Active Surveillance (AS) is a treatment option for managing low and intermediate-risk prostate cancer (PCa), aiming to avoid overtreatment while monitoring disease progression through serial MRI and clinical follow-up. Accurate prostate segmentation is an important preliminary step for automating this process, enabling automated detection and diagnosis of PCa. However, existing deep-learning segmentation models are often trained on single-time-point and expertly annotated datasets, making them unsuitable for longitudinal AS analysis, where multiple time points and a scarcity of expert labels hinder their effective fine-tuning. To address these challenges, we propose MambaX-Net, a novel semi-supervised, dual-scan 3D segmentation architecture that computes the segmentation for time point t by leveraging the MRI and the corresponding segmentation mask from the previous time point. We introduce two new components: (i) a Mamba-enhanced Cross-Attention Module, which integrates the Mamba block into cross attention to efficiently capture temporal evolution and long-range spatial dependencies, and (ii) a Shape Extractor Module that encodes the previous segmentation mask into a latent anatomical representation for refined zone delination. Moreover, we introduce a semi-supervised self-training strategy that leverages pseudo-labels generated from a pre-trained nnU-Net, enabling effective learning without expert annotations. MambaX-Net was evaluated on a longitudinal AS dataset, and results showed that it significantly outperforms state-of-the-art U-Net and Transformer-based models, achieving superior prostate zone segmentation even when trained on limited and noisy data.

Concentric tube robots (CTRs) offer dexterous motion at millimeter scales, enabling minimally invasive procedures through natural orifices. This work presents a coordinated model-based resection planner and learning-based retraction network that work together to enable semi-autonomous tissue resection using a dual-arm transurethral concentric tube robot (the Virtuoso). The resection planner operates directly on segmented CT volumes of prostate phantoms, automatically generating tool trajectories for a three-phase median lobe resection workflow: left/median trough resection, right/median trough resection, and median blunt dissection. The retraction network, PushCVAE, trained on surgeon demonstrations, generates retractions according to the procedural phase. The procedure is executed under Level-3 (supervised) autonomy on a prostate phantom composed of hydrogel materials that replicate the mechanical and cutting properties of tissue. As a feasibility study, we demonstrate that our combined autonomous system achieves a 97.1% resection of the targeted volume of the median lobe. Our study establishes a foundation for image-guided autonomy in transurethral robotic surgery and represents a first step toward fully automated minimally-invasive prostate enucleation.

Accurate and scalable cancer diagnosis remains a critical challenge in modern pathology, particularly for malignancies such as breast, prostate, bone, and cervical, which exhibit complex histological variability. In this study, we propose a transformer-based deep learning framework for multi-class tumor classification in histopathological images. Leveraging a fine-tuned Vision Transformer (ViT) architecture, our method addresses key limitations of conventional convolutional neural networks, offering improved performance, reduced preprocessing requirements, and enhanced scalability across tissue types. To adapt the model for histopathological cancer images, we implement a streamlined preprocessing pipeline that converts tiled whole-slide images into PyTorch tensors and standardizes them through data normalization. This ensures compatibility with the ViT architecture and enhances both convergence stability and overall classification performance. We evaluate our model on four benchmark datasets: ICIAR2018 (breast), SICAPv2 (prostate), UT-Osteosarcoma (bone), and SipakMed (cervical) dataset -- demonstrating consistent outperformance over existing deep learning methods. Our approach achieves classification accuracies of 99.32%, 96.92%, 95.28%, and 96.94% for breast, prostate, bone, and cervical cancers respectively, with area under the ROC curve (AUC) scores exceeding 99% across all datasets. These results confirm the robustness, generalizability, and clinical potential of transformer-based architectures in digital pathology. Our work represents a significant advancement toward reliable, automated, and interpretable cancer diagnosis systems that can alleviate diagnostic burdens and improve healthcare outcomes.

Pediatric medical imaging presents unique challenges due to significant anatomical and developmental differences compared to adults. Direct application of segmentation models trained on adult data often yields suboptimal performance, particularly for small or rapidly evolving structures. To address these challenges, several strategies leveraging the nnU-Net framework have been proposed, differing along four key axes: (i) the fingerprint dataset (adult, pediatric, or a combination thereof) from which the Training Plan -- including the network architecture--is derived; (ii) the Learning Set (adult, pediatric, or mixed), (iii) Data Augmentation parameters, and (iv) the Transfer learning method (fine-tuning versus continual learning). In this work, we introduce PSAT (Pediatric Segmentation Approaches via Adult Augmentations and Transfer learning), a systematic study that investigates the impact of these axes on segmentation performance. We benchmark the derived strategies on two pediatric CT datasets and compare them with state-of-the-art methods, including a commercial radiotherapy solution. PSAT highlights key pitfalls and provides actionable insights for improving pediatric segmentation. Our experiments reveal that a training plan based on an adult fingerprint dataset is misaligned with pediatric anatomy--resulting in significant performance degradation, especially when segmenting fine structures--and that continual learning strategies mitigate institutional shifts, thus enhancing generalization across diverse pediatric datasets.

