Ultrasound imaging is pivotal in clinical diagnostics due to its affordability, portability, safety, real-time capability, and non-invasive nature. It is widely utilized for examining various organs, such as the breast, thyroid, ovary, cardiac, and more. However, the manual interpretation and annotation of ultrasound images are time-consuming and prone to variability among physicians. While single-task artificial intelligence (AI) solutions have been explored, they are not ideal for scaling AI applications in medical imaging. Foundation models, although a trending solution, often struggle with real-world medical datasets due to factors such as noise, variability, and the incapability of flexibly aligning prior knowledge with task adaptation. To address these limitations, we propose an orchestration learning framework named PerceptGuide for general-purpose ultrasound classification and segmentation. Our framework incorporates a novel orchestration mechanism based on prompted hyper-perception, which adapts to the diverse inductive biases required by different ultrasound datasets. Unlike self-supervised pre-trained models, which require extensive fine-tuning, our approach leverages supervised pre-training to directly capture task-relevant features, providing a stronger foundation for multi-task and multi-organ ultrasound imaging. To support this research, we compiled a large-scale Multi-task, Multi-organ public ultrasound dataset (M²-US), featuring images from 9 organs and 16 datasets, encompassing both classification and segmentation tasks. Our approach employs four specific prompts-Object, Task, Input, and Position-to guide the model, ensuring task-specific adaptability. Additionally, a downstream synchronization training stage is introduced to fine-tune the model for new data, significantly improving generalization capabilities and enabling real-world applications. Experimental results demonstrate the robustness and versatility of our framework in handling multi-task and multi-organ ultrasound image processing, outperforming both specialist models and existing general AI solutions. Compared to specialist models, our method improves segmentation from 82.26% to 86.45%, classification from 71.30% to 79.08%, while also significantly reducing model parameters.

The radiology specialty examination assesses clinical decision-making, image interpretation, and diagnostic reasoning. With the expansion of medical knowledge, traditional test design faces challenges in maintaining accuracy and relevance. Large language models (LLMs) demonstrate potential in medical education. This study evaluates LLM performance in radiology specialty exams, explores their role in assessing question difficulty, and investigates their reasoning processes, aiming to develop a more objective and efficient framework for exam design. This study compared the performance of LLMs and human examinees in a radiology specialty examination. Three LLMs (GPT-4o, o1-preview, and GPT-3.5-turbo-1106) were evaluated under zero-shot conditions. Exam accuracy, examinee accuracy, discrimination index, and point-biserial correlation were used to assess LLMs' ability to predict question difficulty and reasoning processes. The data provided by the Taiwan Radiological Society ensures comparability between AI and human performance. As for accuracy, GPT-4o (88.0%) and o1-preview (90.9%) outperformed human examinees (76.3%), whereas GPT-3.5-turbo-1106 showed significantly lower accuracy (50.2%). Question difficulty analysis revealed that newer LLMs excel in solving complex questions, while GPT-3.5-turbo-1106 exhibited greater performance variability. Discrimination index and point-biserial Correlation analyses demonstrated that GPT-4o and o1-preview accurately identified key differentiating questions, closely mirroring human reasoning patterns. These findings suggest that advanced LLMs can assess medical examination difficulty, offering potential applications in exam standardization and question evaluation. This study evaluated the problem-solving capabilities of GPT-3.5-turbo-1106, GPT-4o, and o1-preview in a radiology specialty examination. LLMs should be utilized as tools for assessing exam question difficulty and assisting in the standardized development of medical examinations.

