SYN-LUNGS: Towards Simulating Lung Nodules with Anatomy-Informed Digital Twins for AI Training

AI models for lung cancer screening are limited by data scarcity, impacting generalizability and clinical applicability. Generative models address this issue but are constrained by training data variability. We introduce SYN-LUNGS, a framework for generating high-quality 3D CT images with detailed annotations. SYN-LUNGS integrates XCAT3 phantoms for digital twin generation, X-Lesions for nodule simulation (varying size, location, and appearance), and DukeSim for CT image formation with vendor and parameter variability. The dataset includes 3,072 nodule images from 1,044 simulated CT scans, with 512 lesions and 174 digital twins. Models trained on clinical + simulated data outperform clinical only models, achieving 10% improvement in detection, 2-9% in segmentation and classification, and enhanced synthesis.By incorporating anatomy-informed simulations, SYN-LUNGS provides a scalable approach for AI model development, particularly in rare disease representation and improving model reliability.

MiniGPT-Pancreas: Multimodal Large Language Model for Pancreas Cancer Classification and Detection

Problem: Pancreas radiological imaging is challenging due to the small size, blurred boundaries, and variability of shape and position of the organ among patients. Goal: In this work we present MiniGPT-Pancreas, a Multimodal Large Language Model (MLLM), as an interactive chatbot to support clinicians in pancreas cancer diagnosis by integrating visual and textual information. Methods: MiniGPT-v2, a general-purpose MLLM, was fine-tuned in a cascaded way for pancreas detection, tumor classification, and tumor detection with multimodal prompts combining questions and computed tomography scans from the National Institute of Health (NIH), and Medical Segmentation Decathlon (MSD) datasets. The AbdomenCT-1k dataset was used to detect the liver, spleen, kidney, and pancreas. Results: MiniGPT-Pancreas achieved an Intersection over Union (IoU) of 0.595 and 0.550 for the detection of pancreas on NIH and MSD datasets, respectively. For the pancreas cancer classification task on the MSD dataset, accuracy, precision, and recall were 0.876, 0.874, and 0.878, respectively. When evaluating MiniGPT-Pancreas on the AbdomenCT-1k dataset for multi-organ detection, the IoU was 0.8399 for the liver, 0.722 for the kidney, 0.705 for the spleen, and 0.497 for the pancreas. For the pancreas tumor detection task, the IoU score was 0.168 on the MSD dataset. Conclusions: MiniGPT-Pancreas represents a promising solution to support clinicians in the classification of pancreas images with pancreas tumors. Future research is needed to improve the score on the detection task, especially for pancreas tumors.

A Comprehensive Analysis on Machine Learning based Methods for Lung Cancer Level Classification

Lung cancer is a major issue in worldwide public health, requiring early diagnosis using stable techniques. This work begins a thorough investigation of the use of machine learning (ML) methods for precise classification of lung cancer stages. A cautious analysis is performed to overcome overfitting issues in model performance, taking into account minimum child weight and learning rate. A set of machine learning (ML) models including XGBoost (XGB), LGBM, Adaboost, Logistic Regression (LR), Decision Tree (DT), Random Forest (RF), CatBoost, and k-Nearest Neighbor (k-NN) are run methodically and contrasted. Furthermore, the correlation between features and targets is examined using the deep neural network (DNN) model and thus their capability in detecting complex patternsis established. It is argued that several ML models can be capable of classifying lung cancer stages with great accuracy. In spite of the complexity of DNN architectures, traditional ML models like XGBoost, LGBM, and Logistic Regression excel with superior performance. The models perform better than the others in lung cancer prediction on the complete set of comparative metrics like accuracy, precision, recall, and F-1 score

Polyp-Gen: Realistic and Diverse Polyp Image Generation for Endoscopic Dataset Expansion

