Non-Small Cell Lung Cancer

Early and timely screening of laryngeal cancer is crucial for improving clinical outcomes. In recent years, NBI endoscopy has become a standard diagnostic tool for the detection of laryngeal lesions. However, its effective use requires well-trained clinicians and the procedure is time-consuming and subject to interobserver variability. In this context, the application of artificial intelligence (AI) offers a promising solution to support clinical decision-making. In this work, we proposed applying transformer and attention mechanism for analyzing the narrow band imaging and distinguish benign and malignant lesions. Results show it has good classification performance with F1 (82.72%), accuracy(82.33%). In addition, the result of laryngeal cancer screening is explainable for clinicians. The explainability is utilizing the state of art segmentation method (MedSAM) to provide the useful pathological information area for clinicians. The proposed methodology fusing classification and segmentation provides a translating on laryngeal cancer screening.

Vision-language models trained with contrastive objectives have shown promise in medical image analysis. However, conventional global image-text alignment is ill-suited for mammography, where diagnostically relevant lesions are spatially localized and occupy only a small fraction of the image. Subtle morphological cues critical for malignancy assessment can be diluted when representations are learned at the whole-image level. In this work, we propose a novel region-grounded vision-language learning method for detection-guided mammographic lesion classification. The method mirrors radiologists' diagnostic paradigm. First, a region-text contrastive pretraining stage aligns lesion-specific features with structured clinical descriptors derived from radiology metadata. To mitigate semantic collapse and background bias in low-vocabulary settings, we introduce a multi-component objective incorporating positive alignment, fine-grained semantic hard negatives, and background suppression. Second, an auxiliary lesion detection head is jointly optimized with contrastive classification to preserve spatial sensitivity and enable localization-aware malignancy classification. Extensive experiments on two independent datasets, CBIS-DDSM and VinDr-Mammo, show superior performance of our method compared to related methods under in-domain, cross-dataset, and transfer learning settings.

Ovarian cancer is the deadliest gynecological malignancy; accurate and objective segmentation of adnexal masses and functional ovaries in ultrasound (US) remains challenging due to operator variability and morphological complexity. We present OvAi Focus (SynDiag s.r.l., Italy), a stand-alone AI software medical device that performs multi-class semantic segmentation of functional ovaries and adnexal masses, distinguishing cystic from solid components. The system was trained and independently validated on a multicenter dataset of 1,081 adult women from 6 centers across Italy and Israel. Segmentation achieved DICE scores of 0.87 (complete lesion), 0.85 (cystic), 0.68 (solid), and 0.62 (functional ovary), in line with or superior to state-of-the-art approaches across heterogeneous acquisition settings.

Accurate determination of pancreatic ductal adenocarcinoma (PDAC) resectability relies on evaluating how the tumor interacts with major peripancreatic vessels on CT imaging, yet expert assessment often shows substantial variability. We introduce a fully automated multimodal deep learning framework that jointly analyzes 3D contrast enhanced CT and structured clinical information to classify patients into the three National Comprehensive Cancer Network (NCCN) resectability categories (upfront resectable, borderline resectable, locally advanced). The approach uses a Swin-UNETR backbone to obtain anatomy aware image representations through auxiliary segmentation of pancreas, tumor, and vascular structures. These features are fused with a compact clinical embedding derived from 17 routinely collected variables and processed by a lightweight classification head. Model training is guided by a dynamic multitask objective that adapts the balance between segmentation and classification based on current tumor Dice performance, promoting feature representations that remain both anatomically informed and discriminative.

The Segment Anything Model (SAM) has demonstrated strong generalizability across a variety of segmentation tasks. However, SAM often struggles in situations where the target to be segmented is ambiguous. This poses a problem in medical imaging, where accurate delineation of targets such as tumors is vital, but even expert radiologists can disagree on the appropriate boundary for a target. Addressing this, we propose SARFA (Segment Anything with Radiomic Feature Alignment), a novel framework for improved medical image segmentation. Via probabilistic prompting, SARFA generates a diverse set of plausible masks for each input image and optimizes them with a radiomics-driven training objective based on Fréchet Radiomic Distance (FRD) and Direct Preference Optimization (DPO). By minimizing the FRD between masked predicted and ground truth regions within each image, SARFA encourages segmentation outputs whose anatomical and textural characteristics align with clinically meaningful ground truth representations, without relying solely on pixel-level overlap. Evaluated on computed tomography (CT) and magnetic resonance imaging (MRI) benchmarks, SARFA outperforms existing ambiguous segmentation methods, demonstrating the effectiveness of radiomic feature alignment and DPO-style candidate mask ranking as a training objective. Our code is available at https://github.com/tbwa233/SARFA.

Accurate dermatological diagnosis naturally necessitates equitable performance across diverse populations, yet a systematic lack of expertly annotated images, especially for underrepresented skin tones and rare diseases, impedes progress toward measurably fair methods. We introduce cgDDI (Controllable Generation of Diverse Dermatological Imagery), a hybrid framework that (1) synthesizes realistic healthy skin samples without disturbing other input properties, (2) maps single-sample rare lesions onto novel skin-tones and locations non-parametrically, and (3) allows for efficient parametric generation with as few as 10 training samples. The framework supports both human and automated segmentation masking, enabling scalability to datasets without pre-made lesion masks. We grow a 656-image dataset by more than 400x and validate across two datasets: biopsy-confirmed Diverse Dermatology Images (DDI) and expert-verified Fitzpatrick17k (F17k). On the DDI benchmark, we achieve malignancy classification accuracy of 86.4% under synthetic-only training and 90.9% state-of-the-art performance with real data fine-tuning, alongside leading fairness metrics. Cross-dataset experiments show +13.9% accuracy improvements on unseen F17k data despite minimal disease overlap. We openly release 266k+ synthetic images, code, and generative models to further support fairness research at https://github.com/hectorcarrion/ControllableGenDDI.

Limited-angle digital breast tomosynthesis (DBT) reconstructs a volume from a few low-dose projections over a narrow arc. At a representative nine-view, $25^{\circ}$ protocol more than 98% of image space is unmeasured, so a learned prior must supply structure in the missing wedge. Conditional diffusion priors achieve strong perceptual quality here but leave three clinical obstacles: inexact data consistency, unlocalized hallucination, and uncalibrated uncertainty. We enforce measurements exactly by replacing the per-step proximal update of a conditional diffusion sampler with exact Euclidean projection onto the data-consistent set, computed via an $m$-dimensional dual system with a one-time Gram matrix $AA^{\top}$ factorization. This projection costs 4.5 ms per step (a $248\times$ speedup) and drives the data residual to the double-precision floor ($2.4\times10^{-13}$). We prove it is the $ρ\to0$ limit of the proximal step, provide a no-harm theorem, and show that exactly consistent sample ensembles have variance supported on null($A$). Thus, the mean's entire error lies in the unmeasured subspace covered by the uncertainty map. On patient-derived breast phantoms, this improves fidelity at no depth-resolution cost. Conversely, a proximal step applied post-update degrades quality, isolating the consistency step's placement as decisive. Isotonic recalibration brings the ensemble spread to a calibrated error scale (expected calibration error $0.029\to0.008$; standardized error $4.7\to0.96$), ranking errors better than the pure prior. We also repair a 20.3% adjoint mismatch in a deployed projector via a materialized operator of record. This is the first data-consistent, uncertainty-calibrated learned reconstruction for limited-angle DBT. The solver naturally relaxes to discrepancy-ball and maximum-a-posteriori modes for noisy measurements.

Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer-related deaths globally, with approximately 1,926,425 new cases and 904,019 deaths reported in 2022. Accurate histologic grading plays a critical role in prognosis and treatment planning for colorectal adenocarcinoma. In recent years, artificial intelligence and its subcategories, including machine learning and deep learning, have been increasingly employed for automated cancer detection and classification. An appropriate and well-organized dataset is the essential first step to achieve this goal. This paper introduces CRC-HGD, a histopathological microscopy image dataset of 1,914 images obtained from 214 colorectal adenocarcinoma patients (Grade I: 106, Grade II: 75, Grade III: 33). The specimens are H&E-stained colorectal tissue sections acquired at the Poursina Hakim Research Center of Isfahan University of Medical Sciences, Iran, diagnosed between 2014 and 2019, and graded according to the World Health Organization (WHO) criteria into three grades: well-differentiated (Grade I), moderately differentiated (Grade II), and poorly differentiated (Grade III). For each specimen, four magnification levels are provided: 4x, 10x, 20x, and 40x. The dataset is accessible via Mendeley Data (https://doi.org/10.17632/yfp5sfj47m.4) and at http://databiox.com, where the latest version is also available. The distinctive feature of this dataset is the provision of labeled specimens across all three differentiation grades at multiple magnification levels, enabling comprehensive computational analysis of colorectal cancer grading.

