Explainable Artificial Intelligence (XAI) encompasses a broad spectrum of methods that aim to enhance the transparency of deep learning models, with Class Activation Mapping (CAM) methods widely used for visual interpretability. However, systematic evaluations of these methods in veterinary radiography remain scarce. This study presents a comparative analysis of eleven CAM methods, including GradCAM, XGradCAM, ScoreCAM, and EigenCAM, on a dataset of 7362 canine and feline X-ray images. A ResNet18 model was chosen based on the specificity of the dataset and preliminary results where it outperformed other models. Quantitative and qualitative evaluations were performed to determine how well each CAM method produced interpretable heatmaps relevant to clinical decision-making. Among the techniques evaluated, EigenGradCAM achieved the highest mean score and standard deviation (SD) of 2.571 (SD = 1.256), closely followed by EigenCAM at 2.519 (SD = 1.228) and GradCAM++ at 2.512 (SD = 1.277), with methods such as FullGrad and XGradCAM achieving worst scores of 2.000 (SD = 1.300) and 1.858 (SD = 1.198) respectively. Despite variations in saliency visualization, no single method universally improved veterinarians' diagnostic confidence. While certain CAM methods provide better visual cues for some pathologies, they generally offered limited explainability and didn't substantially improve veterinarians' diagnostic confidence.

Deep learning has significantly advanced medical image analysis, particularly in semantic segmentation, which is essential for clinical decisions. However, existing 3D segmentation models, like the traditional 3D UNet, face challenges in balancing computational efficiency and accuracy when processing volumetric medical data. This study aims to develop an improved architecture for 3D medical image segmentation with enhanced learning strategies to improve accuracy and address challenges related to limited training data. We propose ES-UNet, a 3D segmentation architecture that achieves superior segmentation performance while offering competitive efficiency across multiple computational metrics, including memory usage, inference time, and parameter count. The model builds upon the full-scale skip connection design of UNet3+ by integrating channel attention modules into each encoder-to-decoder path and incorporating full-scale deep supervision to enhance multi-resolution feature learning. We further introduce Region Specific Scaling (RSS), a data augmentation method that adaptively applies geometric transformations to annotated regions, and a Dynamically Weighted Dice (DWD) loss to improve the balance between precision and recall. The model was evaluated on the MICCAI HECKTOR dataset, and additional validation was conducted on selected tasks from the Medical Segmentation Decathlon (MSD). On the HECKTOR dataset, ES-UNet achieved a Dice Similarity Coefficient (DSC) of 76.87%, outperforming baseline models including 3D UNet, 3D UNet 3+, nnUNet, and Swin UNETR. Ablation studies showed that RSS and DWD contributed up to 1.22% and 1.06% improvement in DSC, respectively. A sensitivity analysis demonstrated that the chosen scaling range in RSS offered a favorable trade-off between deformation and anatomical plausibility. Cross-dataset evaluation on MSD Heart and Spleen tasks also indicated strong generalization. Computational analysis revealed that ES-UNet achieves superior segmentation performance with moderate computational demands. Specifically, the enhanced skip connection design with lightweight channel attention modules integrated throughout the network architecture enables this favorable balance between high segmentation accuracy and computational efficiency. ES-UNet integrates architectural and algorithmic improvements to achieve robust 3D medical image segmentation. While the framework incorporates established components, its core contributions lie in the optimized skip connection strategy and supporting techniques like RSS and DWD. Future work will explore adaptive scaling strategies and broader validation across diverse imaging modalities.

This study investigated radiologists' perceptions of AI-generated, patient-friendly radiology reports across three modalities: MRI, CT, and mammogram/ultrasound. The evaluation focused on report correctness, completeness, terminology complexity, and emotional impact. Seventy-nine radiologists from four major Saudi Arabian hospitals assessed AI-simplified versions of clinical radiology reports. Each participant reviewed one report from each modality and completed a structured questionnaire covering factual correctness, completeness, terminology complexity, and emotional impact. A structured and detailed prompt was used to guide ChatGPT-4 in generating the reports, which included clear findings, a lay summary, glossary, and clarification of ambiguous elements. Statistical analyses included descriptive summaries, Friedman tests, and Pearson correlations. Radiologists rated mammogram reports highest for correctness (M = 4.22), followed by CT (4.05) and MRI (3.95). Completeness scores followed a similar trend. Statistically significant differences were found in correctness (χ²(2) = 17.37, p < 0.001) and completeness (χ²(2) = 13.13, p = 0.001). Anxiety and complexity ratings were moderate, with MRI reports linked to slightly higher concern. A weak positive correlation emerged between radiologists' experience and mammogram correctness ratings (r = .235, p = .037). Radiologists expressed overall support for AI-generated simplified radiology reports when created using a structured prompt that includes summaries, glossaries, and clarification of ambiguous findings. While mammography and CT reports were rated favorably, MRI reports showed higher emotional impact, highlighting a need for clearer and more emotionally supportive language.

