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Computer-aided segmentation of brain tumors from MRI data is of crucial significance to clinical decision-making in diagnosis, treatment planning, and follow-up disease monitoring. Gliomas, owing to their high malignancy and heterogeneity, represent a very challenging task for accurate and reliable segmentation into intra-tumoral sub-regions. Manual segmentation is typically time-consuming and not reliable, which justifies the need for robust automated techniques.This research resolves this problem by leveraging the BraTS 2020 dataset, where we have labeled MRI scans of glioma patients with four significant classes: background/healthy tissue, necrotic/non-enhancing core, edema, and enhancing tumor. In this work, we present a new segmentation technique based on a U-Net model augmented with executed attention gates to focus on the most significant regions of images. To counter class imbalance, we employ manually designed loss functions like Dice Loss and Categorical Dice Loss, in conjunction with standard categorical cross-entropy. Other evaluation metrics, like sensitivity and specificity, were used to measure discriminability of the model between tumor classes. Besides, we introduce Grad-CAM-based explainable AI to enable visualizing attention regions and improve model interpretability, together with a smooth heatmap generation technique through Gaussian filtering. Our approach achieved superior performance with accuracy of 0.9919, Dice coefficient of 0.9901, mean IoU of 0.9873, sensitivity of 0.9908, and specificity of 0.9974. This study demonstrates that the use of attention mechanisms, personalized loss functions, and explainable AI significantly improves highly complex tumor structure segmentation precision in MRI scans, providing a reliable and explainable method for clinical applications.

Automated radiology report generation from 3D computed tomography (CT) volumes is challenging due to extreme sequence lengths, severe class imbalance, and the tendency of large language models (LLMs) to ignore visual tokens in favor of linguistic priors. We present Ker-VLJEPA-3B, a four-phase curriculum learning framework for free-text report generation from thoracic CT volumes. A phased training curriculum progressively adapts a Llama 3.2 3B decoder to ground its output in visual features from a frozen, self-supervised encoder. Our visual backbone (LeJEPA ViT-Large) is trained via self-supervised joint-embedding prediction on unlabeled CTs, without text supervision. Unlike contrastive models (CLIP, BiomedCLIP), this language-free backbone yields modality-pure representations. Vision-language alignment is deferred to the curriculum's bridge and generation phases. This modality-agnostic design can integrate any self-supervised encoder into an LLM without paired text during foundation training. Methodological innovations include: (1) zone-constrained cross-attention compressing slice embeddings into 32 spatially-grounded visual tokens; (2) PCA whitening of anisotropic LLM embeddings; (3) a positive-findings-only strategy eliminating posterior collapse; (4) warm bridge initialization transferring projection weights; and (5) selective cross-attention freezing with elastic weight consolidation to prevent catastrophic forgetting. Evaluated on the CT-RATE benchmark (2,984 validation volumes, 18 classes), Ker-VLJEPA-3B achieves a macro F1 of 0.429, surpassing the state-of-the-art (U-VLM, macro F1 = 0.414) by 3.6%, and reaching 0.448 (+8.2%) with threshold optimization. Ablation studies confirm 56.6% of generation quality derives from patient-specific visual content. Code and weights are available.

Radiotherapy workflows for oncological patients increasingly rely on multi-modal medical imaging, commonly involving both Magnetic Resonance Imaging (MRI) and Computed Tomography (CT). MRI-only treatment planning has emerged as an attractive alternative, as it reduces patient exposure to ionizing radiation and avoids errors introduced by inter-modality registration. While nnU-Net-based frameworks are predominantly used for MRI-to-CT synthesis, we explore Mamba-based architectures for this task, aiming to showcase the advantages of state-space modeling for cross-modality translation compared to standard convolutional neural networks. Specifically, we adapt both the U-Mamba and the SegMamba architecture, originally proposed for segmentation, to perform cross-modality image generation. Our 3D Mamba architecture effectively captures complex volumetric features and long-range dependencies, thus allowing accurate CT synthesis while maintaining fast inference times. Experiments were conducted on a subset of SynthRAD2025 dataset, comprising registered single-channel MRI-CT volume pairs across three anatomical regions. Quantitative evaluation is performed via a combination of image similarity metrics computed in Hounsefield Units (HU) and segmentation-based metrics obtained from TotalSegmentator to ensure geometric consistency is preserved. The findings pave the way for the integration of state-space models into radiotherapy workflows.

