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Joint Holistic and Lesion Controllable Mammogram Synthesis via Gated Conditional Diffusion Model

Xin Li, Kaixiang Yang, Qiang Li, Zhiwei Wang

arxiv logopreprintJul 25 2025
Mammography is the most commonly used imaging modality for breast cancer screening, driving an increasing demand for deep-learning techniques to support large-scale analysis. However, the development of accurate and robust methods is often limited by insufficient data availability and a lack of diversity in lesion characteristics. While generative models offer a promising solution for data synthesis, current approaches often fail to adequately emphasize lesion-specific features and their relationships with surrounding tissues. In this paper, we propose Gated Conditional Diffusion Model (GCDM), a novel framework designed to jointly synthesize holistic mammogram images and localized lesions. GCDM is built upon a latent denoising diffusion framework, where the noised latent image is concatenated with a soft mask embedding that represents breast, lesion, and their transitional regions, ensuring anatomical coherence between them during the denoising process. To further emphasize lesion-specific features, GCDM incorporates a gated conditioning branch that guides the denoising process by dynamically selecting and fusing the most relevant radiomic and geometric properties of lesions, effectively capturing their interplay. Experimental results demonstrate that GCDM achieves precise control over small lesion areas while enhancing the realism and diversity of synthesized mammograms. These advancements position GCDM as a promising tool for clinical applications in mammogram synthesis. Our code is available at https://github.com/lixinHUST/Gated-Conditional-Diffusion-Model/

Reconstruct or Generate: Exploring the Spectrum of Generative Modeling for Cardiac MRI

Niklas Bubeck, Yundi Zhang, Suprosanna Shit, Daniel Rueckert, Jiazhen Pan

arxiv logopreprintJul 25 2025
In medical imaging, generative models are increasingly relied upon for two distinct but equally critical tasks: reconstruction, where the goal is to restore medical imaging (usually inverse problems like inpainting or superresolution), and generation, where synthetic data is created to augment datasets or carry out counterfactual analysis. Despite shared architecture and learning frameworks, they prioritize different goals: generation seeks high perceptual quality and diversity, while reconstruction focuses on data fidelity and faithfulness. In this work, we introduce a "generative model zoo" and systematically analyze how modern latent diffusion models and autoregressive models navigate the reconstruction-generation spectrum. We benchmark a suite of generative models across representative cardiac medical imaging tasks, focusing on image inpainting with varying masking ratios and sampling strategies, as well as unconditional image generation. Our findings show that diffusion models offer superior perceptual quality for unconditional generation but tend to hallucinate as masking ratios increase, whereas autoregressive models maintain stable perceptual performance across masking levels, albeit with generally lower fidelity.

Extreme Cardiac MRI Analysis under Respiratory Motion: Results of the CMRxMotion Challenge

Kang Wang, Chen Qin, Zhang Shi, Haoran Wang, Xiwen Zhang, Chen Chen, Cheng Ouyang, Chengliang Dai, Yuanhan Mo, Chenchen Dai, Xutong Kuang, Ruizhe Li, Xin Chen, Xiuzheng Yue, Song Tian, Alejandro Mora-Rubio, Kumaradevan Punithakumar, Shizhan Gong, Qi Dou, Sina Amirrajab, Yasmina Al Khalil, Cian M. Scannell, Lexiaozi Fan, Huili Yang, Xiaowu Sun, Rob van der Geest, Tewodros Weldebirhan Arega, Fabrice Meriaudeau, Caner Özer, Amin Ranem, John Kalkhof, İlkay Öksüz, Anirban Mukhopadhyay, Abdul Qayyum, Moona Mazher, Steven A Niederer, Carles Garcia-Cabrera, Eric Arazo, Michal K. Grzeszczyk, Szymon Płotka, Wanqin Ma, Xiaomeng Li, Rongjun Ge, Yongqing Kou, Xinrong Chen, He Wang, Chengyan Wang, Wenjia Bai, Shuo Wang

arxiv logopreprintJul 25 2025
Deep learning models have achieved state-of-the-art performance in automated Cardiac Magnetic Resonance (CMR) analysis. However, the efficacy of these models is highly dependent on the availability of high-quality, artifact-free images. In clinical practice, CMR acquisitions are frequently degraded by respiratory motion, yet the robustness of deep learning models against such artifacts remains an underexplored problem. To promote research in this domain, we organized the MICCAI CMRxMotion challenge. We curated and publicly released a dataset of 320 CMR cine series from 40 healthy volunteers who performed specific breathing protocols to induce a controlled spectrum of motion artifacts. The challenge comprised two tasks: 1) automated image quality assessment to classify images based on motion severity, and 2) robust myocardial segmentation in the presence of motion artifacts. A total of 22 algorithms were submitted and evaluated on the two designated tasks. This paper presents a comprehensive overview of the challenge design and dataset, reports the evaluation results for the top-performing methods, and further investigates the impact of motion artifacts on five clinically relevant biomarkers. All resources and code are publicly available at: https://github.com/CMRxMotion

