Transformer-based segmentation methods exhibit considerable potential in medical image analysis. However, their improved performance often comes with increased computational complexity, limiting their application in resource-constrained medical settings. Prior methods follow two independent tracks: (i) accelerating existing networks via semantic-aware routing, and (ii) optimizing token adapter design to enhance network performance. Despite directness, they encounter unavoidable defects (e.g., inflexible acceleration techniques or non-discriminative processing) limiting further improvements of quality-complexity trade-off. To address these shortcomings, we integrate these schemes by proposing the semantic-aware adapter (SarAdapter), which employs a semantic-based routing strategy, leveraging neural operators (ViT and CNN) of varying complexities. Specifically, it merges semantically similar tokens volume into low-resolution regions while preserving semantically distinct tokens as high-resolution regions. Additionally, we introduce a Mixed-adapter unit, which adaptively selects convolutional operators of varying complexities to better model regions at different scales. We evaluate our method on four medical datasets from three modalities and show that it achieves a superior balance between accuracy, model size, and efficiency. Notably, our proposed method achieves state-of-the-art segmentation quality on the Synapse dataset while reducing the number of tokens by 65.6%, signifying a substantial improvement in the efficiency of ViTs for the segmentation task.

Graph neural networks (GNNs) have achieved remarkable success in learning graph representations, especially graph Transformers, which have recently shown superior performance on various graph mining tasks. However, the graph Transformer generally treats nodes as tokens, which results in quadratic complexity regarding the number of nodes during self-attention computation. The graph multilayer perceptron (MLP) mixer addresses this challenge using the efficient MLP Mixer technique from computer vision. However, the time-consuming process of extracting graph tokens limits its performance. In this article, we present a novel architecture named ChebMixer, a newly proposed graph MLP Mixer that uses fast Chebyshev polynomials-based spectral filtering to extract a sequence of tokens. First, we produce multiscale representations of graph nodes via fast Chebyshev polynomial-based spectral filtering. Next, we consider each node's multiscale representations as a sequence of tokens and refine the node representation with an effective MLP Mixer. Finally, we aggregate the multiscale representations of nodes through Chebyshev interpolation. Owing to the powerful representation capabilities and fast computational properties of the MLP Mixer, we can quickly extract more informative node representations to improve the performance of downstream tasks. The experimental results prove our significant improvements in various scenarios, ranging from homogeneous and heterophilic graph node classification to medical image segmentation. Compared with NAGphormer, the average performance improved by 1.45% on homogeneous graphs and 4.15% on heterophilic graphs. And the average performance improved by 1.39% on medical image segmentation tasks compared with VM-UNet. We will release the source code after this article is accepted.

Deep learning models for medical image segmentation often struggle with task-specific characteristics, limiting their generalization to unseen tasks with new anatomies, labels, or modalities. Retraining or fine-tuning these models requires substantial human effort and computational resources. To address this, in-context learning (ICL) has emerged as a promising paradigm, enabling query image segmentation by conditioning on example image-mask pairs provided as prompts. Unlike previous approaches that rely on implicit modeling or non-end-to-end pipelines, we redefine the core interaction mechanism in ICL as an explicit retrieval process, termed E-ICL, benefiting from the emergence of vision foundation models (VFMs). E-ICL captures dense correspondences between queries and prompts at minimal learning cost and leverages them to dynamically weight multi-class prompt masks. Built upon E-ICL, we propose EICSeg, the first end-to-end ICL framework that integrates complementary VFMs for universal medical image segmentation. Specifically, we introduce a lightweight SD-Adapter to bridge the distinct functionalities of the VFMs, enabling more accurate segmentation predictions. To fully exploit the potential of EICSeg, we further design a scalable self-prompt training strategy and an adaptive token-to-image prompt selection mechanism, facilitating both efficient training and inference. EICSeg is trained on 47 datasets covering diverse modalities and segmentation targets. Experiments on nine unseen datasets demonstrate its strong few-shot generalization ability, achieving an average Dice score of 74.0%, outperforming existing in-context and few-shot methods by 4.5%, and reducing the gap to task-specific models to 10.8%. Even with a single prompt, EICSeg achieves a competitive average Dice score of 60.1%. Notably, it performs automatic segmentation without manual prompt engineering, delivering results comparable to interactive models while requiring minimal labeled data. Source code will be available at https://github.com/ zerone-fg/EICSeg.

