Manual field-of-view (FoV) prescription in whole-body magnetic resonance imaging (WB-MRI) is vital for ensuring comprehensive anatomic coverage and minimising artifacts, thereby enhancing image quality. However, this procedure is time-consuming, subject to operator variability, and adversely impacts both patient comfort and workflow efficiency. To overcome these limitations, an automated system was developed and evaluated that prescribes multiple consecutive FoV stations for WB-MRI using deep-learning (DL)-based three-dimensional anatomic segmentations. A total of 374 patients (mean age: 50.5 ± 18.2 y; 52% females) who underwent WB-MRI, including T2-weighted Half-Fourier acquisition single-shot turbo spin-echo (T2-HASTE) and fast whole-body localizer (FWBL) sequences acquired during continuous table movement on a 3T MRI system, were retrospectively collected between March 2012 and January 2025. An external cohort of 10 patients, acquired on two 1.5T scanners, was utilized for generalizability testing. Complementary nnUNet-v2 models were fine-tuned to segment tissue compartments, organs, and a whole-body (WB) outline on FWBL images. From these predicted segmentations, 5 consecutive FoVs (head/neck, thorax, liver, pelvis, and spine) were generated. Segmentation accuracy was quantified by Sørensen-Dice coefficients (DSC), Precision (P), Recall (R), and Specificity (S). Clinical utility was assessed on 30 test cases by 4 blinded experts using Likert scores and a 4-way ranking against 3 radiographer prescriptions. Interrater reliability and statistical comparisons were employed using the intraclass correlation coefficient (ICC), Kendall W, Friedman, and Wilcoxon signed-rank tests. Mean DSCs were 0.98 for torso (P = 0.98, R = 0.98, S = 1.00), 0.96 for head/neck (P = 0.95, R = 0.96, S = 1.00), 0.94 for abdominal cavity (P = 0.95, R = 0.94, S = 1.00), 0.90 for thoracic cavity (P = 0.90, R = 0.91, S = 1.00), 0.86 for liver (P = 0.85, R = 0.87, S = 1.00), and 0.63 for spinal cord (P = 0.64, R = 0.63, S = 1.00). The clinical utility was evidenced by assessments from 2 expert radiologists and 2 radiographers, with 98.3% and 87.5% of cases rated as clinically acceptable in the internal test data set and the external test data set. Predicted FoVs received the highest ranking in 60% of cases. They placed within the top 2 in 85.8% of cases, outperforming radiographers with 9 and 13 years of experience (P < 0.001) and matching the performance of a radiographer with 20 years of experience. DL-based three-dimensional anatomic segmentations enable accurate and reliable multistation FoV prescription for WB-MRI, achieving expert-level performance while significantly reducing manual workload. Automated FoV planning has the potential to standardize WB-MRI acquisition, reduce interoperator variability, and enhance workflow efficiency, thereby facilitating broader clinical adoption.

Medical image recognition serves as a key way to aid in clinical diagnosis, enabling more accurate and timely identification of diseases and abnormalities. Vision transformer-based approaches have proven effective in handling various medical recognition tasks. However, these methods encounter two primary challenges. First, they are often task-specific and architecture-tailored, limiting their general applicability. Second, they usually either adopt full attention to model long-range dependencies, resulting in high computational costs, or rely on handcrafted sparse attention, potentially leading to suboptimal performance. To tackle these issues, we present MedFormer, an efficient medical vision transformer with two key ideas. First, it employs a pyramid scaling structure as a versatile backbone for various medical image recognition tasks, including image classification and dense prediction tasks such as semantic segmentation and lesion detection. This structure facilitates hierarchical feature representation while reducing the computation load of feature maps, highly beneficial for boosting performance. Second, it introduces a novel Dual Sparse Selection Attention (DSSA) with content awareness to improve computational efficiency and robustness against noise while maintaining high performance. As the core building technique of MedFormer, DSSA is designed to explicitly attend to the most relevant content. Theoretical analysis demonstrates that MedFormer outperforms existing medical vision transformers in terms of generality and efficiency. Extensive experiments across various imaging modality datasets show that MedFormer consistently enhances performance in all three medical image recognition tasks mentioned above. MedFormer provides an efficient and versatile solution for medical image recognition, with strong potential for clinical application. The code is available on GitHub.

