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Multimodal Attention-Aware Fusion for Diagnosing Distal Myopathy: Evaluating Model Interpretability and Clinician Trust

Mohsen Abbaspour Onari, Lucie Charlotte Magister, Yaoxin Wu, Amalia Lupi, Dario Creazzo, Mattia Tordin, Luigi Di Donatantonio, Emilio Quaia, Chao Zhang, Isel Grau, Marco S. Nobile, Yingqian Zhang, Pietro Liò

arxiv logopreprintAug 2 2025
Distal myopathy represents a genetically heterogeneous group of skeletal muscle disorders with broad clinical manifestations, posing diagnostic challenges in radiology. To address this, we propose a novel multimodal attention-aware fusion architecture that combines features extracted from two distinct deep learning models, one capturing global contextual information and the other focusing on local details, representing complementary aspects of the input data. Uniquely, our approach integrates these features through an attention gate mechanism, enhancing both predictive performance and interpretability. Our method achieves a high classification accuracy on the BUSI benchmark and a proprietary distal myopathy dataset, while also generating clinically relevant saliency maps that support transparent decision-making in medical diagnosis. We rigorously evaluated interpretability through (1) functionally grounded metrics, coherence scoring against reference masks and incremental deletion analysis, and (2) application-grounded validation with seven expert radiologists. While our fusion strategy boosts predictive performance relative to single-stream and alternative fusion strategies, both quantitative and qualitative evaluations reveal persistent gaps in anatomical specificity and clinical usefulness of the interpretability. These findings highlight the need for richer, context-aware interpretability methods and human-in-the-loop feedback to meet clinicians' expectations in real-world diagnostic settings.

Integrating Time and Frequency Domain Features of fMRI Time Series for Alzheimer's Disease Classification Using Graph Neural Networks.

Peng W, Li C, Ma Y, Dai W, Fu D, Liu L, Liu L, Yu N, Liu J

pubmed logopapersAug 2 2025
Accurate and early diagnosis of Alzheimer's Disease (AD) is crucial for timely interventions and treatment advancement. Functional Magnetic Resonance Imaging (fMRI), measuring brain blood-oxygen level changes over time, is a powerful AD-diagnosis tool. However, current fMRI-based AD diagnosis methods rely on noise-susceptible time-domain features and focus only on synchronous brain-region interactions in the same time phase, neglecting asynchronous ones. To overcome these issues, we propose Frequency-Time Fusion Graph Neural Network (FTF-GNN). It integrates frequency- and time-domain features for robust AD classification, considering both asynchronous and synchronous brain-region interactions. First, we construct a fully connected hypervariate graph, where nodes represent brain regions and their Blood Oxygen Level-Dependent (BOLD) values at a time series point. A Discrete Fourier Transform (DFT) transforms these BOLD values from the spatial to the frequency domain for frequency-component analysis. Second, a Fourier-based Graph Neural Network (FourierGNN) processes the frequency features to capture asynchronous brain region connectivity patterns. Third, these features are converted back to the time domain and reshaped into a matrix where rows represent brain regions and columns represent their frequency-domain features at each time point. Each brain region then fuses its frequency-domain features with position encoding along the time series, preserving temporal and spatial information. Next, we build a brain-region network based on synchronous BOLD value associations and input the brain-region network and the fused features into a Graph Convolutional Network (GCN) to capture synchronous brain region connectivity patterns. Finally, a fully connected network classifies the brain-region features. Experiments on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset demonstrate the method's effectiveness: Our model achieves 91.26% accuracy and 96.79% AUC in AD versus Normal Control (NC) classification, showing promising performance. For early-stage detection, it attains state-of-the-art performance in distinguishing NC from Late Mild Cognitive Impairment (LMCI) with 87.16% accuracy and 93.22% AUC. Notably, in the challenging task of differentiating LMCI from AD, FTF-GNN achieves optimal performance (85.30% accuracy, 94.56% AUC), while also delivering competitive results (77.40% accuracy, 91.17% AUC) in distinguishing Early MCI (EMCI) from LMCI-the most clinically complex subtype classification. These results indicate that leveraging complementary frequency- and time-domain information, along with considering asynchronous and synchronous brain-region interactions, can address existing approach limitations, offering a robust neuroimaging-based diagnostic solution.

[Tips and tricks for the cytological management of cysts].