Accurate differentiation between gastric adenoma and carcinoma during endoscopy is critical for clinical decision-making. Yet, this task is highly challenging due to high inter-class similarity and ambiguous boundaries between the two classes. Existing ROI-based classification methods often suffer from detection/segmentation error propagation and loss of surrounding global context. In contrast, full-image classification lacks the necessary spatial focus. Furthermore, we observe that deep neural networks gravitate towards domain-specific texture biases(e.g. bleeding, lighting artifacts), often causing models to predict based on spurious correlations instead of intrinsic morphological features. To address these limitations, we propose a novel framework, Masked Achromatic Guidance Expert (MAGE). During training, we introduce an auxiliary local expert branch trained on masked achromatic views of the neoplasm. By suppressing background context and color, this branch is forced to learn highly discriminative, purely structural features. We then employ a dual-objective distillation strategy, transferring both classification logits and spatial attention maps to provide implicit spatial supervision to the main branch that receives full WLI as input. This dual-objective distillation forces the model to ground its predictions in morphology rather than relying on shortcuts, while still retaining clinically relevant color cues. At inference time, our deployable model operates on images without annotated masks, ensuring real-time deployability . Extensive experiments on a clinical gastric endoscopy dataset show that our method significantly outperforms existing detection-based methodologies (e.g. YOLO) and classification-based methodologies (e.g. Swin-Transformer), providing not only superior classification performance but also interpretable attention maps for clinical reliability.

Chromoendoscopy (CE) is a common clinical practice that sprays indigo carmine blue dye onto the gastric surface to improve the visibility of gastric lesions, such as an early cancer. While CE is effective in detecting the lesions, preparing and spraying the dye needs additional cost and time, which is undesirable both for patients and medical practitioners. To overcome this issue, virtual chromoendoscopy (V-CE) was recently proposed, which applies a learned image translation model to virtually generate a CE image from a standard endoscopy (SE) image. In this paper, we propose virtual enhanced chromoendoscopy (V-ECE) that combines V-CE with image enhancement techniques to further improve the visibility of gastric lesions. Because a desired enhancement level depends on the inspected lesion and the practitioner's preference, we introduce a novel image translation model that can generate V-ECE images using an enhancement level tunable by a user. Experimental results demonstrate that our proposed model can plausibly generate V-ECE images with various enhancement levels using a unified model.

Objective: Radiomic texture features are usually computed in voxel-index neighborhoods, implicitly assuming isotropic spatial relationships. In anisotropic images, this can confound voxel geometry with interpolation-induced signal changes. We developed a voxel-spacing-aware radiomic framework that incorporates physical geometry into texture computation without resampling. Approach: We modified PyRadiomics to account for voxel spacing while preserving the native image signal. Four configurations were compared: native non-resampled extraction (NR), isotropic resampling (RS), voxel-spacing-aware extraction (VS), and fake-isotropic preprocessing (FK), in which spacing metadata were overwritten without altering the image array. Experiments included 685 LIDC-IDRI pulmonary nodules and 209 I-SPY2 breast MRI cases, with 196 radiomic descriptors. Robustness was assessed using ICC, within-subject variability, Friedman testing, feature selection, machine learning, a multilayer perceptron, and external validation. Main results: VS showed near-native agreement with NR: median ICC(A,1) was 0.9976 in CT and 0.9984 in MRI. RS produced lower agreement and larger deviations, while FK showed intermediate behavior, confirming that spacing metadata alone can affect radiomic features. Gradient-derived and neighborhood-sensitive descriptors were most affected by preprocessing. VS preserved predictive performance comparable to NR in external CT validation, whereas MRI showed greater variability across preprocessing strategies and classifiers. Significance: Voxel-spacing-aware extraction separates geometric modeling from interpolation-induced signal modification while preserving the native image signal, offering a coherent alternative to isotropic resampling for radiomic analysis of anisotropic CT and MRI.

Background: Deep learning models can classify thyroid nodules on ultrasound, but reliable clinical decision support also requires calibrated probabilities, uncertainty estimation, and selective referral, particularly under dataset shift. Methods: We developed a calibrated deterministic five-member deep ensemble for ROI-based thyroid nodule classification and selective image-based triage. TN5000 was used for model development, five-fold cross-validation, member-wise vector-scaling calibration, and fold-specific threshold selection. TN3K served as an independent external dataset-shift evaluation. The framework used ConvNeXt-Tiny with squeeze-and-excitation attention, ensemble-mean malignancy probability, and mutual information (MI) as an ensemble-disagreement score. A three-tier policy assigned images to No-FNA suggestion, FNA recommendation, or radiologist review. Results: On pooled out-of-fold TN5000 predictions, the ensemble achieved AUC-ROC 0.9395, AP 0.9715, ECE 0.0088, and Brier score 0.0813. At 50% nominal MI retention, 7.2% of cases received a No-FNA suggestion, 39.9% an FNA recommendation, and 52.9% radiologist review, with 98.3% No-FNA NPV and 99.83% malignancy capture. On TN3K, AUC-ROC decreased to 0.7870, AP to 0.7254, ECE increased to 0.1899, and Brier score to 0.2281. The frozen TN5000 policy assigned 83.7% to review, 1.0% to No-FNA, and 15.3% to FNA recommendation. No malignant image entered the No-FNA pathway, but FNA-recommendation PPV fell to 76.6%. Conclusion: The framework showed strong internal discrimination and calibration, but limited external threshold transportability. Selective prediction may help identify images unsuitable for automated triage, but local recalibration, threshold validation, and prospective clinical evaluation are required before deployment.

Breast ultrasound is widely used for screening, yet automated analysis remains challenging due to speckle noise, acquisition variability, and weak separation of benign and malignant cases in standard ultrasound imaging. Graph convolutional networks (GCNs) have recently emerged as a promising approach by leveraging relationships among similar patient samples. However, it remains unclear how the choice of image encoder influences graph construction and downstream classification performance. In this work, we systematically evaluate five image encoders spanning convolutional and transformer-based architectures for GCN-based breast ultrasound classification. Image embeddings are used to construct cosine similarity k-nearest-neighbor graphs, which are classified using a single-layer GCN with a linear classification head. Across three patientwise cross-validation folds, higher-capacity encoders consistently improve graph homophily and downstream classification performance, yielding gains in accuracy, AUC, sensitivity, specificity, and F1-score. Moreover, test-set graph homophily exhibits a strong linear correlation with classification accuracy, with higher-capacity encoders consistently occupying the high-homophily, high-accuracy region suggesting that encoder-driven improvements in graph structure are a key mechanism underlying the observed performance gains. These findings establish encoder selection as a critical factor in graph-based breast ultrasound classification and identify graph homophily as a key indicator linking representation quality to downstream classification performance.

Diffusion-weighted imaging (DWI) is acquired as part of bi-parametric prostate MRI, but suffers from artifacts that degrade downstream quantitative and diagnostic performance. While DWI preprocessing is standard in brain imaging, its adoption in prostate imaging remains limited and lacks standardized pipelines. This study investigated the effect of different DWI preprocessing strategies on apparent diffusion coefficient (ADC) estimation and automatic Prostate Imaging Reporting and Data System (PI-RADS) classification. 268 cases were derived from the fastMRI prostate cohort by sequentially applying denoising, Gibbs-ringing correction, and diffeomorphic registration for susceptibility distortion correction. ADC maps were compared using linear least squares (LLS) and iteratively-weighted LLS (IWLLS). A 3-class DenseNet classifier was trained to predict PI-RADS scores from multi-channel MRI inputs. ADC analysis revealed statistically significant differences across preprocessing pipelines, with LLS and IWLLS producing numerically equivalent maps. Linear relationships between ADC values were preserved across most datasets (PCC ~0.99), while distortion correction realigned DWI to T2w anatomy and altered ADC values accordingly (PCC ~0.90). Classification showed the best AUROC and sensitivity for high-risk PI-RADS classes in the fully processed dataset. False-negative analysis revealed this dataset produced the least overconfident incorrect predictions on high-risk classes, which is a desirable property for clinical triage. DWI preprocessing, particularly distortion correction, enhances both ADC map quality and the predictive power of deep learning models for PI-RADS classification, supporting the need for optimized preprocessing pipelines in prostate MRI.

Accurate breast cancer risk prediction from screening mammography is critical for enabling personalized screening intervals and early detection. Recent deep learning methods have shown the value of longitudinal data and explicit temporal alignment. However, existing approaches either perform explicit alignment using a single mammographic view or model multiple views without explicit longitudinal alignment, limiting their ability to exploit the complementary spatial-temporal information used in clinical practice. To address this gap, we propose LMV-Net, a longitudinal multi-view breast cancer risk prediction model that jointly analyzes anatomically complementary CC and MLO views within an explicitly aligned longitudinal framework. We evaluate our approach on the public EMBED and CSAW-CC datasets, comparing it to state-of-the-art breast cancer risk prediction methods. Our model consistently outperforms existing approaches in overall risk prediction performance and across different breast density and cancer subgroups. Importantly, these improvements highlight the potential of longitudinal multi-view modeling to enhance risk stratification, paving the way for future work on personalized screening, earlier identification of high-risk patients, and more efficient screening resource allocation. The code is available at https://github.com/sot176/LMV-Net.

Foundation models are increasingly used as image feature extractors for mammography, but their robustness under external domain shift remains unclear. We benchmark 15 foundation-model backbones across breast density, BI-RADS severity, and cancer status using a unified frozen-backbone linear-probe protocol, training on 3 source datasets and evaluating on 12 task-compatible out-of-distribution (OOD) datasets after label harmonization. Mammography-specific vision-language models (Mammo-FM and MaMA) provide the strongest mean OOD performance, but robustness is not explained by mammography exposure alone. DINOv3 remains a competitive vision-only baseline, and mammography-adapted pretraining does not consistently improve generalization. Dataset-level analysis further shows that even leading models show heterogeneous performance across datasets. Feature-space inspection reveals that useful representations can preserve clinical signal while retaining dataset and acquisition structure. These findings highlight dataset-level OOD evaluation as a central criterion for assessing mammography representations. Our code is publicly available: https://github.com/biomedia-mira/mammo-ood.