Fontan palliation for univentricular congenital heart disease progresses to hemodynamic failure with complex flow patterns poorly characterized by conventional 2D imaging. Current assessment relies on fluoroscopic angiography, providing limited 3D geometric information essential for computational fluid dynamics (CFD) analysis and surgical planning. A multi-step AI pipeline was developed utilizing Google's Gemini 2.5 Flash (2.5B parameters) for systematic, iterative processing of fluoroscopic angiograms through transformer-based neural architecture. The pipeline encompasses medical image preprocessing, vascular segmentation, contrast enhancement, artifact removal, and virtual hemodynamic flow visualization within 2D projections. Final views were processed through Tencent's Hunyuan3D-2mini (384M parameters) for stereolithography file generation. The pipeline successfully generated geometrically optimized 2D projections from single-view angiograms after 16 processing steps using a custom web interface. Initial iterations contained hallucinated vascular features requiring iterative refinement to achieve anatomically faithful representations. Final projections demonstrated accurate preservation of complex Fontan geometry with enhanced contrast suitable for 3D conversion. AI-generated virtual flow visualization identified stagnation zones in central connections and flow patterns in branch arteries. Complete processing required under 15 minutes with second-level API response times. This approach demonstrates clinical feasibility of generating CFD-suitable geometries from routine angiographic data, enabling 3D generation and rapid virtual flow visualization for cursory insights prior to full CFD simulation. While requiring refinement cycles for accuracy, this establishes foundation for democratizing advanced geometric and hemodynamic analysis using readily available imaging data.

Sparse-View CT (SVCT) reconstruction enhances temporal resolution and reduces radiation dose, yet its clinical use is hindered by artifacts due to view reduction and domain shifts from scanner, protocol, or anatomical variations, leading to performance degradation in out-of-distribution (OOD) scenarios. In this work, we propose a Cross-Distribution Diffusion Priors-Driven Iterative Reconstruction (CDPIR) framework to tackle the OOD problem in SVCT. CDPIR integrates cross-distribution diffusion priors, derived from a Scalable Interpolant Transformer (SiT), with model-based iterative reconstruction methods. Specifically, we train a SiT backbone, an extension of the Diffusion Transformer (DiT) architecture, to establish a unified stochastic interpolant framework, leveraging Classifier-Free Guidance (CFG) across multiple datasets. By randomly dropping the conditioning with a null embedding during training, the model learns both domain-specific and domain-invariant priors, enhancing generalizability. During sampling, the globally sensitive transformer-based diffusion model exploits the cross-distribution prior within the unified stochastic interpolant framework, enabling flexible and stable control over multi-distribution-to-noise interpolation paths and decoupled sampling strategies, thereby improving adaptation to OOD reconstruction. By alternating between data fidelity and sampling updates, our model achieves state-of-the-art performance with superior detail preservation in SVCT reconstructions. Extensive experiments demonstrate that CDPIR significantly outperforms existing approaches, particularly under OOD conditions, highlighting its robustness and potential clinical value in challenging imaging scenarios.

Medical image enhancement and segmentation are critical yet challenging tasks in modern clinical practice, constrained by artifacts and complex anatomical variations. Traditional deep learning approaches often rely on complex architectures with limited interpretability. While Kolmogorov-Arnold networks offer interpretable solutions, their reliance on flattened feature representations fundamentally disrupts the intrinsic spatial structure of imaging data. To address this issue we propose a Functional Kolmogorov-Arnold Network (FunKAN) -- a novel interpretable neural framework, designed specifically for image processing, that formally generalizes the Kolmogorov-Arnold representation theorem onto functional spaces and learns inner functions using Fourier decomposition over the basis Hermite functions. We explore FunKAN on several medical image processing tasks, including Gibbs ringing suppression in magnetic resonance images, benchmarking on IXI dataset. We also propose U-FunKAN as state-of-the-art binary medical segmentation model with benchmarks on three medical datasets: BUSI (ultrasound images), GlaS (histological structures) and CVC-ClinicDB (colonoscopy videos), detecting breast cancer, glands and polyps, respectively. Experiments on those diverse datasets demonstrate that our approach outperforms other KAN-based backbones in both medical image enhancement (PSNR, TV) and segmentation (IoU, F1). Our work bridges the gap between theoretical function approximation and medical image analysis, offering a robust, interpretable solution for clinical applications.

Lung transplantation remains a critical treatment for end-stage lung diseases, yet it continues to have 1 of the lowest survival rates among solid organ transplants. Despite its life-saving potential, the field faces several challenges, including organ shortages, suboptimal donor matching, and post-transplant complications. The rapidly advancing field of artificial intelligence (AI) offers significant promise in addressing these challenges. Traditional statistical models, such as linear and logistic regression, have been used to predict post-transplant outcomes but struggle to adapt to new trends and evolving data. In contrast, machine learning algorithms can evolve with new data, offering dynamic and updated predictions. AI holds the potential to enhance lung transplantation at multiple stages. In the pre-transplant phase, AI can optimize waitlist management, refine donor selection, and improve donor-recipient matching, and enhance diagnostic imaging by harnessing vast datasets. Post-transplant, AI can help predict allograft rejection, improve immunosuppressive management, and better forecast long-term patient outcomes, including quality of life. However, the integration of AI in lung transplantation also presents challenges, including data privacy concerns, algorithmic bias, and the need for external clinical validation. This review explores the current state of AI in lung transplantation, summarizes key findings from recent studies, and discusses the potential benefits, challenges, and ethical considerations in this rapidly evolving field, highlighting future research directions.

