Prostate cancer is a major cause of cancer-related deaths in men, where early detection greatly improves survival rates. Although MRI-TRUS fusion biopsy offers superior accuracy by combining MRI's detailed visualization with TRUS's real-time guidance, it is a complex and time-intensive procedure that relies heavily on manual annotations, leading to potential errors. To address these challenges, we propose a fully automatic MRI-TRUS fusion-based segmentation method that identifies prostate tumors directly in TRUS images without requiring manual annotations. Unlike traditional multimodal fusion approaches that rely on naive data concatenation, our method integrates a registration-segmentation framework to align and leverage spatial information between MRI and TRUS modalities. This alignment enhances segmentation accuracy and reduces reliance on manual effort. Our approach was validated on a dataset of 1,747 patients from Stanford Hospital, achieving an average Dice coefficient of 0.212, outperforming TRUS-only (0.117) and naive MRI-TRUS fusion (0.132) methods, with significant improvements (p $<$ 0.01). This framework demonstrates the potential for reducing the complexity of prostate cancer diagnosis and provides a flexible architecture applicable to other multimodal medical imaging tasks.

Pre-biopsy magnetic resonance imaging (MRI) is increasingly used to target suspicious prostate lesions. This has led to artificial intelligence (AI) applications improving MRI-based detection of clinically significant prostate cancer (CsPCa). However, MRI-detected lesions must still be mapped to transrectal ultrasound (TRUS) images during biopsy, which results in missing CsPCa. This study systematically evaluates a multimodal AI framework integrating MRI and TRUS image sequences to enhance CsPCa identification. The study included 3110 patients from three cohorts across two institutions who underwent prostate biopsy. The proposed framework, based on the 3D UNet architecture, was evaluated on 1700 test cases, comparing performance to unimodal AI models that use either MRI or TRUS alone. Additionally, the proposed model was compared to radiologists in a cohort of 110 patients. The multimodal AI approach achieved superior sensitivity (80%) and Lesion Dice (42%) compared to unimodal MRI (73%, 30%) and TRUS models (49%, 27%). Compared to radiologists, the multimodal model showed higher specificity (88% vs. 78%) and Lesion Dice (38% vs. 33%), with equivalent sensitivity (79%). Our findings demonstrate the potential of multimodal AI to improve CsPCa lesion targeting during biopsy and treatment planning, surpassing current unimodal models and radiologists; ultimately improving outcomes for prostate cancer patients.

We detail the training of the LLM360 K2-65B model, scaling up our 360-degree OPEN SOURCE approach to the largest and most powerful models under project LLM360. While open-source LLMs continue to advance, the answer to "How are the largest LLMs trained?" remains unclear within the community. The implementation details for such high-capacity models are often protected due to business considerations associated with their high cost. This lack of transparency prevents LLM researchers from leveraging valuable insights from prior experience, e.g., "What are the best practices for addressing loss spikes?" The LLM360 K2 project addresses this gap by providing full transparency and access to resources accumulated during the training of LLMs at the largest scale. This report highlights key elements of the K2 project, including our first model, K2 DIAMOND, a 65 billion-parameter LLM that surpasses LLaMA-65B and rivals LLaMA2-70B, while requiring fewer FLOPs and tokens. We detail the implementation steps and present a longitudinal analysis of K2 DIAMOND's capabilities throughout its training process. We also outline ongoing projects such as TXT360, setting the stage for future models in the series. By offering previously unavailable resources, the K2 project also resonates with the 360-degree OPEN SOURCE principles of transparency, reproducibility, and accessibility, which we believe are vital in the era of resource-intensive AI research.

The recent surge in open-source Large Language Models (LLMs), such as LLaMA, Falcon, and Mistral, provides diverse options for AI practitioners and researchers. However, most LLMs have only released partial artifacts, such as the final model weights or inference code, and technical reports increasingly limit their scope to high-level design choices and surface statistics. These choices hinder progress in the field by degrading transparency into the training of LLMs and forcing teams to rediscover many details in the training process. We present LLM360, an initiative to fully open-source LLMs, which advocates for all training code and data, model checkpoints, and intermediate results to be made available to the community. The goal of LLM360 is to support open and collaborative AI research by making the end-to-end LLM training process transparent and reproducible by everyone. As a first step of LLM360, we release two 7B parameter LLMs pre-trained from scratch, Amber and CrystalCoder, including their training code, data, intermediate checkpoints, and analyses (at https://www.llm360.ai). We are committed to continually pushing the boundaries of LLMs through this open-source effort. More large-scale and stronger models are underway and will be released in the future.

Prostate cancer pathology plays a crucial role in clinical management but is time-consuming. Artificial intelligence (AI) shows promise in detecting prostate cancer and grading patterns. We tested an AI-based digital twin of a pathologist, vPatho, on 2,603 histology images of prostate tissue stained with hematoxylin and eosin. We analyzed various factors influencing tumor-grade disagreement between vPatho and six human pathologists. Our results demonstrated that vPatho achieved comparable performance in prostate cancer detection and tumor volume estimation, as reported in the literature. Concordance levels between vPatho and human pathologists were examined. Notably, moderate to substantial agreement was observed in identifying complementary histological features such as ductal, cribriform, nerve, blood vessels, and lymph cell infiltrations. However, concordance in tumor grading showed a decline when applied to prostatectomy specimens (kappa = 0.44) compared to biopsy cores (kappa = 0.70). Adjusting the decision threshold for the secondary Gleason pattern from 5% to 10% improved the concordance level between pathologists and vPatho for tumor grading on prostatectomy specimens (kappa from 0.44 to 0.64). Potential causes of grade discordance included the vertical extent of tumors toward the prostate boundary and the proportions of slides with prostate cancer. Gleason pattern 4 was particularly associated with discordance. Notably, grade discordance with vPatho was not specific to any of the six pathologists involved in routine clinical grading. In conclusion, our study highlights the potential utility of AI in developing a digital twin of a pathologist. This approach can help uncover limitations in AI adoption and the current grading system for prostate cancer pathology.