Large language models (LLMs) are increasingly used to extract structured information from free-text clinical records, but prior work often focuses on single tasks, limited models, and English-language reports. We evaluated 15 open-weight LLMs on pathology and radiology reports across six use cases, colorectal liver metastases, liver tumours, neurodegenerative diseases, soft-tissue tumours, melanomas, and sarcomas, at three institutes in the Netherlands, UK, and Czech Republic. Models included general-purpose and medical-specialised LLMs of various sizes, and six prompting strategies were compared: zero-shot, one-shot, few-shot, chain-of-thought, self-consistency, and prompt graph. Performance was assessed using task-appropriate metrics, with consensus rank aggregation and linear mixed-effects models quantifying variance. Top-ranked models achieved macro-average scores close to inter-rater agreement across tasks. Small-to-medium general-purpose models performed comparably to large models, while tiny and specialised models performed worse. Prompt graph and few-shot prompting improved performance by ~13%. Task-specific factors, including variable complexity and annotation variability, influenced results more than model size or prompting strategy. These findings show that open-weight LLMs can extract structured data from clinical reports across diseases, languages, and institutions, offering a scalable approach for clinical data curation.

Surgical resection of malignant solid tumors is critically dependent on the surgeon's ability to accurately identify pathological tissue and remove the tumor while preserving surrounding healthy structures. However, building an intraoperative 3D tumor model for subsequent removal faces major challenges due to the lack of high-fidelity tumor reconstruction, difficulties in developing generalized tissue models to handle the inherent complexities of tumor diagnosis, and the natural physical limitations of bimanual operation, physiologic tremor, and fatigue creep during surgery. To overcome these challenges, we introduce "TumorMap", a surgical robotic platform to formulate intraoperative 3D tumor boundaries and achieve autonomous tissue resection using a set of multifunctional lasers. TumorMap integrates a three-laser mechanism (optical coherence tomography, laser-induced endogenous fluorescence, and cutting laser scalpel) combined with deep learning models to achieve fully-automated and noncontact tumor resection. We validated TumorMap in murine osteoscarcoma and soft-tissue sarcoma tumor models, and established a novel histopathological workflow to estimate sensor performance. With submillimeter laser resection accuracy, we demonstrated multimodal sensor-guided autonomous tumor surgery without any human intervention.

Ewing's sarcoma (ES), characterized by a high density of small round blue cells without structural organization, presents a significant health concern, particularly among adolescents aged 10 to 19. Artificial intelligence-based systems for automated analysis of histopathological images are promising to contribute to an accurate diagnosis of ES. In this context, this study explores the feature extraction ability of different pre-training strategies for distinguishing ES from other soft tissue or bone sarcomas with similar morphology in digitized tissue microarrays for the first time, as far as we know. Vision-language supervision (VLS) is compared to fully-supervised ImageNet pre-training within a multiple instance learning paradigm. Our findings indicate a substantial improvement in diagnostic accuracy with the adaption of VLS using an in-domain dataset. Notably, these models not only enhance the accuracy of predicted classes but also drastically reduce the number of trainable parameters and computational costs.

The field of computational pathology has been transformed with recent advances in foundation models that encode histopathology region-of-interests (ROIs) into versatile and transferable feature representations via self-supervised learning (SSL). However, translating these advancements to address complex clinical challenges at the patient and slide level remains constrained by limited clinical data in disease-specific cohorts, especially for rare clinical conditions. We propose TITAN, a multimodal whole slide foundation model pretrained using 335,645 WSIs via visual self-supervised learning and vision-language alignment with corresponding pathology reports and 423,122 synthetic captions generated from a multimodal generative AI copilot for pathology. Without any finetuning or requiring clinical labels, TITAN can extract general-purpose slide representations and generate pathology reports that generalize to resource-limited clinical scenarios such as rare disease retrieval and cancer prognosis. We evaluate TITAN on diverse clinical tasks and find that TITAN outperforms both ROI and slide foundation models across machine learning settings such as linear probing, few-shot and zero-shot classification, rare cancer retrieval and cross-modal retrieval, and pathology report generation.

