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ESE and Transfer Learning for Breast Tumor Classification.

He Y, Batumalay M, Thinakaran R

pubmed logopapersJul 14 2025
In this study, we proposed a lightweight neural network architecture based on inverted residual network, efficient squeeze excitation (ESE) module, and double transfer learning, called TLese-ResNet, for breast cancer molecular subtype recognition. The inverted ResNet reduces the number of network parameters while enhancing the cross-layer gradient propagation and feature expression capabilities. The introduction of the ESE module reduces the network complexity while maintaining the channel relationship collection. The dataset of this study comes from the mammography images of patients diagnosed with invasive breast cancer in a hospital in Jiangxi. The dataset comprises preoperative mammography images with CC and MLO views. Given that the dataset is somewhat small, in addition to the commonly used data augmentation methods, double transfer learning is also used. Double transfer learning includes the first transfer, in which the source domain is ImageNet and the target domain is the COVID-19 chest X-ray image dataset, and the second transfer, in which the source domain is the target domain of the first transfer, and the target domain is the mammography dataset we collected. By using five-fold cross-validation, the mean accuracy and area under received surgery feature on mammographic images of CC and MLO views were 0.818 and 0.883, respectively, outperforming other state-of-the-art deep learning-based models such as ResNet-50 and DenseNet-121. Therefore, the proposed model can provide clinicians with an effective and non-invasive auxiliary tool for molecular subtype identification of breast cancer.

Deep Learning Applications in Lymphoma Imaging.

Sorin V, Cohen I, Lekach R, Partovi S, Raskin D

pubmed logopapersJul 14 2025
Lymphomas are a diverse group of disorders characterized by the clonal proliferation of lymphocytes. While definitive diagnosis of lymphoma relies on histopathology, immune-phenotyping and additional molecular analyses, imaging modalities such as PET/CT, CT, and MRI play a central role in the diagnostic process and management, from assessing disease extent, to evaluation of response to therapy and detecting recurrence. Artificial intelligence (AI), particularly deep learning models like convolutional neural networks (CNNs), is transforming lymphoma imaging by enabling automated detection, segmentation, and classification. This review elaborates on recent advancements in deep learning for lymphoma imaging and its integration into clinical practice. Challenges include obtaining high-quality, annotated datasets, addressing biases in training data, and ensuring consistent model performance. Ongoing efforts are focused on enhancing model interpretability, incorporating diverse patient populations to improve generalizability, and ensuring safe and effective integration of AI into clinical workflows, with the goal of improving patient outcomes.

Multimodal Deep Learning Model Based on Ultrasound and Cytological Images Predicts Risk Stratification of cN0 Papillary Thyroid Carcinoma.

He F, Chen S, Liu X, Yang X, Qin X

pubmed logopapersJul 14 2025
Accurately assessing the risk stratification of cN0 papillary thyroid carcinoma (PTC) preoperatively aids in making treatment decisions. We integrated preoperative ultrasound and cytological images of patients to develop and validate a multimodal deep learning (DL) model for non-invasive assessment of N0 PTC risk stratification before surgery. In this retrospective multicenter group study, we developed a comprehensive DL model based on ultrasound and cytological images. The model was trained and validated on 890 PTC patients undergoing thyroidectomy and lymph node dissection across five medical centers. The testing group included 107 patients from one medical center. We analyzed the model's performance, including the area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity. The combined DL model demonstrated strong performance, with an area under the curve (AUC) of 0.922 (0.866-0.979) in the internal validation group and an AUC of 0.845 (0.794-0.895) in the testing group. The diagnostic performance of the combined DL model surpassed that of clinical models. Image region heatmaps assisted in interpreting the diagnosis of risk stratification. The multimodal DL model based on ultrasound and cytological images can accurately determine the risk stratification of N0 PTC and guide treatment decisions.

STF: A Spherical Transformer for Versatile Cortical Surfaces Applications.

Cheng J, Zhao F, Wu Z, Yuan X, Wang L, Gilmore JH, Lin W, Zhang X, Li G

pubmed logopapersJul 14 2025
Inspired by the remarkable success of attention mechanisms in various applications, there is a growing need to adapt the Transformer architecture from conventional Euclidean domains to non-Euclidean spaces commonly encountered in medical imaging. Structures such as brain cortical surfaces, represented by triangular meshes, exhibit spherical topology and present unique challenges. To address this, we propose the Spherical Transformer (STF), a versatile backbone that leverages self-attention for analyzing cortical surface data. Our approach involves mapping cortical surfaces onto a sphere, dividing them into overlapping patches, and tokenizing both patches and vertices. By performing self-attention at patch and vertex levels, the model simultaneously captures global dependencies and preserves fine-grained contextual information within each patch. Overlapping regions between neighboring patches naturally enable efficient cross-patch information sharing. To handle longitudinal cortical surface data, we introduce the spatiotemporal self-attention mechanism, which jointly captures spatial context and temporal developmental patterns within a single layer. This innovation enhances the representational power of the model, making it well-suited for dynamic surface data. We evaluate the Spherical Transformer on key tasks, including cognition prediction at the surface level and two vertex-level tasks: cortical surface parcellation and cortical property map prediction. Across these applications, our model consistently outperforms state-of-the-art methods, demonstrating its ability to effectively model global dependencies and preserve detailed spatial information. The results highlight its potential as a general-purpose framework for cortical surface analysis.