SP-Mamba: Spatial-Perception State Space Model for Unsupervised Medical Anomaly Detection

Rui Pan, Ruiying Lu

arxiv logopreprintJul 25 2025
Radiography imaging protocols target on specific anatomical regions, resulting in highly consistent images with recurrent structural patterns across patients. Recent advances in medical anomaly detection have demonstrated the effectiveness of CNN- and transformer-based approaches. However, CNNs exhibit limitations in capturing long-range dependencies, while transformers suffer from quadratic computational complexity. In contrast, Mamba-based models, leveraging superior long-range modeling, structural feature extraction, and linear computational efficiency, have emerged as a promising alternative. To capitalize on the inherent structural regularity of medical images, this study introduces SP-Mamba, a spatial-perception Mamba framework for unsupervised medical anomaly detection. The window-sliding prototype learning and Circular-Hilbert scanning-based Mamba are introduced to better exploit consistent anatomical patterns and leverage spatial information for medical anomaly detection. Furthermore, we excavate the concentration and contrast characteristics of anomaly maps for improving anomaly detection. Extensive experiments on three diverse medical anomaly detection benchmarks confirm the proposed method's state-of-the-art performance, validating its efficacy and robustness. The code is available at https://github.com/Ray-RuiPan/SP-Mamba.

MedIQA: A Scalable Foundation Model for Prompt-Driven Medical Image Quality Assessment

Siyi Xun, Yue Sun, Jingkun Chen, Zitong Yu, Tong Tong, Xiaohong Liu, Mingxiang Wu, Tao Tan

arxiv logopreprintJul 25 2025
Rapid advances in medical imaging technology underscore the critical need for precise and automated image quality assessment (IQA) to ensure diagnostic accuracy. Existing medical IQA methods, however, struggle to generalize across diverse modalities and clinical scenarios. In response, we introduce MedIQA, the first comprehensive foundation model for medical IQA, designed to handle variability in image dimensions, modalities, anatomical regions, and types. We developed a large-scale multi-modality dataset with plentiful manually annotated quality scores to support this. Our model integrates a salient slice assessment module to focus on diagnostically relevant regions feature retrieval and employs an automatic prompt strategy that aligns upstream physical parameter pre-training with downstream expert annotation fine-tuning. Extensive experiments demonstrate that MedIQA significantly outperforms baselines in multiple downstream tasks, establishing a scalable framework for medical IQA and advancing diagnostic workflows and clinical decision-making.

PerioDet: Large-Scale Panoramic Radiograph Benchmark for Clinical-Oriented Apical Periodontitis Detection

Xiaocheng Fang, Jieyi Cai, Huanyu Liu, Chengju Zhou, Minhua Lu, Bingzhi Chen

arxiv logopreprintJul 25 2025
Apical periodontitis is a prevalent oral pathology that presents significant public health challenges. Despite advances in automated diagnostic systems across various medical fields, the development of Computer-Aided Diagnosis (CAD) applications for apical periodontitis is still constrained by the lack of a large-scale, high-quality annotated dataset. To address this issue, we release a large-scale panoramic radiograph benchmark called "PerioXrays", comprising 3,673 images and 5,662 meticulously annotated instances of apical periodontitis. To the best of our knowledge, this is the first benchmark dataset for automated apical periodontitis diagnosis. This paper further proposes a clinical-oriented apical periodontitis detection (PerioDet) paradigm, which jointly incorporates Background-Denoising Attention (BDA) and IoU-Dynamic Calibration (IDC) mechanisms to address the challenges posed by background noise and small targets in automated detection. Extensive experiments on the PerioXrays dataset demonstrate the superiority of PerioDet in advancing automated apical periodontitis detection. Additionally, a well-designed human-computer collaborative experiment underscores the clinical applicability of our method as an auxiliary diagnostic tool for professional dentists.

Dealing with Segmentation Errors in Needle Reconstruction for MRI-Guided Brachytherapy

Vangelis Kostoulas, Arthur Guijt, Ellen M. Kerkhof, Bradley R. Pieters, Peter A. N. Bosman, Tanja Alderliesten

arxiv logopreprintJul 25 2025
Brachytherapy involves bringing a radioactive source near tumor tissue using implanted needles. Image-guided brachytherapy planning requires amongst others, the reconstruction of the needles. Manually annotating these needles on patient images can be a challenging and time-consuming task for medical professionals. For automatic needle reconstruction, a two-stage pipeline is commonly adopted, comprising a segmentation stage followed by a post-processing stage. While deep learning models are effective for segmentation, their results often contain errors. No currently existing post-processing technique is robust to all possible segmentation errors. We therefore propose adaptations to existing post-processing techniques mainly aimed at dealing with segmentation errors and thereby improving the reconstruction accuracy. Experiments on a prostate cancer dataset, based on MRI scans annotated by medical professionals, demonstrate that our proposed adaptations can help to effectively manage segmentation errors, with the best adapted post-processing technique achieving median needle-tip and needle-bottom point localization errors of $1.07$ (IQR $\pm 1.04$) mm and $0.43$ (IQR $\pm 0.46$) mm, respectively, and median shaft error of $0.75$ (IQR $\pm 0.69$) mm with 0 false positive and 0 false negative needles on a test set of 261 needles.

