Accurate lung cancer tumor staging is crucial for prognosis and treatment planning. However, it remains challenging for end-to-end deep learning approaches, as such approaches often overlook spatial and anatomical information that are central to the tumor-node-metastasis system. The tumor stage depends on multiple quantitative criteria, including the tumor size and its proximity to the nearest anatomical structures, and small variations can alter the staging outcome. We propose a medically grounded hybrid pipeline that performs staging by explicitly measuring the tumor's size and distance properties rather than treating it as a pure image classification task. Our method employs specialized encoder-decoder networks to precisely segment the lung and adjacent anatomy, including the lobes, tumor, mediastinum, and diaphragm. Subsequently, we extract the necessary tumor properties, i.e. measure the largest tumor dimension and calculate the distance between the tumor and neighboring anatomical structures by a quantitative analysis of the segmentation masks. Finally, we apply rule-based tumor staging aligned with the medical guidelines. This novel framework has been evaluated on the Lung-PET-CT-Dx dataset, demonstrating superior performance compared to traditional deep learning models, achieving an overall classification accuracy of 91.36%. We report the per-stage F1-scores of 0.93 (T1), 0.89 (T2), 0.96 (T3), and 0.90 (T4), a critical evaluation aspect often omitted in prior literature. To our knowledge, this is the first study that embeds explicit clinical context into tumor stage classification. Unlike standard convolutional neural networks that operate in an uninterpretable "black box" manner, our method offers both state-of-the-art performance and transparent decision support.

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.

Three-dimensional X-ray histology techniques offer a non-invasive alternative to conventional 2D histology, enabling volumetric imaging of biological tissues without the need for physical sectioning or chemical staining. However, the inherent greyscale image contrast of X-ray tomography limits its biochemical specificity compared to traditional histological stains. Within digital pathology, deep learning-based virtual staining has demonstrated utility in simulating stained appearances from label-free optical images. In this study, we extend virtual staining to the X-ray domain by applying cross-modality image translation to generate artificially stained slices from synchrotron-radiation-based micro-CT scans. Using over 50 co-registered image pairs of micro-CT and toluidine blue-stained histology from bone-implant samples, we trained a modified CycleGAN network tailored for limited paired data. Whole slide histology images were downsampled to match the voxel size of the CT data, with on-the-fly data augmentation for patch-based training. The model incorporates pixelwise supervision and greyscale consistency terms, producing histologically realistic colour outputs while preserving high-resolution structural detail. Our method outperformed Pix2Pix and standard CycleGAN baselines across SSIM, PSNR, and LPIPS metrics. Once trained, the model can be applied to full CT volumes to generate virtually stained 3D datasets, enhancing interpretability without additional sample preparation. While features such as new bone formation were able to be reproduced, some variability in the depiction of implant degradation layers highlights the need for further training data and refinement. This work introduces virtual staining to 3D X-ray imaging and offers a scalable route for chemically informative, label-free tissue characterisation in biomedical research.

Generative modelling of entire CT volumes conditioned on clinical reports has the potential to accelerate research through data augmentation, privacy-preserving synthesis and reducing regulator-constraints on patient data while preserving diagnostic signals. With the recent release of CT-RATE, a large-scale collection of 3D CT volumes paired with their respective clinical reports, training large text-conditioned CT volume generation models has become achievable. In this work, we introduce CTFlow, a 0.5B latent flow matching transformer model, conditioned on clinical reports. W e leverage the A-VAE from FLUX to define our latent space, and rely on the CT-Clip text encoder to encode the clinical reports. T o generate consistent whole CT volumes while keeping the memory constraints tractable, we rely on a custom autoregressive approach, where the model predicts the first sequence of slices of the volume from text-only, and then relies on the previously generated sequence of slices and the text, to predict the following sequence. W e evaluate our results against state-of-the-art generative CT model, and demonstrate the superiority of our approach in terms of temporal coherence, image diversity and text-image alignment, with FID, FVD, IS scores and CLIP score.

Visual question answering (VQA) in medical imaging aims to support clinical diagnosis by automatically interpreting complex imaging data in response to natural language queries. Existing studies typically rely on distinct visual and textual encoders to independently extract features from medical images and clinical questions, which are subsequently combined to generate answers. Specifically, in computed tomography (CT), such approaches are similar to the conventional practices in medical image analysis. However, these approaches pay less attention to the spatial continuity and inter-slice correlations in the volumetric CT data, leading to fragmented and imprecise responses. In this paper, we propose a novel large language model (LLM)-based framework enhanced by a graph representation of salient features. Different from conventional multimodal encoding strategies, our approach constructs a cross-modal graph integrating both visual and textual features, treating individual CT slices and question tokens as nodes within the graph. We further leverage an attentive graph convolutional network to dynamically fuse information within this structure. The resulting aggregated graph features then serve as a soft prompt to guide a large language model in generating accurate answers. Extensive experiments on the M3D-VQA benchmark demonstrate that our approach consistently outperforms baselines across multiple evaluation metrics, offering more robust reasoning capabilities.

