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Application of Artificial Intelligence in rheumatic disease classification: an example of ankylosing spondylitis severity inspection model.

Chen CW, Tsai HH, Yeh CY, Yang CK, Tsou HK, Leong PY, Wei JC

pubmed logopapersDec 1 2025
The development of the Artificial Intelligence (AI)-based severity inspection model for ankylosing spondylitis (AS) could support health professionals to rapidly assess the severity of the disease, enhance proficiency, and reduce the demands of human resources. This paper aims to develop an AI-based severity inspection model for AS using patients' X-ray images and modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The numerical simulation with AI is developed following the progress of data preprocessing, building and testing the model, and then the model. The training data is preprocessed by inviting three experts to check the X-ray images of 222 patients following the Gold Standard. The model is then developed through two stages, including keypoint detection and mSASSS evaluation. The two-stage AI-based severity inspection model for AS was developed to automatically detect spine points and evaluate mSASSS scores. At last, the data obtained from the developed model was compared with those from experts' assessment to analyse the accuracy of the model. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. The spine point detection at the first stage achieved 1.57 micrometres in mean error distance with the ground truth, and the second stage of the classification network can reach 0.81 in mean accuracy. The model can correctly identify 97.4% patches belonging to mSASSS score 3, while those belonging to score 0 can still be classified into scores 1 or 2. The automatic severity inspection model for AS developed in this paper is accurate and can support health professionals in rapidly assessing the severity of AS, enhancing assessment proficiency, and reducing the demands of human resources.

Cerebral ischemia detection using deep learning techniques.

Pastor-Vargas R, Antón-Munárriz C, Haut JM, Robles-Gómez A, Paoletti ME, Benítez-Andrades JA

pubmed logopapersDec 1 2025
Cerebrovascular accident (CVA), commonly known as stroke, stands as a significant contributor to contemporary mortality and morbidity rates, often leading to lasting disabilities. Early identification is crucial in mitigating its impact and reducing mortality. Non-contrast computed tomography (NCCT) remains the primary diagnostic tool in stroke emergencies due to its speed, accessibility, and cost-effectiveness. NCCT enables the exclusion of hemorrhage and directs attention to ischemic causes resulting from arterial flow obstruction. Quantification of NCCT findings employs the Alberta Stroke Program Early Computed Tomography Score (ASPECTS), which evaluates affected brain structures. This study seeks to identify early alterations in NCCT density in patients with stroke symptoms using a binary classifier distinguishing NCCT scans with and without stroke. To achieve this, various well-known deep learning architectures, namely VGG3D, ResNet3D, and DenseNet3D, validated in the ImageNet challenges, are implemented with 3D images covering the entire brain volume. The training results of these networks are presented, wherein diverse parameters are examined for optimal performance. The DenseNet3D network emerges as the most effective model, attaining a training set accuracy of 98% and a test set accuracy of 95%. The aim is to alert medical professionals to potential stroke cases in their early stages based on NCCT findings displaying altered density patterns.

SurgPointTransformer: transformer-based vertebra shape completion using RGB-D imaging.

Massalimova A, Liebmann F, Jecklin S, Carrillo F, Farshad M, Fürnstahl P

pubmed logopapersDec 1 2025
State-of-the-art computer- and robot-assisted surgery systems rely on intraoperative imaging technologies such as computed tomography and fluoroscopy to provide detailed 3D visualizations of patient anatomy. However, these methods expose both patients and clinicians to ionizing radiation. This study introduces a radiation-free approach for 3D spine reconstruction using RGB-D data. Inspired by the "mental map" surgeons form during procedures, we present SurgPointTransformer, a shape completion method that reconstructs unexposed spinal regions from sparse surface observations. The method begins with a vertebra segmentation step that extracts vertebra-level point clouds for subsequent shape completion. SurgPointTransformer then uses an attention mechanism to learn the relationship between visible surface features and the complete spine structure. The approach is evaluated on an <i>ex vivo</i> dataset comprising nine samples, with CT-derived data used as ground truth. SurgPointTransformer significantly outperforms state-of-the-art baselines, achieving a Chamfer distance of 5.39 mm, an F-score of 0.85, an Earth mover's distance of 11.00 and a signal-to-noise ratio of 22.90 dB. These results demonstrate the potential of our method to reconstruct 3D vertebral shapes without exposing patients to ionizing radiation. This work contributes to the advancement of computer-aided and robot-assisted surgery by enhancing system perception and intelligence.

