Medical Image Classification

This dissertation investigates privacy-preserving federated learning for Alzheimer's disease classification using three-dimensional MRI data from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Existing methodologies often suffer from unrealistic data partitioning, inadequate privacy guarantees, and insufficient benchmarking, limiting their practical deployment in healthcare. To address these gaps, this research proposes a novel site-aware data partitioning strategy that preserves institutional boundaries, reflecting real-world multi-institutional collaborations and data heterogeneity. Furthermore, an Adaptive Local Differential Privacy (ALDP) mechanism is introduced, dynamically adjusting privacy parameters based on training progression and parameter characteristics, thereby significantly improving the privacy-utility trade-off over traditional fixed-noise approaches. Systematic empirical evaluation across multiple client federations and privacy budgets demonstrated that advanced federated optimisation algorithms, particularly FedProx, could equal or surpass centralised training performance while ensuring rigorous privacy protection. Notably, ALDP achieved up to 80.4% accuracy in a two-client configuration, surpassing fixed-noise Local DP by 5-7 percentage points and demonstrating substantially greater training stability. The comprehensive ablation studies and benchmarking establish quantitative standards for privacy-preserving collaborative medical AI, providing practical guidelines for real-world deployment. This work thereby advances the state-of-the-art in federated learning for medical imaging, establishing both methodological foundations and empirical evidence necessary for future privacy-compliant AI adoption in healthcare.

The tortuosity of corneal nerve fibers are used as indication for different diseases. Current state-of-the-art methods for grading the tortuosity heavily rely on expensive segmentation maps of these nerve fibers. In this paper, we demonstrate that self-supervised pretrained features from ImageNet are transferable to the domain of in vivo confocal microscopy. We show that DINO should not be disregarded as a deep learning model for medical imaging, although it was superseded by two later versions. After careful fine-tuning, DINO improves upon the state-of-the-art in terms of accuracy (84,25%) and sensitivity (77,97%). Our fine-tuned model focuses on the key morphological elements in grading without the use of segmentation maps.

Robust detection of COVID-19 from chest CT remains challenging in multi-institutional settings due to substantial source shift, source imbalance, and hidden test-source identities. In this work, we propose a three-stage source-aware multi-expert framework for multi-source COVID-19 CT classification. First, we build a lung-aware 3D expert by combining original CT volumes and lung-extracted CT volumes for volumetric classification. Second, we develop two MedSigLIP-based experts: a slice-wise representation and probability learning module, and a Transformer-based inter-slice context modeling module for capturing cross-slice dependency. Third, we train a source classifier to predict the latent source identity of each test scan. By leveraging the predicted source information, we perform model fusion and voting based on different experts. On the validation set covering all four sources, the Stage 1 model achieves the best macro-F1 of 0.9711, ACC of 0.9712, and AUC of 0.9791. Stage2a and Stage2b achieve the best AUC scores of 0.9864 and 0.9854, respectively. Stage~3 source classifier reaches 0.9107 ACC and 0.9114 F1. These results demonstrate that source-aware expert modeling and hierarchical voting provide an effective solution for robust COVID-19 CT classification under heterogeneous multi-source conditions.

Accurate classification of lung diseases from chest CT scans plays an important role in computer-aided diagnosis systems. However, medical imaging datasets often suffer from severe class imbalance, which may significantly degrade the performance of deep learning models, especially for minority disease categories. To address this issue, we propose a gender-aware two-stage lung disease classification framework. The proposed approach explicitly incorporates gender information into the disease recognition pipeline. In the first stage, a gender classifier is trained to predict the patient's gender from CT scans. In the second stage, the input CT image is routed to a corresponding gender-specific disease classifier to perform final disease prediction. This design enables the model to better capture gender-related imaging characteristics and alleviate the influence of imbalanced data distribution. Experimental results demonstrate that the proposed method improves the recognition performance for minority disease categories, particularly squamous cell carcinoma, while maintaining competitive performance on other classes.

