Generative artificial intelligence has emerged as a transformative force in medical imaging since 2022, enabling the creation of derivative synthetic datasets that closely resemble real-world data. This Viewpoint examines key aspects of synthetic data, focusing on its advancements, applications, and challenges in medical imaging. Various generative artificial intelligence image generation paradigms, such as physics-informed and statistical models, and their potential to augment and diversify medical research resources are explored. The promises of synthetic datasets, including increased diversity, privacy preservation, and multifunctionality, are also discussed, along with their ability to model complex biological phenomena. Next, specific applications using synthetic data such as enhancing medical education, augmenting rare disease datasets, improving radiology workflows, and enabling privacy-preserving multicentre collaborations are highlighted. The challenges and ethical considerations surrounding generative artificial intelligence, including patient privacy, data copying, and potential biases that could impede clinical translation, are also addressed. Finally, future directions for research and development in this rapidly evolving field are outlined, emphasising the need for robust evaluation frameworks and responsible utilisation of generative artificial intelligence in medical imaging.

Prevalent knee osteoarthritis (OA) imposes substantial burden on health systems with no cure available. Its ultimate treatment is total knee replacement (TKR). Complications from surgery and recovery are difficult to predict in advance, and numerous factors may affect them. Radiographic knee alignment is one of the key factors that impacts TKR outcomes, affecting outcomes such as postoperative pain or function. Recently, artificial intelligence (AI) has been introduced to the automatic analysis of knee radiographs, for example, to automate knee alignment measurements. Existing review articles tend to focus on knee OA diagnosis and segmentation of bones or cartilages in MRI rather than exploring knee alignment biomarkers for TKR outcomes and their assessment. In this review, we first examine the current scoring protocols for evaluating TKR outcomes and potential knee alignment biomarkers associated with these outcomes. We then discuss existing AI-based approaches for generating knee alignment biomarkers from knee radiographs, and explore future directions for knee alignment assessment and TKR outcome prediction.

Radiomics research has been hindered by inconsistent and often poor methodological quality, limiting its potential for clinical translation. To address this challenge, the METhodological RadiomICs Score (METRICS) was recently introduced as a tool for systematically assessing study rigor. However, its effective application requires clearer guidance. The METRICS-E3 (Explanation and Elaboration with Examples) resource was developed by the European Society of Medical Imaging Informatics-Radiomics Auditing Group in response. This international initiative provides comprehensive support for users by offering detailed rationales, interpretive guidance, scoring recommendations, and illustrative examples for each METRICS item and condition. Each criterion includes positive examples from peer-reviewed, open-access studies and hypothetical negative examples. In total, the finalized METRICS-E3 includes over 200 examples. The complete resource is publicly available through an interactive website. CRITICAL RELEVANCE STATEMENT: METRICS-E3 offers deeper insights into each METRICS item and condition, providing concrete examples with accompanying commentary and recommendations to enhance the evaluation of methodological quality in radiomics research. KEY POINTS: As a complementary initiative to METRICS, METRICS-E3 is intended to support stakeholders in evaluating the methodological aspects of radiomics studies. In METRICS-E3, each METRICS item and condition is supplemented with interpretive guidance, positive literature-based examples, hypothetical negative examples, and scoring recommendations. The complete METRICS-E3 explanation and elaboration resource is accessible at its interactive website.

Prostate MRI has traditionally relied on qualitative interpretation. However, quantitative components hold the potential to markedly improve performance. The ADC from DWI is probably the most widely recognized quantitative MRI biomarker and has shown strong discriminatory value for clinically significant prostate cancer as well as for recurrent cancer after treatment. Advanced diffusion techniques, including intravoxel incoherent motion imaging, diffusion kurtosis imaging, diffusion-tensor imaging, and specific implementations such as restriction spectrum imaging, purport even better discrimination but are more technically challenging. The inherent T1 and T2 of tissue also provide diagnostic value, with more advanced techniques deriving luminal water fraction and hybrid multidimensional MRI metrics. Dynamic contrast-enhanced imaging, primarily using a modified Tofts model, also shows independent discriminatory value. Finally, quantitative lesion size and shape features can be combined with the aforementioned techniques and can be further refined using radiomics, texture analysis, and artificial intelligence. Which technique will ultimately find widespread clinical use will depend on validation across a myriad of platforms and use cases.

This clinically oriented review explores the technical advancements of simultaneous PET/magnetic resonance (MR) imaging to provide an overview of the addressed obstacles over time, current challenges, and future trends in the field. In particular, advanced attenuation and motion correction techniques and MR-guided PET reconstruction frameworks were reviewed, and the state-of-the-art PET/MR systems and their strengths were discussed. Overall, PET/MR holds great potential in various clinical applications, including oncology, neurology, and cardiology. However, it requires continued optimization in hardware, algorithms, and clinical protocols to achieve broader adoption and be included in the routine clinical standards.

Prostate cancer remains one of the most prevalent malignancies and a leading cause of cancer-related deaths among men worldwide. Despite advances in traditional diagnostic methods such as Prostate-specific antigen testing, digital rectal examination, and multiparametric Magnetic resonance imaging, these approaches remain constrained by modality-specific limitations, suboptimal sensitivity and specificity, and reliance on expert interpretation, which may introduce diagnostic inconsistency. Multimodal deep learning and machine learning fusion, which integrates diverse data sources including imaging, clinical, and molecular information, has emerged as a promising strategy to enhance the accuracy of prostate cancer classification. This review aims to outline the current state-of-the-art deep learning and machine learning based fusion techniques for prostate cancer classification, focusing on their implementation, performance, challenges, and clinical applicability. Following the PRISMA guidelines, a total of 131 studies were identified, of which 27 met the inclusion criteria for studies published between 2021 and 2025. Extracted data included input techniques, deep learning architectures, performance metrics, and validation approaches. The majority of the studies used an early fusion approach with convolutional neural networks to integrate the data. Clinical and imaging data were the most commonly used modalities in the reviewed studies for prostate cancer research. Overall, multimodal deep learning and machine learning-based fusion significantly advances prostate cancer classification and outperform unimodal approaches.

