Find the papers that actually matter

Prompt-based methods, which encode medical priors through descriptive text, have been only minimally explored for CT Image Quality Assessment (IQA). While such prompts can embed prior knowledge about diagnostic quality, they often introduce bias by reflecting idealized definitions that may not hold under real-world degradations such as noise, motion artifacts, or scanner variability. To address this, we propose the Context-Aware Prompt-guided Image Quality Assessment (CAP-IQA) framework, which integrates text-level priors with instance-level context prompts and applies causal debiasing to separate idealized knowledge from factual, image-specific degradations. Our framework combines a CNN-based visual encoder with a domain-specific text encoder to assess diagnostic visibility, anatomical clarity, and noise perception in abdominal CT images. The model leverages radiology-style prompts and context-aware fusion to align semantic and perceptual representations. On the 2023 LDCTIQA challenge benchmark, CAP-IQA achieves an overall correlation score of 2.8590 (sum of PLCC, SROCC, and KROCC), surpassing the top-ranked leaderboard team (2.7427) by 4.24%. Moreover, our comprehensive ablation experiments confirm that prompt-guided fusion and the simplified encoder-only design jointly enhance feature alignment and interpretability. Furthermore, evaluation on an in-house dataset of 91,514 pediatric CT images demonstrates the true generalizability of CAP-IQA in assessing perceptual fidelity in a different patient population.

Identifying cancer driver genes is crucial for understanding tumor biology and developing precision therapies. However, existing computational methods often rely on single biological networks or population-level mutation patterns, limiting their ability to identify patient-specific drivers and leverage the complementary information from multiple network types. Here, we present HyperNetWalk, a novel computational framework that integrates multiple biological networks and hypergraph diffusion to identify driver genes at both personalized and cohort levels. In the first stage, HyperNetWalk integrates protein-protein interaction networks, gene regulatory networks, and dynamic co-expression networks through sample-independent random walks on patient-specific subnetworks to capture topological importance and expression perturbation effects. In the second stage, it refines predictions through hypergraph-based random walks that leverage cross-sample information while preserving individual mutational contexts. Comprehensive evaluation on 12 TCGA cancer types demonstrates that HyperNetWalk achieves superior or competitive performance compared to state-of-the-art methods in both personalized and cohort-level predictions. Notably, HyperNetWalk successfully identifies known driver genes with high precision while revealing cancer type-specific drivers that reflect distinct biological mechanisms. Our framework provides a unified solution for personalized and population-based driver gene identification, offering valuable insights for precision oncology and therapeutic target discovery.

Medical image segmentation requires balancing local precision for boundary-critical clinical applications, global context for anatomical coherence, and computational efficiency for deployment on limited data and hardware a trilemma that existing architectures fail to resolve. Although convolutional networks provide local precision at $\mathcal{O}(n)$ cost but limited receptive fields, vision transformers achieve global context through $\mathcal{O}(n^2)$ self-attention at prohibitive computational expense, causing overfitting on small clinical datasets. We propose S2M-Net, a 4.7M-parameter architecture that achieves $\mathcal{O}(HW \log HW)$ global context through two synergistic innovations: (i) Spectral-Selective Token Mixer (SSTM), which exploits the spectral concentration of medical images via truncated 2D FFT with learnable frequency filtering and content-gated spatial projection, avoiding quadratic attention cost while maintaining global receptive fields; and (ii) Morphology-Aware Adaptive Segmentation Loss (MASL), which automatically analyzes structure characteristics (compactness, tubularity, irregularity, scale) to modulate five complementary loss components through constrained learnable weights, eliminating manual per-dataset tuning. Comprehensive evaluation in 16 medical imaging datasets that span 8 modalities demonstrates state-of-the-art performance: 96.12\% Dice on polyp segmentation, 83.77\% on surgical instruments (+17.85\% over the prior art) and 80.90\% on brain tumors, with consistent 3-18\% improvements over specialized baselines while using 3.5--6$\times$ fewer parameters than transformer-based methods.