Comparing large language models and text embedding models for automated classification of textual, semantic, and critical changes in radiology reports.

Lindholz M, Burdenski A, Ruppel R, Schulze-Weddige S, Baumgärtner GL, Schobert I, Haack AM, Eminovic S, Milnik A, Hamm CA, Frisch A, Penzkofer T

pubmed logopapersJul 14 2025
Radiology reports can change during workflows, especially when residents draft preliminary versions that attending physicians finalize. We explored how large language models (LLMs) and embedding techniques can categorize these changes into textual, semantic, or clinically actionable types. We evaluated 400 adult CT reports drafted by residents against finalized versions by attending physicians. Changes were rated on a five-point scale from no changes to critical ones. We examined open-source LLMs alongside traditional metrics like normalized word differences, Levenshtein and Jaccard similarity, and text embedding similarity. Model performance was assessed using quadratic weighted Cohen's kappa (κ), (balanced) accuracy, F<sub>1</sub>, precision, and recall. Inter-rater reliability among evaluators was excellent (κ = 0.990). Of the reports analyzed, 1.3 % contained critical changes. The tested methods showed significant performance differences (P < 0.001). The Qwen3-235B-A22B model using a zero-shot prompt, most closely aligned with human assessments of changes in clinical reports, achieving a κ of 0.822 (SD 0.031). The best conventional metric, word difference, had a κ of 0.732 (SD 0.048), the difference between the two showed statistical significance in unadjusted post-hoc tests (P = 0.038) but lost significance after adjusting for multiple testing (P = 0.064). Embedding models underperformed compared to LLMs and classical methods, showing statistical significance in most cases. Large language models like Qwen3-235B-A22B demonstrated moderate to strong alignment with expert evaluations of the clinical significance of changes in radiology reports. LLMs outperformed embedding methods and traditional string and word approaches, achieving statistical significance in most instances. This demonstrates their potential as tools to support peer review.

A Multi-Modal Deep Learning Framework for Predicting PSA Progression-Free Survival in Metastatic Prostate Cancer Using PSMA PET/CT Imaging

Ghaderi, H., Shen, C., Issa, W., Pomper, M. G., Oz, O. K., Zhang, T., Wang, J., Yang, D. X.

medrxiv logopreprintJul 14 2025
PSMA PET/CT imaging has been increasingly utilized in the management of patients with metastatic prostate cancer (mPCa). Imaging biomarkers derived from PSMA PET may provide improved prognostication and prediction of treatment response for mPCa patients. This study investigates a novel deep learning-derived imaging biomarker framework for outcome prediction using multi-modal PSMA PET/CT and clinical features. A single institution cohort of 99 mPCa patients with 396 lesions was evaluated. Imaging features were extracted from cropped lesion areas and combined with clinical variables including body mass index, ECOG performance status, prostate specific antigen (PSA) level, Gleason score, and treatments received. The PSA progression-free survival (PFS) model was trained using a ResNet architecture with a Cox proportional hazards loss function using five-fold cross-validation. Performance was assessed using concordance index (C-index) and Kaplan-Meier survival analysis. Among evaluated model architectures, the ResNet-18 backbone offered the best performance. The multi-modal deep learning framework achieved a 5-fold cross-validation C-index ranging from 0.75 to 0.94, outperforming models incorporating imaging only (0.70-0.89) and clinical features only (0.53-0.65). Kaplan-Meir survival analysis performed on the deep learning-derived predictions demonstrated clear risk stratification, with a median PSA progression free survival (PFS) of 19.7 months in the high-risk group and 26 months in the low-risk group (P < 0.001). Deep learning-derived imaging biomarker based on PSMA PET/CT can effectively predict PSA PFS for mPCa patients. Further clinical validation in prospective cohorts is warranted.

Early breast cancer detection via infrared thermography using a CNN enhanced with particle swarm optimization.

Alzahrani RM, Sikkandar MY, Begum SS, Babetat AFS, Alhashim M, Alduraywish A, Prakash NB, Ng EYK

pubmed logopapersJul 13 2025
Breast cancer remains the most prevalent cause of cancer-related mortality among women worldwide, with an estimated incidence exceeding 500,000 new cases annually. Timely diagnosis is vital for enhancing therapeutic outcomes and increasing survival probabilities. Although conventional diagnostic tools such as mammography are widely used and generally effective, they are often invasive, costly, and exhibit reduced efficacy in patients with dense breast tissue. Infrared thermography, by contrast, offers a non-invasive and economical alternative; however, its clinical adoption has been limited, largely due to difficulties in accurate thermal image interpretation and the suboptimal tuning of machine learning algorithms. To overcome these limitations, this study proposes an automated classification framework that employs convolutional neural networks (CNNs) for distinguishing between malignant and benign thermographic breast images. An Enhanced Particle Swarm Optimization (EPSO) algorithm is integrated to automatically fine-tune CNN hyperparameters, thereby minimizing manual effort and enhancing computational efficiency. The methodology also incorporates advanced image preprocessing techniques-including Mamdani fuzzy logic-based edge detection, Contrast-Limited Adaptive Histogram Equalization (CLAHE) for contrast enhancement, and median filtering for noise suppression-to bolster classification performance. The proposed model achieves a superior classification accuracy of 98.8%, significantly outperforming conventional CNN implementations in terms of both computational speed and predictive accuracy. These findings suggest that the developed system holds substantial potential for early, reliable, and cost-effective breast cancer screening in real-world clinical environments.