Currently, a central challenge and bottleneck in the deployment and validation of computer-aided diagnosis (CAD) models within the field of medical imaging is data scarcity. For lung cancer, one of the most prevalent types worldwide, limited datasets can delay diagnosis and have an impact on patient outcome. Generative AI offers a promising solution for this issue, but dealing with the complex distribution of full Hounsfield Unit (HU) range lung CT scans is challenging and remains as a highly computationally demanding task. This paper introduces a novel decomposition strategy that synthesizes CT images one HU interval at a time, rather than modelling the entire HU domain at once. This framework focuses on training generative architectures on individual tissue-focused HU windows, then merges their output into a full-range scan via a learned reconstruction network that effectively reverses the HU-windowing process. We further propose multi-head and multi-decoder models to better capture textures while preserving anatomical consistency, with a multi-head VQVAE achieving the best performance for the generative task. Quantitative evaluation shows this approach significantly outperforms conventional 2D full-range baselines, achieving a 6.2% improvement in FID and superior MMD, Precision, and Recall across all HU intervals. The best performance is achieved by a multi-head VQVAE variant, demonstrating that it is possible to enhance visual fidelity and variability while also reducing model complexity and computational cost. This work establishes a new paradigm for structure-aware medical image synthesis, aligning generative modelling with clinical interpretation.

Expert eye movements provide a rich, passive source of domain knowledge in radiology, offering a powerful cue for integrating diagnostic reasoning into computer-aided analysis. However, direct integration into CNN-based systems, which historically have dominated the medical image analysis domain, is challenging: gaze recordings are sequential, temporally dense yet spatially sparse, noisy, and variable across experts. As a consequence, most existing image-based models utilize reduced representations such as heatmaps. In contrast, gaze naturally aligns with transformer architectures, as both are sequential in nature and rely on attention to highlight relevant input regions. In this work, we introduce FixationFormer, a transformer-based architecture that represents expert gaze trajectories as sequences of tokens, thereby preserving their temporal and spatial structure. By modeling gaze sequences jointly with image features, our approach addresses sparsity and variability in gaze data while enabling a more direct and fine-grained integration of expert diagnostic cues through explicit cross-attention between the image and gaze token sequences. We evaluate our method on three publicly available benchmark chest X-ray datasets and demonstrate that it achieves state-of-the-art classification performance, highlighting the value of representing gaze as a sequence in transformer-based medical image analysis.

Chest X-ray report generation and automated evaluation are limited by poor recognition of low-prevalence abnormalities and inadequate handling of clinically important language, including negation and ambiguity. We develop a clinician-guided framework combining human expertise and large language models for multi-label finding extraction from free-text chest X-ray reports and use it to define Ran Score, a finding-level metric for report evaluation. Using three non-overlapping MIMIC-CXR-EN cohorts from a public chest X-ray dataset and an independent ChestX-CN validation cohort, we optimize prompts, establish radiologist-derived reference labels and evaluate report generation models. The optimized framework improves the macro-averaged score from 0.753 to 0.956 on the MIMIC-CXR-EN development cohort, exceeds the CheXbert benchmark by 15.7 percentage points on directly comparable labels, and shows robust generalization on the ChestX-CN validation cohort. Here we show that clinician-guided prompt optimization improves agreement with a radiologist-derived reference standard and that Ran Score enables finding-level evaluation of report fidelity, particularly for low-prevalence abnormalities.

While spatial transcriptomics (ST) has advanced our understanding of gene expression in tissue context, its high experimental cost limits its large-scale application. Predicting ST from pathology images is a promising, cost-effective alternative, but existing methods struggle to capture complex cross-slide spatial relationships. To address the challenge, we propose SpaHGC, a multi-modal heterogeneous graph-based model that captures both intra-slice and inter-slice spot-spot relationships from histology images. It integrates local spatial context within the target slide and cross-slide similarities computed from image embeddings extracted by a pathology foundation model. These embeddings enable inter-slice knowledge transfer, and SpaHGC further incorporates Masked Graph Contrastive Learning to enhance feature representation and transfer spatial gene expression knowledge from reference to target slides, enabling it to model complex spatial dependencies and significantly improve prediction accuracy. We conducted comprehensive benchmarking on seven matched histology-ST datasets from different platforms, tissues, and cancer subtypes. The results demonstrate that SpaHGC significantly outperforms the existing nine state-of-the-art methods across all evaluation metrics. Additionally, the predictions are significantly enriched in multiple cancer-related pathways, thereby highlighting its strong biological relevance and application potential.

