White matter hyperintensity (WMH) is a primary manifestation of small vessel disease (SVD), leading to vascular cognitive impairment and other disorders. Accurate WMH quantification is vital for diagnosis and prognosis, but current automatic segmentation methods often fall short, especially across different datasets. The aims of this study are to develop and validate a robust deep learning segmentation method for WMH of vascular-origin. In this study, we developed a transformer-based method for the automatic segmentation of vascular-origin WMH using both 3D T1 and 3D T2-FLAIR images. Our initial dataset comprised 126 participants with varying WMH burdens due to SVD, each with manually segmented WMH masks used for training and testing. External validation was performed on two independent datasets: the WMH Segmentation Challenge 2017 dataset (170 subjects) and an in-house vascular risk factor dataset (70 subjects), which included scans acquired on eight different MRI systems at field strengths of 1.5T, 3T, and 5T. This approach enabled a comprehensive assessment of the method's generalizability across diverse imaging conditions. We further compared our method against LGA, LPA, BIANCA, UBO-detector and TrUE-Net in optimized settings. Our method consistently outperformed others, achieving a median Dice coefficient of 0.78±0.09 in our primary dataset, 0.72±0.15 in the external dataset 1, and 0.72±0.14 in the external dataset 2. The relative volume errors were 0.15±0.14, 0.50±0.86, and 0.47±1.02, respectively. The true positive rates were 0.81±0.13, 0.92±0.09, and 0.92±0.12, while the false positive rates were 0.20±0.09, 0.40±0.18, and 0.40±0.19. None of the external validation datasets were used for model training; instead, they comprise previously unseen MRI scans acquired from different scanners and protocols. This setup closely reflects real-world clinical scenarios and further demonstrates the robustness and generalizability of our model across diverse MRI systems and acquisition settings. As such, the proposed method provides a reliable solution for WMH segmentation in large-scale cohort studies.

AI-driven models have shown great promise in detecting errors in radiology reports, yet the field lacks a unified benchmark for rigorous evaluation of error detection and further correction. To address this gap, we introduce CorBenchX, a comprehensive suite for automated error detection and correction in chest X-ray reports, designed to advance AI-assisted quality control in clinical practice. We first synthesize a large-scale dataset of 26,326 chest X-ray error reports by injecting clinically common errors via prompting DeepSeek-R1, with each corrupted report paired with its original text, error type, and human-readable description. Leveraging this dataset, we benchmark both open- and closed-source vision-language models,(e.g., InternVL, Qwen-VL, GPT-4o, o4-mini, and Claude-3.7) for error detection and correction under zero-shot prompting. Among these models, o4-mini achieves the best performance, with 50.6 % detection accuracy and correction scores of BLEU 0.853, ROUGE 0.924, BERTScore 0.981, SembScore 0.865, and CheXbertF1 0.954, remaining below clinical-level accuracy, highlighting the challenge of precise report correction. To advance the state of the art, we propose a multi-step reinforcement learning (MSRL) framework that optimizes a multi-objective reward combining format compliance, error-type accuracy, and BLEU similarity. We apply MSRL to QwenVL2.5-7B, the top open-source model in our benchmark, achieving an improvement of 38.3% in single-error detection precision and 5.2% in single-error correction over the zero-shot baseline.

Medical image segmentation relies heavily on convolutional neural networks (CNNs) and Transformer-based models. However, CNNs are constrained by limited receptive fields, while Transformers suffer from scalability challenges due to their quadratic computational complexity. To address these limitations, recent advances have explored alternative architectures. The state-space model Mamba offers near-linear complexity while capturing long-range dependencies, and the Kolmogorov-Arnold Network (KAN) enhances nonlinear expressiveness by replacing fixed activation functions with learnable ones. Building on these strengths, we propose MedVKAN, an efficient feature extraction model integrating Mamba and KAN. Specifically, we introduce the EFC-KAN module, which enhances KAN with convolutional operations to improve local pixel interaction. We further design the VKAN module, integrating Mamba with EFC-KAN as a replacement for Transformer modules, significantly improving feature extraction. Extensive experiments on five public medical image segmentation datasets show that MedVKAN achieves state-of-the-art performance on four datasets and ranks second on the remaining one. These results validate the potential of Mamba and KAN for medical image segmentation while introducing an innovative and computationally efficient feature extraction framework. The code is available at: https://github.com/beginner-cjh/MedVKAN.

