Coronary artery calcification assessment in National Lung Screening Trial CT images (DeepCAC2)

Coronary artery calcification (CAC) is a strong predictor of cardiovascular risk but remains underutilized in clinical routine thoracic imaging due to the need for dedicated imaging protocols and manual annotation. We present DeepCAC2, a publicly available dataset containing automated CAC segmentations, coronary artery calcium scores, and derived risk categories generated from low-dose chest CT scans of the National Lung Screening Trial (NLST). Using a fully automated deep learning pipeline trained on expert-annotated cardiac CT data, we processed 127,776 CT scans from 26,228 individuals and generated standardized CAC segmentations and risk estimates for each acquisition. We already provide a public dashboard as a simple tool to visually inspect a random subset of 200 NLST patients of the dataset. The dataset will be released with DICOM-compatible segmentation objects and structured metadata to support reproducible downstream analysis. The deep learning pipeline will be made publicly available as a DICOM-compatible MHub.ai container. DeepCAC2 provides a transparent, large-scale, public, fully reproducible resource for research in cardiovascular risk assessment, opportunistic screening, and imaging biomarker development.

MHub.ai: A Simple, Standardized, and Reproducible Platform for AI Models in Medical Imaging

Artificial intelligence (AI) has the potential to transform medical imaging by automating image analysis and accelerating clinical research. However, research and clinical use are limited by the wide variety of AI implementations and architectures, inconsistent documentation, and reproducibility issues. Here, we introduce MHub.ai, an open-source, container-based platform that standardizes access to AI models with minimal configuration, promoting accessibility and reproducibility in medical imaging. MHub.ai packages models from peer-reviewed publications into standardized containers that support direct processing of DICOM and other formats, provide a unified application interface, and embed structured metadata. Each model is accompanied by publicly available reference data that can be used to confirm model operation. MHub.ai includes an initial set of state-of-the-art segmentation, prediction, and feature extraction models for different modalities. The modular framework enables adaptation of any model and supports community contributions. We demonstrate the utility of the platform in a clinical use case through comparative evaluation of lung segmentation models. To further strengthen transparency and reproducibility, we publicly release the generated segmentations and evaluation metrics and provide interactive dashboards that allow readers to inspect individual cases and reproduce or extend our analysis. By simplifying model use, MHub.ai enables side-by-side benchmarking with identical execution commands and standardized outputs, and lowers the barrier to clinical translation.

Foundation Artificial Intelligence Models for Health Recognition Using Face Photographs (FAHR-Face)

Background: Facial appearance offers a noninvasive window into health. We built FAHR-Face, a foundation model trained on >40 million facial images and fine-tuned it for two distinct tasks: biological age estimation (FAHR-FaceAge) and survival risk prediction (FAHR-FaceSurvival). Methods: FAHR-FaceAge underwent a two-stage, age-balanced fine-tuning on 749,935 public images; FAHR-FaceSurvival was fine-tuned on 34,389 photos of cancer patients. Model robustness (cosmetic surgery, makeup, pose, lighting) and independence (saliency mapping) was tested extensively. Both models were clinically tested in two independent cancer patient datasets with survival analyzed by multivariable Cox models and adjusted for clinical prognostic factors. Findings: For age estimation, FAHR-FaceAge had the lowest mean absolute error of 5.1 years on public datasets, outperforming benchmark models and maintaining accuracy across the full human lifespan. In cancer patients, FAHR-FaceAge outperformed a prior facial age estimation model in survival prognostication. FAHR-FaceSurvival demonstrated robust prediction of mortality, and the highest-risk quartile had more than triple the mortality of the lowest (adjusted hazard ratio 3.22; P<0.001). These findings were validated in the independent cohort and both models showed generalizability across age, sex, race and cancer subgroups. The two algorithms provided distinct, complementary prognostic information; saliency mapping revealed each model relied on distinct facial regions. The combination of FAHR-FaceAge and FAHR-FaceSurvival improved prognostic accuracy. Interpretation: A single foundation model can generate inexpensive, scalable facial biomarkers that capture both biological ageing and disease-related mortality risk. The foundation model enabled effective training using relatively small clinical datasets.