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Gliomas are among the most aggressive cancers, characterized by high mortality rates and complex diagnostic processes. Existing studies on glioma diagnosis and classification often describe issues such as high variability in imaging data, inadequate optimization of computational resources, and inefficient segmentation and classification of gliomas. To address these challenges, we propose novel techniques utilizing multi-parametric MRI data to enhance tumor segmentation and classification efficiency. Our work introduces the first-ever radiomics-enhanced fused residual multiparametric 3D network (ReFRM3D) for brain tumor characterization, which is based on a 3D U-Net architecture and features multi-scale feature fusion, hybrid upsampling, and an extended residual skip mechanism. Additionally, we propose a multi-feature tumor marker-based classifier that leverages radiomic features extracted from the segmented regions. Experimental results demonstrate significant improvements in segmentation performance across the BraTS2019, BraTS2020, and BraTS2021 datasets, achieving high Dice Similarity Coefficients (DSC) of 94.04%, 92.68%, and 93.64% for whole tumor (WT), enhancing tumor (ET), and tumor core (TC) respectively in BraTS2019; 94.09%, 92.91%, and 93.84% in BraTS2020; and 93.70%, 90.36%, and 92.13% in BraTS2021.

In this work, we present an annotation framework that demonstrates how a multilingual LLM pretrained on a large corpus can be used as a teacher model to distill the expert knowledge needed for tagging medical texts in Polish. This work is part of a larger project called ADMEDVOICE, within which we collected an extensive corpus of medical texts representing five clinical categories - Radiology, Oncology, Cardiology, Hypertension, and Pathology. Using this data, we had to develop a multi-class classifier, but the fundamental problem turned out to be the lack of resources for annotating an adequate number of texts. Therefore, in our solution, we used the multilingual Llama3.1 model to annotate an extensive corpus of medical texts in Polish. Using our limited annotation resources, we verified only a portion of these labels, creating a test set from them. The data annotated in this way were then used for training and validation of 3 different types of classifiers based on the BERT architecture - the distilled DistilBERT model, BioBERT fine-tuned on medical data, and HerBERT fine-tuned on the Polish language corpus. Among the models we trained, the DistilBERT model achieved the best results, reaching an F1 score > 0.80 for each clinical category and an F1 score > 0.93 for 3 of them. In this way, we obtained a series of highly effective classifiers that represent an alternative to large language models, due to their nearly 500 times smaller size, 300 times lower GPU VRAM consumption, and several hundred times faster inference.

The popular use of histopathology images, such as hematoxylin and eosin (H&E), has proven to be useful in detecting tumors. However, moving such cancer cases forward for treatment requires accurate on the amount of the human epidermal growth factor receptor 2 (HER2) protein expression. Predicting both the lower and higher levels of HER2 can be challenging. Moreover, jointly analyzing H&E and immunohistochemistry (IHC) stained images for HER2 scoring is difficult. Although several deep learning methods have been investigated to address the challenge of HER2 scoring, they suffer from providing a pixel-level localization of HER2 status. In this study, we propose a single end-to-end pipeline using a system of vision transformers with HER2 status scoring on whole slide images of WSIs. The method includes patch-wise processing of H&E WSIs for tumor localization. A novel mapping function is proposed to correspondingly identify correlated IHC WSIs regions with malignant regions on H&E. A clinically inspired HER2 scoring mechanism is embedded in the pipeline and allows for automatic pixel-level annotation of 4-way HER2 scoring (0, 1+, 2+, and 3+). Also, the proposed method accurately returns HER2-negative and HER2-positive. Privately curated datasets were collaboratively extracted from 13 different cases of WSIs of H&E and IHC. A thorough experiment is conducted on the proposed method. Results obtained showed a good classification accuracy during tumor localization. Also, a classification accuracy of 0.94 and a specificity of 0.933 were returned for the prediction of HER2 status, scoring in the 4-way methods. The applicability of the proposed pipeline was investigated using WSIs patches as comparable to human pathologists. Findings from the study showed the usability of jointly evaluated H&E and IHC images on end-to-end ViTs-based models for HER2 scoring

