Given the high burden of hepatocellular carcinoma (HCC), risk stratification in patients with cirrhosis is critical but remains inadequate. In this study, we aimed to develop and validate an HCC prediction model by integrating radiomics and deep learning features from liver and spleen computed tomography (CT) images into the established age-male-ALBI-platelet (aMAP) clinical model. Patients were enrolled between 2018 and 2023 from a Chinese multicenter, prospective, observational cirrhosis cohort, all of whom underwent 3-phase contrast-enhanced abdominal CT scans at enrollment. The aMAP clinical score was calculated, and radiomic (PyRadiomics) and deep learning (ResNet-18) features were extracted from liver and spleen regions of interest. Feature selection was performed using the least absolute shrinkage and selection operator. Among 2,411 patients (median follow-up: 42.7 months [IQR: 32.9-54.1]), 118 developed HCC (three-year cumulative incidence: 3.59%). Chronic hepatitis B virus infection was the main etiology, accounting for 91.5% of cases. The aMAP-CT model, which incorporates CT signatures, significantly outperformed existing models (area under the receiver-operating characteristic curve: 0.809-0.869 in three cohorts). It stratified patients into high-risk (three-year HCC incidence: 26.3%) and low-risk (1.7%) groups. Stepwise application (aMAP → aMAP-CT) further refined stratification (three-year incidences: 1.8% [93.0% of the cohort] vs. 27.2% [7.0%]). The aMAP-CT model improves HCC risk prediction by integrating CT-based liver and spleen signatures, enabling precise identification of high-risk cirrhosis patients. This approach personalizes surveillance strategies, potentially facilitating earlier detection and improved outcomes.

To evaluate the predictive performance of a clinical-CT-radiomics nomogram based on radiomics signature and independent clinical-CT predictors for predicting endoscopic red color sign (RC) in cirrhotic patients with esophageal varices (EV). We retrospectively evaluated 215 cirrhotic patients. Among them, 108 and 107 cases were positive and negative for endoscopic RC, respectively. Patients were assigned to a training cohort (n = 150) and a validation cohort (n = 65) at a 7:3 ratio. In the training cohort, univariate and multivariate logistic regression analyses were performed on clinical and CT features to develop a clinical-CT model. Radiomic features were extracted from portal venous phase CT images to generate a Radiomic score (Rad-score) and to construct five machine learning models. A combined model was built using clinical-CT predictors and Rad-score through logistic regression. The performance of different models was evaluated using the receiver operating characteristic (ROC) curves and the area under the curve (AUC). The spleen-to-platelet ratio, liver volume, splenic vein diameter, and superior mesenteric vein diameter were independent predictors. Six radiomics features were selected to construct five machine learning models. The adaptive boosting model showed excellent predictive performance, achieving an AUC of 0.964 in the validation cohort, while the combined model achieved the highest predictive accuracy with an AUC of 0.985 in the validation cohort. The clinical-CT-radiomics nomogram demonstrates high predictive accuracy for endoscopic RC in cirrhotic patients with EV, which provides a novel tool for non-invasive prediction of esophageal varices bleeding.

The anatomical relationship between the maxillary sinus and maxillary molars is critical for planning dental procedures such as tooth extraction, implant placement and periodontal surgery. This study presents a novel artificial intelligence-based approach for the detection and classification of these anatomical relationships in cone beam computed tomography (CBCT) images. The model, developed using advanced image recognition technology, can automatically detect the relationship between the maxillary sinus and adjacent molars with high accuracy. The artificial intelligence algorithm used in our study provided faster and more consistent results compared to traditional manual evaluations, reaching 89% accuracy in the classification of anatomical structures. With this technology, clinicians will be able to more accurately assess the risks of sinus perforation, oroantral fistula and other surgical complications in the maxillary posterior region preoperatively. By reducing the workload associated with CBCT analysis, the system accelerates clinicians' diagnostic process, improves treatment planning and increases patient safety. It also has the potential to assist in the early detection of maxillary sinus pathologies and the planning of sinus floor elevation procedures. These findings suggest that the integration of AI-powered image analysis solutions into daily dental practice can improve clinical decision-making in oral and maxillofacial surgery by providing accurate, efficient and reliable diagnostic support.