Convolutional autoencoder-based deep learning for intracerebral hemorrhage classification using brain CT images.

Nageswara Rao B, Acharya UR, Tan RS, Dash P, Mohapatra M, Sabut S

pubmed logopapersDec 1 2025
Intracerebral haemorrhage (ICH) is a common form of stroke that affects millions of people worldwide. The incidence is associated with a high rate of mortality and morbidity. Accurate diagnosis using brain non-contrast computed tomography (NCCT) is crucial for decision-making on potentially life-saving surgery. Limited access to expert readers and inter-observer variability imposes barriers to timeous and accurate ICH diagnosis. We proposed a hybrid deep learning model for automated ICH diagnosis using NCCT images, which comprises a convolutional autoencoder (CAE) to extract features with reduced data dimensionality and a dense neural network (DNN) for classification. In order to ensure that the model generalizes to new data, we trained it using tenfold cross-validation and holdout methods. Principal component analysis (PCA) based dimensionality reduction and classification is systematically implemented for comparison. The study dataset comprises 1645 ("ICH" class) and 1648 ("Normal" class belongs to patients with non-hemorrhagic stroke) labelled images obtained from 108 patients, who had undergone CT examination on a 64-slice computed tomography scanner at Kalinga Institute of Medical Sciences between 2020 and 2023. Our developed CAE-DNN hybrid model attained 99.84% accuracy, 99.69% sensitivity, 100% specificity, 100% precision, and 99.84% F1-score, which outperformed the comparator PCA-DNN model as well as the published results in the literature. In addition, using saliency maps, our CAE-DNN model can highlight areas on the images that are closely correlated with regions of ICH, which have been manually contoured by expert readers. The CAE-DNN model demonstrates the proof-of-concept for accurate ICH detection and localization, which can potentially be implemented to prioritize the treatment using NCCT images in clinical settings.

TFKT V2: task-focused knowledge transfer from natural images for computed tomography perceptual image quality assessment.

Rifa KR, Ahamed MA, Zhang J, Imran A

pubmed logopapersSep 1 2025
The accurate assessment of computed tomography (CT) image quality is crucial for ensuring diagnostic reliability while minimizing radiation dose. Radiologists' evaluations are time-consuming and labor-intensive. Existing automated approaches often require large CT datasets with predefined image quality assessment (IQA) scores, which often do not align well with clinical evaluations. We aim to develop a reference-free, automated method for CT IQA that closely reflects radiologists' evaluations, reducing the dependency on large annotated datasets. We propose Task-Focused Knowledge Transfer (TFKT), a deep learning-based IQA method leveraging knowledge transfer from task-similar natural image datasets. TFKT incorporates a hybrid convolutional neural network-transformer model, enabling accurate quality predictions by learning from natural image distortions with human-annotated mean opinion scores. The model is pre-trained on natural image datasets and fine-tuned on low-dose computed tomography perceptual image quality assessment data to ensure task-specific adaptability. Extensive evaluations demonstrate that the proposed TFKT method effectively predicts IQA scores aligned with radiologists' assessments on in-domain datasets and generalizes well to out-of-domain clinical pediatric CT exams. The model achieves robust performance without requiring high-dose reference images. Our model is capable of assessing the quality of <math xmlns="http://www.w3.org/1998/Math/MathML"><mrow><mo>∼</mo> <mn>30</mn></mrow> </math> CT image slices in a second. The proposed TFKT approach provides a scalable, accurate, and reference-free solution for CT IQA. The model bridges the gap between traditional and deep learning-based IQA, offering clinically relevant and computationally efficient assessments applicable to real-world clinical settings.

