Federated learning enables collaborative training of machine learning models among different clients while ensuring data privacy, emerging as the mainstream for breaking data silos in the healthcare domain. However, the imbalance of medical resources, data corruption or improper data preservation may lead to a situation where different clients possess medical images of different modality. This heterogeneity poses a significant challenge for cross-domain medical image segmentation within the federated learning framework. To address this challenge, we propose a new Federated Domain Adaptation (FedDA) segmentation training framework. Specifically, we propose a feature-level adversarial learning among clients by aligning feature maps across clients through embedding an adversarial training mechanism. This design can enhance the model's generalization on multiple domains and alleviate the negative impact from domain-shift. Comprehensive experiments on three medical image datasets demonstrate that our proposed FedDA substantially achieves cross-domain federated aggregation, endowing single modality client with cross-modality processing capabilities, and consistently delivers robust performance compared to state-of-the-art federated aggregation algorithms in objective and subjective assessment. Our code are available at https://github.com/GGbond-study/FedDA.

Advanced esophageal squamous cell carcinoma (ESCC) has an extremely poor prognosis. Preoperative chemoradiotherapy (CRT) can significantly prolong survival, especially in those who achieve pathological complete response (pCR). However, the pretherapeutic prediction of pCR remains challenging. To predict pCR and survival in ESCC patients undergoing CRT using an artificial intelligence (AI)-based diffusion-weighted magnetic resonance imaging (DWI-MRI) radiomics model. We retrospectively analyzed 70 patients with ESCC who underwent curative surgery following CRT. For each patient, pre-treatment tumors were semi-automatically segmented in three dimensions from DWI-MRI images (<i>b</i> = 0, 1000 second/mm²), and a total of 76 radiomics features were extracted from each segmented tumor. Using these features as explanatory variables and pCR as the objective variable, machine learning models for predicting pCR were developed using AutoGluon, an automated machine learning library, and validated by stratified double cross-validation. pCR was achieved in 15 patients (21.4%). Apparent diffusion coefficient skewness demonstrated the highest predictive performance [area under the curve (AUC) = 0.77]. Gray-level co-occurrence matrix (GLCM) entropy (<i>b</i> = 1000 second/mm²) was an independent prognostic factor for relapse-free survival (RFS) (hazard ratio = 0.32, <i>P</i> = 0.009). In Kaplan-Meier analysis, patients with high GLCM entropy showed significantly better RFS (<i>P</i> < 0.001, log-rank). The best-performing machine learning model achieved an AUC of 0.85. The predicted pCR-positive group showed significantly better RFS than the predicted pCR-negative group (<i>P</i> = 0.007, log-rank). AI-based radiomics analysis of DWI-MRI images in ESCC has the potential to accurately predict the effect of CRT before treatment and contribute to constructing optimal treatment strategies.

Endometrial cancer (EC) is the most common gynecological malignancy in high-income countries, with incidence rates rising globally. Early and accurate diagnosis is essential for improving outcomes. Transvaginal ultrasound (TVUS) remains a cost-effective first-line tool, and emerging techniques such as three-dimensional (3D) ultrasound (US), contrast-enhanced US (CEUS), elastography, and artificial intelligence (AI)-enhanced imaging may further improve diagnostic performance. To systematically review recent advances in US-based imaging techniques for the diagnosis and staging of EC, and to compare their performance with magnetic resonance imaging (MRI). A systematic search of PubMed, Scopus, Web of Science, and Google Scholar was performed to identify studies published between January 2010 and March 2025. Eligible studies evaluated TVUS, 3D-US, CEUS, elastography, or AI-enhanced US in EC diagnosis and staging. Methodological quality was assessed using the QUADAS-2 tool. Sensitivity, specificity, and area under the curve (AUC) were extracted where available, with narrative synthesis due to heterogeneity. Forty-one studies met the inclusion criteria. TVUS demonstrated high sensitivity (76%-96%) but moderate specificity (61%-86%), while MRI achieved higher specificity (84%-95%) and superior staging accuracy. 3D-US yielded accuracy comparable to MRI in selected early-stage cases. CEUS and elastography enhanced tissue characterization, and AI-enhanced US achieved pooled AUCs up to 0.91 for risk prediction and lesion segmentation. Variability in performance was noted across modalities due to patient demographics, equipment differences, and operator experience. TVUS remains a highly sensitive initial screening tool, with MRI preferred for definitive staging. 3D-US, CEUS, elastography, and AI-enhanced techniques show promise as complementary or alternative approaches, particularly in low-resource settings. Standardization, multicenter validation, and integration of multi-modal imaging are needed to optimize diagnostic pathways for EC.

