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.

Voice disorders (VD) are often linked to vocal fold structural pathologies (VFSP). Laryngeal imaging plays a vital role in assessing VFSPs and VD in clinical and research settings, but challenges like scarce and imbalanced datasets can limit the generalizability of findings. Denoising Diffusion Probabilistic Models (DDPMs), a subtype of Generative AI, has gained attention for its ability to generate high-quality and realistic synthetic images to address these challenges. This study explores the feasibility of improving VFSP image classification by generating synthetic images using DDPMs. 404 laryngoscopic images depicting VF without and with VFSP were included. DDPMs were used to generate synthetic images to augment the original dataset. Two convolutional neural network architectures, VGG16 and ResNet50, were applied for model training. The models were initially trained only on the original dataset. Then, they were trained on the augmented datasets. Evaluation metrics were analyzed to assess the performance of the models for both binary classification (with/without VFSPs) and multi-class classification (seven specific VFSPs). Realistic and high-quality synthetic images were generated for dataset augmentation. The model first failed to converge when trained only on the original dataset, but they successfully converged and achieved low loss and high accuracy when trained on the augmented datasets. The best performance was gained for both binary and multi-class classification when the models were trained on an augmented dataset. Generating realistic images of VFSP using DDPMs is feasible and can enhance the classification of VFSPs by an AI model and may support VD screening and diagnosis.

Breast cancer remains a significant global health issue. Despite advances in detection and treatment, its complexity is driven by genetic, environmental, and structural factors. Computational methods like Finite Element Modeling (FEM) have transformed our understanding of breast cancer risk and progression. Advanced computational approaches in breast cancer research are the focus, with an emphasis on FEM's role in simulating breast tissue mechanics and enhancing precision in therapies such as radiofrequency ablation (RFA). Machine learning (ML), particularly Convolutional Neural Networks (CNNs), has revolutionized imaging modalities like mammograms and MRIs, improving diagnostic accuracy and early detection. AI applications in analyzing histopathological images have advanced tumor classification and grading, offering consistency and reducing inter-observer variability. Explainability tools like Grad-CAM, SHAP, and LIME enhance the transparency of AI-driven models, facilitating their integration into clinical workflows. Integrating FEM and ML represents a paradigm shift in breast cancer management. FEM offers precise modeling of tissue mechanics, while ML excels in predictive analytics and image analysis. Despite challenges such as data variability and limited standardization, synergizing these approaches promises adaptive, personalized care. These computational methods have the potential to redefine diagnostics, optimize treatment, and improve patient outcomes.

Deep learning models are increasingly being implemented for automated medical image analysis to inform patient care. Most models, however, lack uncertainty information, without which the reliability of model outputs cannot be ensured. Several uncertainty quantification (UQ) methods exist to capture model uncertainty. Yet, it is not clear which method is optimal for a given task. The purpose of this work was to investigate several commonly used UQ methods for the critical yet understudied task of metastatic lesion segmentation on whole body PET/CT. 
Approach:
59 whole body 68Ga-DOTATATE PET/CT images of patients undergoing theranostic treatment of metastatic neuroendocrine tumors were used in this work. A 3D U-Net was trained for lesion segmentation following five-fold cross validation. Uncertainty measures derived from four UQ methods-probability entropy, Monte Carlo dropout, deep ensembles, and test time augmentation-were investigated. Each uncertainty measure was assessed across four quantitative evaluations: (1) its ability to detect artificially degraded image data at low, medium, and high degradation magnitudes; (2) to detect false-positive (FP) predicted regions; (3) to recover false-negative (FN) predicted regions; and (3) to establish correlations with model biomarker extraction and segmentation performance metrics. 
Results: Test time augmentation and probability entropy respectively achieved the highest and lowest degraded image detection at low (AUC=0.54 vs. 0.68), medium (AUC=0.70 vs. 0.82), and high (AUC=0.83 vs. 0.90) degradation magnitudes. For detecting FPs, all UQ methods achieve strong performance, with AUC values ranging narrowly between 0.77 and 0.81. FN region recovery performance was strongest for test time augmentation and weakest for probability entropy. Performance for the correlation analysis was mixed, where the strongest performance was achieved by test time augmentation for SUVtotal capture (ρ=0.57) and segmentation Dice coefficient (ρ=0.72), by Monte Carlo dropout for SUVmean capture (ρ=0.35), and by probability entropy for segmentation cross entropy (ρ=0.96).
Significance: Overall, test time augmentation demonstrated superior uncertainty quantification performance and is recommended for use in metastatic lesion segmentation task. It also offers the advantage of being post hoc and computationally efficient. In contrast, probability entropy performed the worst, highlighting the need for advanced UQ approaches for this task.&#xD.

Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy, frequently presenting with pain, numbness, and muscle weakness due to median nerve compression. However, diagnosing CTS becomes particularly challenging in patients with Congenital Thenar Hypoplasia (CTH), a rare congenital anomaly characterized by underdeveloped thenar muscles. The overlapping symptoms of CTH and CTS, such as thumb weakness, impaired hand function, and thenar muscle atrophy, can obscure the identification of median nerve compression. This review highlights the diagnostic complexities arising from this overlap and evaluates existing clinical, imaging, and electrophysiological assessment methods. While traditional diagnostic tests, including Phalen's and Tinel's signs, exhibit limited sensitivity in CTH patients, advanced imaging modalities like ultrasonography (US), magnetic resonance imaging (MRI), and diffusion tensor imaging (DTI) provide valuable insights into structural abnormalities. Additionally, emerging technologies such as artificial intelligence (AI) enhance diagnostic precision by automating imaging analysis and identifying subtle nerve alterations. Combining clinical history, functional assessments, and advanced imaging, an interdisciplinary approach is critical to differentiate between CTH-related anomalies and CTS accurately. This comprehensive review underscores the need for tailored diagnostic protocols to improve early detection, personalised management, and outcomes for this unique patient population.

The preoperative human epidermal growth factor receptor type 2 (HER2) status of breast cancer is typically determined by pathological examination of a core needle biopsy, which influences the efficacy of neoadjuvant chemotherapy (NAC). However, the highly heterogeneous nature of breast cancer and the limitations of needle aspiration biopsy increase the instability of pathological evaluation. The aim of this study was to predict HER2 status in preoperative breast cancer using deep learning (DL) models based on ultrasound (US) and magnetic resonance imaging (MRI). The study included women with invasive breast cancer who underwent US and MRI at our institution between January 2021 and July 2024. US images and dynamic contrast-enhanced T1-weighted MRI images were used to construct DL models (DL-US: the DL model based on US; DL-MRI: the model based on MRI; and DL-MRI&US: the combined model based on both MRI and US). All classifications were based on postoperative pathological evaluation. Receiver operating characteristic analysis and the DeLong test were used to compare the diagnostic performance of the DL models. In the test cohort, DL-US differentiated the HER2 status of breast cancer with an AUC of 0.842 (95% CI: 0.708-0.931), and sensitivity and specificity of 89.5% and 79.3%, respectively. DL-MRI achieved an AUC of 0.800 (95% CI: 0.660-0.902), with sensitivity and specificity of 78.9% and 79.3%, respectively. DL-MRI&US yielded an AUC of 0.898 (95% CI: 0.777-0.967), with sensitivity and specificity of 63.2% and 100.0%, respectively.

Employing a whole-brain (WB) mask as a region of interest for extracting radiomic features is a feasible, albeit less common, approach in neuro-oncology research. This study aims to evaluate the relationship between WB radiomic features, derived from various neuroimaging modalities in patients with gliomas, and some key baseline characteristics of patients and tumors such as sex, histological tumor type, WHO Grade (2021), IDH1 mutation status, necrosis lesions, contrast enhancement, T/N peak value and metabolic tumor volume. Forty-one patients (average age 50 ± 15 years, 21 females and 20 males) with supratentorial glial tumors were enrolled in this study. A total of 38,720 radiomic features were extracted. Cluster analysis revealed that whole-brain images of biologically different tumors could be distinguished to a certain extent based on their imaging biomarkers. Machine learning capabilities to detect image properties like contrast-enhanced or necrotic zones validated radiomic features in objectifying image semantics. Furthermore, the predictive capability of imaging biomarkers in determining tumor histology, grade and mutation type underscores their diagnostic potential. Whole-brain radiomics using multimodal neuroimaging data appeared to be informative in neuro-oncology, making research in this area well justified.