Enhancing Lung Cancer Diagnosis: An Optimization-Driven Deep Learning Approach with CT Imaging.

Lakshminarasimha K, Priyeshkumar AT, Karthikeyan M, Sakthivel R

pubmed logopapersJun 23 2025
Lung cancer (LC) remains a leading cause of mortality worldwide, affecting individuals across all genders and age groups. Early and accurate diagnosis is critical for effective treatment and improved survival rates. Computed Tomography (CT) imaging is widely used for LC detection and classification. However, manual identification can be time-consuming and error-prone due to the visual similarities among various LC types. Deep learning (DL) has shown significant promise in medical image analysis. Although numerous studies have investigated LC detection using deep learning techniques, the effective extraction of highly correlated features remains a significant challenge, thereby limiting diagnostic accuracy. Furthermore, most existing models encounter substantial computational complexity and find it difficult to efficiently handle the high-dimensional nature of CT images. This study introduces an optimized CBAM-EfficientNet model to enhance feature extraction and improve LC classification. EfficientNet is utilized to reduce computational complexity, while the Convolutional Block Attention Module (CBAM) emphasizes essential spatial and channel features. Additionally, optimization algorithms including Gray Wolf Optimization (GWO), Whale Optimization (WO), and the Bat Algorithm (BA) are applied to fine-tune hyperparameters and boost predictive accuracy. The proposed model, integrated with different optimization strategies, is evaluated on two benchmark datasets. The GWO-based CBAM-EfficientNet achieves outstanding classification accuracies of 99.81% and 99.25% on the Lung-PET-CT-Dx and LIDC-IDRI datasets, respectively. Following GWO, the BA-based CBAM-EfficientNet achieves 99.44% and 98.75% accuracy on the same datasets. Comparative analysis highlights the superiority of the proposed model over existing approaches, demonstrating strong potential for reliable and automated LC diagnosis. Its lightweight architecture also supports real-time implementation, offering valuable assistance to radiologists in high-demand clinical environments.

MedSeg-R: Medical Image Segmentation with Clinical Reasoning

Hao Shao, Qibin Hou

arxiv logopreprintJun 23 2025
Medical image segmentation is challenging due to overlapping anatomies with ambiguous boundaries and a severe imbalance between the foreground and background classes, which particularly affects the delineation of small lesions. Existing methods, including encoder-decoder networks and prompt-driven variants of the Segment Anything Model (SAM), rely heavily on local cues or user prompts and lack integrated semantic priors, thus failing to generalize well to low-contrast or overlapping targets. To address these issues, we propose MedSeg-R, a lightweight, dual-stage framework inspired by inspired by clinical reasoning. Its cognitive stage interprets medical report into structured semantic priors (location, texture, shape), which are fused via transformer block. In the perceptual stage, these priors modulate the SAM backbone: spatial attention highlights likely lesion regions, dynamic convolution adapts feature filters to expected textures, and deformable sampling refines spatial support. By embedding this fine-grained guidance early, MedSeg-R disentangles inter-class confusion and amplifies minority-class cues, greatly improving sensitivity to small lesions. In challenging benchmarks, MedSeg-R produces large Dice improvements in overlapping and ambiguous structures, demonstrating plug-and-play compatibility with SAM-based systems.

Benchmarking Foundation Models and Parameter-Efficient Fine-Tuning for Prognosis Prediction in Medical Imaging

