To develop two distinct models for predicting microvascular invasion (MVI) and vessels encapsulating tumor clusters (VETC) based on habitat imaging, and to integrate these models for prognosis assessment. In this multicenter retrospective study, patients from two different institutions were enrolled and categorized for MVI (n=295) and VETC (n=276) prediction. Tumor and peritumoral regions on hepatobiliary phase images were segmented into subregions, from which all relevant features were extracted. The MVI and VETC predictive models were constructed by analyzing these features using various machine learning algorithms, and classifying patients into high-risk and low-risk groups. Cox regression analysis was utilized to identify risk factors for early recurrence. The MVI and VETC prediction models demonstrated excellent performance in both the training and external validation cohorts (AUC: 0.961 and 0.838 for MVI; 0.931 and 0.820 for VETC). Based on model predictions, patients were classified into high-risk group (High-risk MVI/ High-risk VETC), medium-risk group (High-risk MVI/Low-risk VETC or Low-risk MVI/High-risk VETC), and low-risk group (Low-risk MVI/Low-risk VETC). Multivariable Cox regression analysis revealed that risk group, number of tumors, and gender were independent predictors of early recurrence. Models based on habitat imaging can be used for the preoperative, noninvasive prediction of MVI and VETC, offering valuable stratification and diagnostic insights for HCC patients.

This study aims to explore a novel approach for predicting cervical lymph node metastasis (CLNM) and pathological subtypes in oral squamous cell carcinoma (OSCC) by comparing deep learning (DL) and habitat analysis models based on contrast-enhanced CT (CECT). A retrospective analysis was conducted using CECT images from patients diagnosed with OSCC via paraffin pathology at the Second Affiliated Hospital of Dalian Medical University. All patients underwent primary tumor resection and cervical lymph node dissection, with a total of 132 cases included. A DL model was developed by analysing regions of interest (ROIs) in the CECT images using a convolutional neural network (CNN). For habitat analysis, the ROI images were segmented into 3 regions using K-means clustering, and features were selected through a fully connected neural network (FCNN) to build the model. A separate clinical model was constructed based on nine clinical features, including age, gender, and tumor location. Using LNM and pathological subtypes as endpoints, the predictive performance of the clinical model, DL model, habitat analysis model, and a combined clinical + habitat model was evaluated using confusion matrices and receiver operating characteristic (ROC) curves. For LNM prediction, the combined clinical + habitat model achieved an area under the ROC curve (AUC) of 0.97. For pathological subtype prediction, the AUC was 0.96. The DL model yielded an AUC of 0.83 for LNM prediction and 0.91 for pathological subtype classification. The clinical model alone achieved an AUC of 0.94 for predicting LNM. The integrated habitat-clinical model demonstrates improved predictive performance. Combining habitat analysis with clinical features offers a promising approach for the prediction of oral cancer. The habitat-clinical integrated model may assist clinicians in performing accurate preoperative prognostic assessments in patients with oral cancer.

A significant obstacle in brain tumor treatment planning is determining the tumor's actual size. Magnetic resonance imaging (MRI) is one of the first-line brain tumor diagnosis. It takes a lot of effort and mostly depends on the operator's experience to manually separate the size of a brain tumor from 3D MRI volumes. Machine learning has been vastly enhanced by deep learning and computer-aided tumor detection methods. This study proposes to investigate the architecture of object detectors, specifically focusing on search efficiency. In order to provide more specificity, our goal is to effectively explore the Feature Pyramid Network (FPN) and prediction head of a straightforward anchor-free object detector called DEEP Q-NAS. The study utilized the BraTS 2021 dataset which includes multi-parametric magnetic resonance imaging (mpMRI) scans. The architecture we found outperforms the latest object detection models (like Fast R-CNN, YOLOv7, and YOLOv8) by 2.2 to 7 points with average precision (AP) on the MS COCO 2017 dataset. It has a similar level of complexity and less memory usage, which shows how effective our proposed NAS is for object detection. The DEEP Q-NAS with ResNeXt-152 model demonstrates the highest level of detection accuracy, achieving a rate of 99%.

