Quantifiable image patterns associated with disease progression and treatment response are critical tools for guiding individual treatment, and for developing novel therapies. Here, we show that unsupervised machine learning can identify a pattern vocabulary of liver tissue in magnetic resonance images that quantifies treatment response in diffuse liver disease. Deep clustering networks simultaneously encode and cluster patches of medical images into a low-dimensional latent space to establish a tissue vocabulary. The resulting tissue types capture differential tissue change and its location in the liver associated with treatment response. We demonstrate the utility of the vocabulary on a randomized controlled trial cohort of non-alcoholic steatohepatitis patients. First, we use the vocabulary to compare longitudinal liver change in a placebo and a treatment cohort. Results show that the method identifies specific liver tissue change pathways associated with treatment, and enables a better separation between treatment groups than established non-imaging measures. Moreover, we show that the vocabulary can predict biopsy derived features from non-invasive imaging data. We validate the method on a separate replication cohort to demonstrate the applicability of the proposed method.

Pathologists comprehensive evaluation of donor liver biopsies provides crucial information for accepting or discarding potential grafts. However, rapidly and accurately obtaining these assessments intraoperatively poses a significant challenge for pathologists. Features in donor liver biopsies, such as portal tract fibrosis, total steatosis, macrovesicular steatosis, and hepatocellular ballooning are correlated with transplant outcomes, yet quantifying these indicators suffers from substantial inter- and intra-observer variability. To address this, we introduce DLiPath, the first benchmark for comprehensive donor liver assessment based on a histopathology image dataset. We collected and publicly released 636 whole slide images from 304 donor liver patients at the Department of Pathology, the Third Xiangya Hospital, with expert annotations for key pathological features (including cholestasis, portal tract fibrosis, portal inflammation, total steatosis, macrovesicular steatosis, and hepatocellular ballooning). We selected nine state-of-the-art multiple-instance learning (MIL) models based on the DLiPath dataset as baselines for extensive comparative analysis. The experimental results demonstrate that several MIL models achieve high accuracy across donor liver assessment indicators on DLiPath, charting a clear course for future automated and intelligent donor liver assessment research. Data and code are available at https://github.com/panliangrui/ACM_MM_2025.

Non-alcoholic fatty liver disease (NAFLD) is one of the most widespread liver disorders on a global scale, posing a significant threat of progressing to more severe conditions like nonalcoholic steatohepatitis (NASH), liver fibrosis, cirrhosis, and hepatocellular carcinoma. Diagnosing and staging NAFLD presents challenges due to its non-specific symptoms and the invasive nature of liver biopsies. Our research introduces a novel artificial intelligence cascade model employing ensemble learning and feature fusion techniques. We developed a non-invasive, robust, and reliable diagnostic artificial intelligence tool that utilizes anthropometric and laboratory parameters, facilitating early detection and intervention in NAFLD progression. Our novel artificial intelligence achieved an 86% accuracy rate for the NASH steatosis staging task (non-NASH, steatosis grade 1, steatosis grade 2, and steatosis grade 3) and an impressive 96% AUC-ROC for distinguishing between NASH (steatosis grade 1, grade 2, and grade3) and non-NASH cases, outperforming current state-of-the-art models. This notable improvement in diagnostic performance underscores the potential application of artificial intelligence in the early diagnosis and treatment of NAFLD, leading to better patient outcomes and a reduced healthcare burden associated with advanced liver disease.

Abdominal computed tomography (CT) scans are frequently performed in clinical settings. Opportunistic CT involves repurposing routine CT images to extract diagnostic information and is an emerging tool for detecting underdiagnosed conditions such as sarcopenia, hepatic steatosis, and ascites. This study utilizes deep learning methods to promote accurate diagnosis and clinical documentation. We analyze 2,674 inpatient CT scans to identify discrepancies between imaging phenotypes (characteristics derived from opportunistic CT scans) and their corresponding documentation in radiology reports and ICD coding. Through our analysis, we find that only 0.5%, 3.2%, and 30.7% of scans diagnosed with sarcopenia, hepatic steatosis, and ascites (respectively) through either opportunistic imaging or radiology reports were ICD-coded. Our findings demonstrate opportunistic CT's potential to enhance diagnostic precision and accuracy of risk adjustment models, offering advancements in precision medicine.