Background: Automated analysis of CT scans for abdominal organ measurement is crucial for improving diagnostic efficiency and reducing inter-observer variability. Manual segmentation and measurement of organs such as the kidneys, liver, spleen, and prostate are time-consuming and subject to inconsistency, underscoring the need for automated approaches. Purpose: The purpose of this study is to develop and validate an automated workflow for the segmentation and measurement of abdominal organs in CT scans using advanced deep learning models, in order to improve accuracy, reliability, and efficiency in clinical evaluations. Methods: The proposed workflow combines nnU-Net, U-Net++ for organ segmentation, followed by a 3D RCNN model for measuring organ volumes and dimensions. The models were trained and evaluated on CT datasets with metrics such as precision, recall, and Mean Squared Error (MSE) to assess performance. Segmentation quality was verified for its adaptability to variations in patient anatomy and scanner settings. Results: The developed workflow achieved high precision and recall values, exceeding 95 for all targeted organs. The Mean Squared Error (MSE) values were low, indicating a high level of consistency between predicted and ground truth measurements. The segmentation and measurement pipeline demonstrated robust performance, providing accurate delineation and quantification of the kidneys, liver, spleen, and prostate. Conclusion: The proposed approach offers an automated, efficient, and reliable solution for abdominal organ measurement in CT scans. By significantly reducing manual intervention, this workflow enhances measurement accuracy and consistency, with potential for widespread clinical implementation. Future work will focus on expanding the approach to other organs and addressing complex pathological cases.

Radiotherapy is a crucial cancer treatment that demands precise planning to balance tumor eradication and preservation of healthy tissue. Traditional treatment planning (TP) is iterative, time-consuming, and reliant on human expertise, which can potentially introduce variability and inefficiency. We propose a novel framework to transform a large multimodal foundation model (MLM) into an action model for TP using a few-shot reinforcement learning (RL) approach. Our method leverages the MLM's extensive pre-existing knowledge of physics, radiation, and anatomy, enhancing it through a few-shot learning process. This allows the model to iteratively improve treatment plans using a Monte Carlo simulator. Our results demonstrate that this method outperforms conventional RL-based approaches in both quality and efficiency, achieving higher reward scores and more optimal dose distributions in simulations on prostate cancer data. This proof-of-concept suggests a promising direction for integrating advanced AI models into clinical workflows, potentially enhancing the speed, quality, and standardization of radiotherapy treatment planning.

Spatial correspondence can be represented by pairs of segmented regions, such that the image registration networks aim to segment corresponding regions rather than predicting displacement fields or transformation parameters. In this work, we show that such a corresponding region pair can be predicted by the same language prompt on two different images using the pre-trained large multimodal models based on GroundingDINO and SAM. This enables a fully automated and training-free registration algorithm, potentially generalisable to a wide range of image registration tasks. In this paper, we present experimental results using one of the challenging tasks, registering inter-subject prostate MR images, which involves both highly variable intensity and morphology between patients. Tell2Reg is training-free, eliminating the need for costly and time-consuming data curation and labelling that was previously required for this registration task. This approach outperforms unsupervised learning-based registration methods tested, and has a performance comparable to weakly-supervised methods. Additional qualitative results are also presented to suggest that, for the first time, there is a potential correlation between language semantics and spatial correspondence, including the spatial invariance in language-prompted regions and the difference in language prompts between the obtained local and global correspondences. Code is available at https://github.com/yanwenCi/Tell2Reg.git.

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.

The Innovative Medicines Initiative (IMI) 2 sponsored public-private research initiative OPTIMA (Optimal Treatment for Patients with Solid Tumours in Europe Through Artificial intelligence) aims to employ artificial intelligence (AI) to enhance patient care for prostate, breast, and lung cancer. Creating the first interoperable, GDPR-compliant real-world data (RWD) and guidelines-driven evidence-generation platform in Europe was OPTIMA's main objective. The interdisciplinary collaboration of OPTIMA is concentrated on: establishing a safe, substantial, GDPR-compliant data platform with RWD from more than 200 million individuals. The federated learning tools, datasets, data analysis tools, and AI algorithms will all be hosted under the interoperable platform; creating clinical decision support toolkits that are based on global and national treatment recommendations and supported by data from cutting-edge AI models; using massive RWD to drive knowledge production, especially when the present evidence supporting clinical recommendations is insufficient or unreliable. In the disciplines of clinical, academic, patient, regulatory, data sciences, legal, ethical, and pharmaceutical, the interdisciplinary pan-European cooperation comprised 36 partners from 13 different countries. It has been given €21.3 million in IMI financing, a strong project management methodology, a Scientific Governance Board, and three independent advisory boards--Multistakeholder, Ethical/Legal; and Public/Private--are in place to offer prompt, objective guidance from subject matter experts.

Artificial intelligence, in the form of queried databases, is helping to tackle certain cancers. Algorithms have been developed to cross-reference a patient's medical records, habits and genetic information to spot any early signs of cancer. With cancer, the key problem is about the late diagnosis of cancer and the argument of using artificial intelligence is to identify those members of the population who are at greatest risk and to then bring them in earlier for screening. A pilot has been developed in the U.K., where the focus is particularly with prostate, lung and bowel cancer, and then you can undertake procedures like surgery or administer treatment sooner in order to increase survival rates. Similarly, a U.S. study, published in 2022, found that a machine learning algorithm trained to predict cancer outcomes zeroed in to finds the prostate on male patients and successfully outlines any cancer-suspicious areas without any human supervision.