Wheeler High School, Marietta, GA Abstract This study enhances breast cancer prediction by using large language models to infer the likelihood of confounding diseases, namely diabetes, obesity, and cardiovascular disease, from routine clinical data. These AI-generated features improved Random Forest model performance, particularly for LLMs like Gemma (3.9%) and Llama (6.4%). The approach shows promise for noninvasive prescreening and clinical integration, supporting improved early detection and shared decision-making in breast cancer diagnosis. Introduction Breast cancer (BC) is a leading cause of death among women in the U.S., with most cases having unknown causes despite known risk factors1. Researchers have identified correlations between BC and various clinical features and biomarkers, such as body mass index, glucose, insulin, leptin, adiponectin, resistin, MCP-1, and HOMA, that can be measured through routine blood tests.

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disease that affects millions of people worldwide. Early detection is crucial as it can alter pancreas function through morphological changes and increased deposition of ectopic fat, eventually leading to organ damage. While studies have shown an association between T2DM and pancreas volume and fat content, the role of increased pancreatic surface lobularity (PSL) in patients with T2DM has not been fully investigated. In this pilot work, we propose a fully automated approach to delineate the pancreas and other abdominal structures, derive CT imaging biomarkers, and opportunistically screen for T2DM. Four deep learning-based models were used to segment the pancreas in an internal dataset of 584 patients (297 males, 437 non-diabetic, age: 45$\pm$15 years). PSL was automatically detected and it was higher for diabetic patients (p=0.01) at 4.26 $\pm$ 8.32 compared to 3.19 $\pm$ 3.62 for non-diabetic patients. The PancAP model achieved the highest Dice score of 0.79 $\pm$ 0.17 and lowest ASSD error of 1.94 $\pm$ 2.63 mm (p$<$0.05). For predicting T2DM, a multivariate model trained with CT biomarkers attained 0.90 AUC, 66.7\% sensitivity, and 91.9\% specificity. Our results suggest that PSL is useful for T2DM screening and could potentially help predict the early onset of T2DM.

Objective Renal cancer is a common malignancy and a major cause of cancer-related deaths. Computed tomography (CT) is central to early detection, staging, and treatment planning. However, the growing CT workload increases radiologists' burden and risks incomplete documentation. Automatically generating accurate reports remains challenging because it requires integrating visual interpretation with clinical reasoning. Advances in artificial intelligence (AI), especially large language and vision-language models, offer potential to reduce workload and enhance diagnostic quality. Methods We propose a clinically informed, two-stage framework for automatic renal CT report generation. In Stage 1, a multi-task learning model detects structured clinical features from each 2D image. In Stage 2, a vision-language model generates free-text reports conditioned on the image and the detected features. To evaluate clinical fidelity, generated clinical features are extracted from the reports and compared with expert-annotated ground truth. Results Experiments on an expert-labeled dataset show that incorporating detected features improves both report quality and clinical accuracy. The model achieved an average AUC of 0.75 for key imaging features and a METEOR score of 0.33, demonstrating higher clinical consistency and fewer template-driven errors. Conclusion Linking structured feature detection with conditioned report generation provides a clinically grounded approach to integrate structured prediction and narrative drafting for renal CT reporting. This method enhances interpretability and clinical faithfulness, underscoring the value of domain-relevant evaluation metrics for medical AI development.

Chagas disease affects nearly 6 million people worldwide, with Chagas cardiomyopathy representing its most severe complication. In regions where serological testing capacity is limited, AI-enhanced electrocardiogram (ECG) screening provides a critical diagnostic alternative. However, existing machine learning approaches face challenges such as limited accuracy, reliance on large labeled datasets, and more importantly, weak integration with evidence-based clinical diagnostic indicators. W e propose a retrieval-augmented generation framework, CardioRAG, integrating large language models with interpretable ECG-based clinical features, including right bundle branch block, left anterior fascicular block, and heart rate variability metrics. The framework uses vari-ational autoencoder-learned representations for semantic case retrieval, providing contextual cases to guide clinical reasoning. Evaluation demonstrated high recall performance of 89.80%, with a maximum F1 score of 0.68 for effective identification of positive cases requiring prioritized serological testing. CardioRAG provides an interpretable, clinical evidence-based approach particularly valuable for resource-limited settings, demonstrating a pathway for embedding clinical indicators into trustworthy medical AI systems.

In this work, we study the problem pertaining to personalized classification of subclinical atherosclerosis by developing a hierarchical graph neural network framework to leverage two characteristic modalities of a patient: clinical features within the context of the cohort, and molecular data unique to individual patients. Current graph-based methods for disease classification detect patient-specific molecular fingerprints, but lack consistency and comprehension regarding cohort-wide features, which are an essential requirement for understanding pathogenic phenotypes across diverse atherosclerotic trajectories. Furthermore, understanding patient subtypes often considers clinical feature similarity in isolation, without integration of shared pathogenic interdependencies among patients. To address these challenges, we introduce ATHENA: Atherosclerosis Through Hierarchical Explainable Neural Network Analysis, which constructs a novel hierarchical network representation through integrated modality learning; subsequently, it optimizes learned patient-specific molecular fingerprints that reflect individual omics data, enforcing consistency with cohort-wide patterns. With a primary clinical dataset of 391 patients, we demonstrate that this heterogeneous alignment of clinical features with molecular interaction patterns has significantly boosted subclinical atherosclerosis classification performance across various baselines by up to 13% in area under the receiver operating curve (AUC) and 20% in F1 score. Taken together, ATHENA enables mechanistically-informed patient subtype discovery through explainable AI (XAI)-driven subnetwork clustering; this novel integration framework strengthens personalized intervention strategies, thereby improving the prediction of atherosclerotic disease progression and management of their clinical actionable outcomes.