Inferior alveolar nerve (IAN) injury is a critical complication of mandibular third molar extraction. This study aimed to construct and evaluate a deep learning framework that integrates contrastive learning and Bayesian optimization to enhance predictive performance on cone-beam computed tomography (CBCT) and panoramic radiographs. A retrospective dataset of 902 panoramic radiographs and 1,500 CBCT images was used. Five deep learning architectures (MobileNetV2, ResNet101D, Vision Transformer, Twins-SVT, and SSL-ResNet50) were trained with and without contrastive learning and Bayesian optimization. Model performance was evaluated using accuracy, F1-score, and comparison with oral and maxillofacial surgeons (OMFSs). Contrastive learning significantly improved the F1-scores across all models (e.g., MobileNetV2: 0.302 to 0.740; ResNet101D: 0.188 to 0.689; Vision Transformer: 0.275 to 0.704; Twins-SVT: 0.370 to 0.719; SSL-ResNet50: 0.109 to 0.576). Bayesian optimization further enhanced the F1-scores for MobileNetV2 (from 0.740 to 0.923), ResNet101D (from 0.689 to 0.857), Vision Transformer (from 0.704 to 0.871), Twins-SVT (from 0.719 to 0.857), and SSL-ResNet50 (from 0.576 to 0.875). The AI model outperformed OMFSs on CBCT cross-sectional images (F1-score: 0.923 vs. 0.667) but underperformed on panoramic radiographs (0.666 vs. 0.730). The proposed single-step deep learning approach effectively predicts IAN injury, with contrastive learning addressing data imbalance and Bayesian optimization optimizing model performance. While artificial intelligence surpasses human performance in CBCT images, panoramic radiographs analysis still benefits from expert interpretation. Future work should focus on multi-center validation and explainable artificial intelligence for broader clinical adoption.

Traditional brain connectivity studies have focused mainly on structural connectivity, often relying on tractography with diffusion MRI (dMRI) to reconstruct white matter pathways. In parallel, studies of functional connectivity have examined correlations in brain activity using fMRI. However, emerging methodologies are advancing our understanding of brain networks. Here we explore advanced connectivity approaches beyond conventional tractography, focusing on dMRI morphometry and the integration of structural and functional connectivity analysis. dMRI morphometry enables quantitative assessment of white matter pathway volumes through statistical comparison with normative populations, while functional connectivity reveals network organization that is not restricted to direct anatomical connections. More recently, approaches that combine diffusion tensor imaging (DTI) with functional correlation tensor (FCT) analysis have been introduced, and these complementary methods provide new perspectives into brain structure-function relationships. Together, such approaches have important implications for neurodevelopmental and neurological disorders as well as brain plasticity. The integration of these methods with artificial intelligence techniques have the potential to support both basic neuroscience research and clinical applications.

Tuberculosis (TB) is a serious infectious disease that remains a global health challenge. While chest X-rays (CXRs) are widely used for TB detection, manual interpretation can be subjective and time-consuming. Automated classification of CXRs into TB and non-TB cases can significantly support healthcare professionals in timely and accurate diagnosis. This paper introduces a hybrid deep learning approach for classifying CXR images. The solution is based on the CoAtNet framework, which combines the strengths of Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs). The model is pre-trained on the large-scale ImageNet dataset to ensure robust generalization across diverse images. The evaluation is conducted on the IN-CXR tuberculosis dataset from ICMR-NIRT, which contains a comprehensive collection of CXR images of both normal and abnormal categories. The hybrid model achieves a binary classification accuracy of 86.39% and an ROC-AUC score of 93.79%, outperforming tested baseline models that rely exclusively on either CNNs or ViTs when trained on this dataset. Furthermore, the integration of Local Interpretable Model-agnostic Explanations (LIME) enhances the interpretability of the model's predictions. This combination of reliable performance and transparent, interpretable results strengthens the model's role in AI-driven medical imaging research. Code will be made available upon request.