Accurate cervical cytology image classification is a key component of automated cervical cancer screening, where reliable recognition of normal, precancerous, and cancer-associated cellular patterns from Pap smear images can improve screening efficiency and diagnostic consistency. However, this task remains challenging because cervical cells exhibit complex morphology, subtle intra-class variations, and strong inter-class similarities. Existing convolution-based models capture local texture well but have limited ability to model long-range relationships, whereas attention-based models provide broader context but often lack explicit structural guidance. To address these limitations, we propose a geometry-aware classification framework for cervical cancer screening-oriented cytology image analysis, incorporating semantic abstraction and structural priors learned from pre-trained vision-language features. The method uses Gaussian expert modules to generate axis-wise priors from global semantic information, capturing structural regularities such as nuclear alignment and cellular spatial organization. These priors are embedded into an axial self-attention module to modulate similarity computation along horizontal and vertical directions, improving long-range dependency modeling and structure-sensitive feature interaction. Experiments on the Mendeley liquid-based cytology and SIPaKMeD datasets show that the proposed method achieves 99.48% accuracy on the former and 96.08% on the latter, with balanced gains in recall, precision, and overall classification performance. Visual analysis further shows that the learned priors highlight diagnostically relevant cellular regions, demonstrating the potential of the proposed framework as a screening-oriented decision-support tool for cervical cytology.

Breast cancer remains the most commonly diagnosed malignancy among women worldwide, yet accurate detection and characterization of breast masses in mammography remain challenging due to subtle intensity variations, heterogeneous tissue densities, and indistinct lesion boundaries that complicate radiological interpretation. To address these limitations, we propose BiLoG-Net, a deep learning framework that jointly performs breast mass segmentation and malignancy classification through bi-context location-aware feature modeling and segmentation-guided attention mechanisms. Our architecture integrates a novel encoder-decoder paradigm with Fire-based feature extraction, lightweight global and local feature enhancement modules, and adaptive location-aware gating to simultaneously capture long-range contextual dependencies and fine-grained boundary-sensitive details. Unlike conventional multi-stage pipelines, our tightly coupled multi-task design enables mutual reinforcement between pixel-level localization and image-level diagnosis, reducing error propagation while producing spatially grounded malignancy predictions. Evaluated on CBIS-DDSM and INBreast benchmarks, BiLoG-Net achieves state-of-the-art performance with Dice scores of 94.20% and 93.10%, classification accuracies of 95.20% and 93.60%, and AUC values of 97.10% and 96.00%, respectively, substantially outperforming existing CNN and transformer-based baselines. By combining precise boundary delineation with reliable malignancy assessment in a single end-to-end model, this work holds strong potential for clinical computer-aided detection systems, helping radiologists prioritize suspicious cases and improve screening efficiency in busy clinical settings.

Cervical cytology classification models are typically evaluated on curated, class-balanced benchmarks, but real-world liquid-based cytology (LBC) collections are often small and class-imbalanced. This paper presents a class-imbalance-aware and calibration-aware ensemble classification study on the Mendeley LBC dataset, using its native four-class Bethesda taxonomy (NILM, LSIL, HSIL, SCC) rather than a collapsed binary formulation. Three lightweight architectures (Swin-Tiny, TinyViT-5M, DenseNet121) are trained directly on Mendeley LBC using weighted random sampling to counteract class imbalance, and compared against two soft-voting ensembles (Hybrid-2, Hybrid-3). Post-hoc temperature scaling is fit on a held-out calibration subset carved out of the training portion of each cross-validation fold, distinct from both the training data used to fit model weights and the evaluation fold used for final metrics, avoiding the optimistic calibration estimates that result when the same data is used for both purposes. Calibration substantially reduces expected calibration error, Brier score, and negative log-likelihood for every model and ensemble configuration tested, while discrimination metrics (accuracy, macro-F1, macro-AUROC) remain essentially unchanged. Ensemble size shows no consistent additional reliability benefit over the best individual model once all configurations are properly calibrated. Confusion matrices show that all classification errors, across every configuration, are confined to the boundary between high-grade lesions (HSIL) and carcinoma (SCC); no errors involve the negative (NILM) or low-grade (LSIL) categories. These results suggest that, for this dataset, calibration is the dominant lever for reliability, not ensemble size, though this conclusion should be read in light of the dataset's modest size.

Hepatocellular carcinoma (HCC) is a common malignancy and a leading cause of cancer-related mortality. Current guidelines and staging systems provide coarse categories, but often miss within-stage heterogeneity and the clinical context in electronic medical records (EMRs). We present HCC-STAR (Hepatocellular Carcinoma Staging, Treatment And pRognosis), a clinically aligned large language model that reads routine EMR narratives and jointly outputs risk score-based staging, ranked guideline-consistent treatments with evidence-based rationales, and individualized survival estimates. We curated about 30,000 HCC cases from SEER and expanded them into EMR-style narrative training data using a clinician-validated, prompt-based augmentation workflow. On this corpus, we developed a knowledge-aligned reasoning framework optimized with a step-verifiable composite reward, moving beyond text-level memorization of clinical guidelines. In a multi-center cohort of 6,668 patients from 12 hospitals in China, HCC-STAR achieved state-of-the-art performance in treatment recommendation and risk stratification compared with clinical guidelines and competitive models, including GPT-5 and Gemini-2.5 Pro. Hypothetical overall-survival analysis showed a median survival of 51 months under adherence to HCC-STAR recommendations, compared with 29 and 32 months under BCLC and CNLC. In clinician-centric evaluations, blinded hepatobiliary specialists rated HCC-STAR's reasoning and evidence-based justifications as trustworthy. The model surpassed resident and attending physicians in treatment accuracy and helped physicians make more accurate decisions faster when used as an assistant. These findings support HCC-STAR as a reliable and verifiable decision-support system for risk stratification and precision therapy in HCC.

Accurate prognosis prediction is important for treatment planning in lung cancer, but deep learning-driven survival modelling is often limited by the scarcity of curated imaging cohorts with reliable outcome data. This study evaluates whether representations from a domain-specific foundation model can be used for multimodal survival prediction in data-constrained clinical settings. We assess the foundation model CT-CLIP as a feature extractor for pretreatment computed tomography images and clinical variables from 242 diagnosed lung cancer patients. The evaluation includes adaptation strategies based on frozen encoders, full fine-tuning, and low-rank adaptation, together with modality ablations and comparisons with clinical and multimodal baselines. The results show that a frozen CT-CLIP model combined with a trainable lightweight survival head outperforms the clinical baseline and achieves comparable or improved performance relative to other multimodal approaches, and separates patients into clinically meaningful high- and low-risk groups.

Radiomic features derived from medical images and segmentation masks are used to support decision making in clinical imaging pipelines. In practice, these features are often computed from predicted masks, but segmentation models can be overconfident or poorly calibrated, making derived measurements appear more reliable than they are. Conformal prediction (CP) provides distribution-free prediction intervals with finite-sample marginal coverage guarantees, but black-box intervals for segmentation-derived radiomics can be inefficient because they ignore test-time information about image appearance, mask geometry, and segmentation uncertainty. We propose ConRad, a conformal framework for scalar radiomic targets that uses covariates derived from the predicted mask, input image, predicted radiomics, and boundary uncertainty to construct adaptive intervals while maintaining coverage. Across five 2D medical imaging datasets and 171 retained radiomic targets, we show that ConRad improves feature-level efficiency compared to baselines while maintaining near-nominal empirical coverage. Ablation results further indicate that segmentation boundary uncertainty features are the largest contributors to interval efficiency.

Artificial intelligence (AI) analysis of micro-ultrasound ($μ$US) has shown promise for prostate cancer (PCa) detection. However, most existing AI methods focus on the analysis of single $μ$US images in isolation. By contrast, expert $μ$US readers typically assess a full recorded video study, which provides three-dimensional context, to improve PCa detection compared to single-frame analysis. Inspired by this clinical workflow, we propose Compass, a novel AI methodology which models a $μ$US study as a stream of 2D images. Compass jointly integrates rotational sweep videos of the prostate with $μ$US frames acquired at the moment of biopsy, and performs evidence aggregation across the study using a transformer conditioned on the probe's rotational angle. Finally, a decoder head predicts frame-level and study-level risk scores for the patient. The model is trained and evaluated using a multi-center clinical trial dataset of $μ$US studies, including continuous rotational scans of the prostate and videos captured during biopsy acquisition. We compare the proposed method to baseline AI methods from the literature and to risk scores provided by clinical experts. Our framework shows strong performance, highlighting the value of multi-view context for $μ$US PCa detection, and providing a potentially powerful tool to complement human expertise in $μ$US-based PCa diagnosis. Our code is available at: https://github.com/mharmanani/Compass.