Automated diagnostic systems (ADS) have shown significant potential in the early detection of polyps during endoscopic examinations, thereby reducing the incidence of colorectal cancer. However, due to high annotation costs and strict privacy concerns, acquiring high-quality endoscopic images poses a considerable challenge in the development of ADS. Despite recent advancements in generating synthetic images for dataset expansion, existing endoscopic image generation algorithms failed to accurately generate the details of polyp boundary regions and typically required medical priors to specify plausible locations and shapes of polyps, which limited the realism and diversity of the generated images. To address these limitations, we present Polyp-Gen, the first full-automatic diffusion-based endoscopic image generation framework. Specifically, we devise a spatial-aware diffusion training scheme with a lesion-guided loss to enhance the structural context of polyp boundary regions. Moreover, to capture medical priors for the localization of potential polyp areas, we introduce a hierarchical retrieval-based sampling strategy to match similar fine-grained spatial features. In this way, our Polyp-Gen can generate realistic and diverse endoscopic images for building reliable ADS. Extensive experiments demonstrate the state-of-the-art generation quality, and the synthetic images can improve the downstream polyp detection task. Additionally, our Polyp-Gen has shown remarkable zero-shot generalizability on other datasets. The source code is available at https://github.com/CUHK-AIM-Group/Polyp-Gen.

Efficient and Comprehensive Feature Extraction in Large Vision-Language Model for Clinical Pathology Analysis

Pathological diagnosis is vital for determining disease characteristics, guiding treatment, and assessing prognosis, relying heavily on detailed, multi-scale analysis of high-resolution whole slide images (WSI). However, traditional pure vision models face challenges of redundant feature extraction, whereas existing large vision-language models (LVLMs) are limited by input resolution constraints, hindering their efficiency and accuracy. To overcome these issues, we propose two innovative strategies: the mixed task-guided feature enhancement, which directs feature extraction toward lesion-related details across scales, and the prompt-guided detail feature completion, which integrates coarse- and fine-grained features from WSI based on specific prompts without compromising inference speed. Leveraging a comprehensive dataset of 490,000 samples from diverse pathology tasks-including cancer detection, grading, vascular and neural invasion identification, and so on-we trained the pathology-specialized LVLM, OmniPath. Extensive experiments demonstrate that this model significantly outperforms existing methods in diagnostic accuracy and efficiency, offering an interactive, clinically aligned approach for auxiliary diagnosis in a wide range of pathology applications.

A Knowledge-enhanced Pathology Vision-language Foundation Model for Cancer Diagnosis

Deep learning has enabled the development of highly robust foundation models for various pathological tasks across diverse diseases and patient cohorts. Among these models, vision-language pre-training, which leverages large-scale paired data to align pathology image and text embedding spaces, and provides a novel zero-shot paradigm for downstream tasks. However, existing models have been primarily data-driven and lack the incorporation of domain-specific knowledge, which limits their performance in cancer diagnosis, especially for rare tumor subtypes. To address this limitation, we establish a Knowledge-enhanced Pathology (KEEP) foundation model that harnesses disease knowledge to facilitate vision-language pre-training. Specifically, we first construct a disease knowledge graph (KG) that covers 11,454 human diseases with 139,143 disease attributes, including synonyms, definitions, and hypernym relations. We then systematically reorganize the millions of publicly available noisy pathology image-text pairs, into 143K well-structured semantic groups linked through the hierarchical relations of the disease KG. To derive more nuanced image and text representations, we propose a novel knowledge-enhanced vision-language pre-training approach that integrates disease knowledge into the alignment within hierarchical semantic groups instead of unstructured image-text pairs. Validated on 18 diverse benchmarks with more than 14,000 whole slide images (WSIs), KEEP achieves state-of-the-art performance in zero-shot cancer diagnostic tasks. Notably, for cancer detection, KEEP demonstrates an average sensitivity of 89.8% at a specificity of 95.0% across 7 cancer types. For cancer subtyping, KEEP achieves a median balanced accuracy of 0.456 in subtyping 30 rare brain cancers, indicating strong generalizability for diagnosing rare tumors.

MedGrad E-CLIP: Enhancing Trust and Transparency in AI-Driven Skin Lesion Diagnosis

As deep learning models gain attraction in medical data, ensuring transparent and trustworthy decision-making is essential. In skin cancer diagnosis, while advancements in lesion detection and classification have improved accuracy, the black-box nature of these methods poses challenges in understanding their decision processes, leading to trust issues among physicians. This study leverages the CLIP (Contrastive Language-Image Pretraining) model, trained on different skin lesion datasets, to capture meaningful relationships between visual features and diagnostic criteria terms. To further enhance transparency, we propose a method called MedGrad E-CLIP, which builds on gradient-based E-CLIP by incorporating a weighted entropy mechanism designed for complex medical imaging like skin lesions. This approach highlights critical image regions linked to specific diagnostic descriptions. The developed integrated pipeline not only classifies skin lesions by matching corresponding descriptions but also adds an essential layer of explainability developed especially for medical data. By visually explaining how different features in an image relates to diagnostic criteria, this approach demonstrates the potential of advanced vision-language models in medical image analysis, ultimately improving transparency, robustness, and trust in AI-driven diagnostic systems.