To develop and validate interpretable machine learning models for differentiating glioblastoma (GB) from solitary brain metastasis (SBM) using radiomics features from contrast-enhanced T1-weighted MRI (CE-T1WI), and to compare the impact of low-order and high-order features on model performance. A cohort of 434 patients with histopathologically confirmed GB (226 patients) and SBM (208 patients) was retrospectively analyzed. Radiomic features were derived from CE-T1WI, with feature selection conducted through minimum redundancy maximum relevance and least absolute shrinkage and selection operator regression. Machine learning models, including GradientBoost and lightGBM (LGBM), were trained using low-order and high-order features. The performance of the models was assessed through receiver operating characteristic analysis and computation of the area under the curve, along with other indicators, including accuracy, specificity, and sensitivity. SHapley Additive Explanations (SHAP) analysis is used to measure the influence of each feature on the model's predictions. The performances of various machine learning models on both the training and validation datasets were notably different. For the training group, the LGBM, CatBoost, multilayer perceptron (MLP), and GradientBoost models achieved the highest AUC scores, all exceeding 0.9, demonstrating strong discriminative power. The LGBM model exhibited the best stability, with a minimal AUC difference of only 0.005 between the training and test sets, suggesting strong generalizability. Among the validation group results, the GradientBoost classifier achieved the maximum AUC of 0.927, closely followed by random forest at 0.925. GradientBoost also demonstrated high sensitivity (0.911) and negative predictive value (NPV, 0.889), effectively identifying true positives. The LGBM model showed the highest test accuracy (86.2%) and performed excellently in terms of sensitivity (0.911), NPV (0.895), and positive predictive value (PPV, 0.837). The models utilizing high-order features outperformed those based on low-order features in all the metrics. SHAP analysis further enhances model interpretability, providing insights into feature importance and contributions to classification decisions. Machine learning techniques based on radiomics can effectively distinguish GB from SBM, with gradient boosting tree-based models such as LGBMs demonstrating superior performance. High-order features significantly improve model accuracy and robustness. SHAP technology enhances the interpretability and transparency of models for distinguishing brain tumors, providing intuitive visualization of the contribution of radiomic features to classification.

Early detection of malignant lesions in ultrasound images is crucial for effective cancer diagnosis and treatment. While traditional methods rely on radiologists, deep learning models can improve accuracy, reduce errors, and enhance efficiency. This study explores the application of a deep learning model for classifying benign and malignant lesions, focusing on its performance and interpretability. In this study, we proposed a feature fusion-based deep learning model for classifying benign and malignant lesions in ultrasound images. The model leverages advanced architectures such as MobileNetV2 and DenseNet121, enhanced with feature fusion and attention mechanisms to boost classification accuracy. The clinical dataset comprises 2171 images collected from 1758 patients between December 2020 and May 2024. Additionally, we utilized the publicly available BUSI dataset, consisting of 780 images from female patients aged 25 to 75, collected in 2018. To enhance interpretability, we applied Grad-CAM, Saliency Maps, and shapley additive explanations (SHAP) techniques to explain the model's decision-making. A comparative analysis with radiologists of varying expertise levels is also conducted. The proposed model exhibited the highest performance, achieving an AUC of 0.9320 on our private dataset and an area under the curve (AUC) of 0.9834 on the public dataset, significantly outperforming traditional deep convolutional neural network models. It also exceeded the diagnostic performance of radiologists, showcasing its potential as a reliable tool for medical image classification. The model's success can be attributed to its incorporation of advanced architectures, feature fusion, and attention mechanisms. The model's decision-making process was further clarified using interpretability techniques like Grad-CAM, Saliency Maps, and SHAP, offering insights into its ability to focus on relevant image features for accurate classification. The proposed deep learning model offers superior accuracy in classifying benign and malignant lesions in ultrasound images, outperforming traditional models and radiologists. Its strong performance, coupled with interpretability techniques, demonstrates its potential as a reliable and efficient tool for medical diagnostics. The datasets generated and analyzed during the current study are not publicly available due to the nature of this research and participants of this study, but may be available from the corresponding author on reasonable request.