Solving tough clinical questions that require both image and text understanding is still a major challenge in healthcare AI. In this work, we propose Q-FSRU, a new model that combines Frequency Spectrum Representation and Fusion (FSRU) with a method called Quantum Retrieval-Augmented Generation (Quantum RAG) for medical Visual Question Answering (VQA). The model takes in features from medical images and related text, then shifts them into the frequency domain using Fast Fourier Transform (FFT). This helps it focus on more meaningful data and filter out noise or less useful information. To improve accuracy and ensure that answers are based on real knowledge, we add a quantum inspired retrieval system. It fetches useful medical facts from external sources using quantum-based similarity techniques. These details are then merged with the frequency-based features for stronger reasoning. We evaluated our model using the VQA-RAD dataset, which includes real radiology images and questions. The results showed that Q-FSRU outperforms earlier models, especially on complex cases needing image text reasoning. The mix of frequency and quantum information improves both performance and explainability. Overall, this approach offers a promising way to build smart, clear, and helpful AI tools for doctors.

Medical imaging foundation models must adapt over time, yet full retraining is often blocked by privacy constraints and cost. We present a continual learning framework that avoids storing patient exemplars by pairing class conditional diffusion replay with Elastic Weight Consolidation. Using a compact Vision Transformer backbone, we evaluate across eight MedMNIST v2 tasks and CheXpert. On CheXpert our approach attains 0.851 AUROC, reduces forgetting by more than 30\% relative to DER\texttt{++}, and approaches joint training at 0.869 AUROC, while remaining efficient and privacy preserving. Analyses connect forgetting to two measurable factors: fidelity of replay and Fisher weighted parameter drift, highlighting the complementary roles of replay diffusion and synaptic stability. The results indicate a practical route for scalable, privacy aware continual adaptation of clinical imaging models.

The application of artificial intelligence (AI) in carotid atherosclerotic plaque detection <i>via</i> computed tomography angiography (CTA) has significantly advanced over the past decade. This mini-review consolidates recent innovations in deep learning architectures, domain adaptation techniques, and automated plaque characterization methodologies. Hybrid models, such as residual U-Net-Pyramid Scene Parsing Network, exhibit a remarkable precision of 80.49% in plaque segmentation, outperforming radiologists in diagnostic efficiency by reducing analysis time from minutes to mere seconds. Domain-adaptive frameworks, such as Lesion Assessment through Tracklet Evaluation, demonstrate robust performance across heterogeneous imaging datasets, achieving an area under the curve (AUC) greater than 0.88. Furthermore, novel approaches integrating U-Net and Efficient-Net architectures, enhanced by Bayesian optimization, have achieved impressive correlation coefficients (0.89) for plaque quantification. AI-powered CTA also enables high-precision three-dimensional vascular segmentation, with a Dice coefficient of 0.9119, and offers superior cardiovascular risk stratification compared to traditional Agatston scoring, yielding AUC values of 0.816 <i>vs</i> 0.729 at a 15-year follow-up. These breakthroughs address key challenges in plaque motion analysis, with systolic retractive motion biomarkers successfully identifying 80% of vulnerable plaques. Looking ahead, future directions focus on enhancing the interpretability of AI models through explainable AI and leveraging federated learning to mitigate data heterogeneity. This mini-review underscores the transformative potential of AI in carotid plaque assessment, offering substantial implications for stroke prevention and personalized cerebrovascular management strategies.

Structural MRI of the brain is routinely performed on patients referred to memory clinics; however, resulting radiology reports, including volumetric assessments, are conventionally stored as unstructured free text. We sought to use natural language processing (NLP) to extract text relating to intracranial volumetric assessment from brain MRI text reports to enhance routine data availability for research purposes. Electronic records from a large mental healthcare provider serving a geographic catchment of 1.3 million residents in four boroughs of south London, UK. A corpus of 4007 de-identified brain MRI reports from patients referred to memory assessment services. An NLP algorithm was developed, using a span categorisation approach, to extract six binary (presence/absence) categories from the text reports: (i) global volume loss, (ii) hippocampal/medial temporal lobe volume loss and (iii) other lobar/regional volume loss. Distributions of these categories were evaluated. The overall F1 score for the six categories was 0.89 (precision 0.92, recall 0.86), with the following precision/recall for each category: presence of global volume loss 0.95/0.95, absence of global volume loss 0.94/0.77, presence of regional volume loss 0.80/0.58, absence of regional volume loss 0.91/0.93, presence of hippocampal volume loss 0.90/0.88, and absence of hippocampal volume loss 0.94/0.92. These results support the feasibility and accuracy of using NLP techniques to extract volumetric assessments from radiology reports, and the potential for automated generation of novel meta-data from dementia assessments in electronic health records.

