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AI-Driven insights in pancreatic cancer imaging: from pre-diagnostic detection to prognostication.

Antony A, Mukherjee S, Bi Y, Collisson EA, Nagaraj M, Murlidhar M, Wallace MB, Goenka AH

pubmed logopapersJul 1 2025
Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related deaths in the United States, largely due to its poor five-year survival rate and frequent late-stage diagnosis. A significant barrier to early detection even in high-risk cohorts is that the pancreas often appears morphologically normal during the pre-diagnostic phase. Yet, the disease can progress rapidly from subclinical stages to widespread metastasis, undermining the effectiveness of screening. Recently, artificial intelligence (AI) applied to cross-sectional imaging has shown significant potential in identifying subtle, early-stage changes in pancreatic tissue that are often imperceptible to the human eye. Moreover, AI-driven imaging also aids in the discovery of prognostic and predictive biomarkers, essential for personalized treatment planning. This article uniquely integrates a critical discussion on AI's role in detecting visually occult PDAC on pre-diagnostic imaging, addresses challenges of model generalizability, and emphasizes solutions like standardized datasets and clinical workflows. By focusing on both technical advancements and practical implementation, this article provides a forward-thinking conceptual framework that bridges current gaps in AI-driven PDAC research.

Redefining prostate cancer care: innovations and future directions in active surveillance.

Koett M, Melchior F, Artamonova N, Bektic J, Heidegger I

pubmed logopapersJul 1 2025
This review provides a critical analysis of recent advancements in active surveillance (AS), emphasizing updates from major international guidelines and their implications for clinical practice. Recent revisions to international guidelines have broadened the eligibility criteria for AS to include selected patients with ISUP grade group 2 prostate cancer. This adjustment acknowledges that certain intermediate-risk cancers may be appropriate for AS, reflecting a heightened focus on achieving a balance between oncologic control and maintaining quality of life by minimizing the risk of overtreatment. This review explores key innovations in AS for prostate cancer, including multi parametric magnetic resonance imaging (mpMRI), genomic biomarkers, and risk calculators, which enhance patient selection and monitoring. While promising, their routine use remains debated due to guideline inconsistencies, cost, and accessibility. Special focus is given to biomarkers for identifying ISUP grade group 2 cancers suitable for AS. Additionally, the potential of artificial intelligence to improve diagnostic accuracy and risk stratification is examined. By integrating these advancements, this review provides a critical perspective on optimizing AS for more personalized and effective prostate cancer management.

Multiparametric MRI for Assessment of the Biological Invasiveness and Prognosis of Pancreatic Ductal Adenocarcinoma in the Era of Artificial Intelligence.

Zhao B, Cao B, Xia T, Zhu L, Yu Y, Lu C, Tang T, Wang Y, Ju S

pubmed logopapersJul 1 2025
Pancreatic ductal adenocarcinoma (PDAC) is the deadliest malignant tumor, with a grim 5-year overall survival rate of about 12%. As its incidence and mortality rates rise, it is likely to become the second-leading cause of cancer-related death. The radiological assessment determined the stage and management of PDAC. However, it is a highly heterogeneous disease with the complexity of the tumor microenvironment, and it is challenging to adequately reflect the biological aggressiveness and prognosis accurately through morphological evaluation alone. With the dramatic development of artificial intelligence (AI), multiparametric magnetic resonance imaging (mpMRI) using specific contrast media and special techniques can provide morphological and functional information with high image quality and become a powerful tool in quantifying intratumor characteristics. Besides, AI has been widespread in the field of medical imaging analysis. Radiomics is the high-throughput mining of quantitative image features from medical imaging that enables data to be extracted and applied for better decision support. Deep learning is a subset of artificial neural network algorithms that can automatically learn feature representations from data. AI-enabled imaging biomarkers of mpMRI have enormous promise to bridge the gap between medical imaging and personalized medicine and demonstrate huge advantages in predicting biological characteristics and the prognosis of PDAC. However, current AI-based models of PDAC operate mainly in the realm of a single modality with a relatively small sample size, and the technical reproducibility and biological interpretation present a barrage of new potential challenges. In the future, the integration of multi-omics data, such as radiomics and genomics, alongside the establishment of standardized analytical frameworks will provide opportunities to increase the robustness and interpretability of AI-enabled image biomarkers and bring these biomarkers closer to clinical practice. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 4.