We propose a deep learning framework for COVID-19 detection and disease classification from chest CT scans that integrates both 2.5D and 3D representations to capture complementary slice-level and volumetric information. The 2.5D branch processes multi-view CT slices (axial, coronal, sagittal) using a DINOv3 vision transformer to extract robust visual features, while the 3D branch employs a ResNet-18 architecture to model volumetric context and is pretrained with Variance Risk Extrapolation (VREx) followed by supervised contrastive learning to improve cross-source robustness. Predictions from both branches are combined through logit-level ensemble inference. Experiments on the PHAROS-AIF-MIH benchmark demonstrate the effectiveness of the proposed approach: for binary COVID-19 detection, the ensemble achieves 94.48% accuracy and a 0.9426 Macro F1-score, outperforming both individual models, while for multi-class disease classification the 2.5D DINOv3 model achieves the best performance with 79.35% accuracy and a 0.7497 Macro F1-score. These results highlight the benefit of combining pretrained slice-based representations with volumetric modeling for robust multi-source medical imaging analysis. Code is available at https://github.com/HySonLab/PHAROS-AIF-MIH

Diabetic retinopathy screening traditionally relies on fundus photography, requiring specialized equipment and expertise often unavailable in primary care and resource limited settings. We developed and validated a deep learning (DL) system for automated diabetic classification using anterior segment ocular imaging a readily accessible alternative utilizing standard photography equipment. The system leverages visible biomarkers in the iris, sclera, and conjunctiva that correlate with systemic diabetic status. We systematically evaluated five contemporary architectures (EfficientNet-V2-S with self-supervised learning (SSL), Vision Transformer, Swin Transformer, ConvNeXt-Base, and ResNet-50) on 2,640 clinically annotated anterior segment images spanning Normal, Controlled Diabetic, and Uncontrolled Diabetic categories. A tailored preprocessing pipeline combining specular reflection mitigation and contrast limited adaptive histogram equalization (CLAHE) was implemented to enhance subtle vascular and textural patterns critical for classification. SSL using SimCLR on domain specific ocular images substantially improved model performance.EfficientNet-V2-S with SSL achieved optimal performance with an F1-score of 98.21%, precision of 97.90%, and recall of 98.55% a substantial improvement over ImageNet only initialization (94.63% F1). Notably, the model attained near perfect precision (100%) for Normal classification, critical for minimizing unnecessary clinical referrals.

Contrastive learning (CL) has become a powerful approach for learning representations from unlabeled images. However, existing CL methods focus predominantly on visual appearance features while neglecting topological characteristics (e.g., connectivity patterns, boundary configurations, cavity formations) that provide valuable cues for medical image analysis. To address this limitation, we propose a new topological CL framework (TopoCL) that explicitly exploits topological structures during contrastive learning for medical imaging. Specifically, we first introduce topology-aware augmentations that control topological perturbations using a relative bottleneck distance between persistence diagrams, preserving medically relevant topological properties while enabling controlled structural variations. We then design a Hierarchical Topology Encoder that captures topological features through self-attention and cross-attention mechanisms. Finally, we develop an adaptive mixture-of-experts (MoE) module to dynamically integrate visual and topological representations. TopoCL can be seamlessly integrated with existing CL methods. We evaluate TopoCL on five representative CL methods (SimCLR, MoCo-v3, BYOL, DINO, and Barlow Twins) and five diverse medical image classification datasets. The experimental results show that TopoCL achieves consistent improvements: an average gain of +3.26% in linear probe classification accuracy with strong statistical significance, verifying its effectiveness.

Publicly available full-field digital mammography (FFDM) datasets remain limited in size, clinical annotations, and vendor diversity, hindering the development of robust models. We introduce LUMINA, a curated, multi-vendor FFDM dataset that explicitly encodes acquisition energy and vendor metadata to capture clinically relevant appearance variations often overlooked in existing benchmarks. This dataset contains 1824 images from 468 patients (960 benign, 864 malignant), with pathology-confirmed labels, BI-RADS assessments, and breast-density annotations. LUMINA spans six acquisition systems and includes both high- and low-energy imaging styles, enabling systematic analysis of vendor- and energy-induced domain shifts. To address these variations, we propose a foreground-only pixel-space alignment method (''energy harmonization'') that maps images to a low-energy reference while preserving lesion morphology. We benchmark CNN and transformer models on three clinically relevant tasks: diagnosis (benign vs. malignant), BI-RADS classification, and density estimation. Two-view models consistently outperform single-view models. EfficientNet-B0 achieves an AUC of 93.54% for diagnosis, while Swin-T achieves the best macro-AUC of 89.43% for density prediction. Harmonization improves performance across architectures and produces more localized Grad-CAM responses. Overall, LUMINA provides (1) a vendor-diverse benchmark and (2) a model-agnostic harmonization framework for reliable and deployable mammography AI.