Usual Interstitial Pneumonia (UIP) indicates poor prognosis, and there is significant heterogeneity in the diagnosis of UIP, necessitating an auxiliary diagnostic tool. Can a machine learning (ML) classifier using radiomics features and clinical data accurately identify UIP from patients with interstitial lung diseases (ILD)? This dataset from a prospective cohort consists of 5321 sets of high-resolution computed tomography (HRCT) images from 2901 patients with ILD (male: 63.5%, age: 61.7 ± 10.8 years) across three medical centers. Multimodal data, including whole-lung radiomics features on HRCT and demographics, smoking, lung function, and comorbidity data, were extracted. An eXtreme Gradient Boosting (XGBoost) and logistic regression were used to design a nomogram predicting UIP or not. Area under the receiver operating characteristic curve (AUC) and Cox's regression for all-cause mortality were used to assess the diagnostic performance and prognostic value of models, respectively. 5213 HRCT image datasets were divided into the training group (n=3639), the internal testing group (n=785), and the external validation group (n=789). UIP prevalence was 43.7% across the whole dataset, with 42.7% and 41.3% for the internal validation set and external validation set. The radiomics-based classifier had an AUC of 0.790 in the internal testing set and 0.786 for the external validation dataset. Integrating multimodal data improved AUCs to 0.802 and 0.794, respectively. The performance of the integration model was comparable to pulmonologist with over 10 years of experience in ILD. Within 522 patients deceased during a median follow-up period of 3.37 years, the multimodal-based ML model-predicted UIP status was associated with high all-cause mortality risk (hazard ratio: 2.52, p<0.001). The classifier combining radiomics and clinical features showed strong performance across varied UIP prevalence. This multimodal-based ML model could serve as an adjunct in the diagnosis of UIP.

Time-series forecasting and causal discovery are central in neuroscience, as predicting brain activity and identifying causal relationships between neural populations and circuits can shed light on the mechanisms underlying cognition and disease. With the rise of foundation models, an open question is how they compare to traditional methods for brain signal forecasting and causality analysis, and whether they can be applied in a zero-shot setting. In this work, we evaluate a foundation model against classical methods for inferring directional interactions from spontaneous brain activity measured with functional magnetic resonance imaging (fMRI) in humans. Traditional approaches often rely on Wiener-Granger causality. We tested the forecasting ability of the foundation model in both zero-shot and fine-tuned settings, and assessed causality by comparing Granger-like estimates from the model with standard Granger causality. We validated the approach using synthetic time series generated from ground-truth causal models, including logistic map coupling and Ornstein-Uhlenbeck processes. The foundation model achieved competitive zero-shot forecasting fMRI time series (mean absolute percentage error of 0.55 in controls and 0.27 in patients). Although standard Granger causality did not show clear quantitative differences between models, the foundation model provided a more precise detection of causal interactions. Overall, these findings suggest that foundation models offer versatility, strong zero-shot performance, and potential utility for forecasting and causal discovery in time-series data.

Multimodal learning has attracted much attention in recent years due to its ability to effectively utilize data features from a variety of different modalities. Diagnosing the vulnerability of atherosclerotic plaques directly from carotid 3D MRI images is relatively challenging for both radiologists and conventional 3D vision networks. In clinical practice, radiologists assess patient conditions using a multimodal approach that incorporates various imaging modalities and domain-specific expertise, paving the way for the creation of multimodal diagnostic networks. In this paper, we have developed an effective strategy to leverage radiologists' domain knowledge to automate the diagnosis of carotid plaque vulnerability through Variation inference and Multimodal knowledge Distillation (VMD). This method excels in harnessing cross-modality prior knowledge from limited image annotations and radiology reports within training data, thereby enhancing the diagnostic network's accuracy for unannotated 3D MRI images. We conducted in-depth experiments on the dataset collected in-house and verified the effectiveness of the VMD strategy we proposed.

Major depressive disorder (MDD) is a prevalent mental health condition that negatively impacts both individual well-being and global public health. Automated detection of MDD using structural magnetic resonance imaging (sMRI) and deep learning (DL) methods holds increasing promise for improving diagnostic accuracy and enabling early intervention. Most existing methods employ either voxel-level features or handcrafted regional representations built from predefined brain atlases, limiting their ability to capture complex brain patterns. This paper develops a unified pipeline that utilizes Vision Transformers (ViTs) for extracting 3D region embeddings from sMRI data and Graph Neural Network (GNN) for classification. We explore two strategies for defining regions: (1) an atlas-based approach using predefined structural and functional brain atlases, and (2) an cube-based method by which ViTs are trained directly to identify regions from uniformly extracted 3D patches. Further, cosine similarity graphs are generated to model interregional relationships, and guide GNN-based classification. Extensive experiments were conducted using the REST-meta-MDD dataset to demonstrate the effectiveness of our model. With stratified 10-fold cross-validation, the best model obtained 78.98% accuracy, 76.54% sensitivity, 81.58% specificity, 81.58% precision, and 78.98% F1-score. Further, atlas-based models consistently outperformed the cube-based approach, highlighting the importance of using domain-specific anatomical priors for MDD detection.