Deep learning-based computer-aided diagnosis (CAD) systems have shown strong performance in breast cancer diagnosis, particularly for classification tasks in mammography. However, domain shifts across multi-site datasets remain a challenge, especially when models are applied to unseen domains. In this work, we proposed a calcification classification framework to improve malignant versus benign breast disease classification across multi-site mammography datasets. The framework consisted of two components: (1) an unsupervised domain adaptation module based on style transfer models (AdaIN and CycleGAN) to generate vendor-specific and technique-specific training samples without additional annotations, and (2) a supervised classification module using Swin Transformer V2 as the backbone. We evaluated the proposed method on three datasets: cross-validation on OPTIMAM (National Health Service, United Kingdom; n=2994), followed by external validation on EMBED (Emory University; n=125), and Duke Calcification Dataset v1 (n=788). These datasets cover multiple vendors and include both full-field digital mammography and synthetic 2D images derived from digital breast tomosynthesis. The proposed framework improved cross-site performance for both EMBED (AUC 0.68 to 0.72) and the Duke Calcification Dataset (AUC 0.68 to 0.73). These findings indicate that domain adaptation can reduce domain shifts and improve the generalization for calcification classification across multi-site datasets.

Data from Singapore indicated that about 31% of the population had evidence of Helicobacter pylori infection. Persistent H. pylori infection is associated with chronic active gastritis and peptic ulcer disease, and its eradication is key to gastric cancer prevention. However, evidence supporting \textit{H. pylori} positivity and H. pylori-associated gastritis may be distributed across heterogeneous coded and free-text report fields and may require contextual interpretation of assertion and negation, limiting keyword search, and making manual review difficult to scale. We conducted a retrospective pilot evaluation of the Nimblemind Multi-Agent System (nMAS), a field-name-driven, evidence-linked extraction workflow, using 54 de-identified gastric biopsy pathology reports from a large healthcare system in Singapore. Four clinician-scoped binary fields were evaluated: gastric/stomach biopsy, biopsy status, H. pylori positivity, and H. pylori-associated gastritis. Across 216 feature-case decisions, nMAS correctly classified 213, corresponding to 98.61% overall accuracy. A separately implemented UMA-style MiniMax M2.5 comparator produced similar aggregate and per-field classification metrics. Although predictive performance was similar, nMAS maintained unified report-level outputs with supporting source sentences; the demonstrated contribution is therefore workflow integration and traceability rather than predictive superiority. Under an illustrative, unmeasured scenario, reviewing 1,000 reports at five minutes per manual review versus five seconds per evidence-linked verification would reduce review time from 83.3 to 1.4 staff-hours, corresponding to 81.9 staff-hours and about USD~6,100 in potential staff-time value. Larger multi-institutional studies should evaluate evidence-span correctness, clinician verification time, and generalizability.

Accurate breast cancer classification from mammography requires effective integration of complementary information from craniocaudal (CC) and mediolateral oblique (MLO) views, which provide a more complete characterization of breast abnormalities. However, existing multi-view learning approaches typically rely on feature-level aggregation or single-stage cross-attention, which can entangle view-specific and shared representations and restrict interaction to limited network depths. To address these limitations, we propose a token-centric dual-view learning framework that unifies prompt-based adaptation and cross-view fusion within a frozen vision transformer backbone. The framework reformulates inter-view interaction as structured token-level communication, where dedicated fusion tokens explicitly encode bidirectional information exchange between CC and MLO views via cross-attention, serving as intermediate carriers of cross-view dependencies rather than relying on direct feature fusion. Unlike conventional methods that apply fusion at a single layer, fusion modules are inserted at multiple transformer depths, enabling progressive and repeated interaction across the encoder hierarchy. Fusion tokens are reintegrated into the token sequence and refined by subsequent transformer layers, facilitating hierarchical propagation of complementary information while preserving view-specific structure. Experiments on VinDr-Mammo and CMMD datasets demonstrate consistent improvements over linear probing, prompt-only adaptation, and conventional fusion baselines. On the VinDr-Mammo BI-RADS classification task, the framework achieves 50.40% F1-score and 0.8090 AUC, including a 0.10 AUC improvement over a dual-view fusion baseline in the binary setting. Ablation studies further validate the effectiveness of token-based fusion and multi-depth interaction design.

Whole-body fluorodeoxyglucose positron emission tomography combined with computed tomography is widely used in cancer care, but manual lesion delineation is slow, subjective, and difficult to scale. We present GLOW-FDG, an open-source artificial intelligence model for whole-body cancer lesion segmentation in fluorodeoxyglucose positron emission tomography and computed tomography. The model was trained on 1,563 scans spanning multiple cancer types and evaluated on 185 external scans from independent institutions. Across breast cancer, nonmetastatic and oligometastatic lung cancer, head and neck cancer, and metastatic melanoma, GLOW-FDG consistently outperformed publicly available benchmark models in lesion detection, while reducing false positives and maintaining strong segmentation accuracy. Quantification of total tumor burden and total lesion glycolysis was robust across cohorts, and performance approached the variability observed between expert radiation oncologists. These results support GLOW-FDG as a generalizable tool for automated cancer segmentation and quantitative imaging biomarker extraction in whole-body imaging.

Sparse feature selection is critical for high-dimensional machine learning, yet traditional $\ell_1$-regularized methods are often brittle under observational noise and spurious correlations, leading to unstable feature supports and degraded generalization. Although adversarial training has been widely used to improve model robustness, its interaction with hierarchical sparse feature selection remains underexplored. In this work, we propose Adversarial LassoNet (AdLNet), a stability-driven sparse feature selection framework that integrates input-space adversarial perturbations with the hierarchical sparsity mechanism of LassoNet. We derive a tractable first-order adversarial approximation under local smoothness assumptions and provide an NTK-inspired spectral analysis to characterize how perturbation-driven training can reduce gradient concentration. Experiments on high-dimensional SERS data, six public benchmark datasets, and ColoredMNIST show that AdLNet maintains competitive sparse-selection performance while improving out-of-distribution robustness by 4.4% and feature support reproducibility by 6.3% under nearly matched support sparsity on ColoredMNIST. On the high-dimensional lung cancer screening dataset, AdLNet achieves a 5.3% test accuracy gain and a 6.0% AUC improvement over vanilla LassoNet. Code and dataset are available at https://github.com/719573/Adversarial-LassoNet.

Imaging signatures are quantitative features extracted from medical images that provide clinically meaningful information for tumor diagnosis, characterization, prognosis, and treatment planning. Although deep learning has shown great potential for imaging signature discovery, its limited interpretability remains a major barrier to clinical adoption. Existing approaches often achieve high predictive performance but provide little biological insight into the identified signatures. We propose a unified framework for interpretable imaging signature discovery by integrating deep learning based segmentation, explainable classification, and radiomic analysis. A robust segmentation model is first used to accurately delineate tumors, followed by a Grad-CAM guided pipeline that identifies diagnostically important regions as candidate imaging signatures. A mutual information based adaptive thresholding strategy enables patient-specific signature extraction. The resulting signatures are validated using a downstream deep learning classification model, while radiomic features extracted from the signature regions are evaluated with traditional machine learning models and interpreted using SHAP to identify the most discriminative biomarkers. The proposed framework is evaluated on the public BUSI breast ultrasound, KiTS renal CT, and BraTS brain tumor datasets, as well as a private UF Health renal CT cohort. Compared with conventional whole-tumor radiomics, the proposed signature-based approach achieves improved discriminative performance while providing greater biological interpretability. By converting deep learning attention into reproducible quantitative imaging biomarkers, this framework offers an interpretable and reproducible solution for non-invasive tumor characterization and imaging biomarker discovery.

Modernizing cancer registries with deep learning is opening new opportunities to automate labor-intensive tasks such as the coding of pathology reports. However, progress is constrained by the scarcity of report-level human-annotated training data. Cancer registries generate substantial volumes of expert-assigned labels as a routine product of their operations, but these exist at the patient level and are not linked to the individual pathology reports that informed them, limiting their direct use for training models. We develop an efficient framework for training deep learning classifiers by leveraging these operationally-generated labels without requiring per-report human annotation, demonstrated for tumor group classification at the BC Cancer Registry. We use Attention-Based Multiple Instance Learning (ABMIL) to recover the lost link between patient-level labels and the reports that informed them, leveraging the attention the model places on each report to distil a large, noisily-labeled corpus into a compact, high-quality per-report training dataset. A classifier fine-tuned on a distilled dataset achieved a macro F1 of 0.83, outperforming established baselines across most tumor groups. By turning routine operational labels into high-quality training data without additional annotation or large-scale computing infrastructure, ABMIL offers a practical and accessible route to automating cancer registry workflows.

