed the significance of the association between BrainAGE and post-stroke recovery. $\textbf{Conclusion:}$ FL enables accurate age predictions without data centralization. The strong association between BrainAGE, vascular risk factors, and post-stroke recovery highlights its potential for prognostic modeling in stroke care.

Implicit neural representations for accurate estimation of the standard model of white matter

Tom Hendriks, Gerrit Arends, Edwin Versteeg, Anna Vilanova, Maxime Chamberland, Chantal M. W. Tax

arxiv logopreprintJun 18 2025
Diffusion magnetic resonance imaging (dMRI) enables non-invasive investigation of tissue microstructure. The Standard Model (SM) of white matter aims to disentangle dMRI signal contributions from intra- and extra-axonal water compartments. However, due to the model its high-dimensional nature, extensive acquisition protocols with multiple b-values and diffusion tensor shapes are typically required to mitigate parameter degeneracies. Even then, accurate estimation remains challenging due to noise. This work introduces a novel estimation framework based on implicit neural representations (INRs), which incorporate spatial regularization through the sinusoidal encoding of the input coordinates. The INR method is evaluated on both synthetic and in vivo datasets and compared to parameter estimates using cubic polynomials, supervised neural networks, and nonlinear least squares. Results demonstrate superior accuracy of the INR method in estimating SM parameters, particularly in low signal-to-noise conditions. Additionally, spatial upsampling of the INR can represent the underlying dataset anatomically plausibly in a continuous way, which is unattainable with linear or cubic interpolation. The INR is fully unsupervised, eliminating the need for labeled training data. It achieves fast inference ($\sim$6 minutes), is robust to both Gaussian and Rician noise, supports joint estimation of SM kernel parameters and the fiber orientation distribution function with spherical harmonics orders up to at least 8 and non-negativity constraints, and accommodates spatially varying acquisition protocols caused by magnetic gradient non-uniformities. The combination of these properties along with the possibility to easily adapt the framework to other dMRI models, positions INRs as a potentially important tool for analyzing and interpreting diffusion MRI data.

RadioRAG: Online Retrieval-augmented Generation for Radiology Question Answering.

Tayebi Arasteh S, Lotfinia M, Bressem K, Siepmann R, Adams L, Ferber D, Kuhl C, Kather JN, Nebelung S, Truhn D

pubmed logopapersJun 18 2025
<i>"Just Accepted" papers have undergone full peer review and have been accepted for publication in <i>Radiology: Artificial Intelligence</i>. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content.</i> Purpose To evaluate diagnostic accuracy of various large language models (LLMs) when answering radiology-specific questions with and without access to additional online, up-to-date information via retrieval-augmented generation (RAG). Materials and Methods The authors developed Radiology RAG (RadioRAG), an end-to-end framework that retrieves data from authoritative radiologic online sources in real-time. RAG incorporates information retrieval from external sources to supplement the initial prompt, grounding the model's response in relevant information. Using 80 questions from the RSNA Case Collection across radiologic subspecialties and 24 additional expert-curated questions with reference standard answers, LLMs (GPT-3.5-turbo, GPT-4, Mistral-7B, Mixtral-8 × 7B, and Llama3 [8B and 70B]) were prompted with and without RadioRAG in a zero-shot inference scenario (temperature ≤ 0.1, top- <i>P</i> = 1). RadioRAG retrieved context-specific information from www.radiopaedia.org. Accuracy of LLMs with and without RadioRAG in answering questions from each dataset was assessed. Statistical analyses were performed using bootstrapping while preserving pairing. Additional assessments included comparison of model with human performance and comparison of time required for conventional versus RadioRAG-powered question answering. Results RadioRAG improved accuracy for some LLMs, including GPT-3.5-turbo [74% (59/80) versus 66% (53/80), FDR = 0.03] and Mixtral-8 × 7B [76% (61/80) versus 65% (52/80), FDR = 0.02] on the RSNA-RadioQA dataset, with similar trends in the ExtendedQA dataset. Accuracy exceeded (FDR ≤ 0.007) that of a human expert (63%, (50/80)) for these LLMs, while not for Mistral-7B-instruct-v0.2, Llama3-8B, and Llama3-70B (FDR ≥ 0.21). RadioRAG reduced hallucinations for all LLMs (rates from 6-25%). RadioRAG increased estimated response time fourfold. Conclusion RadioRAG shows potential to improve LLM accuracy and factuality in radiology question answering by integrating real-time domain-specific data. ©RSNA, 2025.