Valid non-invasive biomarkers for Parkinson's disease (PD) and Parkinson-plus syndrome (PPS) are urgently needed. Based on our recent self-supervised vision foundation model the Shift Window UNET TRansformer (Swin UNETR), which uses clinical multi-contrast whole brain MRI, we aimed to develop an efficient and practical model ('SwinClassifier') for the discrimination of PD vs PPS using routine clinical MRI scans. We used 75,861 clinical head MRI scans including T1-weighted, T2-weighted and fluid attenuated inversion recovery imaging as a pre-training dataset to develop a foundation model, using self-supervised learning with a cross-contrast context recovery task. Then clinical head MRI scans from n = 1992 participants with PD and n = 1989 participants with PPS were used as a downstream PD vs PPS classification dataset. We then assessed SwinClassifier's performance in confusion matrices compared to a comparative self-supervised vanilla Vision Transformer (ViT) autoencoder ('ViTClassifier'), and to two convolutional neural networks (DenseNet121 and ResNet50) trained from scratch. SwinClassifier showed very good performance (F1 score 0.83, 95% confidence interval [CI] [0.79-0.87], AUC 0.89) in PD vs PPS discrimination in independent test datasets (n = 173 participants with PD and n = 165 participants with PPS). This self-supervised classifier with pretrained weights outperformed the ViTClassifier and convolutional classifiers trained from scratch (F1 score 0.77-0.82, AUC 0.83-0.85). Occlusion sensitivity mapping in the correctly-classified cases (n = 160 PD and n = 114 PPS) highlighted the brain regions guiding discrimination mainly in sensorimotor and midline structures including cerebellum, brain stem, ventricle and basal ganglia. Our self-supervised digital model based on routine clinical head MRI discriminated PD vs PPS with good accuracy and sensitivity. With incremental improvements the approach may be diagnostically useful in early disease. National Key Research and Development Program of China.

The methods for predicting time-to-total knee replacement (TKR) do not provide enough information to make robust and accurate predictions. Develop and evaluate an artificial intelligence-based model for predicting time-to-TKR by analyzing longitudinal knee data and identifying key features associated with accelerated knee osteoarthritis progression. A total of 547 subjects underwent TKR in the Osteoarthritis Initiative over nine years, and their longitudinal data was used for model training and testing. 518 and 164 subjects from Multi-Center Osteoarthritis Study and internal hospital data were used for external testing, respectively. The clinical variables, magnetic resonance (MR) images, radiographs, and quantitative and semi-quantitative assessments from images were analyzed. Deep learning (DL) models were used to extract features from radiographs and MR images. DL features were combined with clinical and image assessment features for survival analysis. A Lasso Cox feature selection method combined with a random survival forest model was used to estimate time-to-TKR. Utilizing only clinical variables for time-to-TKR predictions provided the estimation accuracy of 60.4% and C-index of 62.9%. Combining DL features extracted from radiographs, MR images with clinical, quantitative, and semi-quantitative image assessment features achieved the highest accuracy of 73.2%, (p=.001) and C-index of 77.3% for predicting time-to-TKR. The proposed predictive model demonstrated the potential of DL models and multimodal data fusion in accurately predicting time-to-TKR surgery that may help assist physicians to personalize treatment strategies and improve patient outcomes.

Alzheimer's disease (AD) is a devastating neurological disorder that affects humans and is a major contributor to dementia. It is characterized by cognitive dysfunction, impairing an individual's ability to perform daily tasks. In AD, nerve cells in areas of the brain related to cognitive function are damaged. Despite extensive research, there is currently no specific therapeutic or diagnostic approach for this fatal disease. However, scientists worldwide have developed effective techniques for diagnosing and managing this challenging disorder. Among the various methods used to diagnose AD are feedback from blood relatives and observations of changes in an individual's behavioral and cognitive abilities. Biomarkers, such as amyloid beta and measures of neurodegeneration, aid in the early detection of Alzheimer's disease (AD) through cerebrospinal fluid (CSF) samples and brain imaging techniques like Magnetic Resonance Imaging (MRI). Advanced medical imaging technologies, including X-ray, CT, MRI, ultrasound, mammography, and PET, provide valuable insights into human anatomy and function. MRI, in particular, is non-invasive and useful for scanning both the structural and functional aspects of the brain. Additionally, Machine Learning (ML) and deep learning (DL) technologies, especially Convolutional Neural Networks (CNNs), have demonstrated high accuracy in diagnosing AD by detecting brain changes. However, these technologies are intended to support, rather than replace, clinical assessments by medical professionals.