This study aims to predict Tumor, Node, and Metastasis (TNM) stage labels independently, with the Cancer Genome Atlas (TCGA) pathology report as the sixth shared task of SMM4H-HeaRD 2026. The problem is framed as three multi-label classification tasks. We explore both classical and deep learning approaches using Term Frequency-Inverse Document Frequency (TF-IDF) features and embeddings from ClinicalBERT, BioBERT, and PubMedBERT. These representations are used with Logistic Regression (LR), Light Gradient Boosting Machine (LightGBM), Feed-Forward Neural Networks (FFNN), and Wide Residual Networks (WRN). Our results show that individual embeddings perform similarly to the TNM label classification, while their combination improves its predictive ability. WRN achieves AUROC scores of 0.839 (T), 0.8502 (N), and 0.803 (M) with F1-scores of 0.622, 0.702, and 0.9337, respectively, for the training phase. LightGBM with TF-IDF performs best with AUROC scores of 0.9368 (T), 0.9524 (N), and 0.8311 (M) and F1-scores of 0.7559 (T), 0.7384 (N), and 0.7017 (M) during the training phase. Furthermore, the result of the Codabench for the test sets indicates a Macro-F1 score of 0.978, 0.957, and 0.879 for the T, N, and M categories respectively for test set 1; while test set 2 records a Macro-F1 score for T, N, and M is 0.807, 0.767, 1.0 respectively. However, performance declined during the evaluation phase of the test sets, a drop from 0.938 to 0.858 of test set 1 to 2, for the Macro-F1 score across all stages; suggesting limitations in model generalizability, sensitivity to class imbalance, and challenges in processing lengthy clinical documents. Although this study provides an efficient baseline model and a reproducible pipeline, further optimization and validation are required before it can be considered suitable for use in a real-world clinical setting.

Deep learning has achieved remarkable performance in medical image segmentation, yet it suffers from critical limitations: mathematical intractability, substantial parameter requirements, and lack of clinical interpretability. We propose RadiomicNet, a novel two-stream hybrid architecture that enhances standard deep learning by integrating handcrafted radiomics features directly into the segmentation learning process. The key contribution is the Radiomics Attention Gate (RAG), which leverages Gray-Level Co-occurrence Matrix (GLCM) and Local Binary Pattern (LBP) features to modulate skip-connection attention in a lightweight MobileNetV2-based encoder-decoder, providing ante-hoc interpretability without post-hoc approximations. A novel Radiomics Consistency Loss further enforces alignment between texture complexity and prediction uncertainty, reducing Expected Calibration Error (ECE) from 0.142 to 0.118. RadiomicNet achieves a Dice Similarity Coefficient (DSC) of 0.763 +/- 0.231 on the Breast Ultrasound Images (BUSI) dataset and 0.854 +/- 0.112 on Kvasir-SEG, outperforming U-KAN by 1.2% and 1.8%, respectively (p < 0.05, Wilcoxon signed-rank test), with only 3.27M parameters, 9.5x fewer than standard U-Net and 4.3x fewer than U-KAN. Gradient-based feature importance analysis reveals that GLCM dissimilarity (15.24%), GLCM energy (14.56%), and LBP entropy (11.49%) are the dominant radiomics cues, providing clinically meaningful explanations for segmentation decisions. The proposed approach demonstrates that compact, interpretable models grounded in domain knowledge can deliver state-of-the-art segmentation performance with substantially reduced computational overhead.

Breast fibroadenoma (FA) and phyllodes tumor (PT) are fibroepithelial breast lesions with highly overlapping appearances on B-mode ultrasound, making benign and borderline PT prone to being misclassified as FA and complicating preoperative decision-making. Existing computer-aided diagnosis methods commonly rely on single-modal imaging features and insufficiently exploit complementary clinical and textual information. To address this limitation, we construct the FAPT-M Dataset, a pathology-confirmed multimodal dataset comprising 910 patients with strictly reviewed ultrasound images, structured clinical attributes, and ultrasound diagnostic descriptions. Based on this dataset, we propose a clinically guided multimodal framework that integrates DenseNet-based visual encoding, CLIP-inspired text encoding, and lightweight clinical encoding, and further introduces clinical-conditioned adaptive modulation, cross-modal Transformer fusion, and dual-path representation learning to improve feature alignment and multimodal interaction. Under patient-level five-fold cross-validation, the proposed method achieves an accuracy of 77.64%, F1-score of 73.38%, and AUC of 89.74%, outperforming representative CNN-, Transformer-, and vision-language-based baselines. Ablation studies and class-balanced evaluations further confirm the contribution of three-modality fusion and the key architectural components. Overall, this work provides an effective multimodal approach for fine-grained FA-PT classification and establishes a high-quality benchmark for multimodal breast ultrasound analysis.

NA methylation profiling has become a powerful approach for central nervous system (CNS) tumor classification, yet important challenges remain regarding cross-cohort transferability, methodological correctness, and robust multiclass evaluation. In this work, we propose a novel and methodologically rigorous machine-learning approach for methylation-based CNS tumor classification that combines Sparse Random Projection for dimensionality reduction with multinomial logistic regression for classification. We evaluate the proposed approach in the same general experimental setting established by a widely used reference classifier. On the 2,801-sample reference cohort, our method achieves a mean accuracy of 96% under stratified 3-fold cross-validation. On the independent 1,104-sample clinical evaluation cohort, it reaches 86% accuracy at the 91-class level and 93% when predictions are evaluated at the methylation class family level. These results improve upon the corresponding state-of-the-art reference figures of 82% class-level concordance and 88% family-level concordance, yielding absolute gains of approximately 4 and 5 percentage points, respectively. This improvement is clinically relevant: in a diagnostic setting, a 5-point increase in correct tumor classification can directly affect cancer subtype assignment and, in turn, influence treatment selection and downstream clinical decision-making. Our results show that the proposed model, grounded in stronger methodological practice in machine learning, consistently outperforms the previous state of the art across evaluation settings and can materially improve the reliability of CNS tumor classification.

Radiomics is the established approach for CT-based lung cancer phenotyping, yet comparisons with foundation models rarely isolate contributions of feature extractor, classification head, and segmentation choice, or test cross-cohort robustness. We benchmark five feature extractors (Curia, Curia-2, DINOv3, Radiomics2D, Radiomics3D), seven classification heads (TabPFN, TabICL, XGBoost, CatBoost, Random Forest, logistic regression, Ridge), and three segmentation regimes on five tasks: tumor volume and stage classification, 2-year survival prediction, histology classification, and age prediction. Models are trained on LUNG1 (n=338) and evaluated on an internal test set (n=84) and the external LUNG2 cohort (n=211), with worst-case cross-cohort performance as the primary metric. The dominant design factor is task-dependent: segmentation drives volume and stage classification, while classifier choice drives survival, histology, and age prediction. Radiomics is competitive for tumor volume, tumor stage and survival (partly due to label-derivation effects for the former); Curia variants reach comparable peak scores for survival; DINOv3 falls slightly short across tasks. Patch and slice aggregation have negligible impact. We recommend Curia with tumor segmentation and a CatBoost head as a safe default, achieving the best mean rank across the three primary clinical tasks, though task-specific selection consistently outperforms any cross-task default. When tumor delineations are unavailable, Curia-2 with lung segmentation and logistic regression offers a competitive alternative. All pipelines use a two-stage design suited to small cohort sizes where end-to-end fine-tuning would risk overfitting.

We present Aegis, a joint-embedding predictive architecture for breast cancer detection and density assessment in mammography. We train three Vision Transformer variants (Small/Base/Large) using self-supervised joint-embedding predictive architecture (JEPA) pre-training on 71,103 studies from 14 clinical sites, followed by supervised fine-tuning with progressive resolution scaling up to 2048x1536. On a curated 785-study test set, our largest model achieves area under the receiver operating characteristic curve (AUC) 0.949 for breast cancer triage with 93% sensitivity and 75% specificity at the optimal operating point. An ensemble combining our model with a U.S. Food and Drug Administration-cleared baseline further improves discrimination to 0.952 AUC. For breast density classification, the model achieves 0.953 AUC for binary (dense vs. non-dense) classification and 62.6% exact accuracy across four Breast Imaging Reporting and Data System (BI-RADS) categories, with 98.8% adjacent accuracy comparable to reported human inter-reader agreement. External validation on the public VinDr-Mammo dataset provides evidence of cross-population transfer under a different reference standard, with the largest model achieving 0.871 AUC for triage in a zero-shot setting.

We present a multi center breast fine needle aspiration cytology (FNAC) dataset designed for patch wise classification using C1 to C5 reporting labels. The prospective dataset includes 321 patients and 470 whole-slide images (WSIs) collected from participating tertiary medical centers in India between May 2023 and March 2026. Slides were stained using Papanicolaou (190 WSIs) or MayGrunwald Giemsa (280 WSIs), scanned on a Hamamatsu NanoZoomer S360 at 40X magnification and 0.25 microns per pixel, and stored directly in NDPI format. Across the 470 WSIs, 446 WSIs contain annotated patch regions, yielding 7,398 PNG image patches with expert-verified C1 to C5 labels. The release includes NDPI WSIs, WSI-level GeoJSON annotation files, extracted patch images, deidentified metadata, a data dictionary, a validation summary, a manifest linking WSIs to Zenodo records, and code for dataset inspection and reuse. The complete dataset is approximately 950 GB and is available through Zenodo.