Non-invasive inference of molecular tumor characteristics from medical imaging is a central goal of radiogenomics, particularly in glioblastoma (GBM), where O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation carries important prognostic and therapeutic significance. Although radiomics-based machine learning methods have shown promise for this task, conventional unimodal and early-fusion approaches are often limited by high feature redundancy and an incomplete modeling of modality-specific information. In this work, we introduce a multi-view latent representation learning framework based on variational autoencoders (VAE) to integrate complementary radiomic features derived from post-contrast T1-weighted (T1Gd) and Fluid-Attenuated Inversion Recovery (FLAIR) magnetic resonance imaging (MRI). By encoding each modality through an independent probabilistic encoder and performing fusion in a compact latent space, the proposed approach preserves modality-specific structure while enabling effective multimodal integration. The resulting latent embeddings are subsequently used for MGMT promoter methylation classification.

Mycetoma is a neglected tropical disease caused by fungi or bacteria leading to severe tissue damage and disabilities. It affects poor and rural communities and presents medical challenges and socioeconomic burdens on patients and healthcare systems in endemic regions worldwide. Mycetoma diagnosis is a major challenge in mycetoma management, particularly in low-resource settings where expert pathologists are limited. To address this challenge, this paper presents an overview of the Mycetoma MicroImage: Detect and Classify Challenge (mAIcetoma) which was organized to advance mycetoma diagnosis through AI solutions. mAIcetoma focused on developing automated models for segmenting mycetoma grains and classifying mycetoma types from histopathological images. The challenge attracted the attention of several teams worldwide to participate and five finalist teams fulfilled the challenge objectives. The teams proposed various deep learning architectures for the ultimate goal of this challenge. Mycetoma database (MyData) was provided to participants as a standardized dataset to run the proposed models. Those models were evaluated using evaluation metrics. Results showed that all the models achieved high segmentation accuracy, emphasizing the necessitate of grain detection as a critical step in mycetoma diagnosis. In addition, the top-performing models show a significant performance in classifying mycetoma types.

Multimodal medical imaging provides complementary information that is crucial for accurate delineation of pathology, but the development of deep learning models is limited by the scarcity of large datasets in which different modalities are paired and spatially aligned. This paper addresses this fundamental limitation by proposing an Adaptive Quaternion Cross-Fusion Network (A-QCF-Net) that learns a single unified segmentation model from completely separate and unpaired CT and MRI cohorts. The architecture exploits the parameter efficiency and expressive power of Quaternion Neural Networks to construct a shared feature space. At its core is the Adaptive Quaternion Cross-Fusion (A-QCF) block, a data driven attention module that enables bidirectional knowledge transfer between the two streams. By learning to modulate the flow of information dynamically, the A-QCF block allows the network to exchange abstract modality specific expertise, such as the sharp anatomical boundary information available in CT and the subtle soft tissue contrast provided by MRI. This mutual exchange regularizes and enriches the feature representations of both streams. We validate the framework by jointly training a single model on the unpaired LiTS (CT) and ATLAS (MRI) datasets. The jointly trained model achieves Tumor Dice scores of 76.7% on CT and 78.3% on MRI, significantly exceeding the strong unimodal nnU-Net baseline by margins of 5.4% and 4.7% respectively. Furthermore, comprehensive explainability analysis using Grad-CAM and Grad-CAM++ confirms that the model correctly focuses on relevant pathological structures, ensuring the learned representations are clinically meaningful. This provides a robust and clinically viable paradigm for unlocking the large unpaired imaging archives that are common in healthcare.

Colonoscopic Polyp Re-Identification aims to match the same polyp from a large gallery with images from different views taken using different cameras, which plays an important role in the prevention and treatment of colorectal cancer in computer-aided diagnosis. However, the coarse resolution of high-level features of a specific polyp often leads to inferior results for small objects where detailed information is important. To address this challenge, we propose a novel architecture, named Gated Progressive Fusion network, to selectively fuse features from multiple levels using gates in a fully connected way for polyp ReID. On the basis of it, a gated progressive fusion strategy is introduced to achieve layer-wise refinement of semantic information through multi-level feature interactions. Experiments on standard benchmarks show the benefits of the multimodal setting over state-of-the-art unimodal ReID models, especially when combined with the specialized multimodal fusion strategy.