Pancreatic cancer carries a poor prognosis and relies on endoscopic ultrasound (EUS) for targeted biopsy and radiotherapy. However, the speckle noise, low contrast, and unintuitive appearance of EUS make segmentation of pancreatic tumors with fully supervised deep learning (DL) models both error-prone and dependent on large, expert-curated annotation datasets. To address these challenges, we present TextSAM-EUS, a novel, lightweight, text-driven adaptation of the Segment Anything Model (SAM) that requires no manual geometric prompts at inference. Our approach leverages text prompt learning (context optimization) through the BiomedCLIP text encoder in conjunction with a LoRA-based adaptation of SAM's architecture to enable automatic pancreatic tumor segmentation in EUS, tuning only 0.86% of the total parameters. On the public Endoscopic Ultrasound Database of the Pancreas, TextSAM-EUS with automatic prompts attains 82.69% Dice and 85.28% normalized surface distance (NSD), and with manual geometric prompts reaches 83.10% Dice and 85.70% NSD, outperforming both existing state-of-the-art (SOTA) supervised DL models and foundation models (e.g., SAM and its variants). As the first attempt to incorporate prompt learning in SAM-based medical image segmentation, TextSAM-EUS offers a practical option for efficient and robust automatic EUS segmentation.

In data-scarce scenarios, deep learning models often overfit to noise and irrelevant patterns, which limits their ability to generalize to unseen samples. To address these challenges in medical image segmentation, we introduce Diff-UMamba, a novel architecture that combines the UNet framework with the mamba mechanism to model long-range dependencies. At the heart of Diff-UMamba is a noise reduction module, which employs a signal differencing strategy to suppress noisy or irrelevant activations within the encoder. This encourages the model to filter out spurious features and enhance task-relevant representations, thereby improving its focus on clinically significant regions. As a result, the architecture achieves improved segmentation accuracy and robustness, particularly in low-data settings. Diff-UMamba is evaluated on multiple public datasets, including medical segmentation decathalon dataset (lung and pancreas) and AIIB23, demonstrating consistent performance gains of 1-3% over baseline methods in various segmentation tasks. To further assess performance under limited data conditions, additional experiments are conducted on the BraTS-21 dataset by varying the proportion of available training samples. The approach is also validated on a small internal non-small cell lung cancer dataset for the segmentation of gross tumor volume in cone beam CT, where it achieves a 4-5% improvement over baseline.

The emergence of Vision Transformers (ViTs) has revolutionized computer vision, yet their effectiveness compared to traditional Convolutional Neural Networks (CNNs) in medical imaging remains under-explored. This study presents a comprehensive comparative analysis of CNN and ViT architectures across three critical medical imaging tasks: chest X-ray pneumonia detection, brain tumor classification, and skin cancer melanoma detection. We evaluated four state-of-the-art models - ResNet-50, EfficientNet-B0, ViT-Base, and DeiT-Small - across datasets totaling 8,469 medical images. Our results demonstrate task-specific model advantages: ResNet-50 achieved 98.37% accuracy on chest X-ray classification, DeiT-Small excelled at brain tumor detection with 92.16% accuracy, and EfficientNet-B0 led skin cancer classification at 81.84% accuracy. These findings provide crucial insights for practitioners selecting architectures for medical AI applications, highlighting the importance of task-specific architecture selection in clinical decision support systems.

BackgroundAdvancements in imaging technology, alongside increasing longevity and co-morbidities, have led to heightened demand for diagnostic radiology services. However, there is a shortfall in radiology and radiography staff to acquire, read and report on such imaging examinations. Artificial intelligence (AI) has been identified, notably by AI developers, as a potential solution to impact positively the workload of radiology services for diagnostics to address this staffing shortfall. MethodsA rapid review complemented with data from interviews with UK radiology service stakeholders was undertaken. ArXiv, Cochrane Library, Embase, Medline and Scopus databases were searched for publications in English published between 2007 and 2022. Following screening 110 full texts were included. Interviews with 15 radiology service managers, clinicians and academics were carried out between May and September 2022. ResultsMost literature was published in 2021 and 2022 with a distinct focus on AI for diagnostics of lung and chest disease (n = 25) notably COVID-19 and respiratory system cancers, closely followed by AI for breast screening (n = 23). AI contribution to streamline the workload of radiology services was categorised as autonomous, augmentative and assistive contributions. However, percentage estimates, of workload reduction, varied considerably with the most significant reduction identified in national screening programmes. AI was also recognised as aiding radiology services through providing second opinion, assisting in prioritisation of images for reading and improved quantification in diagnostics. Stakeholders saw AI as having the potential to remove some of the laborious work and contribute service resilience. ConclusionsThis review has shown there is limited data on real-world experiences from radiology services for the implementation of AI in clinical production. Autonomous, augmentative and assistive AI can, as noted in the article, decrease workload and aid reading and reporting, however the governance surrounding these advancements lags.