Epilepsy is a multifaceted neurological disorder marked by seizures that can present with a wide range of symptoms. Despite the prevalent use of anti-epileptic drugs, drug resistance and adverse effects present considerable obstacles. Despite advancements in anti-epileptic drugs (AEDs), approximately 20-30% of patients remain drug-resistant, highlighting the need for innovative therapeutic strategies. This study aimed to explore advancements in epilepsy diagnosis and treatment utilizing modern technology and medicines. The literature survey was carried out using Scopus, ScienceDirect, and Google Scholar. Data from the last 10 years were preferred to include in the study. Emerging technologies, such as artificial intelligence, gene therapy, and wearable gadgets, have transformed epilepsy care. EEG and MRI play essential roles in diagnosis, while AI aids in evaluating big datasets for more accurate seizure identification. Machine learning and artificial intelligence are increasingly integrated into diagnostic processes to enhance seizure detection and classification. Wearable technology improves patient self-monitoring and helps clinical research. Furthermore, gene treatments offer promise by treating the fundamental causes of seizure activity, while stem cell therapies give neuroprotective and regenerative advantages. Dietary interventions, including ketogenic diets, are being examined for their ability to modify neurochemical pathways implicated in epilepsy. Recent technological and therapeutic developments provide major benefits in epilepsy assessment and treatment, with AI and wearable devices enhancing seizure detection and patient monitoring. Nonetheless, additional study is essential to ensure greater clinical application and efficacy. Future perspectives include the potential of optogenetics and advanced signal processing techniques to revolutionize treatment paradigms, emphasizing the importance of personalized medicine in epilepsy care. Overall, a comprehensive understanding of the multifaceted nature of epilepsy is essential for developing effective interventions and improving patient outcomes.

Suicide represents an egregious threat to society despite major advancements in medicine, in part due to limited knowledge of the biological mechanisms of suicidal behavior. We apply a connectome predictive modeling machine learning approach to identify a reproducible brain network associated with suicidal ideation in the hopes of demonstrating possible targets for novel anti-suicidal therapeutics. Patients were recruited from an inpatient facility at The Menninger Clinic, in Houston, Texas (N = 261; 181 with active and specific suicidal ideation) and had a current major depressive episode and recurrent major depressive disorder, underwent resting-state functional magnetic resonance imaging. The participants' ages ranged from 18 to 70 (mean ± SEM = 31.6 ± 0.8 years) and 136 (52 %) were males. Using this approach, we found a robust and reproducible biomarker of suicidal ideation relative to controls without ideation, showing that increased suicidal ideation was associated with greater internal connectivity and reduced internetwork external connectivity in the central executive, default mode, and dorsal salience networks. We also found evidence for higher external connectivity between ventral salience and sensorimotor/visual networks as being associated with increased suicidal ideation. Overall, these observed differences may reflect reduced network integration and higher segregation of connectivity in individuals with increased suicide risk. Our findings provide avenues for future work to test novel drugs targeting these identified neural alterations, for instance drugs that increase network integration.

This research aims to develop an advanced deep-learning framework for detecting respiratory diseases, including COVID-19, pneumonia, and tuberculosis (TB), using chest X-ray scans. A Deep Neural Network (DNN)-based system was developed to analyze medical images and extract key features from chest X-rays. The system leverages various DNN learning algorithms to study X-ray scan color, curve, and edge-based features. The Adam optimizer is employed to minimize error rates and enhance model training. A dataset of 1800 chest X-ray images, consisting of COVID-19, pneumonia, TB, and typical cases, was evaluated across multiple DNN models. The highest accuracy was achieved using the VGG19 model. The proposed system demonstrated an accuracy of 94.72%, with a sensitivity of 92.73%, a specificity of 96.68%, and an F1-score of 94.66%. The error rate was 5.28% when trained with 80% of the dataset and tested on 20%. The VGG19 model showed significant accuracy improvements of 32.69%, 36.65%, 42.16%, and 8.1% over AlexNet, GoogleNet, InceptionV3, and VGG16, respectively. The prediction time was also remarkably low, ranging between 3 and 5 seconds. The proposed deep learning model efficiently detects respiratory diseases, including COVID-19, pneumonia, and TB, within seconds. The method ensures high reliability and efficiency by optimizing feature extraction and maintaining system complexity, making it a valuable tool for clinicians in rapid disease diagnosis.