Recent tool-use frameworks powered by vision-language models (VLMs) improve image understanding by grounding model predictions with specialized tools. Broadly, these frameworks leverage VLMs and a pre-specified toolbox to decompose the prediction task into multiple tool calls (often deep learning models) which are composed to make a prediction. The dominant approach to composing tools is using text, via function calls embedded in VLM-generated code or natural language. However, these methods often perform poorly on medical image understanding, where salient information is encoded as spatially-localized features that are difficult to compose or fuse via text alone. To address this, we propose a tool-use framework for medical image understanding called the Tool Bottleneck Framework (TBF), which composes VLM-selected tools using a learned Tool Bottleneck Model (TBM). For a given image and task, TBF leverages an off-the-shelf medical VLM to select tools from a toolbox that each extract clinically-relevant features. Instead of text-based composition, these tools are composed by the TBM, which computes and fuses the tool outputs using a neural network before outputting the final prediction. We propose a simple and effective strategy for TBMs to make predictions with any arbitrary VLM tool selection. Overall, our framework not only improves tool-use in medical imaging contexts, but also yields more interpretable, clinically-grounded predictors. We evaluate TBF on tasks in histopathology and dermatology and find that these advantages enable our framework to perform on par with or better than deep learning-based classifiers, VLMs, and state-of-the-art tool-use frameworks, with particular gains in data-limited regimes. Our code is available at https://github.com/christinaliu2020/tool-bottleneck-framework.

The interpretation of small tiles in large whole slide images (WSI) often needs a larger image context. We introduce TICON, a transformer-based tile representation contextualizer that produces rich, contextualized embeddings for ''any'' application in computational pathology. Standard tile encoder-based pipelines, which extract embeddings of tiles stripped from their context, fail to model the rich slide-level information essential for both local and global tasks. Furthermore, different tile-encoders excel at different downstream tasks. Therefore, a unified model is needed to contextualize embeddings derived from ''any'' tile-level foundation model. TICON addresses this need with a single, shared encoder, pretrained using a masked modeling objective to simultaneously unify and contextualize representations from diverse tile-level pathology foundation models. Our experiments demonstrate that TICON-contextualized embeddings significantly improve performance across many different tasks, establishing new state-of-the-art results on tile-level benchmarks (i.e., HEST-Bench, THUNDER, CATCH) and slide-level benchmarks (i.e., Patho-Bench). Finally, we pretrain an aggregator on TICON to form a slide-level foundation model, using only 11K WSIs, outperforming SoTA slide-level foundation models pretrained with up to 350K WSIs.

Acute Myeloid Leukemia (AML) remains a clinical challenge due to its extreme molecular heterogeneity and high relapse rates. While precision medicine has introduced mutation-specific therapies, many patients still lack effective, personalized options. This paper presents a novel, end-to-end computational framework that bridges the gap between patient-specific transcriptomics and de novo drug discovery. By analyzing bulk RNA sequencing data from the TCGA-LAML cohort, the study utilized Weighted Gene Co-expression Network Analysis (WGCNA) to prioritize 20 high-value biomarkers, including metabolic transporters like HK3 and immune-modulatory receptors such as SIGLEC9. The physical structures of these targets were modeled using AlphaFold3, and druggable hotspots were quantitatively mapped via the DOGSiteScorer engine. Then developed a novel, reaction-first evolutionary metaheuristic algorithm as well as multi-objective optimization programming that assembles novel ligands from fragment libraries, guided by spatial alignment to these identified hotspots. The generative model produced structurally unique chemical entities with a strong bias toward drug-like space, as evidenced by QED scores peaking between 0.5 and 0.7. Validation through ADMET profiling and SwissDock molecular docking identified high-confidence candidates, such as Ligand L1, which achieved a binding free energy of -6.571 kcal/mol against the A08A96 biomarker. These results demonstrate that integrating systems biology with metaheuristic molecular assembly can produce pharmacologically viable, patient tailored leads, offering a scalable blueprint for precision oncology in AML and beyond