This investigation delves into the diagnosis of COVID-19, using X-ray images generated by way of an effective deep learning model. In terms of assessing the COVID-19 diagnosis learning model, the methods currently employed tend to focus on the accuracy rate level, while neglecting several significant assessment parameters. These parameters, which include precision, sensitivity and specificity, significantly, F1-score, and ROC-AUC influence the performance level of the model. In this paper, we have improved the InceptionResNet and called Enhanced InceptionResNet with restructured parameters termed, "Enhanced InceptionResNet," which incorporates depth-wise separable convolutions to enhance the efficiency of feature extraction and minimize the consumption of computational resources. For this investigation, three residual network (ResNet) models, namely Res- Net, InceptionResNet model, and the Enhanced InceptionResNet with restructured parameters, were employed for a medical image classification assignment. The performance of each model was evaluated on a balanced dataset of 2600 X-ray images. The models were subsequently assessed for accuracy and loss, as well subjected to a confusion matrix analysis. The Enhanced InceptionResNet consistently outperformed ResNet and InceptionResNet in terms of validation and testing accuracy, recall, precision, F1-score, and ROC-AUC demonstrating its superior capacity for identifying pertinent information in the data. In the context of validation and testing accuracy, our Enhanced InceptionRes- Net repeatedly proved to be more reliable than ResNet, an indication of the former's capacity for the efficient identification of pertinent information in the data (99.0% and 98.35%, respectively), suggesting enhanced feature extraction capabilities. The Enhanced InceptionResNet excelled in COVID-19 diagnosis from chest X-rays, surpassing ResNet and Default InceptionResNet in accuracy, precision, and sensitivity. Despite computational demands, it shows promise for medical image classification. Future work should leverage larger datasets, cloud platforms, and hyperparameter optimisation to improve performance, especially for distinguishing normal and pneumonia cases.

Pancreatic cancer carries a poor prognosis and relies on endoscopic ultrasound (EUS) for targeted biopsy and radiotherapy. However, the speckle noise, low contrast, and unintuitive appearance of EUS make segmentation of pancreatic tumors with fully supervised deep learning (DL) models both error-prone and dependent on large, expert-curated annotation datasets. To address these challenges, we present TextSAM-EUS, a novel, lightweight, text-driven adaptation of the Segment Anything Model (SAM) that requires no manual geometric prompts at inference. Our approach leverages text prompt learning (context optimization) through the BiomedCLIP text encoder in conjunction with a LoRA-based adaptation of SAM's architecture to enable automatic pancreatic tumor segmentation in EUS, tuning only 0.86% of the total parameters. On the public Endoscopic Ultrasound Database of the Pancreas, TextSAM-EUS with automatic prompts attains 82.69% Dice and 85.28% normalized surface distance (NSD), and with manual geometric prompts reaches 83.10% Dice and 85.70% NSD, outperforming both existing state-of-the-art (SOTA) supervised DL models and foundation models (e.g., SAM and its variants). As the first attempt to incorporate prompt learning in SAM-based medical image segmentation, TextSAM-EUS offers a practical option for efficient and robust automatic EUS segmentation. Code is available at https://github.com/HealthX-Lab/TextSAM-EUS .

The integration of artificial intelligence (AI) into medical image analysis has transformed healthcare, offering unprecedented precision in diagnosis, treatment planning, and disease monitoring. However, its adoption within the Internet of Medical Things (IoMT) raises significant challenges related to transparency, trustworthiness, and security. This paper introduces a novel Explainable AI (XAI) framework tailored for Medical Cyber-Physical Systems (MCPS), addressing these challenges by combining deep neural networks with symbolic knowledge reasoning to deliver clinically interpretable insights. The framework incorporates an Enhanced Dynamic Confidence-Weighted Attention (Enhanced DCWA) mechanism, which improves interpretability and robustness by dynamically refining attention maps through adaptive normalization and multi-level confidence weighting. Additionally, a Resilient Observability and Detection Engine (RODE) leverages sparse observability principles to detect and mitigate adversarial threats, ensuring reliable performance in dynamic IoMT environments. Evaluations conducted on benchmark datasets, including CheXpert, RSNA Pneumonia Detection Challenge, and NIH Chest X-ray Dataset, demonstrate significant advancements in classification accuracy, adversarial robustness, and explainability. The framework achieves a 15% increase in lesion classification accuracy, a 30% reduction in robustness loss, and a 20% improvement in the Explainability Index compared to state-of-the-art methods.