Worldwide research trends on artificial intelligence in head and neck cancer: a bibliometric analysis.

Silvestre-Barbosa Y, Castro VT, Di Carvalho Melo L, Reis PED, Leite AF, Ferreira EB, Guerra ENS

pubmed logopapersJul 1 2025
This bibliometric analysis aims to explore scientific data on Artificial Intelligence (AI) and Head and Neck Cancer (HNC). AI-related HNC articles from the Web of Science Core Collection were searched. VosViewer and Biblioshiny/Bibiometrix for R Studio were used for data synthesis. This analysis covered key characteristics such as sources, authors, affiliations, countries, citations and top cited articles, keyword analysis, and trending topics. A total of 1,019 papers from 1995 to 2024 were included. Among them, 71.6% were original research articles, 7.6% were reviews, and 20.8% took other forms. The fifty most cited documents highlighted radiology as the most explored specialty, with an emphasis on deep learning models for segmentation. The publications have been increasing, with an annual growth rate of 94.4% after 2016. Among the 20 most productive countries, 14 are high-income economies. The keywords of strong citation revealed 2 main clusters: radiomics and radiotherapy. The most frequently keywords include machine learning, deep learning, artificial intelligence, and head and neck cancer, with recent emphasis on diagnosis, survival prediction, and histopathology. There has been an increase in the use of AI in HNC research since 2016 and indicated a notable disparity in publication quantity between high-income and low/middle-income countries. Future research should prioritize clinical validation and standardization to facilitate the integration of AI in HNC management, particularly in underrepresented regions.

Medical image translation with deep learning: Advances, datasets and perspectives.

Chen J, Ye Z, Zhang R, Li H, Fang B, Zhang LB, Wang W

pubmed logopapersJul 1 2025
Traditional medical image generation often lacks patient-specific clinical information, limiting its clinical utility despite enhancing downstream task performance. In contrast, medical image translation precisely converts images from one modality to another, preserving both anatomical structures and cross-modal features, thus enabling efficient and accurate modality transfer and offering unique advantages for model development and clinical practice. This paper reviews the latest advancements in deep learning(DL)-based medical image translation. Initially, it elaborates on the diverse tasks and practical applications of medical image translation. Subsequently, it provides an overview of fundamental models, including convolutional neural networks (CNNs), transformers, and state space models (SSMs). Additionally, it delves into generative models such as Generative Adversarial Networks (GANs), Variational Autoencoders (VAEs), Autoregressive Models (ARs), diffusion Models, and flow Models. Evaluation metrics for assessing translation quality are discussed, emphasizing their importance. Commonly used datasets in this field are also analyzed, highlighting their unique characteristics and applications. Looking ahead, the paper identifies future trends, challenges, and proposes research directions and solutions in medical image translation. It aims to serve as a valuable reference and inspiration for researchers, driving continued progress and innovation in this area.

Optimizing clinical risk stratification of localized prostate cancer.

Gnanapragasam VJ

pubmed logopapersJul 1 2025
To review the current risk and prognostic stratification systems in localised prostate cancer. To explore some of the most promising adjuncts to clinical models and what the evidence has shown regarding their value. There are many new biomarker-based models seeking to improve, optimise or replace clinical models. There are promising data on the value of MRI, radiomics, genomic classifiers and most recently artificial intelligence tools in refining stratification. Despite the extensive literature however, there remains uncertainty on where in pathways they can provide the most benefit and whether a biomarker is most useful for prognosis or predictive use. Comparisons studies have also often overlooked the fact that clinical models have themselves evolved and the context of the baseline used in biomarker studies that have shown superiority have to be considered. For new biomarkers to be included in stratification models, well designed prospective clinical trials are needed. Until then, there needs to be caution in interpretation of their use for day-to-day decision making. It is critical that users balance any purported incremental value against the performance of the latest clinical classification and multivariate models especially as the latter are cost free and widely available.