Deep learning (DL), a branch of artificial intelligence (AI), has been applied to diagnose developmental dysplasia of the hip (DDH) on pelvic radiographs and ultrasound (US) images. This technology can potentially assist in early screening, enable timely intervention and improve cost-effectiveness. We conducted a systematic review to evaluate the diagnostic accuracy of the DL algorithm in detecting DDH. PubMed, Medline, EMBASE, EMCARE, the clinicaltrials.gov (clinical trial registry), IEEE Xplore and Cochrane Library databases were searched in October 2024. Prospective and retrospective cohort studies that included children (< 16 years) at risk of or suspected to have DDH and reported hip ultrasonography (US) or X-ray images using AI were included. A review was conducted using the guidelines of the Cochrane Collaboration Diagnostic Test Accuracy Working Group. Risk of bias was assessed using the QUADAS-2 tool. Twenty-three studies met inclusion criteria, with 15 (n = 8315) evaluating DDH on US images and eight (n = 7091) on pelvic radiographs. The area under the curve of the included studies ranged from 0.80 to 0.99 for pelvic radiographs and 0.90-0.99 for US images. Sensitivity and specificity for detecting DDH on radiographs ranged from 92.86% to 100% and 95.65% to 99.82%, respectively. For US images, sensitivity ranged from 86.54% to 100% and specificity from 62.5% to 100%. AI demonstrated comparable effectiveness to physicians in detecting DDH. However, limited evaluation on external datasets restricts its generalisability. Further research incorporating diverse datasets and real-world applications is needed to assess its broader clinical impact on DDH diagnosis.

Timely and accurate diagnosis is crucial in addressing the global rise in thyroid cancer, ensuring effective treatment strategies and improved patient outcomes. We present an intelligent classification method that couples an Adaptive Convolutional Neural Network (CNN) with Cohen-Daubechies-Feauveau (CDF9/7) wavelets whose detail coefficients are modulated by an n-scroll chaotic system to enrich discriminative features. We evaluate on the public DDTI thyroid ultrasound dataset (n = 1,638 images; 819 malignant / 819 benign) using 5-fold cross-validation, where the proposed method attains 98.17% accuracy, 98.76% sensitivity, 97.58% specificity, 97.55% F1-score, and an AUC of 0.9912. A controlled ablation shows that adding chaotic modulation to CDF9/7 improves accuracy by +8.79 percentage points over a CDF9/7-only CNN (from 89.38% to 98.17%). To objectively position our approach, we trained state-of-the-art backbones on the same data and splits: EfficientNetV2-S (96.58% accuracy; AUC 0.987), Swin-T (96.41%; 0.986), ViT-B/16 (95.72%; 0.983), and ConvNeXt-T (96.94%; 0.987). Our method outperforms the best of these by +1.23 points in accuracy and +0.0042 in AUC, while remaining computationally efficient (28.7 ms per image; 1,125 MB peak VRAM). Robustness is further supported by cross-dataset testing on TCIA (accuracy 95.82%) and transfer to an ISIC skin-lesion subset (n = 28 unique images, augmented to 2,048; accuracy 97.31%). Explainability analyses (Grad-CAM, SHAP, LIME) highlight clinically relevant regions. Altogether, the wavelet-chaos-CNN pipeline delivers state-of-the-art thyroid ultrasound classification with strong generalization and practical runtime characteristics suitable for clinical integration.

Current models based on deep learning for low-dose CT denoising rely heavily on paired data and generalize poorly. Even the more concerned diffusion models need to learn the distribution of clean data for reconstruction, which is difficult to satisfy in medical clinical applications. At the same time, self-supervised-based methods face the challenge of significant degradation of generalizability of models pre-trained for the current dose to expand to other doses. To address these issues, this paper proposes a novel method of tunable-generalization diffusion powered by self-supervised contextual sub-data for low-dose CT reconstruction, named SuperDiff. Firstly, a contextual subdata similarity adaptive sensing strategy is designed for denoising centered on the LDCT projection domain, which provides an initial prior for the subsequent progress. Subsequently, the initial prior is used to combine knowledge distillation with a deep combination of latent diffusion models for optimizing image details. The pre-trained model is used for inference reconstruction, and the pixel-level self-correcting fusion technique is proposed for fine-grained reconstruction of the image domain to enhance the image fidelity, using the initial prior and the LDCT image as a guide. In addition, the technique is flexibly applied to the generalization of upper and lower doses or even unseen doses. Dual-domain strategy cascade for self-supervised LDCT denoising, SuperDiff requires only LDCT projection domain data for training and testing. Full qualitative and quantitative evaluations on both datasets and real data show that SuperDiff consistently outperforms existing state-of-the-art methods in terms of reconstruction and generalization performance.