With the maturity achieved by deep learning techniques, intelligent systems that can assist physicians in the daily interpretation of clinical images can play a very important role. In addition, quantum techniques applied to deep learning can enhance this performance, and federated learning techniques can realize privacy-friendly collaborative learning among different participants, solving privacy issues due to the use of sensitive data and reducing the number of data to be collected for each individual participant. We present in this study a hybrid quantum neural network that can be used to quantify non-alcoholic liver steatosis and could be useful in the diagnostic process to determine a liver's suitability for transplantation; at the same time, we propose a federated learning approach based on a classical deep learning solution to solve the same problem, but using a reduced data set in each part. The liver steatosis image classification accuracy of the hybrid quantum neural network, the hybrid quantum ResNet model, consisted of 5 qubits and more than 100 variational gates, reaches 97%, which is 1.8% higher than its classical counterpart, ResNet. Crucially, that even with a reduced dataset, our hybrid approach consistently outperformed its classical counterpart, indicating superior generalization and less potential for overfitting in medical applications. In addition, a federated approach with multiple clients, up to 32, despite the lower accuracy, but still higher than 90%, would allow using, for each participant, a very small dataset, i.e., up to one-thirtieth. Our work, based over real-word clinical data can be regarded as a scalable and collaborative starting point, could thus fulfill the need for an effective and reliable computer-assisted system that facilitates the daily diagnostic work of the clinical pathologist.

Background & Aims: Hepatic steatosis is a major cause of chronic liver disease. 2D ultrasound is the most widely used non-invasive tool for screening and monitoring, but associated diagnoses are highly subjective. We developed a scalable deep learning (DL) algorithm for quantitative scoring of liver steatosis from 2D ultrasound images. Approach & Results: Using retrospectively collected multi-view ultrasound data from 3,310 patients, 19,513 studies, and 228,075 images, we trained a DL algorithm to diagnose steatosis stages (healthy, mild, moderate, or severe) from ultrasound diagnoses. Performance was validated on two multi-scanner unblinded and blinded (initially to DL developer) histology-proven cohorts (147 and 112 patients) with histopathology fatty cell percentage diagnoses, and a subset with FibroScan diagnoses. We also quantified reliability across scanners and viewpoints. Results were evaluated using Bland-Altman and receiver operating characteristic (ROC) analysis. The DL algorithm demonstrates repeatable measurements with a moderate number of images (3 for each viewpoint) and high agreement across 3 premium ultrasound scanners. High diagnostic performance was observed across all viewpoints: area under the curves of the ROC to classify >=mild, >=moderate, =severe steatosis grades were 0.85, 0.90, and 0.93, respectively. The DL algorithm outperformed or performed at least comparably to FibroScan with statistically significant improvements for all levels on the unblinded histology-proven cohort, and for =severe steatosis on the blinded histology-proven cohort. Conclusions: The DL algorithm provides a reliable quantitative steatosis assessment across view and scanners on two multi-scanner cohorts. Diagnostic performance was high with comparable or better performance than FibroScan.

Depending on the application, radiological diagnoses can be associated with high inter- and intra-rater variabilities. Most computer-aided diagnosis (CAD) solutions treat such data as incontrovertible, exposing learning algorithms to considerable and possibly contradictory label noise and biases. Thus, managing subjectivity in labels is a fundamental problem in medical imaging analysis. To address this challenge, we introduce auto-decoded deep latent embeddings (ADDLE), which explicitly models the tendencies of each rater using an auto-decoder framework. After a simple linear transformation, the latent variables can be injected into any backbone at any and multiple points, allowing the model to account for rater-specific effects on the diagnosis. Importantly, ADDLE does not expect multiple raters per image in training, meaning it can readily learn from data mined from hospital archives. Moreover, the complexity of training ADDLE does not increase as more raters are added. During inference each rater can be simulated and a 'mean' or 'greedy' virtual rating can be produced. We test ADDLE on the problem of liver steatosis diagnosis from 2D ultrasound (US) by collecting 46 084 studies along with clinical US diagnoses originating from 65 different raters. We evaluated diagnostic performance using a separate dataset with gold-standard biopsy diagnoses. ADDLE can improve the partial areas under the curve (AUCs) for diagnosing severe steatosis by 10.5% over standard classifiers while outperforming other annotator-noise approaches, including those requiring 65 times the parameters.