This study aimed to determine if an ensemble (stacking) model that integrates three independently developed base models can reliably predict patients' neurological outcomes following out-of-hospital cardiac arrest (OHCA) within 3 h of arrival and outperform each individual model. This retrospective study included patients with OHCA (≥ 18 years) admitted directly to Nara Medical University between April 2015 and March 2024 who remained comatose for ≥ 3 h after arrival and had suitable head computed tomography (CT) images. The area under the receiver operating characteristic curve (AUC) and Briers scores were used to evaluate the performance of four models (resuscitation-related background OHCA score factors, bilateral pupil diameter, single-slice head CT within 3 h of arrival, and an ensemble stacked model combining these three models) in predicting favourable neurological outcomes at hospital discharge or 1 month, as defined by a Cerebral Performance Category scale of 1-2. Among 533 patients, 82 (15%) had favourable outcomes. The OHCA, pupil, and head CT models yielded AUCs of 0.76, 0.65, and 0.68 with Brier scores of 0.11, 0.13, and 0.12, respectively. The ensemble model outperformed the other models (AUC, 0.82; Brier score, 0.10), thereby supporting its application for early clinical decision-making and optimising resource allocation.

Total-body dual X-ray absorptiometry (TBDXA) imaging is a relatively low-cost whole-body imaging modality, widely used for body composition assessment. We develop and validate a deep learning method for automatic fiducial point placement on TBDXA scans using 1,683 manually-annotated TBDXA scans. The method achieves 99.5% percentage correct keypoints in an external testing dataset. To demonstrate the value for shape and appearance modeling (SAM), our method is used to place keypoints on 35,928 scans for five different TBDXA imaging modes, then associations with health markers are tested in two cohorts not used for SAM model generation using two-sample Kolmogorov-Smirnov tests. SAM feature distributions associated with health biomarkers are shown to corroborate existing evidence and generate new hypotheses on body composition and shape's relationship to various frailty, metabolic, inflammation, and cardiometabolic health markers. Evaluation scripts, model weights, automatic point file generation code, and triangulation files are available at https://github.com/hawaii-ai/dxa-pointplacement.

Acute myocardial infarction (MI) alters cardiomyocyte geometry and architecture, leading to changes in the acoustic properties of the myocardium. This study examines ultrasomics-a novel cardiac ultrasound-based radiomics technique to extract high-throughput pixel-level information from images-for identifying ultrasonic texture and morphologic changes associated with infarcted myocardium. We included 684 participants from multisource data: a) a retrospective single-center matched case-control dataset, b) a prospective multicenter matched clinical trial dataset, and c) an open-source international and multivendor dataset. Handcrafted and deep transfer learning-based ultrasomics features from 2- and 4-chamber echocardiographic views were used to train machine learning (ML) models with the use of leave-one-source-out cross-validation for external validation. The ML model showed a higher AUC than transfer learning-based deep features in identifying MI [AUCs: 0.87 [95% CI: 0.84-0.89] vs 0.74 [95% CI: 0.70-0.77]; P < 0.0001]. ML probability was an independent predictor of MI even after adjusting for conventional echocardiographic parameters [adjusted OR: 1.03 [95% CI: 1.01-1.05]; P < 0.0001]. ML probability showed diagnostic value in differentiating acute MI, even in the presence of myocardial dysfunction (averaged longitudinal strain [LS] <16%) (AUC: 0.84 [95% CI: 0.77-0.89]). In addition, combining averaged LS with ML probability significantly improved predictive performance compared with LS alone (AUCs: 0.86 [95% CI: 0.80-0.91] vs 0.80 [95% CI: 0.72-0.87]; P = 0.02). Visualization of ultrasomics features with the use of a Manhattan plot discriminated infarcted and noninfarcted segments (P < 0.001) and facilitated parametric visualization of infarcted myocardium. This study demonstrates the potential of cardiac ultrasomics to distinguish healthy from infarcted myocardium and highlights the need for validation in diverse populations to define its role and incremental value in myocardial tissue characterization beyond conventional echocardiography.