H&E-stained whole-slide images offer cohort-scale availability and rich spatial context but lack molecular specificity, whereas bulk RNA-seq provides transcriptome-wide resolution at high cost with limited archival availability. We show that training a lightweight alignment module atop frozen histopathology and RNA-Seq foundation models enables open-vocabulary molecular prompting -- querying H&E slides with gene-set signatures to predict pathway activity without sequencing or end-to-end retraining. Using contrastive learning on a multi-cancer cohort (N=1,720), we achieve a 25-fold improvement in retrieval over baseline methods. Systematic analysis reveals a graduated predictability spectrum: morphologically grounded programs (cell-cycle programs, immune-related) are most reliably predicted (R^2>0.5), while predicting pathways with no morphological footprint remains challenging as expected. We validate clinical utility on the POSEIDON clinical trial: H&E-predicted squamous cell carcinoma scores recapitulate NSCLC subtype identity and predicted IFN-gamma mirror PD-L1 tumor-cell expression groups. Furthermore, genesets describing immune activation and fibrosis predict known tumor microenvironment archetypes from histology alone. We further validate generalization of our approach across unseen cohorts and demonstrate data-efficient domain adaptation, establishing a slide-native framework for molecular analysis on H&E images.

Multimodal Large Models have significantly advanced automated breast ultrasound diagnosis. However, most existing frameworks utilize opaque, end-to-end paradigms prioritizing global statistical correlations over structured clinical reasoning. Consequently, these models remain susceptible to shortcut learning amid extreme real-world epidemiological imbalances, often bypassing rare but decisive malignant indicators for dominant benign patterns. To address this disconnect, we propose Latent-CURE, a novel diagnostic framework driven by asymmetric weighted chain-of-thought methodology grounded in latent space reasoning. Unlike traditional approaches, our framework constructs an implicit reasoning trajectory forcing the model to sequentially infer standardized BI-RADS morphological descriptors before converging on a final diagnosis. Furthermore, to combat the extreme scarcity of critical malignant features, we couple this architecture with a dual-asymmetric optimization strategy. By dynamically adjusting margins and weights, this strategy safeguards high-specificity malignant descriptors from being overshadowed by common benign priors. Comprehensive evaluations demonstrate that our knowledge-injected approach provides transparent clinical evidence while achieving robust, accurate diagnostic performance in imbalanced medical cohorts.

Ovarian cancer is frequently diagnosed at an advanced stage, making preoperative contrast-enhanced computed tomography (CT) central to staging and surgical planning; yet the scarcity of annotated imaging data, compounded by privacy regulations, limits the development of generalizable computational models in this domain. Text-conditioned 3D CT synthesis has shown promise, but existing pipelines depend on paired radiology reports and have been evaluated only on chest CT. We propose OvESyn (Ovarian Evidence-based Synthesis), a framework that constructs standardized Findings and Impression sections directly from CT-derived imaging descriptors and routine clinical metadata, without any original radiology report, and uses them to condition a latent diffusion model adapted to 493 high-grade serous ovarian carcinoma patients. This is the first text-conditioned 3D CT synthesis framework adapted to an abdomino-pelvic oncologic setting. A systematic ablation over two adaptation axes, vision-language encoder alignment and generator fine-tuning, identifies generator domain adaptation as the operative mechanism for crossing the domain gap and establishing the target anatomy: without it, synthesis remains anchored to the thoracic pretraining domain, with Precision and Recall collapsing to zero and FID2.5D exceeding 140, regardless of encoder alignment. Encoder alignment instead refines intensity and fine detail. The full OvESyn attains the best distributional and intensity fidelity (FID2.5D 29.35, Precision 0.671, Wasserstein-1 0.044), while the generator-only variant maximizes coverage (Recall 0.645), reflecting a fidelity/coverage trade-off governed by encoder adaptation. Requiring only automatic segmentations and routine preoperative metadata, OvESyn supports transferability to report-scarce settings and provides a foundation for synthetic cohort generation in abdomino-pelvic oncologic imaging.

Predicting distant metastasis from the digital H & E slides of the primary tumor is a critical yet challenging task in computational pathology. Multiple Instance Learning (MIL) approaches can attend to subdomains in whole slide images (WSIs) that harbor features of pre-metastatic cancer regions. However, conventional MIL models largely treat tissue patches as unordered bags, discarding the spatial layout that defines how these regions are arranged and interact across the tissue. We propose that metastatic risk is shaped not only by local patch appearance, but also by the geometric organization of patches in the WSI and the interaction between the tissue compartments. To this end, we introduce Distance-aware Tissue Modeling for Multiple Instance Learning (DTMF-MIL), a spatial MIL framework that reinforces feature embeddings with explicit distance priors. By computing signed distance functions (SDFs) to capture regions with similar features, and representing each patch with radial-basis distance responses and local SDF statistics, DTMF-MIL learns positions of patches with respect to regional interiors and boundaries. The interactions between similar patches are contextualized across local tissue neighborhoods and used to guide slide-level attention while pooling patch feature evidence for metastasis prediction. We evaluate DTMF-MIL for prediction of distant prostate cancer metastasis in an internal prostate needle-biopsy cohort (IPC) from a large hospital system and on public TCGA-COAD and TCGA-KIRC datasets across multiple pathology foundation-model backbones. Across most dataset, backbone, and metric combinations, DTMF-MIL achieves the strongest results consistently.

Multiview mammography relies on paired craniocaudal (CC) and mediolateral oblique (MLO) views to provide complementary projections of a 3D breast volume, enabling precise anomaly localization. However, acquiring high-quality, balanced datasets remains challenging for deep learning applications. We propose a novel method to synthesize multiview mammograms by leveraging the inherent geometric relationship between CC and MLO views. To enforce an implicit 3D consistency prior during generation, we develop an alignment module that searches a 2D affine transformation subspace to establish optimal anatomical correspondence. Leveraging this alignment, we introduce a pixel-space self-consistency loss based on the Earth Mover's Distance (EMD) between the 1D anteroposterior (AP) axis tissue distributions of the generated images. Integrated into a pretrained flow matching model, MammoFlow forces synthesized pairs to share physically plausible tissue distributions from the chest wall to the nipple. To our knowledge, this is the first work to guide multiview mammogram generation using implicit geometric tissue correspondence. Our method demonstrates superior image quality, passes expert radiologist evaluation, and generates physically consistent pairs that improve downstream classification AUC by 5%. Code is available at https://github.com/XYPB/MammoFlow

Early detection of oral cancer markedly improves clinical outcomes, yet specialized diagnostic tools remain scarce in low-resource settings. Smartphone-based screening is a scalable alternative but needs lightweight models that run within edge-hardware constraints. Hybrid classical-quantum architectures are emerging candidates for parameter-efficient learning, yet most rely on qubit hardware that needs cryogenic operation, unsuitable for edge deployment. Continuous-variable (CV) photonic quantum computing, which operates at room temperature, offers a complementary route. We investigate a hybrid classical-CV quantum classifier for oral cancer detection from smartphone images. The pipeline combines a MobileNetV1 feature extractor, principal component analysis to 16 dimensions, and a parameterized CV-QNN of displacement, interferometric, and Kerr gates on a photonic backend. We propose a simplified $Φ\circ D \circ U_1$ CV-QNN architecture that cuts trainable parameters 40-45% relative to the standard CV-QNN layer of Killoran et al. (2019a), and identify dimensionality-reduction and encoding-restriction strategies that mitigate barren plateaus, raising loss-gradient variance by roughly 58 orders of magnitude. Whether the simplified layer beats the full layer is width-dependent: the full layer holds a small but significant edge at two qumodes, whereas the simplified layer is significantly better at four qumodes using 44% fewer parameters. The strongest model, a four-qumode simplified CV-QNN with only 18 parameters, attains the highest validation AUC of all models, exceeds a 55-parameter classical baseline using 67% fewer parameters, and reaches 100% calibrated test accuracy across all seeds. These results support CV photonic quantum machine learning for parameter-efficient, room-temperature medical image classification and motivate progress toward edge quantum AI.

Cross-domain diagnosis remains a major challenge in cervical cell pathology due to pronounced domain shifts across institutions and the subtle visual differences among disease stages, which jointly impair model generalization. To address these issues, this paper proposes a two-stage framework for cross-domain cervical cell detection. In the first stage, we propose the Spatially-Continuous Unpaired Neural Schrödinger Bridge (SC-UNSB), which constructs a synthetic intermediate domain to mitigate cross-domain distribution shifts by modeling image translation as an entropy-regularized optimal transport process. In the second stage, we propose a dual-level feature alignment strategy within a knowledge distillation, which progressively aligns shallow structural features and deep semantic representations to facilitate the transfer of domain-invariant knowledge from the source to the target model. Experimental results demonstrate that the proposed method effectively mitigates domain shift and category ambiguity, improving the cross-domain detection performance.

Accurate assessment of tumor proportion score (TPS) in non-small cell lung cancer (NSCLC) is critical for treatment planning and prognosis. Key challenges include the tedious manual work required to annotate each slide, combined with the limited number of experts certified for this task. Multiple instance learning (MIL) has proven to be an effective approach for predicting TPS scores at the slide level; however, existing methods struggle with non-expressive (zero class) images. Our approach involves two models: (1) an embedding-extraction and multiclass-classification network that captures the histopathological features of individual patches, and (2) a MIL model that aggregates these embeddings to predict zero-inflated beta (ZIBeta) parameters representing the overall TPS probability distribution for the entire slide. Using only slide-level TPS scores as labels, we demonstrate how this end-to-end framework can leverage a novel distribution-based architecture to improve prediction accuracy and explainability. ZIBeta modeling significantly outperforms baseline linear and ridge regression while capturing expected accuracy through distribution concentration.