This study evaluates the performance, cost, and processing time of OpenAI's reasoning large language models (LLMs) (o1-preview, o1-mini) and their base models (GPT-4o, GPT-4o-mini) on Japanese radiology board examination questions. A total of 210 questions from the 2022-2023 official board examinations of the Japan Radiological Society were presented to each of the four LLMs. Performance was evaluated by calculating the percentage of correctly answered questions within six predefined radiology subspecialties. The total cost and processing time for each model were also recorded. The McNemar test was used to assess the statistical significance of differences in accuracy between paired model responses. The o1-preview achieved the highest accuracy (85.7%), significantly outperforming GPT-4o (73.3%, P<.001). Similarly, o1-mini (69.5%) performed significantly better than GPT-4o-mini (46.7%, P<.001). Across all radiology subspecialties, o1-preview consistently ranked highest. However, reasoning models incurred substantially higher costs (o1-preview: $17.10, o1-mini: $2.58) compared to their base counterparts (GPT-4o: $0.496, GPT-4o-mini: $0.04), and their processing times were approximately 3.7 and 1.2 times longer, respectively. Reasoning LLMs demonstrated markedly superior performance in answering radiology board exam questions compared to their base models, albeit at a substantially higher cost and increased processing time.

Radiotherapy often involves a prolonged treatment period. During this time, patients may experience organ motion due to breathing and other physiological factors. Predicting and modeling this motion before treatment is crucial for ensuring precise radiation delivery. However, existing pre-treatment organ motion prediction methods primarily rely on deformation analysis using principal component analysis (PCA), which is highly dependent on registration quality and struggles to capture periodic temporal dynamics for motion modeling.In this paper, we observe that organ motion prediction closely resembles an autoregressive process, a technique widely used in natural language processing (NLP). Autoregressive models predict the next token based on previous inputs, naturally aligning with our objective of predicting future organ motion phases. Building on this insight, we reformulate organ motion prediction as an autoregressive process to better capture patient-specific motion patterns. Specifically, we acquire 4D CT scans for each patient before treatment, with each sequence comprising multiple 3D CT phases. These phases are fed into the autoregressive model to predict future phases based on prior phase motion patterns. We evaluate our method on a real-world test set of 4D CT scans from 50 patients who underwent radiotherapy at our institution and a public dataset containing 4D CT scans from 20 patients (some with multiple scans), totaling over 1,300 3D CT phases. The performance in predicting the motion of the lung and heart surpasses existing benchmarks, demonstrating its effectiveness in capturing motion dynamics from CT images. These results highlight the potential of our method to improve pre-treatment planning in radiotherapy, enabling more precise and adaptive radiation delivery.

Severe respiratory infections pose a major challenge in clinical practice, especially in older adults. Body composition analysis could play a crucial role in risk assessment and therapeutic decision-making. This study investigates whether obesity or sarcopenia has a greater impact on mortality in patients with severe respiratory infections. The study focuses on the National Pandemic Cohort Network (NAPKON-SUEP) cohort, which includes patients over 60 years of age with confirmed severe COVID-19 pneumonia. An innovative approach was adopted, using pre-trained deep learning models for automated analysis of body composition based on routine thoracic CT scans. The study included 157 hospitalized patients (mean age 70 ± 8 years, 41% women, mortality rate 39%) from the NAPKON-SUEP cohort at 57 study sites. A pre-trained deep learning model was used to analyze body composition (muscle, bone, fat, and intramuscular fat volumes) from thoracic CT images of the NAPKON-SUEP cohort. Binary logistic regression was performed to investigate the association between obesity, sarcopenia, and mortality. Non-survivors exhibited lower muscle volume (p = 0.043), higher intramuscular fat volume (p = 0.041), and a higher BMI (p = 0.031) compared to survivors. Among all body composition parameters, muscle volume adjusted to weight was the strongest predictor of mortality in the logistic regression model, even after adjusting for factors such as sex, age, diabetes, chronic lung disease and chronic kidney disease, (odds ratio = 0.516). In contrast, BMI did not show significant differences after adjustment for comorbidities. This study identifies muscle volume derived from routine CT scans as a major predictor of survival in patients with severe respiratory infections. The results underscore the potential of AI supported CT-based body composition analysis for risk stratification and clinical decision making, not only for COVID-19 patients but also for all patients over 60 years of age with severe acute respiratory infections. The innovative application of pre-trained deep learning models opens up new possibilities for automated and standardized assessment in clinical practice.