The COVID-19 pandemic exposed critical limitations in diagnostic workflows: RT-PCR tests suffer from slow turnaround times and high false-negative rates, while CT-based screening offers faster complementary diagnosis but requires expert radiological interpretation. Deploying automated CT analysis across multiple hospital centres introduces further challenges, as differences in scanner hardware, acquisition protocols, and patient populations cause substantial domain shift that degrades single-model performance. To address these challenges, we present a heterogeneous ensemble of nine models spanning three inference paradigms: (1) a self-supervised DINOv2 Vision Transformer with slice-level sigmoid aggregation, (2) a RadImageNet-pretrained DenseNet-121 with slice-level sigmoid averaging, and (3) seven Gated Attention Multiple Instance Learning models using EfficientNet-B3, ConvNeXt-Tiny, and EfficientNetV2-S backbones with scan-level softmax classification. Ensemble diversity is further enhanced through random-seed variation and Stochastic Weight Averaging. We address severe overfitting, reducing the validation-to-training loss ratio from 35x to less than 3x, through a combination of Focal Loss, embedding-level Mixup, and domain-aware augmentation. Model outputs are fused via score-weighted probability averaging and calibrated with per-source threshold optimization. The final ensemble achieves an average macro F1 of 0.9280 across four hospital centres, outperforming the best single model (F1=0.8969) by +0.031, demonstrating that heterogeneous architectures combined with source-aware calibration are essential for robust multi-site medical image classification.

Brain tumor classification from magnetic resonance imaging, which is also known as MRI, plays a sensitive role in computer-assisted diagnosis systems. In recent years, deep learning models have achieved high classification accuracy. However, their sensitivity to adversarial perturbations has become an important reliability concern in medical applications. This study suggests a robust brain tumor classification framework that combines Non-Negative Matrix Factorization (NNMF or NMF), lightweight convolutional neural networks (CNNs), and diffusion-based feature purification. Initially, MRI images are preprocessed and converted into a non-negative data matrix, from which compact and interpretable NNMF feature representations are extracted. Statistical metrics, including AUC, Cohen's d, and p-values, are used to rank and choose the most discriminative components. Then, a lightweight CNN classifier is trained directly on the selected feature groups. To improve adversarial robustness, a diffusion-based feature-space purification module is introduced. A forward noise method followed by a learned denoiser network is used before classification. System performance is estimated using both clean accuracy and robust accuracy under powerful adversarial attacks created by AutoAttack. The experimental results show that the proposed framework achieves competitive classification performance while significantly enhancing robustness against adversarial perturbations.The findings presuppose that combining interpretable NNMF-based representations with a lightweight deep approach and diffusion-based defense technique supplies an effective and reliable solution for medical image classification under adversarial conditions.

We present a fairness-aware framework for multi-class lung disease diagnosis from chest CT volumes, developed for the Fair Disease Diagnosis Challenge at the PHAROS-AIF-MIH Workshop (CVPR 2026). The challenge requires classifying CT scans into four categories -- Healthy, COVID-19, Adenocarcinoma, and Squamous Cell Carcinoma -- with performance measured as the average of per-gender macro F1 scores, explicitly penalizing gender-inequitable predictions. Our approach addresses two core difficulties: the sparse pathological signal across hundreds of slices, and a severe demographic imbalance compounded across disease class and gender. We propose an attention-based Multiple Instance Learning (MIL) model on a ConvNeXt backbone that learns to identify diagnostically relevant slices without slice-level supervision, augmented with a Gradient Reversal Layer (GRL) that adversarially suppresses gender-predictive structure in the learned scan representation. Training incorporates focal loss with label smoothing, stratified cross-validation over joint (class, gender) strata, and targeted oversampling of the most underrepresented subgroup. At inference, all five-fold checkpoints are ensembled with horizontal-flip test-time augmentation via soft logit voting and out-of-the-fold threshold optimization for robustness. Our model achieves a mean validation competition score of 0.685 (std - 0.030), with the best single fold reaching 0.759. All training and inference code is publicly available at https://github.com/ADE-17/cvpr-fair-chest-ct