Single-cell studies require analysts to convert raw measurements into specific biological claims through multi-step workflows and integration of metadata, assay context, and auxiliary evidence. Existing AI-biology benchmarks largely measure broad knowledge, executable workflows, or local analysis steps. We introduce scBench-Long, a benchmark for long-horizon single-cell biology in which agents must recover scientific conclusions from raw or near-raw data without prescribed methods. The benchmark contains 21 evaluations spanning melanoma CD8 T-cell reactivity, CD8 RNA+ATAC regulatory inference, human--monkey chimera development, KRAS-driven lung tumor aging, and lethal COVID-19 lung pathology. Tasks cover paired scRNA/TCR sequencing, RNA and chromatin profiling, cross-species transcriptomics, combinatorial scRNA-seq, single-nucleus RNA-seq, immune repertoires, ortholog maps, ligand--receptor resources, and validation evidence. Candidate claims are reproduced, reviewed, and converted into controlled answer vocabularies with deterministic grading and trajectory rubrics. Across 1,068 completed trajectories, the strongest model--harness pair passes 16/63 runs (25.4%). scBench-Long evaluates whether agents can move beyond local analysis steps and make complex scientific claims that are supported by single-cell data.

Mammogram-based deep learning models have improved breast cancer risk prediction, but the learned imaging patterns remain underexplored. Existing interpretability methods rely on single-image saliency maps, failing to identify recurring mammographic phenotypes across large patient cohorts. By clustering patch embeddings from a pre-trained model, Mirai, we isolate recurring phenotypes linked to 5-year cancer risk. Analyses show risk-increasing phenotypes capture complex structures (e.g., dense tissue, microcalcifications) and shortcut artifacts (e.g., clips). These phenotypes correlate strongly with older age and higher BI-RADS density. Our framework connects tissue patterns to AI risk scores, revealing clinical signatures and potential latent model confounders.

Background: Response to neoadjuvant imatinib in gastrointestinal stromal tumors (GISTs) is highly variable and cannot be reliably predicted using current clinical or molecular markers. This study developed and evaluated an explainable multimodal deep learning framework integrating computed tomography (CT) imaging and clinical variables to predict treatment response. Methods: Patients from four tertiary centers were retrospectively included between 2000-2023 in independent pretraining (n=935) and prediction (n=213) cohorts. A cross-attention framework integrating clinical variables and tumor-centered CT imaging was developed to predict response to neoadjuvant imatinib. Two training strategies were evaluated: (1) self-supervised pretraining with low-rank adaptation and (2) training from scratch. Hyperparameters were optimized using SMAC3. Performance was assessed through internal cross-validation and external testing. Ablation analyses and attention-based explanations were used to quantify modality contributions. Results: Among 213 patients (54.5% responders), responders had larger tumors (112 vs. 89 mm, P=0.026), higher mitotic index (3 vs. 0, P<0.001), and more frequent KIT mutations (69.0% vs. 56.7%, P=0.019). Cross-attention models achieved the highest internal performance (AUC up to 0.99) but lower external performance (AUC 0.60-0.63). Clinical-only performance was moderate (AUC 0.66), whereas imaging-only models showed limited generalizability (AUC 0.56-0.66). Explainability analyses identified significant differences in feature importance between responders and non-responders, including CD117, BRAF, PDGFRA, age, sex, disease status, and comorbidities (FDR-adjusted P<=0.036). Conclusion: The cross-attention framework shows potential for improving imatinib response prediction in GIST while providing interpretable insights into multimodal determinants of treatment response.

Artificial intelligence (AI) has achieved remarkable success in medical imaging, but it is widely recognized that these models often perform inconsistently across real-world clinical settings. Such inconsistencies occur when patient demographics and imaging protocols vary, for example, in detecting small tumors, analyzing scans from different contrast phases, or evaluating patients of different ages or sexes. To quantify these inconsistencies, we develop a large-scale, open benchmark of 85,355 CT scans that systematically evaluates 12 tumor-detection AI models across tumor size, location, patient subgroup, and imaging protocol. We leverage large language models (LLMs) to extract and organize subgroup information from clinical data, which makes the analysis both scalable and reproducible. Our benchmark reveals that current state-of-the-art AI models, optimized for average accuracy, perform poorly in rare or underrepresented subgroups, such as young, female African Americans. However, collecting sufficient annotated data for these rare cases is often impractical. The benchmark provides a foundation for building more reliable and robust AI models for tumor detection and highlighting the need for rigorous, subgroup-level evaluation in medical imaging and computer vision. Datasets, code

Gastrointestinal cancers represent a growing health burden in the South Asian region, driven largely by rapid changes in socio-economic conditions & lifestyle habits. However, early diagnosis of such malignancies remains a significant challenge, largely due to a lack of modern equipment, lack of financial support, and a scarcity of GI experts. AI-assisted diagnosis & report generation, show great promise in alleviating this problem by providing low-skill manpower the technical expertise to perform diagnosis. However, almost all open-source, publicly available datasets are predominantly collected from the European region, with no representation from the South Asian region. The lack of open-source GI datasets from diverse geographic regions has made it difficult to assess whether population bias is present in existing models, and to develop geographically inclusive AI tools for automated GI diagnosis. To address this gap, we introduce SAGE: An Expert-Annotated South Asian GI Endoscopy dataset for image captioning, multi-label classification, and visual question answering (VQA) tasks. It consists of 1,300 images, their captions along with hallucination tag, 18 labels and 14,726 question-answer pairs making it well-suited for diverse range of tasks including classification, benchmarking, and fine-tuning large multimodal models (LMMs). We further conducted benchmarking of multi-class classifiers on the effect of population shift in GI imaging AI tasks, and contemporary LMMs on their performance. Our study reveals that task-specific models, such as multi-class classification models, suffer the most, with an average performance drop of 58% when evaluated on the South Asian dataset. For contemporary LMMs, benchmarking reveals a substantial drop in the average GREEN score for anatomical landmark detection (0.308) and abnormality detection (0.410).

Breast arterial calcification (BAC) on screening mammograms is an emerging cardiovascular risk biomarker, but quantitative use requires reproducible segmentation and expert pixel-level labels are costly. We present BAC-JEPA, a label-efficient segmentation framework trained on procedurally generated arterial calcification inserted into real mammographic backgrounds with exact masks. Candidate backgrounds were selected from model-screened mammograms with low predicted BAC response; the generator samples arterial structure, disease burden, radiographic appearance, and hard-negative distractors including nonarterial calcifications and metallic objects. Synthetic masks are paired with mammography self-supervised Vision Transformer encoders and a high-resolution convolutional decoder to produce full-resolution segmentation maps. The study used 75,472 mammography studies from 34,956 patients for background selection and representation learning, trained on synthetic images from 10,000 backgrounds, selected checkpoints with 1,000 development backgrounds, and evaluated transfer on all 1,000 human-labeled BacSeg synthetic 2D mammograms. On held-out synthetic validation data, the larger backbone achieved IoU 0.5325 and Dice 0.6357. On BacSeg, image-level classification from segmentation probability maps reached AUROC 0.8719, with 0.8547 for the smaller backbone. Four-view inference required 110.68--213.63 ms on an RTX 5090 GPU, and severe-preset synthetic image generation averaged 2.7071 s per image on a multicore workstation. These results indicate that BAC-specific synthetic supervision can produce useful image-level transfer without human pixel-level training masks, while expert-reviewed real-mammogram segmentation remains necessary for clinical validation and calibration.

Risk stratification for advanced colorectal polyps typically relies on colonoscopy and/or pathology findings. However, there is growing interest in whether non-invasive features available prior to colonoscopy can help identify patients at higher risk. Such approaches may enhance clinical decision-making by prioritizing surveillance for individuals most likely to harbor high-risk polyps, when colonoscopy resources are limited while potentially reducing unnecessary procedures in lower-risk patients. Importantly, the use of non-invasive, pre-procedural information may also help promote more equitable access to risk stratification, particularly in settings where colonoscopy resources are limited or unevenly distributed. We aimed to develop and externally validate machine learning models to predict high-risk colorectal polyps using only non-invasive, pre-colonoscopy demographic, clinical, and behavioral features in a diverse, predominantly African American, urban cohort. We conducted a retrospective cohort study using demographic, lifestyle, and comorbidity data from patients who underwent colonoscopy at Howard University Hospital to develop and validate several machine learning models, including neural networks, random forest, support vector machines (SVM), Naive Bayes, logistic regression, decision trees, k-nearest neighbors (KNN), and XGBoost, for predicting high-risk colorectal polyps. High-risk polyps (HRP) were defined as villous or tubullovillous adenomas, high-grade dysplasia, polyps >= 10 mm in size, and/or the presence of >= 3 polyps per procedure; all other cases were classified as low-risk polyps (LRP). The dataset included 4,681 patients from 2015-2022 used for internal validation and 1,562 patients from 2023-2024 used for external validation.

Matched multi-omics can improve WSI-based biomarker and prognosis prediction, but most existing pipelines use omics as a paral lel feature stream or textual context rather than as an explicit retrieval constraint. HERO asks whether observed omics can be a testable mor phology hypothesis: a sparse pathway-to-morphology prior maps DNA methylation and miRNA into a K-dimensional intent vector m (K=16), TF-IDF retrieval over structured 10 captions selects endpoint-relevant regions, and a cosine gate c=cos(m,v) triggers deterministic deficit driven repair when c<τc. This closed-loop design bounds VLM calls, reduces reliance on embedding-based semantic matching, and makes every retrieval and verification step lexically auditable. On TCGA-BRCA (930WSIs, patient-level 5-fold CV), HERO sets new state-of-the-art across ER, PR, HER2, subtype, and risk prediction, outperforming both multimodal fusion and VLM-based baselines.