Exploring AI-Based System Design for Pixel-Level Protected Health Information Detection in Medical Images.

Truong T, Baltruschat IM, Klemens M, Werner G, Lenga M

pubmed logopapersJul 25 2025
De-identification of medical images is a critical step to ensure privacy during data sharing in research and clinical settings. The initial step in this process involves detecting Protected Health Information (PHI), which can be found in image metadata or imprinted within image pixels. Despite the importance of such systems, there has been limited evaluation of existing AI-based solutions, creating barriers to the development of reliable and robust tools. In this study, we present an AI-based pipeline for PHI detection, comprising three key modules: text detection, text extraction, and text analysis. We benchmark three models-YOLOv11, EasyOCR, and GPT-4o- across different setups corresponding to these modules, evaluating their performance on two different datasets encompassing multiple imaging modalities and PHI categories. Our findings indicate that the optimal setup involves utilizing dedicated vision and language models for each module, which achieves a commendable balance in performance, latency, and cost associated with the usage of large language models (LLMs). Additionally, we show that the application of LLMs not only involves identifying PHI content but also enhances OCR tasks and facilitates an end-to-end PHI detection pipeline, showcasing promising outcomes through our analysis.

Automatic Prediction of TMJ Disc Displacement in CBCT Images Using Machine Learning.

Choi H, Jeon KJ, Lee C, Choi YJ, Jo GD, Han SS

pubmed logopapersJul 25 2025
Magnetic resonance imaging (MRI) is the gold standard for diagnosing disc displacement in temporomandibular joint (TMJ) disorders, but its high cost and practical challenges limit its accessibility. This study aimed to develop a machine learning (ML) model that can predict TMJ disc displacement using only cone-beam computed tomography (CBCT)-based radiomics features without MRI. CBCT images of 247 mandibular condyles from 134 patients who also underwent MRI scans were analyzed. To conduct three experiments based on the classification of various patient groups, we trained two ML models, random forest (RF) and extreme gradient boosting (XGBoost). Experiment 1 classified the data into three groups: Normal, disc displacement with reduction (DDWR), and disc displacement without reduction (DDWOR). Experiment 2 classified Normal versus disc displacement group (DDWR and DDWOR), and Experiment 3 classified Normal and DDWR versus DDWOR group. The RF model showed higher performance than XGBoost across all three experiments, and in particular, Experiment 3, which differentiated DDWOR from other conditions, achieved the highest accuracy with an area under the receiver operating characteristic curve (AUC) values of 0.86 (RF) and 0.85 (XGBoost). Experiment 2 followed with AUC values of 0.76 (RF) and 0.75 (XGBoost), while Experiment 1, which classified all three groups, had the lowest accuracy of 0.63 (RF) and 0.59 (XGBoost). The RF model, utilizing radiomics features from CBCT images, demonstrated potential as an assistant tool for predicting DDWOR, which requires the most careful management.

CT-free kidney single-photon emission computed tomography for glomerular filtration rate.

Kwon K, Oh D, Kim JH, Yoo J, Lee WW

pubmed logopapersJul 25 2025
This study explores an artificial intelligence-based approach to perform CT-free quantitative SPECT for kidney imaging using Tc-99 m DTPA, aiming to estimate glomerular filtration rate (GFR) without relying on CT. A total of 1000 SPECT/CT scans were used to train and test a deep-learning model that segments kidneys automatically based on synthetic attenuation maps (µ-maps) derived from SPECT alone. The model employed a residual U-Net with edge attention and was optimized using windowing-maximum normalization and a generalized Dice similarity loss function. Performance evaluation showed strong agreement with manual CT-based segmentation, achieving a Dice score of 0.818 ± 0.056 and minimal volume differences of 17.9 ± 43.6 mL (mean ± standard deviation). An additional set of 50 scans confirmed that GFR calculated from the AI-based CT-free SPECT (109.3 ± 17.3 mL/min) was nearly identical to the conventional SPECT/CT method (109.2 ± 18.4 mL/min, p = 0.9396). This CT-free method reduced radiation exposure by up to 78.8% and shortened segmentation time from 40 min to under 1 min. The findings suggest that AI can effectively replace CT in kidney SPECT imaging, maintaining quantitative accuracy while improving safety and efficiency.
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