This study focuses on determining the effective young modulus (stiffness) of various lattice structures for titanium scaffolds filled with magnesium and without magnesium. For specific patient success of the implant is depends on adequate elastic modulus which helps proper osteointegration. The Mg filled portion in the Ti scaffold is expected to dissolve with time as the bone growth through the Ti scaffold porous cavity is started. The proposed method is based on a general numerical homogenization scheme to determine the effective elastic properties of the lattice scaffold at the macroscopic scale. A large numerical campaign has been conducted on 18 geometries. The 3D scaffold is conceived based on the model generated from the Micro CT data of the prepared sample. The effect of the scaffold local features, e.g., the distribution of porosity, presence of scaffold's surface area to the adjacent bone location, strut diameter of implant, on the effective elastic properties is investigated. Results show that both the relative density and the geometrical features of the scaffold strongly affect the equivalent macroscopic elastic behaviour of the lattice. 6 samples are made (three each Mg filled and three without Mg) The compression test was carried out for each type of samples and the displacement obtained from the test results were in close match with the simulated results from finite element analysis. To predict the unknown required stiffness what would be the ratio between Ti scaffold and filled up Mg have been calculated using the data driven AI model.

Radiotherapy is a crucial treatment for brain tumor malignancies. To address the limitations of CT-based treatment planning, recent research has explored MR-only radiotherapy, requiring precise MR-to-CT synthesis. This study compares two deep learning approaches, supervised (Pix2Pix) and unsupervised (CycleGAN), for generating pseudo-CT (pCT) images from T1- and T2-weighted MR sequences. 3270 paired T1- and T2-weighted MRI images were collected and registered with corresponding CT images. After preprocessing, a supervised pCT generative model was trained using the Pix2Pix framework, and an unsupervised generative network (CycleGAN) was also trained to enable a comparative assessment of pCT quality relative to the Pix2Pix model. To assess differences between pCT and reference CT images, three key metrics (SSIM, PSNR, and MAE) were used. Additionally, a dosimetric evaluation was performed on selected cases to assess clinical relevance. The average SSIM, PSNR, and MAE for Pix2Pix on T1 images were 0.964 ± 0.03, 32.812 ± 5.21, and 79.681 ± 9.52 HU, respectively. Statistical analysis revealed that Pix2Pix significantly outperformed CycleGAN in generating high-fidelity pCT images (p < 0.05). There was no notable difference in the effectiveness of T1-weighted versus T2-weighted MR images for generating pCT (p > 0.05). Dosimetric evaluation confirmed comparable dose distributions between pCT and reference CT, supporting clinical feasibility. Both supervised and unsupervised methods demonstrated the capability to generate accurate pCT images from conventional T1- and T2-weighted MR sequences. While supervised methods like Pix2Pix achieve higher accuracy, unsupervised approaches such as CycleGAN offer greater flexibility by eliminating the need for paired training data, making them suitable for applications where paired data is unavailable.

This study investigated deep learning (DL) systems for diagnosing carotid artery calcifications (CAC) on panoramic radiographs. To this end, two DL systems, one with preceding and one with simultaneous area detection functions, were developed to classify CAC on panoramic radiographs, and their person-based classification performances were compared with that of a DL model directly created using entire panoramic radiographs. A total of 580 panoramic radiographs from 290 patients (with CAC) and 290 controls (without CAC) were used to create and evaluate the DL systems. Two convolutional neural networks, GoogLeNet and YOLOv7, were utilized. The following three systems were created: (1) direct classification of entire panoramic images (System 1), (2) preceding region-of-interest (ROI) detection followed by classification (System 2), and (3) simultaneous ROI detection and classification (System 3). Person-based evaluation using the same test data was performed to compare the three systems. A side-based (left and right sides of participants) evaluation was also performed on Systems 2 and 3. Between-system differences in area under the receiver-operating characteristics curve (AUC) were assessed using DeLong's test. For the side-based evaluation, the AUCs of Systems 2 and 3 were 0.89 and 0.84, respectively, and in the person-based evaluation, Systems 2 and 3 had significantly higher AUC values of 0.86 and 0.90, respectively, compared with System 1 (P < 0.001). No significant difference was found between Systems 2 and 3. Preceding or simultaneous use of area detection improved the person-based performance of DL for classifying the presence of CAC on panoramic radiographs.