Lacoste-Collin L, Fabre M

pubmed logopapersAug 2 2025
Fine needle aspiration is a well-known procedure for the diagnosis and management of solid lesions. The approach to cystic lesions on fine needle-aspiration is becoming a popular diagnostic tool due to the increased availability of high-quality cross-sectional imaging such as computed tomography and ultrasound guided procedures like endoscopic ultrasound. Cystic lesions are closed cavities containing liquid, sometimes partially solid with various internal neoplastic and non-neoplastic components. The most frequently punctured cysts are in the neck (thyroid and salivary glands), mediastinum, breast and abdomen (pancreas and liver). The diagnostic accuracy of cytological cyst sampling is highly dependent on laboratory material management. This review highlights how to approach the main features of superficial and deep organ cysts using basic cytological techniques (direct smears, cytocentrifugation), liquid-based cytology and cell block. We show the role of a multimodal approach that can lead to a wider implementation of ancillary tests (biochemical, immunocytochemical and molecular) to improve diagnostic accuracy and clinical management of patients with cystic lesions. In the near future, artificial intelligence models will offer detection, classification and prediction capabilities for various cystic lesions. Two examples in pancreatic and thyroid cytopathology are particularly developed.

Advances in renal cancer: diagnosis, treatment, and emerging technologies.

Saida T, Iima M, Ito R, Ueda D, Nishioka K, Kurokawa R, Kawamura M, Hirata K, Honda M, Takumi K, Ide S, Sugawara S, Watabe T, Sakata A, Yanagawa M, Sofue K, Oda S, Naganawa S

pubmed logopapersAug 2 2025
This review provides a comprehensive overview of current practices and recent advancements in the diagnosis and treatment of renal cancer. It introduces updates in histological classification and explains the imaging characteristics of each tumour based on these changes. The review highlights state-of-the-art imaging modalities, including magnetic resonance imaging, computed tomography, positron emission tomography, and ultrasound, emphasising their crucial role in tumour characterisation and optimising treatment planning. Emerging technologies, such as radiomics and artificial intelligence, are also discussed for their transformative impact on enhancing diagnostic precision, prognostic prediction, and personalised patient management. Furthermore, the review explores current treatment options, including minimally invasive techniques such as cryoablation, radiofrequency ablation, and stereotactic body radiation therapy, as well as systemic therapies such as immune checkpoint inhibitors and targeted therapies.

Evaluating the Efficacy of Various Deep Learning Architectures for Automated Preprocessing and Identification of Impacted Maxillary Canines in Panoramic Radiographs.

Alenezi O, Bhattacharjee T, Alseed HA, Tosun YI, Chaudhry J, Prasad S

pubmed logopapersAug 2 2025
Previously, automated cropping and a reasonable classification accuracy for distinguishing impacted and non-impacted canines were demonstrated. This study evaluates multiple convolutional neural network (CNN) architectures for improving accuracy as a step towards a fully automated software for identification of impacted maxillary canines (IMCs) in panoramic radiographs (PRs). Eight CNNs (SqueezeNet, GoogLeNet, NASNet-Mobile, ShuffleNet, VGG-16, ResNet 50, DenseNet 201, and Inception V3) were compared in terms of their ability to classify 2 groups of PRs (impacted: n = 91; and non-impacted: n = 91 maxillary canines) before pre-processing and after applying automated cropping. For the PRs with impacted and non-impacted maxillary canines, GoogLeNet achieved the highest classification performance among the tested CNN architectures. Area under the curve (AUC) values of the Receiver Operating Characteristic (ROC) analysis without preprocessing and with preprocessing were 0.9 and 0.99 respectively, compared to 0.84 and 0.96 respectively with SqueezeNet. Among the tested CNN architectures, GoogLeNet achieved the highest performance on this dataset for the automated identification of impacted maxillary canines on both cropped and uncropped PRs.

Classification of Brain Tumors using Hybrid Deep Learning Models

Neerav Nemchand Gala

arxiv logopreprintAug 2 2025
The use of Convolutional Neural Networks (CNNs) has greatly improved the interpretation of medical images. However, conventional CNNs typically demand extensive computational resources and large training datasets. To address these limitations, this study applied transfer learning to achieve strong classification performance using fewer training samples. Specifically, the study compared EfficientNetV2 with its predecessor, EfficientNet, and with ResNet50 in classifying brain tumors into three types: glioma, meningioma, and pituitary tumors. Results showed that EfficientNetV2 delivered superior performance compared to the other models. However, this improvement came at the cost of increased training time, likely due to the model's greater complexity.

A RF-based end-to-end Breast Cancer Prediction algorithm.

