Find the papers that actually matter

Accurate and early detection of oral cancer lesions is crucial for effective diagnosis and treatment. This study evaluates two RPA implementations, OC-RPAv1 and OC-RPAv2, using a test set of 31 images. OC-RPAv1 processes one image per prediction in an average of 0.29 seconds, while OCRPAv2 employs a Singleton design pattern and batch processing, reducing prediction time to just 0.06 seconds per image. This represents a 60-100x efficiency improvement over standard RPA methods, showcasing that design patterns and batch processing can enhance scalability and reduce costs in oral cancer detection

PET/CT imaging is pivotal in oncology and nuclear medicine, yet summarizing complex findings into precise diagnostic impressions is labor-intensive. While LLMs have shown promise in medical text generation, their capability in the highly specialized domain of PET/CT remains underexplored. We introduce PET-F2I-41K (PET Findings-to-Impression Benchmark), a large-scale benchmark for PET/CT impression generation using LLMs, constructed from over 41k real-world reports. Using PET-F2I-41K, we conduct a comprehensive evaluation of 27 models across proprietary frontier LLMs, open-source generalist models, and medical-domain LLMs, and we develop a domain-adapted 7B model (PET-F2I-7B) fine-tuned from Qwen2.5-7B-Instruct via LoRA. Beyond standard NLG metrics (e.g., BLEU-4, ROUGE-L, BERTScore), we propose three clinically grounded metrics - Entity Coverage Rate (ECR), Uncovered Entity Rate (UER), and Factual Consistency Rate (FCR) - to assess diagnostic completeness and factual reliability. Experiments reveal that neither frontier nor medical-domain LLMs perform adequately in zero-shot settings. In contrast, PET-F2I-7B achieves substantial gains (e.g., 0.708 BLEU-4) and a 3.0x improvement in entity coverage over the strongest baseline, while offering advantages in cost, latency, and privacy. Beyond this modeling contribution, PET-F2I-41K establishes a standardized evaluation framework to accelerate the development of reliable and clinically deployable reporting systems for PET/CT.

Whole-Slide Images (WSIs) are widely used for estimating the prognosis of cancer patients. Current studies generally follow a cancer-specific learning paradigm. However, the available training samples for one cancer type are usually scarce in pathology. Consequently, the model often struggles to learn generalizable knowledge, thus performing worse on the tumor samples with inherent high heterogeneity. Although multi-cancer joint learning and knowledge transfer approaches have been explored recently to address it, they either rely on large-scale joint training or extensive inference across multiple models, posing new challenges in computational efficiency. To this end, this paper proposes a new scheme, Sparse Task Vector Mixup with Hypernetworks (STEPH). Unlike previous ones, it efficiently absorbs generalizable knowledge from other cancers for the target via model merging: i) applying task vector mixup to each source-target pair and then ii) sparsely aggregating task vector mixtures to obtain an improved target model, driven by hypernetworks. Extensive experiments on 13 cancer datasets show that STEPH improves over cancer-specific learning and an existing knowledge transfer baseline by 5.14% and 2.01%, respectively. Moreover, it is a more efficient solution for learning prognostic knowledge from other cancers, without requiring large-scale joint training or extensive multi-model inference. Code is publicly available at https://github.com/liupei101/STEPH.

Controllable pathology image synthesis requires reliable regulation of spatial layout, tissue morphology, and semantic detail. However, existing text-guided diffusion models offer only coarse global control and lack the ability to enforce fine-grained structural constraints. Progress is further limited by the absence of large datasets that pair patch-level spatial layouts with detailed diagnostic descriptions, since generating such annotations for gigapixel whole-slide images is prohibitively time-consuming for human experts. To overcome these challenges, we first develop a scalable multi-agent LVLM annotation framework that integrates image description, diagnostic step extraction, and automatic quality judgment into a coordinated pipeline, and we evaluate the reliability of the system through a human verification process. This framework enables efficient construction of fine-grained and clinically aligned supervision at scale. Building on the curated data, we propose In-Context Diffusion Transformer (IC-DiT), a layout-aware generative model that incorporates spatial layouts, textual descriptions, and visual embeddings into a unified diffusion transformer. Through hierarchical multimodal attention, IC-DiT maintains global semantic coherence while accurately preserving structural and morphological details. Extensive experiments on five histopathology datasets show that IC-DiT achieves higher fidelity, stronger spatial controllability, and better diagnostic consistency than existing methods. In addition, the generated images serve as effective data augmentation resources for downstream tasks such as cancer classification and survival analysis.

While colorectal liver metastasis (CRLM) is potentially curable via hepatectomy, patient outcomes remain highly heterogeneous. Postoperative survival prediction is necessary to avoid non-beneficial surgeries and guide personalized therapy. In this study, we present an automated AI-based framework for postoperative CRLM survival prediction using pre- and post-contrast MRI. We performed a retrospective study of 227 CRLM patients who had gadoxetate-enhanced MRI prior to curative-intent hepatectomy between 2013 and 2020. We developed a survival prediction framework comprising an anatomy-aware segmentation pipeline followed by a radiomics pipeline. The segmentation pipeline learns liver, CRLMs, and spleen segmentation from partially-annotated data, leveraging promptable foundation models to generate pseudo-labels. To support this pipeline, we propose SAMONAI, a prompt propagation algorithm that extends Segment Anything Model to 3D point-based segmentation. Predicted pre- and post-contrast segmentations are then fed into our radiomics pipeline, which extracts per-tumor features and predicts survival using SurvAMINN, an autoencoder-based multiple instance neural network for time-to-event survival prediction. SurvAMINN jointly learns dimensionality reduction and survival prediction from right-censored data, emphasizing high-risk metastases. We compared our framework against established methods and biomarkers using univariate and multivariate Cox regression. Our segmentation pipeline achieves median Dice scores of 0.96 (liver) and 0.93 (spleen), driving a CRLM segmentation Dice score of 0.78 and a detection F1-score of 0.79. Accurate segmentation enables our radiomics pipeline to achieve a survival prediction C-index of 0.69. Our results show the potential of integrating segmentation algorithms with radiomics-based survival analysis to deliver accurate and automated CRLM outcome prediction.