Mitotic activity is an important feature for grading several cancer types. Counting mitotic figures (MFs) is a time-consuming, laborious task prone to inter-observer variation. Inaccurate recognition of MFs can lead to incorrect grading and hence potential suboptimal treatment. In this study, we propose an artificial intelligence (AI)-aided approach to detect MFs in digitised haematoxylin and eosin-stained whole slide images (WSIs). Advances in this area are hampered by the limited number and types of cancer datasets of MFs. Here we establish the largest pan-cancer dataset of mitotic figures by combining an in-house dataset of soft tissue tumours (STMF) with five open-source mitotic datasets comprising multiple human cancers and canine specimens (ICPR, TUPAC, CCMCT, CMC and MIDOG++). This new dataset identifies 74,620 MFs and 105,538 mitotic-like figures. We then employed a two-stage framework (the Optimised Mitoses Generator Network (OMG-Net) to classify MFs. The framework first deploys the Segment Anything Model (SAM) to automate the contouring of MFs and surrounding objects. An adapted ResNet18 is subsequently trained to classify MFs. OMG-Net reaches an F1-score of 0.84 on pan-cancer MF detection (breast carcinoma, neuroendocrine tumour and melanoma), largely outperforming the previous state-of-the-art MIDOG++ benchmark model on its hold-out testing set (e.g. +16% F1-score on breast cancer detection, p<0.001) thereby providing superior accuracy in detecting MFs on various types of tumours obtained with different scanners.

We propose a prognostic stratum matching framework that addresses the deficiencies of Randomized trial data subgroup analysis and transforms ObservAtional Data to be used as if they were randomized, thus paving the road for precision medicine. Our approach counters the effects of unobserved confounding in observational data by correcting the estimated probabilities of the outcome under a treatment through a novel two-step process. These probabilities are then used to train Optimal Policy Trees (OPTs), which are decision trees that optimally assign treatments to subgroups of patients based on their characteristics. This facilitates the creation of clinically intuitive treatment recommendations. We applied our framework to observational data of patients with gastrointestinal stromal tumors (GIST) and validated the OPTs in an external cohort using the sensitivity and specificity metrics. We show that these recommendations outperformed those of experts in GIST. We further applied the same framework to randomized clinical trial (RCT) data of patients with extremity sarcomas. Remarkably, despite the initial trial results suggesting that all patients should receive treatment, our framework, after addressing imbalances in patient distribution due to the trial's small sample size, identified through the OPTs a subset of patients with unique characteristics who may not require treatment. Again, we successfully validated our recommendations in an external cohort.

Artificial intelligence could be twice as effective at diagnosing rare cancers as biopsies, a study found. British scientists developed a computer algorithm which correctly diagnosed the severity of sarcoma tumours in 82 per cent of cases, compared with 44 per cent of biopsies. Experts said the technique could eventually become standard practice for all cancers - saving thousands of patients from undergoing the invasive procedure every year. Such programmes will also help doctors diagnose subtypes of the disease faster and tailor treatment more effectively, they believe. Researchers used CT scans of 170 patients from the Royal Marsden, London, with sarcoma tumours, an aggressive type of cancer that develops in the body's connective tissues, such as fat, muscle and nerves.

Israeli researchers have developed and tested an innovative artificial intelligence (AI) treatment to eliminate aggressive cancerous tumors, the Rambam Health Care Campus said Wednesday. The new method addresses sarcoma cancer tumors, known for their resistance to chemotherapy treatment, according to the largest hospital in northern Israel. Such tumors cannot be removed by surgery because of their proximity to vital organs, nerves, or blood vessels. To deal with these tumors, Rambam researchers choose radiation treatment with high intensity through a virtual grid, or net, to attack the tumors in a targeted manner. They created the method by using complex calculations of radiation intensity, along with AI to determine the path of radiation.

Identifying causal relationships for a treatment intervention is a fundamental problem in health sciences. Randomized controlled trials (RCTs) are considered the gold standard for identifying causal relationships. However, recent advancements in the theory of causal inference based on the foundations of structural causal models (SCMs) have allowed the identification of causal relationships from observational data, under certain assumptions. Survival analysis provides standard measures, such as the hazard ratio, to quantify the effects of an intervention. While hazard ratios are widely used in clinical and epidemiological studies for RCTs, a principled approach does not exist to compute hazard ratios for observational studies with SCMs. In this work, we review existing approaches to compute hazard ratios as well as their causal interpretation, if it exists. We also propose a novel approach to compute hazard ratios from observational studies using backdoor adjustment through SCMs and do-calculus. Finally, we evaluate the approach using experimental data for Ewing's sarcoma.

After watching his 13-year-old daughter go through a gruelling year of cancer treatment Dom Raban realised more could be done to help children feel at ease in hospital. Now his app, Xploro, has been trialled at The Christie NHS Foundation Trust and Royal Manchester Children's Hospital, with further plans to expand it across the NHS. The app provides an interactive experience for young patients receiving hospital treatment, allowing them to interact with a personally designed avatar that can explain treatments, machines that will be used and answer any questions they have about their hospital stay. With more than 10 years experience as the managing director of an interactive design company, Raban set about looking at digital solutions that would provide important information about care and treatment to young patients. His daughter, Issy, was diagnosed with Ewing's sarcoma in 2011.