Impaction of the mandibular third molar in proximity to the mandibular canal increases the risk of inferior alveolar nerve injury. Panoramic radiography is routinely used to assess this relationship. Automated classification of molar-canal overlap could support clinical triage and reduce unnecessary CBCT referrals, while federated learning (FL) enables multi-center collaboration without sharing patient data. We compared Local Learning (LL), FL, and Centralized Learning (CL) for binary overlap/no-overlap classification on cropped panoramic radiographs partitioned across eight independent labelers. A pretrained ResNet-34 was trained under each paradigm and evaluated using per-client metrics with locally optimized thresholds and pooled test performance with a global threshold. Performance was assessed using area under the receiver operating characteristic curve (AUC) and threshold-based metrics, alongside training dynamics, Grad-CAM visualizations, and server-side aggregate monitoring signals. On the test set, CL achieved the highest performance (AUC 0.831; accuracy = 0.782), FL showed intermediate performance (AUC 0.757; accuracy = 0.703), and LL generalized poorly across clients (AUC range = 0.619-0.734; mean = 0.672). Training curves suggested overfitting, particularly in LL models, and Grad-CAM indicated more anatomically focused attention in CL and FL. Overall, centralized training provided the strongest performance, while FL offers a privacy-preserving alternative that outperforms LL.

Breast ultrasound diagnosis typically proceeds from global lesion localization to local sign assessment and then evidence integration to assign a BI-RADS category and determine benignity or malignancy. Many existing methods rely on end-to-end prediction or provide only weakly grounded evidence, which can miss fine-grained lesion cues and limit auditability and clinical review. To align with the clinical workflow and improve evidence traceability, we propose a hierarchical multi-agent framework, termed UltrasoundAgents. A main agent localizes the lesion in the full image and triggers a crop-and-zoom operation. A sub-agent analyzes the local view and predicts four clinically relevant attributes, namely echogenicity pattern, calcification, boundary type, and edge (margin) morphology. The main agent then integrates these structured attributes to perform evidence-based reasoning and output the BI-RADS category and the malignancy prediction, while producing reviewable intermediate evidence. Furthermore, hierarchical multi-agent training often suffers from error propagation, difficult credit assignment, and sparse rewards. To alleviate this and improve training stability, we introduce a decoupled progressive training strategy. We first train the attribute agent, then train the main agent with oracle attributes to learn robust attribute-based reasoning, and finally apply corrective trajectory self-distillation with spatial supervision to build high-quality trajectories for supervised fine-tuning, yielding a deployable end-to-end policy. Experiments show consistent gains over strong vision-language baselines in diagnostic accuracy and attribute agreement, together with structured evidence and traceable reasoning.

Chest X-ray imaging remains the primary diagnostic tool for pulmonary and cardiac disorders worldwide, yet its accuracy is hampered by radiologist shortages and inter-observer variability. This study presents a systematic comparative evaluation of seven deep learning architectures for multi-class chest disease classification: ConvNeXt-Tiny, DenseNet121, DenseNet201, ResNet50, ViT-B/16, EfficientNetV2-M, and MobileNetV2. A balanced dataset of 18,080 chest X-ray images spanning five disease categories (Cardiomegaly, COVID-19, Normal, Pneumonia, and Tuberculosis) was constructed from three public repositories and partitioned at the patient level to prevent data leakage. All models were trained under identical conditions using ImageNet-pretrained weights, standardized preprocessing, and consistent hyperparameters. All seven architectures exceeded 90% test accuracy. ConvNeXt-Tiny achieved the highest performance (92.31% accuracy, 95.70% AUROC), while MobileNetV2 emerged as the most parameter-efficient model (3.5M parameters, 90.42% accuracy, 94.10% AUROC), completing training in 48 minutes. Tuberculosis and COVID-19 classification was near-perfect (AUROC >= 99.97%) across all architectures, while Normal, Cardiomegaly, and Pneumonia presented greater challenges due to overlapping radiographic features. Grad-CAM visualizations confirmed clinically consistent attention patterns across disease categories. These findings demonstrate that high-accuracy multi-disease chest X-ray classification is achievable without excessive computational resources, with important implications for AI-assisted diagnosis in both resource-rich and resource-constrained healthcare settings.

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%.