Physiological Confounds in BOLD-fMRI and Their Correction.

Addeh A, Williams RJ, Golestani A, Pike GB, MacDonald ME

pubmed logopapersJul 1 2025
Functional magnetic resonance imaging (fMRI) has opened new frontiers in neuroscience by instrumentally driving our understanding of brain function and development. Despite its substantial successes, fMRI studies persistently encounter obstacles stemming from inherent, unavoidable physiological confounds. The adverse effects of these confounds are especially noticeable with higher magnetic fields, which have been gaining momentum in fMRI experiments. This review focuses on the four major physiological confounds impacting fMRI studies: low-frequency fluctuations in both breathing depth and rate, low-frequency fluctuations in the heart rate, thoracic movements, and cardiac pulsatility. Over the past three decades, numerous correction techniques have emerged to address these challenges. Correction methods have effectively enhanced the detection of task-activated voxels and minimized the occurrence of false positives and false negatives in functional connectivity studies. While confound correction methods have merit, they also have certain limitations. For instance, model-based approaches require externally recorded physiological data that is often unavailable in fMRI studies. Methods reliant on independent component analysis, on the other hand, need prior knowledge about the number of components. Machine learning techniques, although showing potential, are still in the early stages of development and require additional validation. This article reviews the mechanics of physiological confound correction methods, scrutinizes their performance and limitations, and discusses their impact on fMRI studies.

The Evolution of Radiology Image Annotation in the Era of Large Language Models.

Flanders AE, Wang X, Wu CC, Kitamura FC, Shih G, Mongan J, Peng Y

pubmed logopapersJul 1 2025
Although there are relatively few diverse, high-quality medical imaging datasets on which to train computer vision artificial intelligence models, even fewer datasets contain expertly classified observations that can be repurposed to train or test such models. The traditional annotation process is laborious and time-consuming. Repurposing annotations and consolidating similar types of annotations from disparate sources has never been practical. Until recently, the use of natural language processing to convert a clinical radiology report into labels required custom training of a language model for each use case. Newer technologies such as large language models have made it possible to generate accurate and normalized labels at scale, using only clinical reports and specific prompt engineering. The combination of automatically generated labels extracted and normalized from reports in conjunction with foundational image models provides a means to create labels for model training. This article provides a short history and review of the annotation and labeling process of medical images, from the traditional manual methods to the newest semiautomated methods that provide a more scalable solution for creating useful models more efficiently. <b>Keywords:</b> Feature Detection, Diagnosis, Semi-supervised Learning © RSNA, 2025.

Challenges, optimization strategies, and future horizons of advanced deep learning approaches for brain lesion segmentation.

Zaman A, Yassin MM, Mehmud I, Cao A, Lu J, Hassan H, Kang Y

pubmed logopapersJul 1 2025
Brain lesion segmentation is challenging in medical image analysis, aiming to delineate lesion regions precisely. Deep learning (DL) techniques have recently demonstrated promising results across various computer vision tasks, including semantic segmentation, object detection, and image classification. This paper offers an overview of recent DL algorithms for brain tumor and stroke segmentation, drawing on literature from 2021 to 2024. It highlights the strengths, limitations, current research challenges, and unexplored areas in imaging-based brain lesion classification based on insights from over 250 recent review papers. Techniques addressing difficulties like class imbalance and multi-modalities are presented. Optimization methods for improving performance regarding computational and structural complexity and processing speed are discussed. These include lightweight neural networks, multilayer architectures, and computationally efficient, highly accurate network designs. The paper also reviews generic and latest frameworks of different brain lesion detection techniques and highlights publicly available benchmark datasets and their issues. Furthermore, open research areas, application prospects, and future directions for DL-based brain lesion classification are discussed. Future directions include integrating neural architecture search methods with domain knowledge, predicting patient survival levels, and learning to separate brain lesions using patient statistics. To ensure patient privacy, future research is anticipated to explore privacy-preserving learning frameworks. Overall, the presented suggestions serve as a guideline for researchers and system designers involved in brain lesion detection and stroke segmentation tasks.
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