Recently, combining the strategy of consistency regularization with uncertainty estimation has shown promising performance on semi-supervised medical image segmentation tasks. However, most existing methods estimate the uncertainty solely based on the outputs of a single neural network, which results in imprecise uncertainty estimations and eventually degrades the segmentation performance. In this paper, we propose a novel Uncertainty Co-estimator (UnCo) framework to deal with this problem. Inspired by the co-training technique, UnCo establishes two different mean-teacher modules (i.e., two pairs of teacher and student models), and estimates three types of uncertainty from the multi-source predictions generated by these models. Through combining these uncertainties, their differences will help to filter out incorrect noise in each estimate, thus allowing the final fused uncertainty maps to be more accurate. These resulting maps are then used to enhance a cross-consistency regularization imposed between the two modules. In addition, UnCo also designs an internal consistency regularization within each module, so that the student models can aggregate diverse feature information from both modules, thus promoting the semi-supervised segmentation performance. Finally, an adversarial constraint is introduced to maintain the model diversity. Experimental results on four medical image datasets indicate that UnCo can achieve new state-of-the-art performance on both 2D and 3D semi-supervised segmentation tasks. The source code will be available at https://github.com/z1010x/UnCo.

The present study followed the reporting guidelines for systematic reviews and meta-analyses. We conducted this study to review the diagnostic value of artificial intelligence (AI) for various types of lumbar spinal stenosis (LSS) and the level of stenosis, offering evidence-based support for the development of smart diagnostic tools. AI is currently being utilized for image processing in clinical practice. Some studies have explored AI techniques for identifying the severity of LSS in recent years. Nevertheless, there remains a shortage of structured data proving its effectiveness. Four databases (PubMed, Cochrane, Embase, and Web of Science) were searched until March 2024, including original studies that utilized deep learning (DL) and machine learning (ML) models to diagnose LSS. The risk of bias of included studies was assessed using Quality Assessment of Diagnostic Accuracy Studies is a quality evaluation tool for diagnostic research (diagnostic tests). Computed Tomography. PROSPERO is an international database of prospectively registered systematic reviews. Summary Receiver Operating Characteristic. Magnetic Resonance. Central canal stenosis. three-dimensional magnetic resonance myelography. The accuracy in the validation set was extracted for a meta-analysis. The meta-analysis was completed in R4.4.0. A total of 48 articles were included, with an overall accuracy of 0.885 (95% CI: 0.860-0907) for dichotomous tasks. Among them, the accuracy was 0.892 (95% CI: 0.867-0915) for DL and 0.833 (95% CI: 0.760-0895) for ML. The overall accuracy for LSS was 0.895 (95% CI: 0.858-0927), with an accuracy of 0.912 (95% CI: 0.873-0.944) for DL and 0.843 (95% CI: 0.766-0.907) for ML. The overall accuracy for central canal stenosis was 0.875 (95% CI: 0.821-0920), with an accuracy of 0.881 (95% CI: 0.829-0.925) for DL and 0.733 (95% CI: 0.541-0.877) for ML. The overall accuracy for neural foramen stenosis was 0.893 (95% CI: 0.851-0.928). In polytomous tasks, the accuracy was 0.936 (95% CI: 0.895-0.967) for no LSS, 0.503 (95% CI: 0.391-0.614) for mild LSS, 0.512 (95% CI: 0.336-0.688) for moderate LSS, and 0.860 for severe LSS (95% CI: 0.733-0.954). AI is highly valuable for diagnosing LSS. However, further external validation is necessary to enhance the analysis of different stenosis categories and improve the diagnostic accuracy for mild to moderate stenosis levels.