The preoperative differentiation of adenocarcinomas in situ, minimally invasive adenocarcinoma, and invasive adenocarcinoma using computed tomography (CT) is crucial for guiding clinical management decisions. However, accurately classifying ground-glass nodules poses a significant challenge. Incorporating quantitative intratumoral heterogeneity scores may improve the accuracy of this ternary classification. In this multicenter retrospective study, we developed ternary classification models by leveraging insights from both base and stacking ensemble machine learning models, incorporating intratumoral heterogeneity scores along with clinical-radiological features to distinguish adenocarcinomas in situ, minimally invasive adenocarcinoma, and invasive adenocarcinoma. The machine learning models were trained, and final model selection depended on maximizing the macro-average area under the curve (macro-AUC) in both the internal and external validation sets. Data from 802 patients from three centers were divided into a training set (n = 477) and an internal test set (n = 205), in a 7:3 ratio, with an additional external validation set comprising 120 patients. The stacking classifier exhibited superior performance relative to the other models, achieving macro-AUC values of 0.7850 and 0.7717 for the internal and external validation sets, respectively. Moreover, an interpretability analysis utilizing the Shapley Additive Explanation identified four key features of this ternary classification: intratumoral heterogeneity score, nodule size, nodule type, and age. The stacking classifier, recognized as the optimal algorithm for integrating the intratumoral heterogeneity score and clinical-radiological features, effectively served as a ternary classification model for assessing the invasiveness of lung adenocarcinoma in chest CT images. Our stacking classifier integrated intratumoral heterogeneity scores and clinical-radiological features to improve the ternary classification of lung adenocarcinoma invasiveness (adenocarcinomas in situ/minimally invasive adenocarcinoma/invasive adenocarcinoma), aiding in precise diagnosis and clinical decision-making for ground-glass nodules. The intratumoral heterogeneity score effectively assessed the invasiveness of lung adenocarcinoma. The stacking classifier outperformed other methods for this ternary classification task. Intratumoral heterogeneity score, nodule size, nodule type, and age predict invasiveness.

To develop machine-learning model that combines pre-operative vertebral-body CT radiomics with clinical data to predict cage subsidence after single-level ACDF with Zero-P. We retrospectively review 253 patients (2016-2023). Subsidence is defined as ≥ 3 mm loss of fused-segment height at final follow-up. Patients are split 8:2 into a training set (n = 202; 39 subsidence) and an independent test set (n = 51; 14 subsidence). Vertebral bodies adjacent to the target level are segmented on pre-operative CT, and high-throughput radiomic features are extracted with PyRadiomics. Features are z-score-normalized, then reduced by variance, correlation and LASSO. Age, vertebral Hounsfield units (HU) and T1-slope entered a clinical model. Eight classifiers are tuned by cross-validation; performance is assessed by AUC and related metrics, with thresholds optimized on the training cohort. Subsidence patients are older, lower HU and higher T1-slope (all P < 0.05). LASSO retained 11 radiomic features. In the independent test set, the clinical model had limited discrimination (AUC 0.595). The radiomics model improved performance (AUC 0.775; sensitivity 100%; specificity 60%). The combined model is best (AUC 0.813; sensitivity 80%; specificity 80%) and surpassed both single-source models (P < 0.05). A pre-operative model integrating CT-based radiomic signatures with key clinical variables predicts cage subsidence after ACDF with good accuracy. This tool may facilitate individualized risk stratification and guide strategies-such as endplate protection, implant choice and bone-quality optimization-to mitigate subsidence risk. Multicentre prospective validation is warranted.