Nanotheranostics has garnered significant interest for its capacity to improve customized healthcare via targeted and efficient treatment alternatives. Nanotheranostics promises an innovative approach to precision medicine by integrating therapeutic and diagnostic capabilities into nanoscale devices. Nanotheranostics provides an integrated approach that improves diagnosis and facilitates real-time, tailored treatment, revolutionizing patient care. Through the application of nanotheranostic devices, outcomes can be modified for patients on an individualized therapeutic level by taking into consideration individual differences in disease manifestation as well as treatment response. In this review, no aspect of imaging in nanotheranostics is excluded, thus including MRI and CT as well as PET and OI, which are essential for comprehensive analysis needed in medical decision making. Integration of AI and ML into theranostics facilitates predicting treatment outcomes and personalizing the approaches to the methods, which significantly enhances reproducibility in medicine. In addition, several nanoparticles such as lipid-based and polymeric particles, iron oxide, quantum dots, and mesoporous silica have shown promise in diagnosis and targeted drug delivery. These nanoparticles are capable of treating multiple diseases such as cancers, some other neurological disorders, and infectious diseases. While having potential, the field of nanotheranostics still encounters issues regarding clinical applicability, alongside some regulatory hurdles pertaining to new therapeutic agents. Advanced research in this sphere is bound to enhance existing perspectives and fundamentally aid the integration of nanomedicine into conventional health procedures, especially relating to efficacy and the growing emphasis on safe, personalized healthcare.

Alzheimer's disease (AD) is the most common form of dementia, and it is important to diagnose the disease at an early stage to help people with the condition and their families. Recently, artificial intelligence, especially deep learning approaches applied to medical imaging, has shown potential in enhancing AD diagnosis. This comprehensive review investigates the current state of the art in multimodal deep learning for the early diagnosis of Alzheimer's disease using image processing. The research underpinning this review spanned several months. Numerous deep learning architectures are examined, including CNNs, transfer learning methods, and combined models that use different imaging modalities, such as structural MRI, functional MRI, and amyloid PET. The latest work on explainable AI (XAI) is also reviewed to improve the understandability of the models and identify the particular regions of the brain related to AD pathology. The results indicate that multimodal approaches generally outperform single-modality methods, and three-dimensional (volumetric) data provides a better form of representation compared to two-dimensional images. Current challenges are also discussed, including insufficient and/or poorly prepared datasets, computational expense, and the lack of integration with clinical practice. The findings highlight the potential of applying deep learning approaches for early AD diagnosis and for directing future research pathways. The integration of multimodal imaging with deep learning techniques presents an exciting direction for developing improved AD diagnostic tools. However, significant challenges remain in achieving accurate, reliable, and understandable clinical applications.

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide, necessitating accurate and early diagnosis to guide therapy, along with assessment of treatment response. Response assessment criteria have evolved from traditional morphologic approaches, such as WHO criteria and Response Evaluation Criteria in Solid Tumors (RECIST), to more recent methods focused on evaluating viable tumor burden, including European Association for Study of Liver (EASL) criteria, modified RECIST (mRECIST) and Liver Imaging Reporting and Data System (LI-RADS) Treatment Response (LI-TR) algorithm. This shift reflects the complex and evolving landscape of HCC treatment in the context of emerging systemic and locoregional therapies. Each of these criteria have their own nuanced strengths and limitations in capturing the detailed characteristics of HCC treatment and response assessment. The emergence of functional imaging techniques, including dual-energy CT, perfusion imaging, and rising use of radiomics, are enhancing the capabilities of response assessment. Growth in the realm of artificial intelligence and machine learning models provides an opportunity to refine the precision of response assessment by facilitating analysis of complex imaging data patterns. This review article provides a comprehensive overview of existing criteria, discusses functional and emerging imaging techniques, and outlines future directions for advancing HCC tumor response assessment.

In recent years, Artificial Intelligence (AI) has gained prominence as a robust tool for clinical decision-making and diagnostics, owing to its capacity to process and analyze large datasets with high accuracy. More specifically, Deep Learning, and its subclasses, have shown significant potential in image processing, including medical imaging and histological analysis. In forensic pathology, AI has been employed for the interpretation of histopathological data, identifying conditions such as myocardial infarction, traumatic injuries, and heart rhythm abnormalities. This review aims to highlight key advances in AI's role, particularly machine learning (ML) and deep learning (DL) techniques, in forensic neuropathology, with a focus on its ability to interpret instrumental and histopathological data to support professional diagnostics. A systematic review of the literature regarding applications of Artificial Intelligence in forensic neuropathology was carried out according to the Preferred Reporting Item for Systematic Review (PRISMA) standards. We selected 34 articles regarding the main applications of AI in this field, dividing them into two categories: those addressing traumatic brain injury (TBI), including intracranial hemorrhage or cerebral microbleeds, and those focusing on epilepsy and SUDEP, including brain disorders and central nervous system neoplasms capable of inducing seizure activity. In both cases, the application of AI techniques demonstrated promising results in the forensic investigation of cerebral pathology, providing a valuable computer-assisted diagnostic tool to aid in post-mortem computed tomography (PMCT) assessments of cause of death and histopathological analyses. In conclusion, this paper presents a comprehensive overview of the key neuropathology areas where the application of artificial intelligence can be valuable in investigating causes of death.