Abstract--Generating reports for computed tomography (CT) images is a challenging task, while similar to existing studies for medical image report generation, yet has its unique characteristics, such as spatial encoding of multiple images, alignment between image volume and texts, etc. Existing solutions typically use general 2D or 3D image processing techniques to extract features from a CT volume, where they firstly compress the volume and then divide the compressed CT slices into patches for visual encoding. These approaches do not explicitly account for the transformations among CT slices, nor do they effectively integrate multi-level image features, particularly those containing specific organ lesions, to instruct CT report generation (CTRG). In considering the strong correlation among consecutive slices in CT scans, in this paper, we propose a large language model (LLM) based CTRG method with recurrent visual feature extraction and stereo attentions for hierarchical feature modeling. Specifically, we use a vision T ransformer to recurrently process each slice in a CT volume, and employ a set of attentions over the encoded slices from different perspectives to selectively obtain important visual information and align them with textual features, so as to better instruct an LLM for CTRG. Experiment results and further analysis on the benchmark M3D-Cap dataset show that our method outperforms strong baseline models and achieves state-of-the-art results, demonstrating its validity and effectiveness.

Coronary artery disease (CAD), one of the leading causes of mortality worldwide, necessitates effective risk assessment strategies, with coronary artery calcium (CAC) scoring via computed tomography (CT) being a key method for prevention. Traditional methods, primarily based on UNET architectures implemented on pre-built models, face challenges like the scarcity of annotated CT scans containing CAC and imbalanced datasets, leading to reduced performance in segmentation and scoring tasks. In this study, we address these limitations by incorporating the self-supervised learning (SSL) technique of DINO (self-distillation with no labels), which trains without requiring CAC-specific annotations, enhancing its robustness in generating distinct features. The DINO-LG model, which leverages label guidance to focus on calcified areas, achieves significant improvements, with a sensitivity of 89% and specificity of 90% for detecting CAC-containing CT slices, compared to the standard DINO model's sensitivity of 79% and specificity of 77%. Additionally, false-negative and false-positive rates are reduced by 49% and 59%, respectively, instilling greater confidence in clinicians when ruling out calcification in low-risk patients and minimizing unnecessary imaging reviews by radiologists. Further, CAC scoring and segmentation tasks are conducted using a basic UNET architecture, applied specifically to CT slices identified by the DINO-LG model as containing calcified areas. This targeted approach enhances CAC scoring accuracy by feeding the UNET model with relevant slices, significantly improving diagnostic precision, reducing both false positives and false negatives, and ultimately lowering overall healthcare costs by minimizing unnecessary tests and treatments, presenting a valuable advancement in CAD risk assessment.

Self-supervised pre-training of deep learning models with contrastive learning is a widely used technique in image analysis. Current findings indicate a strong potential for contrastive pre-training on medical images. However, further research is necessary to incorporate the particular characteristics of these images. We hypothesize that the similarity of medical images hinders the success of contrastive learning in the medical imaging domain. To this end, we investigate different strategies based on deep embedding, information theory, and hashing in order to identify and reduce redundancy in medical pre-training datasets. The effect of these different reduction strategies on contrastive learning is evaluated on two pre-training datasets and several downstream classification tasks. In all of our experiments, dataset reduction leads to a considerable performance gain in downstream tasks, e.g., an AUC score improvement from 0.78 to 0.83 for the COVID CT Classification Grand Challenge, 0.97 to 0.98 for the OrganSMNIST Classification Challenge and 0.73 to 0.83 for a brain hemorrhage classification task. Furthermore, pre-training is up to nine times faster due to the dataset reduction. In conclusion, the proposed approach highlights the importance of dataset quality and provides a transferable approach to improve contrastive pre-training for classification downstream tasks on medical images.

Conventional Computed Tomography (CT) imaging recognition faces two significant challenges: (1) There is often considerable variability in the resolution and size of each CT scan, necessitating strict requirements for the input size and adaptability of models. (2) CT-scan contains large number of out-of-distribution (OOD) slices. The crucial features may only be present in specific spatial regions and slices of the entire CT scan. How can we effectively figure out where these are located? To deal with this, we introduce an enhanced Spatial-Slice Feature Learning (SSFL++) framework specifically designed for CT scan. It aim to filter out a OOD data within whole CT scan, enabling our to select crucial spatial-slice for analysis by reducing 70% redundancy totally. Meanwhile, we proposed Kernel-Density-based slice Sampling (KDS) method to improve the stability when training and inference stage, therefore speeding up the rate of convergence and boosting performance. As a result, the experiments demonstrate the promising performance of our model using a simple EfficientNet-2D (E2D) model, even with only 1% of the training data. The efficacy of our approach has been validated on the COVID-19-CT-DB datasets provided by the DEF-AI-MIA workshop, in conjunction with CVPR 2024. Our source code is available at https://github.com/ming053l/E2D

Automated slice classification is clinically relevant since it can be incorporated into medical image segmentation workflows as a preprocessing step that would flag slices with a higher probability of containing tumors, thereby directing physicians' attention to the important slices. In this work, we train a ResNet-18 network to classify axial slices of lymphoma PET/CT images (collected from two institutions) depending on whether the slice intercepted a tumor (positive slice) in the 3D image or if the slice did not (negative slice). Various instances of the network were trained on 2D axial datasets created in different ways: (i) slice-level split and (ii) patient-level split; inputs of different types were used: (i) only PET slices and (ii) concatenated PET and CT slices; and different training strategies were employed: (i) center-aware (CAW) and (ii) center-agnostic (CAG). Model performances were compared using the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC), and various binary classification metrics. We observe and describe a performance overestimation in the case of slice-level split as compared to the patient-level split training. The model trained using patient-level split data with the network input containing only PET slices in the CAG training regime was the best performing/generalizing model on a majority of metrics. Our models were additionally more closely compared using the sensitivity metric on the positive slices from their respective test sets.