Win KN

pubmed logopapersAug 1 2025
Breast cancer became the primary cause of cancer-related deaths among women year by year. Early detection and accurate prediction of breast cancer play a crucial role in strengthening the quality of human life. Many scientists have concentrated on analyzing and conducting the development of many algorithms and progressing computer-aided diagnosis applications. Whereas many research have been conducted, feature research on cancer diagnosis is rare, especially regarding predicting the desired features by providing and feeding breast cancer features into the system. In this regard, this paper proposed a Breast Cancer Prediction (RF-BCP) algorithm based on Random Forest by taking inputs to predict cancer. For the experiment of the proposed algorithm, two datasets were utilized namely Breast Cancer dataset and a curated mammography dataset, and also compared the accuracy of the proposed algorithm with SVM, Gaussian NB, and KNN algorithms. Experimental results show that the proposed algorithm can predict well and outperform other existing machine learning algorithms to support decision-making.

Light Convolutional Neural Network to Detect Chronic Obstructive Pulmonary Disease (COPDxNet): A Multicenter Model Development and External Validation Study.

Rabby ASA, Chaudhary MFA, Saha P, Sthanam V, Nakhmani A, Zhang C, Barr RG, Bon J, Cooper CB, Curtis JL, Hoffman EA, Paine R, Puliyakote AK, Schroeder JD, Sieren JC, Smith BM, Woodruff PG, Reinhardt JM, Bhatt SP, Bodduluri S

pubmed logopapersAug 1 2025
Approximately 70% of adults with chronic obstructive pulmonary disease (COPD) remain undiagnosed. Opportunistic screening using chest computed tomography (CT) scans, commonly acquired in clinical practice, may be used to improve COPD detection through simple, clinically applicable deep-learning models. We developed a lightweight, convolutional neural network (COPDxNet) that utilizes minimally processed chest CT scans to detect COPD. We analyzed 13,043 inspiratory chest CT scans from the COPDGene participants, (9,675 standard-dose and 3,368 low-dose scans), which we randomly split into training (70%) and test (30%) sets at the participant level to no individual contributed to both sets. COPD was defined by postbronchodilator FEV /FVC < 0.70. We constructed a simple, four-block convolutional model that was trained on pooled data and validated on the held-out standard- and low-dose test sets. External validation was performed using standard-dose CT scans from 2,890 SPIROMICS participants and low-dose CT scans from 7,893 participants in the National Lung Screening Trial (NLST). We evaluated performance using the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, Brier scores, and calibration curves. On COPDGene standard-dose CT scans, COPDxNet achieved an AUC of 0.92 (95% CI: 0.91 to 0.93), sensitivity of 80.2%, and specificity of 89.4%. On low-dose scans, AUC was 0.88 (95% CI: 0.86 to 0.90). When the COPDxNet model was applied to external validation datasets, it showed an AUC of 0.92 (95% CI: 0.91 to 0.93) in SPIROMICS and 0.82 (95% CI: 0.81 to 0.83) on NLST. The model was well-calibrated, with Brier scores of 0.11 for standard- dose and 0.13 for low-dose CT scans in COPDGene, 0.12 in SPIROMICS, and 0.17 in NLST. COPDxNet demonstrates high discriminative accuracy and generalizability for detecting COPD on standard- and low-dose chest CT scans, supporting its potential for clinical and screening applications across diverse populations.

Structured Spectral Graph Learning for Anomaly Classification in 3D Chest CT Scans

Theo Di Piazza, Carole Lazarus, Olivier Nempont, Loic Boussel

arxiv logopreprintAug 1 2025
With the increasing number of CT scan examinations, there is a need for automated methods such as organ segmentation, anomaly detection and report generation to assist radiologists in managing their increasing workload. Multi-label classification of 3D CT scans remains a critical yet challenging task due to the complex spatial relationships within volumetric data and the variety of observed anomalies. Existing approaches based on 3D convolutional networks have limited abilities to model long-range dependencies while Vision Transformers suffer from high computational costs and often require extensive pre-training on large-scale datasets from the same domain to achieve competitive performance. In this work, we propose an alternative by introducing a new graph-based approach that models CT scans as structured graphs, leveraging axial slice triplets nodes processed through spectral domain convolution to enhance multi-label anomaly classification performance. Our method exhibits strong cross-dataset generalization, and competitive performance while achieving robustness to z-axis translation. An ablation study evaluates the contribution of each proposed component.
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