PRISM-Net: Patient-specific reference-guided inter-breast symmetry matching for three-class breast DCE-MRI classification

Breast DCE-MRI AI is increasingly being explored for breast-level classification of no-lesion, benign, and malignant findings, beyond conventional lesion-centered diagnosis. Within this broader diagnostic scope, however, patient-specific background variability remains a major source of imaging confounding across classification tasks. Existing approaches predominantly focus on unilateral or lesion-centric analysis, whereas bilateral methods offer limited explicit modeling of spatially adaptive cross-breast correspondence. We propose PRISM-Net, a registration-free bilateral framework that leverages contralateral breast features as patient-specific references for background-aware representation learning. PRISM-Net integrates bilateral feature matching and asymmetry-aware attention to establish adaptive inter-breast correspondence and enhance representations of discriminative asymmetric patterns. On ODELIA, Macro AUC, Micro AUC, and quadratic weighted kappa were $84.11 \pm 2.33$, $90.64 \pm 1.61$, and $60.94 \pm 5.64$ on the in-distribution test set, and $68.51 \pm 4.54$, $80.74 \pm 2.68$, and $43.45 \pm 7.10$ on the held-out institution, respectively, outperforming the evaluated baseline methods across the primary evaluation metrics. PRISM-Net further demonstrated performance on independent institutional and background-complexity evaluations. Ablation experiments revealed that both bilateral relation modeling and asymmetry-aware reweighting contributed to improved classification performance. These findings highlight patient-specific bilateral reference modeling as a clinically grounded strategy for DCE-MRI interpretation, improving asymmetric pattern discrimination through explicit modeling of background complexity.

GaussianPile: A Unified Sparse Gaussian Splatting Framework for Slice-based Volumetric Reconstruction

Slice-based volumetric imaging is widely applied and it demands representations that compress aggressively while preserving internal structure for analysis. We introduce GaussianPile, unifying 3D Gaussian splatting with an imaging system-aware focus model to address this challenge. Our proposed method introduces three key innovations: (i) a slice-aware piling strategy that positions anisotropic 3D Gaussians to model through-slice contributions, (ii) a differentiable projection operator that encodes the finite-thickness point spread function of the imaging acquisition system, and (iii) a compact encoding and joint optimization pipeline that simultaneously reconstructs and compresses the Gaussian sets. Our CUDA-based design retains the compression and real-time rendering efficiency of Gaussian primitives while preserving high-frequency internal volumetric detail. Experiments on microscopy and ultrasound datasets demonstrate that our method reduces storage and reconstruction cost, sustains diagnostic fidelity, and enables fast 2D visualization, along with 3D voxelization. In practice, it delivers high-quality results in as few as 3 minutes, up to 11x faster than NeRF-based approaches, and achieves consistent 16x compression over voxel grids, offering a practical path to deployable compression and exploration of slice-based volumetric datasets.