Computer-aided diagnosis (CADx) has become vital in medical imaging, but automated systems often struggle to replicate the nuanced process of clinical interpretation. Expert diagnosis requires a comprehensive analysis of how abnormalities relate to each other across various views and time points, but current multi-view CADx methods frequently overlook these complex dependencies. Specifically, they fail to model the crucial relationships within a single view and the dynamic changes lesions exhibit across different views. This limitation, combined with the common challenge of incomplete data, greatly reduces their predictive reliability. To address these gaps, we reframe the diagnostic task as one of relationship modeling and propose GIIM, a novel graph-based approach. Our framework is uniquely designed to simultaneously capture both critical intra-view dependencies between abnormalities and inter-view dynamics. Furthermore, it ensures diagnostic robustness by incorporating specific techniques to effectively handle missing data, a common clinical issue. We demonstrate the generality of this approach through extensive evaluations on diverse imaging modalities, including CT, MRI, and mammography. The results confirm that our GIIM model significantly enhances diagnostic accuracy and robustness over existing methods, establishing a more effective framework for future CADx systems.

Modern foundation models provide highly expressive visual representations, yet adapting them to high-resolution medical imaging remains challenging due to limited annotations and weak supervision. Mammography, in particular, is characterized by large images, variable multi-view studies and predominantly breast-level labels, making end-to-end fine-tuning computationally expensive and often impractical. We propose Multiple Instance Learning on Precomputed Features (MIL-PF), a scalable framework that combines frozen foundation encoders with a lightweight MIL head for mammography classification. By precomputing the semantic representations and training only a small task-specific aggregation module (40k parameters), the method enables efficient experimentation and adaptation without retraining large backbones. The architecture explicitly models the global tissue context and the sparse local lesion signals through attention-based aggregation. MIL-PF achieves state-of-the-art classification performance at clinical scale while substantially reducing training complexity. We release the code for full reproducibility.

Concept Bottleneck Models (CBMs) are a prominent framework for interpretable AI that map learned visual features to a set of meaningful concepts for task-specific downstream predictions. Their sequential structure enhances transparency by connecting model predictions to the underlying concepts that support them. In medical imaging, where transparency is essential, CBMs offer an appealing foundation for explainable model design. However, discrete concept representations often overlook broader clinical context such as diagnostic guidelines and expert heuristics, reducing reliability in complex cases. We propose MedCBR, a concept-based reasoning framework that integrates clinical guidelines with vision-language and reasoning models. Labeled clinical descriptors are transformed into guideline-conformant text, and a concept-based model is trained with a multitask objective combining multimodal contrastive alignment, concept supervision, and diagnostic classification to jointly ground image features, concepts, and pathology. A reasoning model then converts these predictions into structured clinical narratives that explain the diagnosis, emulating expert reasoning based on established guidelines. MedCBR achieves superior diagnostic and concept-level performance, with AUROCs of 94.2% on ultrasound and 84.0% on mammography. Further experiments on non-medical datasets achieve 86.1% accuracy. Our framework enhances interpretability and forms an end-to-end bridge from medical image analysis to decision-making.

Thyroid ultrasound (US) automation couples two competing requirements: global, geometry-driven reasoning for nodule delineation and local, texture-driven reasoning for malignancy risk assessment. Under cross-center domain shift, these cues degrade asymmetrically, yet most multi-task pipelines rely on a single shared backbone, often inducing negative transfer. In this paper, we characterize this interference across CNN (ResNet34) and medical ViT (MedSAM) backbones, and observe a consistent trend: ViTs transfer geometric priors that benefit segmentation, whereas CNNs more reliably preserve texture cues for malignancy discrimination under strong shift and artifacts. Motivated by this failure mode, we propose a lightweight family of decoder-side adapters, the Multi-Kernel Gated Adapter (MKGA) and a residual variant (ResMKGA), which refine multi-scale skip features using complementary receptive fields and apply semantic, context-conditioned gating to suppress artifact-prone content before fusion. Across two US benchmarks, the proposed adapters improve cross-center robustness: they strengthen out-of-domain segmentation and, in the CNN setting, yield clear gains in clinical TI-RADS diagnostic accuracy compared to standard multi-task baselines. Code and models will be released.