Marker Track: Accurate Fiducial Marker Tracking for Evaluation of Residual Motions During Breath-Hold Radiotherapy

Fiducial marker positions in projection image of cone-beam computed tomography (CBCT) scans have been studied to evaluate daily residual motion during breath-hold radiation therapy. Fiducial marker migration posed challenges in accurately locating markers, prompting the development of a novel algorithm that reconstructs volumetric probability maps of marker locations from filtered gradient maps of projections. This guides the development of a Python-based algorithm to detect fiducial markers in projection images using Meta AI's Segment Anything Model 2 (SAM 2). Retrospective data from a pancreatic cancer patient with two fiducial markers were analyzed. The three-dimensional (3D) marker positions from simulation computed tomography (CT) were compared to those reconstructed from CBCT images, revealing a decrease in relative distances between markers over time. Fiducial markers were successfully detected in 2777 out of 2786 projection frames. The average standard deviation of superior-inferior (SI) marker positions was 0.56 mm per breath-hold, with differences in average SI positions between two breath-holds in the same scan reaching up to 5.2 mm, and a gap of up to 7.3 mm between the end of the first and beginning of the second breath-hold. 3D marker positions were calculated using projection positions and confirmed marker migration. This method effectively calculates marker probability volume and enables accurate fiducial marker tracking during treatment without requiring any specialized equipment, additional radiation doses, or manual initialization and labeling. It has significant potential for automatically assessing daily residual motion to adjust planning margins, functioning as an adaptive radiation therapy tool.

From Images to Insights: Transforming Brain Cancer Diagnosis with Explainable AI

Brain cancer represents a major challenge in medical diagnostics, requisite precise and timely detection for effective treatment. Diagnosis initially relies on the proficiency of radiologists, which can cause difficulties and threats when the expertise is sparse. Despite the use of imaging resources, brain cancer remains often difficult, time-consuming, and vulnerable to intraclass variability. This study conveys the Bangladesh Brain Cancer MRI Dataset, containing 6,056 MRI images organized into three categories: Brain Tumor, Brain Glioma, and Brain Menin. The dataset was collected from several hospitals in Bangladesh, providing a diverse and realistic sample for research. We implemented advanced deep learning models, and DenseNet169 achieved exceptional results, with accuracy, precision, recall, and F1-Score all reaching 0.9983. In addition, Explainable AI (XAI) methods including GradCAM, GradCAM++, ScoreCAM, and LayerCAM were employed to provide visual representations of the decision-making processes of the models. In the context of brain cancer, these techniques highlight DenseNet169's potential to enhance diagnostic accuracy while simultaneously offering transparency, facilitating early diagnosis and better patient outcomes.

Multivariate Feature Selection and Autoencoder Embeddings of Ovarian Cancer Clinical and Genetic Data

This study explores a data-driven approach to discovering novel clinical and genetic markers in ovarian cancer (OC). Two main analyses were performed: (1) a nonlinear examination of an OC dataset using autoencoders, which compress data into a 3-dimensional latent space to detect potential intrinsic separability between platinum-sensitive and platinum-resistant groups; and (2) an adaptation of the informative variable identifier (IVI) to determine which features (clinical or genetic) are most relevant to disease progression. In the autoencoder analysis, a clearer pattern emerged when using clinical features and the combination of clinical and genetic data, indicating that disease progression groups can be distinguished more effectively after supervised fine tuning. For genetic data alone, this separability was less apparent but became more pronounced with a supervised approach. Using the IVI-based feature selection, key clinical variables (such as type of surgery and neoadjuvant chemotherapy) and certain gene mutations showed strong relevance, along with low-risk genetic factors. These findings highlight the strength of combining machine learning tools (autoencoders) with feature selection methods (IVI) to gain insights into ovarian cancer progression. They also underscore the potential for identifying new biomarkers that integrate clinical and genomic indicators, ultimately contributing to improved patient stratification and personalized treatment strategies.