Filippo Ruffini, Elena Mulero Ayllon, Linlin Shen, Paolo Soda, Valerio Guarrasi

arxiv logopreprintJun 23 2025
Artificial Intelligence (AI) holds significant promise for improving prognosis prediction in medical imaging, yet its effective application remains challenging. In this work, we introduce a structured benchmark explicitly designed to evaluate and compare the transferability of Convolutional Neural Networks and Foundation Models in predicting clinical outcomes in COVID-19 patients, leveraging diverse publicly available Chest X-ray datasets. Our experimental methodology extensively explores a wide set of fine-tuning strategies, encompassing traditional approaches such as Full Fine-Tuning and Linear Probing, as well as advanced Parameter-Efficient Fine-Tuning methods including Low-Rank Adaptation, BitFit, VeRA, and IA3. The evaluations were conducted across multiple learning paradigms, including both extensive full-data scenarios and more clinically realistic Few-Shot Learning settings, which are critical for modeling rare disease outcomes and rapidly emerging health threats. By implementing a large-scale comparative analysis involving a diverse selection of pretrained models, including general-purpose architectures pretrained on large-scale datasets such as CLIP and DINOv2, to biomedical-specific models like MedCLIP, BioMedCLIP, and PubMedCLIP, we rigorously assess each model's capacity to effectively adapt and generalize to prognosis tasks, particularly under conditions of severe data scarcity and pronounced class imbalance. The benchmark was designed to capture critical conditions common in prognosis tasks, including variations in dataset size and class distribution, providing detailed insights into the strengths and limitations of each fine-tuning strategy. This extensive and structured evaluation aims to inform the practical deployment and adoption of robust, efficient, and generalizable AI-driven solutions in real-world clinical prognosis prediction workflows.

Adaptive Mask-guided K-space Diffusion for Accelerated MRI Reconstruction

Qinrong Cai, Yu Guan, Zhibo Chen, Dong Liang, Qiuyun Fan, Qiegen Liu

arxiv logopreprintJun 23 2025
As the deep learning revolution marches on, masked modeling has emerged as a distinctive approach that involves predicting parts of the original data that are proportionally masked during training, and has demonstrated exceptional performance in multiple fields. Magnetic Resonance Imaging (MRI) reconstruction is a critical task in medical imaging that seeks to recover high-quality images from under-sampled k-space data. However, previous MRI reconstruction strategies usually optimized the entire image domain or k-space, without considering the importance of different frequency regions in the k-space This work introduces a diffusion model based on adaptive masks (AMDM), which utilizes the adaptive adjustment of frequency distribution based on k-space data to develop a hybrid masks mechanism that adapts to different k-space inputs. This enables the effective separation of high-frequency and low-frequency components, producing diverse frequency-specific representations. Additionally, the k-space frequency distribution informs the generation of adaptive masks, which, in turn, guide a closed-loop diffusion process. Experimental results verified the ability of this method to learn specific frequency information and thereby improved the quality of MRI reconstruction, providing a flexible framework for optimizing k-space data using masks in the future.

SafeClick: Error-Tolerant Interactive Segmentation of Any Medical Volumes via Hierarchical Expert Consensus

Yifan Gao, Jiaxi Sheng, Wenbin Wu, Haoyue Li, Yaoxian Dong, Chaoyang Ge, Feng Yuan, Xin Gao

arxiv logopreprintJun 23 2025
Foundation models for volumetric medical image segmentation have emerged as powerful tools in clinical workflows, enabling radiologists to delineate regions of interest through intuitive clicks. While these models demonstrate promising capabilities in segmenting previously unseen anatomical structures, their performance is strongly influenced by prompt quality. In clinical settings, radiologists often provide suboptimal prompts, which affects segmentation reliability and accuracy. To address this limitation, we present SafeClick, an error-tolerant interactive segmentation approach for medical volumes based on hierarchical expert consensus. SafeClick operates as a plug-and-play module compatible with foundation models including SAM 2 and MedSAM 2. The framework consists of two key components: a collaborative expert layer (CEL) that generates diverse feature representations through specialized transformer modules, and a consensus reasoning layer (CRL) that performs cross-referencing and adaptive integration of these features. This architecture transforms the segmentation process from a prompt-dependent operation to a robust framework capable of producing accurate results despite imperfect user inputs. Extensive experiments across 15 public datasets demonstrate that our plug-and-play approach consistently improves the performance of base foundation models, with particularly significant gains when working with imperfect prompts. The source code is available at https://github.com/yifangao112/SafeClick.
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