Tabular data are central to biomedical research, from liquid biopsy and bulk and single-cell transcriptomics to electronic health records and phenotypic profiling. Unlike images or sequences, however, tabular datasets lack intrinsic spatial organization: features are treated as unordered dimensions, and their relationships must be inferred implicitly by the model. This limits the ability of vision architectures to exploit local structure and higher-order feature interactions in non-spatial biomedical data. Here we introduce Dynamic Feature Mapping (Dynomap), an end-to-end deep learning framework that learns a task-optimized spatial topology of features directly from data. Dynomap jointly optimizes feature placement and prediction through a fully differentiable rendering mechanism, without relying on heuristics, predefined groupings, or external priors. By transforming high-dimensional tabular vectors into learned feature maps, Dynomap enables vision-based models to operate effectively on unordered biomedical inputs. Across multiple clinical and biological datasets, Dynomap consistently outperformed classical machine learning, modern deep tabular models, and existing vector-to-image approaches. In liquid biopsy data, Dynomap organized clinically relevant gene signatures into coherent spatial patterns and improved multiclass cancer subtype prediction accuracy by up to 18%. In a Parkinson disease voice dataset, it clustered disease-associated acoustic descriptors and improved accuracy by up to 8%. Similar gains and interpretable feature organization were observed in additional biomedical datasets. These results establish Dynomap as a general strategy for bridging tabular and vision-based deep learning and for uncovering structured, clinically relevant patterns in high-dimensional biomedical data.

Though self-supervised learning (SSL) has demonstrated incredible ability to learn robust representations from unlabeled data, the choice of optimal SSL strategy can lead to vastly different performance outcomes in specialized domains. Joint embedding architectures (JEAs) and joint embedding predictive architectures (JEPAs) have shown robustness to noise and strong semantic feature learning compared to pixel reconstruction-based SSL methods, leading to widespread adoption in medical imaging. However, no prior work has systematically investigated which SSL objective is better aligned with the spatial organization of clinically relevant signal. In this work, we empirically investigate how the choice of SSL method impacts the learned representations in medical imaging. We select two representative imaging modalities characterized by unique noise profiles: ultrasound and histopathology. When informative signal is spatially localized, as in histopathology, JEAs are more effective due to their view-invariance objective. In contrast, when diagnostically relevant information is globally structured, such as the macroscopic anatomy present in liver ultrasounds, JEPAs are optimal. These differences are especially evident in the clinical relevance of the learned features, as independently validated by board-certified radiologists and pathologists. Together, our results provide a framework for matching SSL objectives to the structural and noise properties of medical imaging modalities.

Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors, of which 15-25% develop metastatic disease with 5-year survival rates reported as low as 34%. PPGL may indicate hereditary syndromes requiring stricter, syndrome-specific treatment and surveillance, but clinicians often fail to recognize these associations in routine care. Clinical practice uses GAPP score for PPGL grading, but several limitations remain for PPGL diagnosis: (1) GAPP scoring demands a high workload for clinician because it requires the manual evaluation of six independent components; (2) key components such as cellularity and Ki-67 are often evaluated with subjective criteria; (3) several clinically relevant metastatic risk factors are not captured by GAPP, such as SDHB mutations, which have been associated with reported metastatic rates of 35-75%. Agent-driven diagnostic systems appear promising, but most lack traceable reasoning for decision-making and do not incorporate domain-specific knowledge such as PPGL genotype information. To address these limitations, we present PPGL-Swarm, an agentic PPGL diagnostic system that generates a comprehensive report, including automated GAPP scoring (with quantified cellularity and Ki-67), genotype risk alerts, and multimodal report with integrated evidence. The system provides an auditable reasoning trail by decomposing diagnosis into micro-tasks, each assigned to a specialized agent. The gene and table agents use knowledge enhancement to better interpret genotype and laboratory findings, and during training we use reinforcement learning to refine tool selection and task assignment.