The automatic diagnosis of chest diseases is a popular and challenging task. Most current methods are based on convolutional neural networks (CNNs), which focus on local features while neglecting global features. Recently, self-attention mechanisms have been introduced into the field of computer vision, demonstrating superior performance. Therefore, this paper proposes an effective model, CheX-DS, for classifying long-tail multi-label data in the medical field of chest X-rays. The model is based on the excellent CNN model DenseNet for medical imaging and the newly popular Swin Transformer model, utilizing ensemble deep learning techniques to combine the two models and leverage the advantages of both CNNs and Transformers. The loss function of CheX-DS combines weighted binary cross-entropy loss with asymmetric loss, effectively addressing the issue of data imbalance. The NIH ChestX-ray14 dataset is selected to evaluate the model's effectiveness. The model outperforms previous studies with an excellent average AUC score of 83.76\%, demonstrating its superior performance.

Accurate and fully automated pancreas segmentation is critical for advancing imaging biomarkers in early pancreatic cancer detection and for biomarker discovery in endocrine and exocrine pancreatic diseases. We developed and evaluated a deep learning (DL)-based convolutional neural network (CNN) for automated pancreas segmentation using the largest single-institution dataset to date (n = 3031 CTs). Ground truth segmentations were performed by radiologists, which were used to train a 3D nnU-Net model through five-fold cross-validation, generating an ensemble of top-performing models. To assess generalizability, the model was externally validated on the multi-institutional AbdomenCT-1K dataset (n = 585), for which volumetric segmentations were newly generated by expert radiologists and will be made publicly available. In the test subset (n = 452), the CNN achieved a mean Dice Similarity Coefficient (DSC) of 0.94 (SD 0.05), demonstrating high spatial concordance with radiologist-annotated volumes (Concordance Correlation Coefficient [CCC]: 0.95). On the AbdomenCT-1K dataset, the model achieved a DSC of 0.96 (SD 0.04) and a CCC of 0.98, confirming its robustness across diverse imaging conditions. The proposed DL model establishes new performance benchmarks for fully automated pancreas segmentation, offering a scalable and generalizable solution for large-scale imaging biomarker research and clinical translation.

Recent advances in data-centric deep generative models have led to significant progress in solving inverse imaging problems. However, these models (e.g., diffusion models (DMs)) typically require large amounts of fully sampled (clean) training data, which is often impractical in medical and scientific settings such as dynamic imaging. On the other hand, training-data-free approaches like the Deep Image Prior (DIP) do not require clean ground-truth images but suffer from noise overfitting and can be computationally expensive as the network parameters need to be optimized for each measurement set independently. Moreover, DIP-based methods often overlook the potential of learning a prior using a small number of sub-sampled measurements (or degraded images) available during training. In this paper, we propose UGoDIT, an Unsupervised Group DIP via Transferable weights, designed for the low-data regime where only a very small number, M, of sub-sampled measurement vectors are available during training. Our method learns a set of transferable weights by optimizing a shared encoder and M disentangled decoders. At test time, we reconstruct the unseen degraded image using a DIP network, where part of the parameters are fixed to the learned weights, while the remaining are optimized to enforce measurement consistency. We evaluate UGoDIT on both medical (multi-coil MRI) and natural (super resolution and non-linear deblurring) image recovery tasks under various settings. Compared to recent standalone DIP methods, UGoDIT provides accelerated convergence and notable improvement in reconstruction quality. Furthermore, our method achieves performance competitive with SOTA DM-based and supervised approaches, despite not requiring large amounts of clean training data.

Diffusion models are extensively used for modeling image priors for inverse problems. We introduce \emph{Diff-Unfolding}, a principled framework for learning posterior score functions of \emph{conditional diffusion models} by explicitly incorporating the physical measurement operator into a modular network architecture. Diff-Unfolding formulates posterior score learning as the training of an unrolled optimization scheme, where the measurement model is decoupled from the learned image prior. This design allows our method to generalize across inverse problems at inference time by simply replacing the forward operator without retraining. We theoretically justify our unrolling approach by showing that the posterior score can be derived from a composite model-based optimization formulation. Extensive experiments on image restoration and accelerated MRI show that Diff-Unfolding achieves state-of-the-art performance, improving PSNR by up to 2 dB and reducing LPIPS by $22.7\%$, while being both compact (47M parameters) and efficient (0.72 seconds per $256 \times 256$ image). An optimized C++/LibTorch implementation further reduces inference time to 0.63 seconds, underscoring the practicality of our approach.