We are concerned with the challenge of reliably classifying and assessing intracranial aneurysms using deep learning without compromising clinical transparency. While traditional black-box models achieve high predictive accuracy, their lack of inherent interpretability remains a significant barrier to clinical adoption and regulatory approval. Explainability is paramount in medical modeling to ensure that AI-driven diagnoses align with established neurosurgical principles. Unlike traditional eXplainable AI (XAI) methods -- such as saliency maps, which often provide post-hoc, non-causal visual correlations -- Concept Bottleneck Models (CBMs) offer a robust alternative by constraining the model's internal logic to human-understandable clinical indices. In this article, we propose an end-to-end 3D Concept Bottleneck framework that maps high-dimensional neuroimaging features to a discrete set of morphological and hemodynamic concepts for aneurysm identification. We implemented this pipeline using a pre-trained 3D ResNet-34 backbone and a 3D DenseNet-121 to extract features from CTA volumes, which were subsequently processed through a soft bottleneck layer representing human-interpretable clinical concepts. The model was optimized using a joint-loss function to balance diagnostic focal loss and concept mean squared error (MSE), validated via stratified five-fold cross-validation. Our results demonstrate a peak task classification accuracy of 93.33% +/- 4.5% for the ResNet-34 architecture and 91.43% +/- 5.8% for the DenseNet-121 model. Furthermore, the implementation of 8-pass Test-Time Augmentation (TTA) yielded a robust mean accuracy of 88.31%, ensuring diagnostic stability during inference. By maintaining an accuracy-generalization gap of less than 0.04, this framework proves that high predictive performance can be achieved without sacrificing interpretability.

The development of effective treatments for Cerebral Palsy (CP) can begin with the early identification of affected children while they are still in the early stages of the disorder. Pathological issues in the brain can be better diagnosed with the use of one of many medical imaging techniques. Magnetic Resonance Imaging (MRI) has revolutionized medical imaging with its unparalleled image resolution. A unique Machine Learning (ML) model that was built to identify CP disorder is presented in this paper. The model is intended to assist in the early diagnosis of CP in newborns. In this study, the brain MRI images dataset was first collected, and then the preprocessing techniques were applied to this dataset to make it ready for use in the proposed model. Following this, the proposed model was constructed by combining three CNN models, specifically VGG 19, Efficient-Net, and the ResNet50 model, to extract features from the image. Following this, a Bi-LSTM was utilized as a classifier to determine whether or not CP was present, and finally, the proposed model was employed for training and testing. The results show that the proposed model achieved an accuracy of 98.83%, which is higher than VGG-19 (96.79%), Efficient-Net (97.29%), and VGG-16 (97.50%).. When the suggested model is compared to other models that have been pre-trained in the past, the accuracy scores seem to be much higher.

Accurate characterization of carotid plaques is critical for stroke prevention in patients with carotid stenosis. We analyze 500 plaques from CREST-2, a multi-center clinical trial, to identify radiomics-based markers from B-mode ultrasound images linked with high-risk. We propose a new kernel-based additive model, combining coherence loss with group-sparse regularization for nonlinear classification. Group-wise additive effects of each feature group are visualized using partial dependence plots. Results indicate our method accurately and interpretably assesses plaques, revealing a strong association between plaque texture and clinical risk.

Diffusion-weighted imaging (DWI) can support lesion detection and characterization in breast magnetic resonance imaging (MRI), however especially high b-value diffusion-weighted acquisitions can be prone to intensity artifacts that can affect diagnostic image assessment. This study aims to detect both hyper- and hypointense artifacts on high b-value diffusion-weighted images (b=1500 s/mm2) using deep learning, employing either a binary classification (artifact presence) or a multiclass classification (artifact intensity) approach on a slice-wise dataset.This IRB-approved retrospective study used the single-center dataset comprising n=11806 slices from routine 3T breast MRI examinations performed between 2022 and mid-2023. Three convolutional neural network (CNN) architectures (DenseNet121, ResNet18, and SEResNet50) were trained for binary classification of hyper- and hypointense artifacts. The best performing model (DenseNet121) was applied to an independent holdout test set and was further trained separately for multiclass classification. Evaluation included area under receiver operating characteristic curve (AUROC), area under precision recall curve (AUPRC), precision, and recall, as well as analysis of predicted bounding box positions, derived from the network Grad-CAM heatmaps. DenseNet121 achieved AUROCs of 0.92 and 0.94 for hyper- and hypointense artifact detection, respectively, and weighted AUROCs of 0.85 and 0.88 for multiclass classification on single-slice high b-value diffusion-weighted images. A radiologist evaluated bounding box precision on a 1-5 Likert-like scale across 200 slices, achieving mean scores of 3.33+-1.04 for hyperintense artifacts and 2.62+-0.81 for hypointense artifacts. Hyper- and hypointense artifact detection in slice-wise breast DWI MRI dataset (b=1500 s/mm2) using CNNs particularly DenseNet121, seems promising and requires further validation.