Disentanglement and Assessment of Shortcuts in Ophthalmological Retinal Imaging Exams

Leonor Fernandes, Tiago Gonçalves, João Matos, Luis Filipe Nakayama, Jaime S. Cardoso

arxiv logopreprintJul 13 2025
Diabetic retinopathy (DR) is a leading cause of vision loss in working-age adults. While screening reduces the risk of blindness, traditional imaging is often costly and inaccessible. Artificial intelligence (AI) algorithms present a scalable diagnostic solution, but concerns regarding fairness and generalization persist. This work evaluates the fairness and performance of image-trained models in DR prediction, as well as the impact of disentanglement as a bias mitigation technique, using the diverse mBRSET fundus dataset. Three models, ConvNeXt V2, DINOv2, and Swin V2, were trained on macula images to predict DR and sensitive attributes (SAs) (e.g., age and gender/sex). Fairness was assessed between subgroups of SAs, and disentanglement was applied to reduce bias. All models achieved high DR prediction performance in diagnosing (up to 94% AUROC) and could reasonably predict age and gender/sex (91% and 77% AUROC, respectively). Fairness assessment suggests disparities, such as a 10% AUROC gap between age groups in DINOv2. Disentangling SAs from DR prediction had varying results, depending on the model selected. Disentanglement improved DINOv2 performance (2% AUROC gain), but led to performance drops in ConvNeXt V2 and Swin V2 (7% and 3%, respectively). These findings highlight the complexity of disentangling fine-grained features in fundus imaging and emphasize the importance of fairness in medical imaging AI to ensure equitable and reliable healthcare solutions.

AI-Enhanced Pediatric Pneumonia Detection: A CNN-Based Approach Using Data Augmentation and Generative Adversarial Networks (GANs)

Abdul Manaf, Nimra Mughal

arxiv logopreprintJul 13 2025
Pneumonia is a leading cause of mortality in children under five, requiring accurate chest X-ray diagnosis. This study presents a machine learning-based Pediatric Chest Pneumonia Classification System to assist healthcare professionals in diagnosing pneumonia from chest X-ray images. The CNN-based model was trained on 5,863 labeled chest X-ray images from children aged 0-5 years from the Guangzhou Women and Children's Medical Center. To address limited data, we applied augmentation techniques (rotation, zooming, shear, horizontal flipping) and employed GANs to generate synthetic images, addressing class imbalance. The system achieved optimal performance using combined original, augmented, and GAN-generated data, evaluated through accuracy and F1 score metrics. The final model was deployed via a Flask web application, enabling real-time classification with probability estimates. Results demonstrate the potential of deep learning and GANs in improving diagnostic accuracy and efficiency for pediatric pneumonia classification, particularly valuable in resource-limited clinical settings https://github.com/AbdulManaf12/Pediatric-Chest-Pneumonia-Classification

Brain Stroke Detection and Classification Using CT Imaging with Transformer Models and Explainable AI

Shomukh Qari, Maha A. Thafar

arxiv logopreprintJul 13 2025
Stroke is one of the leading causes of death globally, making early and accurate diagnosis essential for improving patient outcomes, particularly in emergency settings where timely intervention is critical. CT scans are the key imaging modality because of their speed, accessibility, and cost-effectiveness. This study proposed an artificial intelligence framework for multiclass stroke classification (ischemic, hemorrhagic, and no stroke) using CT scan images from a dataset provided by the Republic of Turkey's Ministry of Health. The proposed method adopted MaxViT, a state-of-the-art Vision Transformer, as the primary deep learning model for image-based stroke classification, with additional transformer variants (vision transformer, transformer-in-transformer, and ConvNext). To enhance model generalization and address class imbalance, we applied data augmentation techniques, including synthetic image generation. The MaxViT model trained with augmentation achieved the best performance, reaching an accuracy and F1-score of 98.00%, outperforming all other evaluated models and the baseline methods. The primary goal of this study was to distinguish between stroke types with high accuracy while addressing crucial issues of transparency and trust in artificial intelligence models. To achieve this, Explainable Artificial Intelligence (XAI) was integrated into the framework, particularly Grad-CAM++. It provides visual explanations of the model's decisions by highlighting relevant stroke regions in the CT scans and establishing an accurate, interpretable, and clinically applicable solution for early stroke detection. This research contributed to the development of a trustworthy AI-assisted diagnostic tool for stroke, facilitating its integration into clinical practice and enhancing access to timely and optimal stroke diagnosis in emergency departments, thereby saving more lives.
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