Neoadjuvant chemotherapy (NAC) is a crucial therapeutic approach for treating breast cancer, yet accurately predicting treatment response remains a significant clinical challenge. Conventional ultrasound plays a vital role in assessing tumor morphology but lacks the ability to quantitatively capture intratumoral heterogeneity. Ultrasound radiomics, which extracts high-throughput quantitative imaging features, offers a novel approach to enhance NAC response prediction. This study aims to evaluate the predictive efficacy of ultrasound radiomics models based on pre-treatment, post-treatment, and combined imaging features for assessing the NAC response in patients with HER2-low breast cancer. This retrospective multicenter study included 359 patients with HER2-low breast cancer who underwent NAC between January 1, 2016, and December 31, 2020. A total of 488 radiomic features were extracted from pre- and post-treatment ultrasound images. Feature selection was conducted in two stages: first, Pearson correlation analysis (threshold: 0.65) was applied to remove highly correlated features and reduce redundancy; then, Recursive Feature Elimination with Cross-Validation (RFECV) was employed to identify the optimal feature subset for model construction. The dataset was divided into a training set (244 patients) and an external validation set (115 patients from independent centers). Model performance was assessed via the area under the receiver operating characteristic curve (AUC), accuracy, precision, recall, and F1 score. Three models were initially developed: (1) a pre-treatment model (AUC = 0.716), (2) a post-treatment model (AUC = 0.772), and (3) a combined pre- and post-treatment model (AUC = 0.762).To enhance feature selection, Recursive Feature Elimination with Cross-Validation was applied, resulting in optimized models with reduced feature sets: (1) the pre-treatment model (AUC = 0.746), (2) the post-treatment model (AUC = 0.712), and (3) the combined model (AUC = 0.759). Ultrasound radiomics is a non-invasive and promising approach for predicting response to neoadjuvant chemotherapy in HER2-low breast cancer. The pre-treatment model yielded reliable performance after feature selection. While the combined model did not substantially enhance predictive accuracy, its stable performance suggests that longitudinal ultrasound imaging may help capture treatment-induced phenotypic changes. These findings offer preliminary support for individualized therapeutic decision-making.

To construct a pathomics-based machine learning model to enhance the diagnostic efficacy of LungPro navigational bronchoscopy for peripheral pulmonary lesions and to optimize the management strategy for LungPro-diagnosed negative lesions. Clinical data and hematoxylin and eosin (H&E)-stained whole slide images (WSIs) were collected from 144 consecutive patients undergoing LungPro virtual bronchoscopy at a single institution between January 2022 and December 2023. Patients were stratified into diagnosis-positive and diagnosis-negative cohorts based on histopathological or etiological confirmation. An artificial intelligence (AI) model was developed and validated using 94 diagnosis-positive cases. Logistic regression (LR) identified associations between clinical/imaging characteristics and malignant pulmonary lesion risk factors. We implemented a convolutional neural network (CNN) with weakly supervised learning to extract image-level features, followed by multiple instance learning (MIL) for patient-level feature aggregation. Multiple machine learning (ML) algorithms were applied to model the extracted features. A multimodal diagnostic framework integrating clinical, imaging, and pathomics data were subsequently developed and evaluated on 50 LungPro-negative patients to assess the framework's diagnostic performance and predictive validity. Univariable and multivariable logistic regression analyses identified that age, lesion boundary and mean computed tomography (CT) attenuation were independent risk factors for malignant peripheral pulmonary lesions (P < 0.05). A histopathological model using a MIL fusion strategy showed strong diagnostic performance for lung cancer, with area under the curve (AUC) values of 0.792 (95% CI 0.680-0.903) in the training cohort and 0.777 (95% CI 0.531-1.000) in the test cohort. Combining predictive clinical features with pathological characteristics enhanced diagnostic yield for peripheral pulmonary lesions to 0.848 (95% CI 0.6945-1.0000). In patients with initially negative LungPro biopsy results, the model identified 20 of 28 malignant lesions (sensitivity: 71.43%) and 15 of 22 benign lesions (specificity: 68.18%). Class activation mapping (CAM) validated the model by highlighting key malignant features, including conspicuous nucleoli and nuclear atypia. The fusion diagnostic model that incorporates clinical and pathomic features markedly enhances the diagnostic accuracy of LungPro in this retrospective cohort. This model aids in the detection of subtle malignant characteristics, thereby offering evidence to support precise and targeted therapeutic interventions for lesions that LungPro classifies as negative in clinical settings.