Classical radiomic features are designed to quantify image appearance and intensity patterns. Compared with end-to-end deep learning (DL) models trained for disease classification, radiomics pipelines with low-dimensional parametric classifiers offer enhanced transparency and interpretability, yet often underperform because of the reliance on population-level predefined feature sets. Recent work on adaptive radiomics uses DL to predict feature weights over a radiomic pool, then thresholds these weights to retain the top-k features from large radiomic pool F (often ~10^3). However, such marginal ranking can over-admit redundant descriptors and overlook complementary feature interactions. We propose a patient-specific feature-set selection framework that predicts a single compact feature set per subject, targeting complementary and diverse evidence rather than marginal top-k features. To overcome the intractable combinatorial search space of F choose k features, our method utilizes a 2-stage retrieval strategy: randomly sample diverse candidate feature sets, then rank these sets with a learned scoring function to select a high-performing feature set for the specific patient. The system consists of a feature-set scorer, and a classifier that performs the final diagnosis. We empirically show that the proposed two-stage retrieval approximates the original exhaustive all k-feature selection. Validating on tasks including ACL tear detection and KL grading for osteoarthritis, the experimental results achieve diagnostic performance, outperforming the top-k approach with the same k values, and competitive with end-to-end DL models while maintaining high transparency. The model generates auditable feature sets that link clinical outcomes to specific anatomical regions and radiomic families, allowing clinicians to inspect which anatomical structures and quantitative descriptors drive the prediction.

Recent 3D CT vision-language models align volumes with reports via contrastive pretraining, but typically rely on limited public data and provide only coarse global supervision. We train a 3D CT vision-language model on 98k report-volume pairs (50k patients) collected at a single hospital, combined with public datasets, using SigLIP-style contrastive pretraining together with prompt-based disease supervision in the shared vision-text embedding space. On CT-RATE, our model achieves state-of-the-art text-to-image retrieval (R@10 31.5 vs. 22.2) and competitive disease classification (AUC 83.8 vs. 83.8), with consistent results on Rad-ChestCT (AUC 77.0 vs. 77.3). We further observe that radiologists routinely reference specific images within their reports (e.g., ``series X, image Y''), linking textual descriptions to precise axial locations. We automatically mine 262k such snippet-slice pairs and introduce the task of intra-scan snippet localization -- predicting the axial depth referred to by a text snippet -- reducing mean absolute error to 36.3 mm at 12 mm feature resolution, compared with 67.0 mm for the best baseline. Adding this localization objective leaves retrieval and classification broadly unchanged within confidence bounds, yielding a single unified model for retrieval, classification, and intra-scan grounding.

White blood cell (WBC) classification is fundamental for hematology applications such as infection assessment, leukemia screening, and treatment monitoring. However, real-world WBC datasets present substantial appearance variations caused by staining and scanning conditions, as well as severe class imbalance in which common cell types dominate while rare but clinically important categories are underrepresented. To address these challenges, we propose a stain-normalized, decoupled training framework that first learns transferable representations using instance-balanced sampling, and then rebalances the classifier with class-aware sampling and a hybrid loss combining effective-number weighting and focal modulation. In inference stage, we further enhance robustness by ensembling various trained backbones with test-time augmentation. Our approach achieved the top rank on the leaderboard of the WBCBench 2026: Robust White Blood Cell Classification Challenge at ISBI 2026.