The era of digital pathology has advanced histopathological examinations, making automated image analysis essential in clinical practice. This study evaluates the classification performance of machine learning and deep learning models on the LC25000 dataset, which includes five classes of histopathological images. We used the fine-tuned InceptionResNet-v2 network both as a classifier and for feature extraction. Our results show that the fine-tuned InceptionResNet-v2 achieved a classification accuracy of 96.01\% and an average AUC of 96.8\%. Models trained on deep features from InceptionResNet-v2 outperformed those using only the pre-trained network, with the Neural Network model achieving an AUC of 99.99\% and accuracy of 99.84\%. Evaluating model robustness under varying SNR conditions revealed that models using deep features exhibited greater resilience, particularly GBM and KNN. The combination of HOG and deep features showed enhanced performance, however, less so in noisy environments.

We present a reproducible deep learning pipeline for leukemic cell classification, focusing on system architecture, experimental robustness, and software design choices for medical image analysis. Acute lymphoblastic leukemia (ALL) is the most common childhood cancer, requiring expert microscopic diagnosis that suffers from inter-observer variability and time constraints. The proposed system integrates an attention-based convolutional neural network combining EfficientNetV2-B3 with Squeeze-and-Excitation mechanisms for automated ALL cell classification. Our approach employs comprehensive data augmentation, focal loss for class imbalance, and patient-wise data splitting to ensure robust and reproducible evaluation. On the C-NMC 2019 dataset (12,528 original images from 62 patients), the system achieves a 97.89% F1-score and 97.89% accuracy on the test set, with statistical validation through 100-iteration Monte Carlo experiments confirming significant improvements (p < 0.001) over baseline methods. The proposed pipeline outperforms existing approaches by up to 4.67% while using 89% fewer parameters than VGG16 (15.2M vs. 138M). The attention mechanism provides interpretable visualizations of diagnostically relevant cellular features, demonstrating that modern attention-based architectures can improve leukemic cell classification while maintaining computational efficiency suitable for clinical deployment.

Artificial intelligence models have shown strong potential in acute ischemic stroke imaging, particularly for lesion detection and segmentation using computed tomography and magnetic resonance imaging. However, most existing approaches operate as black box predictors, producing deterministic outputs without explicit uncertainty awareness or structured mechanisms to abstain under ambiguous conditions. This limitation raises serious safety and trust concerns in high risk emergency radiology settings. In this paper, we propose an explainable agentic AI framework for uncertainty aware and abstention enabled decision support in acute ischemic stroke imaging. The framework follows a modular agentic pipeline in which a perception agent performs lesion aware image analysis, an uncertainty estimation agent computes slice level predictive reliability, and a decision agent determines whether to issue a prediction or abstain based on predefined uncertainty thresholds. Unlike prior stroke imaging systems that primarily focus on improving segmentation or classification accuracy, the proposed framework explicitly prioritizes clinical safety, transparency, and clinician aligned decision behavior. Qualitative and case based analyses across representative stroke imaging scenarios demonstrate that uncertainty driven abstention naturally emerges in diagnostically ambiguous regions and low information slices. The framework further integrates visual explanation mechanisms to support both predictive and abstention decisions, addressing a key limitation of existing uncertainty aware medical imaging systems. Rather than introducing a new performance benchmark, this work presents agentic control, uncertainty awareness, and selective abstention as essential design principles for developing safe and trustworthy medical imaging AI systems.