Mammography is an essential tool for breast cancer detection, with millions of examinations conducted annually. However, publicly available high-quality mammography datasets for AI development remain limited in both scale and annotation richness, particularly regarding pathological subtype coverage and structured diagnostic reasoning annotations. In this paper, we present MammoExpert, the first mammography dataset with Chain-of-Thought reasoning annotations across three diagnostic phases: (i) primal observation, (ii) factual assessment, and (iii) diagnostic synthesis. Comprising 2,379 mammography images covering 67 WHO-classified histopathology subtypes, each exam provides 42 radiographic features annotated by nine senior radiologists. We evaluate its performance on the breast lesion classification task, demonstrating superior accuracy and reasonability compared to existing classification models. Combining public dataset CBIS-DDSM with MammoExpert yields 7.1% classification accuracy improvement, while the training model to learn CoT reasoning achieves another 4% gain on the MammoExpert test set. Similar improvements are observed on INBreast and Vindr datasets, where the full approach yields accuracy gains of 6.9% and 6.7%, respectively. MammoExpert can serve as a benchmark for interpretable breast lesion diagnosis through explicit CoT reasoning.

Gastric intestinal metaplasia (GIM) is a precursor lesion to gastric dysplasia and adenocarcinoma whose early detection is crucial for intervening in the carcinogenesis cascade. Artificial intelligence (AI) holds considerable promise for real-time endoscopic detection and characterization of GIM. However, development of reliable AI models has been constrained by the absence of publicly available, histopathologically validated datasets that combine detailed endoscopic annotations, histological subtype (complete and incomplete), standardized grading systems, and normal mucosal patterns. GIM-ENDO was designed to fill this gap. The dataset comprises demographic data, endoscopic findings, histopathological results, and H. pylori status acquired using the Olympus EVIS X1 system with white-light endoscopy (WLE) and image-enhanced endoscopy (IEE), including narrow-band imaging (NBI) and magnifying NBI (M-NBI), along with images and video clips from 24 patients (22 GIM-positive, 2 normal controls). Annotations cover six primary IEE endoscopic signs -- light blue crest (LBC), marginal turbid band (MTB), white opaque substance (WOS), TV pattern (Fusion), atrophy, and map-like erythema (MLE) -- plus two additional endoscopic findings (AHP and GA) recorded where present. GIM subtypes (complete and incomplete) are annotated for all GIM-positive cases; OLGA and OLGIM staging are provided where complete histological sampling was available. The dataset is publicly accessible at https://doi.org/10.5281/zenodo.20707267. For the latest updates and further information regarding this dataset, readers are referred to the DataBioX website: https://databiox.com A short version of this work has been submitted to MICCAI 2026 Open Data Track.

Cell-free DNA (cfDNA) is a promising avenue for non-invasive multicancer early detection (MCED), in that, it can enable multiple cancer detection simultaneously from a single blood draw, with particular sensitivity to cancers that currently lack established screening programs. Here we review the computational methods developed between 2022 and 2025 for cfDNA-based MCED. We focus on how fragmentomics and epigenetic features are extracted and analyzed to detect cancer at early stages. We first briefly outline the biological basis of cfDNA signals, then review classical statistical and machine learning approaches alongside deep learning frameworks including autoencoder-based models. For each method we discuss biological interpretability, validation strategy, and readiness for clinical integration. Furthermore, we categorize the current challenges into technical, computational, and methodological while outlining open problems in the field. This review shows that multimodal ensemble approaches have the strongest promise for clinical integration and the highest readiness. However, for better assessment of future work and side-by-side comparison, standardization of evaluation protocols and reporting results will be crucial.

Head and neck cancers (HNC) represent a significant global health burden, with accurate tumor delineation being essential for effective radiotherapy planning. The complexity of the oropharyngeal anatomy, combined with the heterogeneous appearance of tumors on imaging, makes manual segmentation time-intensive and subject to inter-observer variability. Beyond segmentation, predicting long-term clinical outcomes, such as recurrence-free survival (RFS), and determining human papillomavirus (HPV) status from noninvasive imaging, remain challenging yet clinically valuable goals. The HECKTOR 2025 challenge addresses these needs by establishing a comprehensive benchmark for automated HNC analysis using multimodal PET/CT imaging and electronic health records. Building on previous editions (2020-2022), this challenge features an expanded multi-institutional dataset comprising over 1,100 patients from 10 centers worldwide. Participants were tasked with three complementary objectives: (1) segmenting primary gross tumor volumes (GTVp) and metastatic lymph nodes (GTVn), (2) predicting recurrence-free survival, and (3) classifying HPV status. The challenge attracted 35 registered teams, with 15 final submissions evaluated on a held-out test set. Top-performing algorithms achieved a mean Dice similarity coefficient of 0.75 for segmentation, a concordance index of 0.66 for survival prediction, and a balanced accuracy of 0.56 for HPV classification. This paper presents a comprehensive analysis of the submitted methodologies, evaluates their performance across different lesion characteristics, and discusses their implications for clinical translation in automated oncology workflows and decision support systems.

This article presents a complementary approach for integrating multimodal medical data in cancer classification, based on state space models represented by the Mamba architecture. To this end, a mixed multimodal fusion architecture, called Mixed Fusion, was employed and developed to enhance the interpretability of the decision-making process. The proposed approach explores two variants of Mamba: one dedicated to visual processing, responsible for classifying the lesion image and generating probabilities associated with the target classes, and another focused on tabular processing, which uses these probabilities together with clinical and/or sociodemographic data to produce the final diagnosis. The experiments were conducted on two medical datasets: PAD-UFES-20, composed of clinical images and information associated with skin lesions, and NDB-UFES, consisting of histopathological images and sociodemographic data related to oral cancer. The results indicate slightly lower performance in balanced accuracy, compared with Transformer-based approaches, on PAD-UFES-20, and superior performance on NDB-UFES. Additionally, substantial gains were observed in the recall metric. Furthermore, the adoption of the Mixed Fusion architecture enables the application of the Shapley Additive Explanations (SHAP) method, increasing the interpretability of the results. These findings indicate that Mamba-based models constitute a suitable alternative for multimodal classification in medical data, especially in scenarios in which sensitivity is a relevant requirement.

Binary data factorization is common, but real-valued methods ignore discreteness and yield hard-to-interpret factors. Boolean Matrix Factorization (BooMF) instead decomposes a binary matrix into two lower-rank binary matrices via logical AND and OR, expressing the data as a Boolean disjunction of interpretable patterns. In cancer genomics, BooMF can reveal coordinated feature changes that may drive tumor evolution, unlike rotational or additive decompositions. Most existing BooMF methods are heuristic, greedy, sensitive to initialization, prone to local optima, and do not support principled model selection or uncertainty quantification. We introduce Bayesian Boolean Matrix Factorization (BBMF), a fully conjugate generative model with sparsity-inducing priors. It enforces Boolean constraints, yields interpretable latent factors with coherent uncertainty quantification, and admits Gibbs sampling with closed-form full conditionals. Because cancer evolution often involves widespread, near-simultaneous chromosome-number changes (e.g., whole-genome duplication followed by instability and selection), Boolean factorizations capture these patterns more naturally than additive models. Applied to arm-level copy-number alteration data in multiple myeloma, where entries indicate presence/absence of chromosomal-arm amplifications, BBMF finds a small set of interpretable bicliques linking patient subsets to recurrently co-altered chromosomal arms, providing a compact, biologically meaningful summary of tumor heterogeneity and demonstrating BBMF's utility for uncovering discrete latent structure in complex binary data.

Label-free, image-based cellular mechanophenotyping in microfluidic devices provides a high-throughput method for single-cell profiling. However, while complex microchannels (e.g., hyperbolic geometries) reveal transient deformation dynamics under continuous extensional stress, the resulting high-dimensional feature spaces are highly susceptible to hydrodynamic artifacts. Flow rate variations often distort discriminative boundaries, linking feature distributions to fluid conditions rather than intrinsic biology. To overcome this, we introduce a stability-guided analytical framework that decouples flow-induced noise from authentic mechanobiological signatures. We tracked the morphodynamic, kinematic, and intracellular optical-density trajectories of healthy and malignant ovarian cells to build a 93-dimensional feature space. Using a cross-flow screening strategy based on structural consistency and statistical persistence, we isolated robust descriptors, creating task-adapted subsets (20 features for binary classification; 25 for cancer subtyping). Variance-attribution analysis confirmed the neutralization of flow-conditioned artifacts; notably, flow-associated variance in the primary principal component fell from 69.9% to 9.3% in the subtyping task. We also found that macroscopic binary discrimination depends on bulk kinematic transitions, while clonal subtyping requires localized intracellular optical heterogeneity. These optimized subsets maintained diagnostic fidelity across multiple machine learning architectures and restricted sampling conditions. This framework establishes a robust, flow-independent foundation for continuous dynamic phenotyping.