Joint lesion segmentation and tissue classification in breast ultrasound are usually trained with a shared encoder, so the two branches stop exchanging information once their decoders separate. That is exactly where boundary detail and semantic evidence are most complementary. The proposed method restores this exchange during decoding and, because its value differs between images, lets the network decide per image how much to keep. A Task Interaction Module (TIM) at each of four decoder levels passes pooled boundary context into the classification representation and modulates decoder channels with class-conditioned priors. An Adaptive Interaction Weighting (AIW) unit then blends interacted and original features with a coefficient computed for each image and level. On BUSI the model reaches 74.19% IoU and 90.60% accuracy, and on BUSI-WHU 86.40% IoU and 95.00% accuracy, ahead of encoder-sharing multi-task, transformer segmentation and decoder-interaction baselines evaluated under the same protocol. The ablation shows that multi-scale context and cross-task exchange are not independent: applied separately they contribute 4.00 points of IoU in total, applied together 6.76. Adding the adaptive blend to task interaction alone raises AUC from 94.41% to 97.31%, indicating that the blend acts primarily on the classification branch. Code: https://github.com/C-loud-Nine/Adaptive-Task-Interaction-BUS.

Foundation models pre-trained on large-scale datasets demonstrate strong transfer learning capabilities; however, their adaptation to complex multi-label diagnostic tasks-such as comprehensive head CT finding detection-remains understudied. Standard parameter-efficient fine-tuning methods such as LoRA apply uniform adaptations across pathology types, which may limit performance for diverse medical findings. We propose a Mixture of Low-Rank Experts (MoLRE) framework that extends LoRA with multiple specialized low-rank adapters and unsupervised soft routing. This approach enables conditional feature adaptation with less than 0.5% additional parameters and without explicit pathology supervision. We present a comprehensive benchmark of MoLRE across six state-of-the-art medical imaging foundation models spanning 2D and 3D architectures, general-domain, medical-domain, and head CT-specific pretraining, and model sizes ranging from 7M to 431M parameters. Using over 70,000 non-contrast head CT scans with 75 annotated findings-including hemorrhage, infarction, trauma, mass lesions, structural abnormalities, and chronic changes-our experiments demonstrate consistent performance improvements across all models. Gains vary substantially: general-purpose and medical-domain models show the largest improvements (DINOv3-Base: +4.6%; MedGemma: +4.3%), whereas 3D CT-specialized or very large models show more modest gains (+0.2-1.3%). The combination of MoLRE and MedGemma achieves the highest average detection AUC of 0.917. These findings highlight the importance of systematic benchmarking on target clinical tasks, as pretraining domain, architecture, and model scale interact in non-obvious ways.

Despite advances in machine learning-based medical image classifiers, the safety and reliability of these systems remain major concerns in practical settings. Existing auditing approaches mainly rely on unimodal features or metadata-based subgroup analyses, which are limited in interpretability and often fail to capture hidden systematic failures. To address these limitations, we introduce the first automated auditing framework that extends slice discovery methods to multimodal representations specifically for medical applications. Comprehensive experiments were conducted under common failure scenarios using the MIMIC-CXR-JPG dataset, demonstrating the framework's strong capability in both failure discovery and explanation generation. Our results also show that multimodal information generally allows more comprehensive and effective auditing of classifiers, while unimodal variants beyond image-only inputs exhibit strong potential in scenarios where resources are constrained.

Automated identification of DICOM image series is essential for large-scale medical image analysis, quality control, protocol harmonization, and reliable downstream processing. However, DICOM series classification remains challenging due to heterogeneous slice content, variable series length, and entirely missing, incomplete or inconsistent DICOM metadata. We propose an end-to-end multimodal framework for DICOM series classification that jointly models image content and acquisition metadata while explicitly accounting for all these challenges. (i) Images and metadata are encoded with modality-aware modules and fused using a bi-directional cross-modal attention mechanism. (ii) Metadata is processed by a sparse, missingness-aware encoder based on learnable feature dictionaries and value-conditioned modulation. By design, the approach does not require any form of imputation. (iii) Variability in series length and image data dimensions is handled via a 2.5D visual encoder and attention operating on equidistantly sampled slices. We evaluate the proposed approach on the publicly available Duke Liver MRI dataset and a large multi-institutional in-house cohort, assessing both in-domain performance and out-of-domain generalization. Across all evaluation settings, the proposed method consistently outperforms relevant image only, metadata-only and multimodal 2D/3D baselines. The results demonstrate that explicitly modeling metadata sparsity and cross-modal interactions improves robustness for DICOM series classification.