Medical image segmentation faces critical challenges in semi-supervised learning scenarios due to severe annotation scarcity requiring expert radiological knowledge, significant inter-annotator variability across different viewpoints and expertise levels, and inadequate multi-scale feature integration for precise boundary delineation in complex anatomical structures. Existing semi-supervised methods demonstrate substantial performance degradation compared to fully supervised approaches, particularly in small target segmentation and boundary refinement tasks. To address these fundamental challenges, we propose SASNet (Scale-aware Adaptive Supervised Network), a dual-branch architecture that leverages both low-level and high-level feature representations through novel scale-aware adaptive reweight mechanisms. Our approach introduces three key methodological innovations, including the Scale-aware Adaptive Reweight strategy that dynamically weights pixel-wise predictions using temporal confidence accumulation, the View Variance Enhancement mechanism employing 3D Fourier domain transformations to simulate annotation variability, and segmentation-regression consistency learning through signed distance map algorithms for enhanced boundary precision. These innovations collectively address the core limitations of existing semi-supervised approaches by integrating spatial, temporal, and geometric consistency principles within a unified optimization framework. Comprehensive evaluation across LA, Pancreas-CT, and BraTS datasets demonstrates that SASNet achieves superior performance with limited labeled data, surpassing state-of-the-art semi-supervised methods while approaching fully supervised performance levels. The source code for SASNet is available at https://github.com/HUANGLIZI/SASNet.

Skin cancer is also one of the most common and dangerous types of cancer in the world that requires timely and precise diagnosis. In this paper, a deep-learning architecture of the multi-class skin lesion classification on the HAM10000 dataset will be described. The system suggested combines high-quality data balancing methods, large-scale data augmentation, hybridized EfficientNetV2-L framework with channel attention, and a three-stage progressive learning approach. Moreover, we also use explainable AI (XAI) techniques such as Grad-CAM and saliency maps to come up with intelligible visual representations of model predictions. Our strategy is with a total accuracy of 91.15 per cent, macro F1 of 85.45\% and micro-average AUC of 99.33\%. The model has shown high performance in all the seven lesion classes with specific high performance of melanoma and melanocytic nevi. In addition to enhancing diagnostic transparency, XAI also helps to find out the visual characteristics that cause the classifications, which enhances clinical trustworthiness.

Vision-Language Models have demonstrated strong potential in medical image analysis and disease diagnosis. However, after deployment, their performance may deteriorate when the input data distribution shifts from that observed during development. Detecting such performance degradation is essential for clinical reliability, yet remains challenging for large pre-trained VLMs operating without labeled data. In this study, we investigate performance degradation detection under data shift in a state-of-the-art pathology VLM. We examine both input-level data shift and output-level prediction behavior to understand their respective roles in monitoring model reliability. To facilitate systematic analysis of input data shift, we develop DomainSAT, a lightweight toolbox with a graphical interface that integrates representative shift detection algorithms and enables intuitive exploration of data shift. Our analysis shows that while input data shift detection is effective at identifying distributional changes and providing early diagnostic signals, it does not always correspond to actual performance degradation. Motivated by this observation, we further study output-based monitoring and introduce a label-free, confidence-based degradation indicator that directly captures changes in model prediction confidence. We find that this indicator exhibits a close relationship with performance degradation and serves as an effective complement to input shift detection. Experiments on a large-scale pathology dataset for tumor classification demonstrate that combining input data shift detection and output confidence-based indicators enables more reliable detection and interpretation of performance degradation in VLMs under data shift. These findings provide a practical and complementary framework for monitoring the reliability of foundation models in digital pathology.

Melanoma is the most lethal subtype of skin cancer, and early and accurate detection of this disease can greatly improve patients' outcomes. Although machine learning models, especially convolutional neural networks (CNNs), have shown great potential in automating melanoma classification, their diagnostic reliability still suffers due to inconsistent focus on lesion areas. In this study, we analyze the relationship between lesion attention and diagnostic performance, involving masked images, bounding box detection, and transfer learning. We used multiple explainability and sensitivity analysis approaches to investigate how well models aligned their attention with lesion areas and how this alignment correlated with precision, recall, and F1-score. Results showed that models with a higher focus on lesion areas achieved better diagnostic performance, suggesting the potential of interpretable AI in medical diagnostics. This study provides a foundation for developing more accurate and trustworthy melanoma classification models in the future.