Early detection of lung cancer is critical to improving survival outcomes. We present a deep learning framework for automated lung cancer screening from chest computed tomography (CT) images with integrated explainability. Using the IQ-OTH/NCCD dataset (1,197 scans across Normal, Benign, and Malignant classes), we evaluate a custom convolutional neural network (CNN) and three fine-tuned transfer learning backbones: DenseNet121, ResNet152, and VGG19. Models are trained with cost-sensitive learning to mitigate class imbalance and evaluated via accuracy, precision, recall, F1-score, and ROC-AUC. While ResNet152 achieved the highest accuracy (97.3%), DenseNet121 provided the best overall balance in precision, recall, and F1 (up to 92%, 90%, 91%, respectively). We further apply Shapley Additive Explanations (SHAP) to visualize evidence contributing to predictions, improving clinical transparency. Results indicate that CNN-based approaches augmented with explainability can provide fast, accurate, and interpretable support for lung cancer screening, particularly in resource-limited settings.

Purpose: Prenatal ultrasound is a key tool in evaluating fetal structural development and detecting abnormalities, contributing to reduced perinatal complications and improved neonatal survival. Accurate identification of standard fetal torso planes is essential for reliable assessment and personalized prenatal care. However, limitations such as low contrast and unclear texture details in ultrasound imaging pose significant challenges for fine-grained anatomical recognition. Methods: We propose a novel Multi-Contrast Fusion Module (MCFM) to enhance the model's ability to extract detailed information from ultrasound images. MCFM operates exclusively on the lower layers of the neural network, directly processing raw ultrasound data. By assigning attention weights to image representations under different contrast conditions, the module enhances feature modeling while explicitly maintaining minimal parameter overhead. Results: The proposed MCFM was evaluated on a curated dataset of fetal torso plane ultrasound images. Experimental results demonstrate that MCFM substantially improves recognition performance, with a minimal increase in model complexity. The integration of multi-contrast attention enables the model to better capture subtle anatomical structures, contributing to higher classification accuracy and clinical reliability. Conclusions: Our method provides an effective solution for improving fetal torso plane recognition in ultrasound imaging. By enhancing feature representation through multi-contrast fusion, the proposed approach supports clinicians in achieving more accurate and consistent diagnoses, demonstrating strong potential for clinical adoption in prenatal screening. The codes are available at https://github.com/sysll/MCFM.

Low-dose CT (LDCT) protocols reduce radiation exposure but increase image noise, compromising diagnostic confidence. Diffusion-based generative models have shown promise for LDCT denoising by learning image priors and performing iterative refinement. In this work, we introduce AST-n, an accelerated inference framework that initiates reverse diffusion from intermediate noise levels, and integrate high-order ODE solvers within conditioned models to further reduce sampling steps. We evaluate two acceleration paradigms--AST-n sampling and standard scheduling with high-order solvers -- on the Low Dose CT Grand Challenge dataset, covering head, abdominal, and chest scans at 10-25 % of standard dose. Conditioned models using only 25 steps (AST-25) achieve peak signal-to-noise ratio (PSNR) above 38 dB and structural similarity index (SSIM) above 0.95, closely matching standard baselines while cutting inference time from ~16 seg to under 1 seg per slice. Unconditional sampling suffers substantial quality loss, underscoring the necessity of conditioning. We also assess DDIM inversion, which yields marginal PSNR gains at the cost of doubling inference time, limiting its clinical practicality. Our results demonstrate that AST-n with high-order samplers enables rapid LDCT reconstruction without significant loss of image fidelity, advancing the feasibility of diffusion-based methods in clinical workflows.

Atrial fibrillation, a common cardiac arrhythmia with rapid and irregular atrial electrical activity, requires accurate left atrial segmentation for effective treatment planning. Recently, deep learning methods have gained encouraging success in left atrial segmentation. However, current methodologies critically depend on the assumption of consistently complete centered left atrium as input, which neglects the structural incompleteness and boundary discontinuities arising from random-crop operations during inference. In this paper, we propose BSA-Net, which exploits an adaptive adjustment strategy in both feature position and loss optimization to establish long-range feature relationships and strengthen robust intermediate feature representations in boundary regions. Specifically, we propose a Spatial-adaptive Convolution (SConv) that employs a shuffle operation combined with lightweight convolution to directly establish cross-positional relationships within regions of potential relevance. Moreover, we develop the dual Boundary Prioritized loss, which enhances boundary precision by differentially weighting foreground and background boundaries, thus optimizing complex boundary regions. With the above technologies, the proposed method enjoys a better speed-accuracy trade-off compared to current methods. BSA-Net attains Dice scores of 92.55%, 91.42%, and 84.67% on the LA, Utah, and Waikato datasets, respectively, with a mere 2.16 M parameters-approximately 80% fewer than other contemporary state-of-the-art models. Extensive experimental results on three benchmark datasets have demonstrated that BSA-Net, consistently and significantly outperforms existing state-of-the-art methods.