A precise assessment of the risk of breast lesions can greatly lower it and assist physicians in choosing the best course of action. To categorise breast lesions, the majority of current computer-aided systems only use characteristics from mammograms. Although this method is practical, it does not completely utilise clinical reports' valuable information to attain the best results. When compared to utilising mammography alone, will clinical features greatly enhance the categorisation of breast lesions? How may clinical features and mammograms be combined most effectively? In what ways may explainable AI approaches improve the interpretability and reliability of models used to diagnose breast cancer? To answer these basic problems, a comprehensive investigation is desperately needed. In order to integrate mammography and categorical clinical characteristics, this study examines a number of multimodal deep networks grounded on feature concatenation, co-attention, and cross-attention. The model achieved an AUC-ROC of 0.98, accuracy of 0.96, F1-score of 0.94, precision of 0.92, and recall of 0.95 when tested on publicly accessible datasets (TCGA and CBIS-DDSM).

Medical image segmentation exhibits intra-and inter-annotator variability due to ambiguous object boundaries, annotator preferences, expertise, and tools, among other factors. Lesions with ambiguous boundaries, e.g., spiculated or infiltrative nodules, or irregular borders per the ABCD rule, are particularly prone to disagreement and are often associated with malignancy. In this work, we curate IMA++, the largest multi-annotator skin lesion segmentation dataset, on which we conduct an in-depth study of variability due to annotator, malignancy, tool, and skill factors. We find a statistically significant ( p <0.001) association between inter-annotator agreement (IAA), measured using Dice, and the malignancy of skin lesions. We further show that IAA can be accurately predicted directly from dermoscopic images, achieving a mean absolute error of 0.108. Finally, we leverage this association by utilizing IAA as a "soft" clinical feature within a multi-task learning objective, yielding a 4.2% improvement in balanced accuracy averaged across multiple model architectures and across IMA++ and four public dermoscopic datasets.

Trustworthy survival prediction is essential for clinical decision making. Longitudinal electronic health records (EHRs) provide a uniquely powerful opportunity for the prediction. However, it is challenging to accurately model the continuous clinical progression of patients underlying the irregularly sampled clinical features and to transparently link the progression to survival outcomes. To address these challenges, we develop TrajSurv, a model that learns continuous latent trajectories from longitudinal EHR data for trustworthy survival prediction. TrajSurv employs a neural controlled differential equation (NCDE) to extract continuous-time latent states from the irregularly sampled data, forming continuous latent trajectories. To ensure the latent trajectories reflect the clinical progression, TrajSurv aligns the latent state space with patient state space through a time-aware contrastive learning approach. To transparently link clinical progression to the survival outcome, TrajSurv uses latent trajectories in a two-step divide-and-conquer interpretation process. First, it explains how the changes in clinical features translate into the latent trajectory's evolution using a learned vector field. Second, it clusters these latent trajectories to identify key clinical progression patterns associated with different survival outcomes. Evaluations on two real-world medical datasets, MIMIC-III and eICU, show TrajSurv's competitive accuracy and superior transparency over existing deep learning methods.

Mechanical thrombectomy has become the standard of care in patients with stroke due to large vessel occlusion (LVO). However, only 50% of successfully treated patients show a favorable outcome. We developed and evaluated interpretable deep learning models to predict functional outcomes in terms of the modified Rankin Scale score alongside individualized treatment effects (ITEs) using data of 449 LVO stroke patients from a randomized clinical trial. Besides clinical variables, we considered non-contrast CT (NCCT) and angiography (CTA) scans which were integrated using novel foundation models to make use of advanced imaging information. Clinical variables had a good predictive power for binary functional outcome prediction (AUC of 0.719 [0.666, 0.774]) which could slightly be improved when adding CTA imaging (AUC of 0.737 [0.687, 0.795]). Adding NCCT scans or a combination of NCCT and CTA scans to clinical features yielded no improvement. The most important clinical predictor for functional outcome was pre-stroke disability. While estimated ITEs were well calibrated to the average treatment effect, discriminatory ability was limited indicated by a C-for-Benefit statistic of around 0.55 in all models. In summary, the models allowed us to jointly integrate CT imaging and clinical features while achieving state-of-the-art prediction performance and ITE estimates. Yet, further research is needed to particularly improve ITE estimation.

Inconsistencies between clinical and omics data may arise within medical cohorts. The identification, annotation and explanation of anomalous omics-based patients or individuals may become crucial to better reshape the disease, e.g., by detecting early onsets signaled by the omics and undetectable from observable symptoms. Here, we developed MLASDO (Machine Learning based Anomalous Sample Detection on Omics), a new method and software tool to identify, characterize and automatically describe anomalous samples based on omics data. Its workflow is based on three steps: (1) classification of healthy and cases individuals using a support vector machine algorithm; (2) detection of anomalous samples within groups; (3) explanation of anomalous individuals based on clinical data and expert knowledge. We showcase MLASDO using transcriptomics data of 317 healthy controls (HC) and 465 Parkinson's disease (PD) cases from the Parkinson's Progression Markers Initiative. In this cohort, MLASDO detected 15 anomalous HC with a PD-like transcriptomic signature and PD-like clinical features, including a lower proportion of CD4/CD8 naive T-cells and CD4 memory T-cells compared to HC (P<3.5*10^-3). MLASDO also identified 22 anomalous PD cases with a transcriptomic signature more similar to that of HC and some clinical features more similar to HC, including a lower proportion of mature neutrophils compared to PD cases (P<6*10^-3). In summary, MLASDO is a powerful tool that can help the clinician to detect and explain anomalous HC and cases of interest to be followed up. MLASDO is an open-source R package available at: https://github.com/JoseAdrian3/MLASDO.