Cardiac ultrasound exams provide real-time data to guide clinical decisions but require highly trained sonographers. Artificial intelligence (AI) that uses deep learning algorithms to guide novices in the acquisition of diagnostic echocardiographic studies may broaden access and improve care. The objective of this trial was to evaluate whether nurses without previous ultrasound experience (novices) could obtain diagnostic-quality acquisitions of 10 echocardiographic views using AI-based software. This noninferiority study was prospective, international, nonrandomized, and conducted at 2 medical centers, in the United States and France, from November 2023 to August 2024. Two limited cardiac exams were performed on adult patients scheduled for a clinically indicated echocardiogram; one was conducted by a novice using AI guidance and one by an expert (experienced sonographer or cardiologist) without it. Primary endpoints were evaluated by 5 experienced cardiologists to assess whether the novice exam was of sufficient quality to visually analyze the left ventricular size and function, the right ventricle size, and the presence of nontrivial pericardial effusion. Secondary endpoints included 8 additional cardiac parameters. A total of 240 patients (mean age 62.6 years; 117 women (48.8%); mean body mass index 26.6 kg/m²) completed the study. One hundred percent of the exams performed by novices with the studied software were of sufficient quality to assess the primary endpoints. Cardiac parameters assessed in exams conducted by novices and experts were strongly correlated. AI-based software provides a safe means for novices to perform diagnostic-quality cardiac ultrasounds after a short training period.

Precise segmentation of papillary thyroid microcarcinoma (PTMC) during ultrasound-guided radiofrequency ablation (RFA) is critical for effective treatment but remains challenging due to acoustic artifacts, small lesion size, and anatomical variability. In this study, we propose DualSwinUnet++, a dual-decoder transformer-based architecture designed to enhance PTMC segmentation by incorporating thyroid gland context. DualSwinUnet++ employs independent linear projection heads for each decoder and a residual information flow mechanism that passes intermediate features from the first (thyroid) decoder to the second (PTMC) decoder via concatenation and transformation. These design choices allow the model to condition tumor prediction explicitly on gland morphology without shared gradient interference. Trained on a clinical ultrasound dataset with 691 annotated RFA images and evaluated against state-of-the-art models, DualSwinUnet++ achieves superior Dice and Jaccard scores while maintaining sub-200ms inference latency. The results demonstrate the model's suitability for near real-time surgical assistance and its effectiveness in improving segmentation accuracy in challenging PTMC cases.

Myocardial strain plays a crucial role in diagnosing heart failure and myocardial infarction. Its computation relies on assessing heart muscle motion throughout the cardiac cycle. This assessment can be performed by following key points on each frame of a cine Magnetic Resonance Imaging (MRI) sequence. The use of segmentation labels yields more accurate motion estimation near heart muscle boundaries. However, since few frames in a cardiac sequence usually have segmentation labels, most methods either rely on annotated pairs of frames/volumes, greatly reducing available data, or use all frames of the cardiac cycle without segmentation supervision. Moreover, these techniques rarely utilize more than two phases during training. In this work, a new semi-supervised motion estimation algorithm using all frames of the cardiac sequence is presented. The distance map generated from the end-diastolic segmentation label is used to weight loss functions. The method is tested on an in-house dataset containing 271 patients. Several deep learning image registration and tracking algorithms were retrained on our dataset and compared to our approach. The proposed approach achieves an average End Point Error (EPE) of 1.02mm, against 1.19mm for RAFT (Recurrent All-Pairs Field Transforms). Using the end-diastolic distance map further improves this metric to 0.95mm compared to 0.91 for the fully supervised version. Correlations in systolic peak were 0.83 and 0.90 for the left ventricular global radial and circumferential strain respectively, and 0.91 for the right ventricular circumferential strain.

Magnetic resonance imaging (MRI) involves a trade-off between imaging time, signal-to-noise ratio (SNR), and spatial resolution. Reducing the imaging time often leads to a lower SNR or resolution. Deep-learning-based reconstruction (DLR) methods have been introduced to address these limitations. Image-domain super-resolution DLR enables high resolution without additional image scans. High-quality images can be obtained within a shorter timeframe by appropriately configuring DLR parameters. It is necessary to maximize the performance of super-resolution DLR to enable efficient use in MRI. We evaluated the performance of a vendor-provided super-resolution DLR method (PIQE) on a Canon 3 T MRI scanner using an edge phantom and clinical brain images from eight patients. Quantitative assessment included structural similarity index (SSIM), peak SNR (PSNR), root mean square error (RMSE), and full width at half maximum (FWHM). FWHM was used to quantitatively assess spatial resolution and image sharpness. Visual evaluation using a five-point Likert scale was also performed to assess perceived image quality. Image domain super-resolution DLR reduced scan time by up to 70 % while preserving the structural image quality. Acquisition matrices of 0.87 mm/pixel or finer with a zoom ratio of ×2 yielded SSIM ≥0.80, PSNR ≥35 dB, and non-significant FWHM differences compared to full-resolution references. In contrast, aggressive downsampling (zoom ratio 3 from low-resolution matrices) led to image degradation including truncation artifacts and reduced sharpness. These results clarify the optimal use of PIQE as an image-domain super-resolution method and provide practical guidance for its application in clinical MRI workflows.