DGG-XNet: A Hybrid Deep Learning Framework for Multi-Class Brain Disease Classification with Explainable AI

Sumshun Nahar Eity, Mahin Montasir Afif, Tanisha Fairooz, Md. Mortuza Ahmmed, Md Saef Ullah Miah

arxiv logopreprintJun 17 2025
Accurate diagnosis of brain disorders such as Alzheimer's disease and brain tumors remains a critical challenge in medical imaging. Conventional methods based on manual MRI analysis are often inefficient and error-prone. To address this, we propose DGG-XNet, a hybrid deep learning model integrating VGG16 and DenseNet121 to enhance feature extraction and classification. DenseNet121 promotes feature reuse and efficient gradient flow through dense connectivity, while VGG16 contributes strong hierarchical spatial representations. Their fusion enables robust multiclass classification of neurological conditions. Grad-CAM is applied to visualize salient regions, enhancing model transparency. Trained on a combined dataset from BraTS 2021 and Kaggle, DGG-XNet achieved a test accuracy of 91.33\%, with precision, recall, and F1-score all exceeding 91\%. These results highlight DGG-XNet's potential as an effective and interpretable tool for computer-aided diagnosis (CAD) of neurodegenerative and oncological brain disorders.

Toward general text-guided multimodal brain MRI synthesis for diagnosis and medical image analysis.

Wang Y, Xiong H, Sun K, Bai S, Dai L, Ding Z, Liu J, Wang Q, Liu Q, Shen D

pubmed logopapersJun 17 2025
Multimodal brain magnetic resonance imaging (MRI) offers complementary insights into brain structure and function, thereby improving the diagnostic accuracy of neurological disorders and advancing brain-related research. However, the widespread applicability of MRI is substantially limited by restricted scanner accessibility and prolonged acquisition times. Here, we present TUMSyn, a text-guided universal MRI synthesis model capable of generating brain MRI specified by textual imaging metadata from routinely acquired scans. We ensure the reliability of TUMSyn by constructing a brain MRI database comprising 31,407 3D images across 7 MRI modalities from 13 worldwide centers and pre-training an MRI-specific text encoder to process text prompts effectively. Experiments on diverse datasets and physician assessments indicate that TUMSyn-generated images can be utilized along with acquired MRI scan(s) to facilitate large-scale MRI-based screening and diagnosis of multiple brain diseases, substantially reducing the time and cost of MRI in the healthcare system.

PRO: Projection Domain Synthesis for CT Imaging

Kang Chen, Bin Huang, Xuebin Yang, Junyan Zhang, Qiegen Liu

arxiv logopreprintJun 16 2025
Synthesizing high quality CT projection data remains a significant challenge due to the limited availability of annotated data and the complex nature of CT imaging. In this work, we present PRO, a projection domain synthesis foundation model for CT imaging. To the best of our knowledge, this is the first study that performs CT synthesis in the projection domain. Unlike previous approaches that operate in the image domain, PRO learns rich structural representations from raw projection data and leverages anatomical text prompts for controllable synthesis. This projection domain strategy enables more faithful modeling of underlying imaging physics and anatomical structures. Moreover, PRO functions as a foundation model, capable of generalizing across diverse downstream tasks by adjusting its generative behavior via prompt inputs. Experimental results demonstrated that incorporating our synthesized data significantly improves performance across multiple downstream tasks, including low-dose and sparse-view reconstruction. These findings underscore the versatility and scalability of PRO in data generation for various CT applications. These results highlight the potential of projection domain synthesis as a powerful tool for data augmentation and robust CT imaging. Our source code is publicly available at: https://github.com/yqx7150/PRO.

Brain Imaging Foundation Models, Are We There Yet? A Systematic Review of Foundation Models for Brain Imaging and Biomedical Research

Salah Ghamizi, Georgia Kanli, Yu Deng, Magali Perquin, Olivier Keunen

arxiv logopreprintJun 16 2025
Foundation models (FMs), large neural networks pretrained on extensive and diverse datasets, have revolutionized artificial intelligence and shown significant promise in medical imaging by enabling robust performance with limited labeled data. Although numerous surveys have reviewed the application of FM in healthcare care, brain imaging remains underrepresented, despite its critical role in the diagnosis and treatment of neurological diseases using modalities such as MRI, CT, and PET. Existing reviews either marginalize brain imaging or lack depth on the unique challenges and requirements of FM in this domain, such as multimodal data integration, support for diverse clinical tasks, and handling of heterogeneous, fragmented datasets. To address this gap, we present the first comprehensive and curated review of FMs for brain imaging. We systematically analyze 161 brain imaging datasets and 86 FM architectures, providing information on key design choices, training paradigms, and optimizations driving recent advances. Our review highlights the leading models for various brain imaging tasks, summarizes their innovations, and critically examines current limitations and blind spots in the literature. We conclude by outlining future research directions to advance FM applications in brain imaging, with the aim of fostering progress in both clinical and research settings.
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