Multiple Instance Learning (MIL) has been widely applied in histopathology to classify Whole Slide Images (WSIs) with slide-level diagnoses. While the ground truth is established by expert pathologists, the slides can be difficult to diagnose for non-experts and lead to disagreements between the annotators. In this paper, we introduce the notion of Whole Slide Difficulty (WSD), based on the disagreement between an expert and a non-expert pathologist. We propose two different methods to leverage WSD, a multi-task approach and a weighted classification loss approach, and we apply them to Gleason grading of prostate cancer slides. Results show that integrating WSD during training consistently improves the classification performance across different feature encoders and MIL methods, particularly for higher Gleason grades (i.e. worse diagnosis).

In interventional radiology, Cone-Beam Computed Tomography (CBCT) is a helpful imaging modality that provides guidance to practicians during minimally invasive procedures. CBCT differs from traditional Computed Tomography (CT) due to its limited reconstructed field of view, specific artefacts, and the intra-arterial administration of contrast medium. While CT benefits from abundant publicly available annotated datasets, interventional CBCT data remain scarce and largely unannotated, with existing datasets focused primarily on radiotherapy applications. To address this limitation, we leverage a proprietary collection of unannotated interventional CBCT scans in conjunction with annotated CT data, employing domain adaptation techniques to bridge the modality gap and enhance liver segmentation performance on CBCT. We propose a novel unsupervised domain adaptation (UDA) framework based on the formalism of Margin Disparity Discrepancy (MDD), which improves target domain performance through a reformulation of the original MDD optimization framework. Experimental results on CT and CBCT datasets for liver segmentation demonstrate that our method achieves state-of-the-art performance in UDA, as well as in the few-shot setting.

Osteosarcoma is the most common primary bone cancer, mainly affecting the youngest and oldest populations. Its detection at early stages is crucial to reduce the probability of developing bone metastasis. In this context, accurate and fast diagnosis is essential to help physicians during the prognosis process. The research goal is to automate the diagnosis of osteosarcoma through a pipeline that includes the preprocessing, detection, postprocessing, and visualization of computed tomography (CT) scans. Thus, this paper presents a machine learning and visualization framework for classifying CT scans using different convolutional neural network (CNN) models. Preprocessing includes data augmentation and identification of the region of interest in scans. Post-processing includes data visualization to render a 3D bone model that highlights the affected area. An evaluation on 12 patients revealed the effectiveness of our framework, obtaining an area under the curve (AUC) of 94.8\% and a specificity of 94.6\%.

Background: Pleuroparenchymal fibroelastosis (PPFE) is an upper lobe predominant fibrotic lung abnormality associated with increased mortality in established interstitial lung disease. However, the clinical significance of radiologic PPFE progression in lung cancer screening (LCS) populations remains unclear. Methods: We analysed longitudinal low-dose CT scans and clinical data from two LCS studies: National Lung Screening Trial (NLST; n=7,980); SUMMIT study (n=8,561). An automated algorithm quantified PPFE volume on baseline and follow-up scans. Annualised change in PPFE was derived and dichotomised using a distribution-based threshold to define progressive PPFE. Associations between progressive PPFE and mortality were evaluated using Cox proportional hazards models adjusted for demographic and clinical variables. In SUMMIT cohort, associations between progressive PPFE and clinical outcomes were assessed using incidence rate ratios (IRR) and odds ratios (OR). Findings: Progressive PPFE independently associated with mortality in both LCS cohorts (NLST: Hazard Ratio (HR)=1.25, 95% Confidence Interval (CI): 1.01--1.56, p=0.042; SUMMIT: HR=3.14, 95% CI: 1.66--5.97, p<0.001). Within SUMMIT, progressive PPFE was strongly associated with higher respiratory admissions (IRR=2.79, p<0.001), increased antibiotic and steroid use (IRR=1.55, p=0.010), and showed a trend towards higher modified medical research council scores (OR=1.40, p=0.055). Interpretation: Radiologic PPFE progression independently associates with mortality across two large LCS cohorts, and associates with adverse clinical outcomes. Quantitative assessment of PPFE progression may provide a clinically relevant imaging biomarker to identify individuals at increased risk of respiratory morbidity within LCS programmes.

Delineating the clinical target volume (CTV) in radiotherapy involves complex margins constrained by tumor location and anatomical barriers. While deep learning models automate this process, their rigid reliance on expert-annotated data requires costly retraining whenever clinical guidelines update. To overcome this limitation, we introduce OncoAgent, a novel guideline-aware AI agent framework that seamlessly converts textual clinical guidelines into three-dimensional target contours in a training-free manner. Evaluated on esophageal cancer cases, the agent achieves a zero-shot Dice similarity coefficient of 0.842 for the CTV and 0.880 for the planning target volume, demonstrating performance highly comparable to a fully supervised nnU-Net baseline. Notably, in a blinded clinical evaluation, physicians strongly preferred OncoAgent over the supervised baseline, rating it higher in guideline compliance, modification effort, and clinical acceptability. Furthermore, the framework generalizes zero-shot to alternative esophageal guidelines and other anatomical sites (e.g., prostate) without any retraining. Beyond mere volumetric overlap, our agent-based paradigm offers near-instantaneous adaptability to alternative guidelines, providing a scalable and transparent pathway toward interpretability in radiotherapy treatment planning.