PMPBench: A Paired Multi-Modal Pan-Cancer Benchmark for Medical Image Synthesis

Contrast medium plays a pivotal role in radiological imaging, as it amplifies lesion conspicuity and improves detection for the diagnosis of tumor-related diseases. However, depending on the patient's health condition or the medical resources available, the use of contrast medium is not always feasible. Recent work has explored AI-based image translation to synthesize contrast-enhanced images directly from non-contrast scans, aims to reduce side effects and streamlines clinical workflows. Progress in this direction has been constrained by data limitations: (1) existing public datasets focus almost exclusively on brain-related paired MR modalities; (2) other collections include partially paired data but suffer from missing modalities/timestamps and imperfect spatial alignment; (3) explicit labeling of CT vs. CTC or DCE phases is often absent; (4) substantial resources remain private. To bridge this gap, we introduce the first public, fully paired, pan-cancer medical imaging dataset spanning 11 human organs. The MR data include complete dynamic contrast-enhanced (DCE) sequences covering all three phases (DCE1-DCE3), while the CT data provide paired non-contrast and contrast-enhanced acquisitions (CTC). The dataset is curated for anatomical correspondence, enabling rigorous evaluation of 1-to-1, N-to-1, and N-to-N translation settings (e.g., predicting DCE phases from non-contrast inputs). Built upon this resource, we establish a comprehensive benchmark. We report results from representative baselines of contemporary image-to-image translation. We release the dataset and benchmark to catalyze research on safe, effective contrast synthesis, with direct relevance to multi-organ oncology imaging workflows. Our code and dataset are publicly available at https://github.com/YifanChen02/PMPBench.

A Machine Vision Approach to Preliminary Skin Lesion Assessments

Early detection of malignant skin lesions is critical for improving patient outcomes in aggressive, metastatic skin cancers. This study evaluates a comprehensive system for preliminary skin lesion assessment that combines the clinically established ABCD rule of dermoscopy (analyzing Asymmetry, Borders, Color, and Dermoscopic Structures) with machine learning classification. Using a 1,000-image subset of the HAM10000 dataset, the system implements an automated, rule-based pipeline to compute a Total Dermoscopy Score (TDS) for each lesion. This handcrafted approach is compared against various machine learning solutions, including traditional classifiers (Logistic Regression, Random Forest, and SVM) and deep learning models. While the rule-based system provides high clinical interpretability, results indicate a performance bottleneck when reducing complex morphology to five numerical features. Experimental findings show that transfer learning with EfficientNet-B0 failed significantly due to domain shift between natural and medical images. In contrast, a custom three-layer Convolutional Neural Network (CNN) trained from scratch achieved 78.5% accuracy and 86.5% recall on median-filtered images, representing a 19-point accuracy improvement over traditional methods. The results demonstrate that direct pixel-level learning captures diagnostic patterns beyond handcrafted features and that purpose-built lightweight architectures can outperform large pretrained models for small, domain-specific medical datasets.

PanopMamba: Vision State Space Modeling for Nuclei Panoptic Segmentation

Nuclei panoptic segmentation supports cancer diagnostics by integrating both semantic and instance segmentation of different cell types to analyze overall tissue structure and individual nuclei in histopathology images. Major challenges include detecting small objects, handling ambiguous boundaries, and addressing class imbalance. To address these issues, we propose PanopMamba, a novel hybrid encoder-decoder architecture that integrates Mamba and Transformer with additional feature-enhanced fusion via state space modeling. We design a multiscale Mamba backbone and a State Space Model (SSM)-based fusion network to enable efficient long-range perception in pyramid features, thereby extending the pure encoder-decoder framework while facilitating information sharing across multiscale features of nuclei. The proposed SSM-based feature-enhanced fusion integrates pyramid feature networks and dynamic feature enhancement across different spatial scales, enhancing the feature representation of densely overlapping nuclei in both semantic and spatial dimensions. To the best of our knowledge, this is the first Mamba-based approach for panoptic segmentation. Additionally, we introduce alternative evaluation metrics, including image-level Panoptic Quality ($i$PQ), boundary-weighted PQ ($w$PQ), and frequency-weighted PQ ($fw$PQ), which are specifically designed to address the unique challenges of nuclei segmentation and thereby mitigate the potential bias inherent in vanilla PQ. Experimental evaluations on two multiclass nuclei segmentation benchmark datasets, MoNuSAC2020 and NuInsSeg, demonstrate the superiority of PanopMamba for nuclei panoptic segmentation over state-of-the-art methods. Consequently, the robustness of PanopMamba is validated across various metrics, while the distinctiveness of PQ variants is also demonstrated. Code is available at https://github.com/mkang315/PanopMamba.

Robust Multicentre Detection and Classification of Colorectal Liver Metastases on CT: Application of Foundation Models

Colorectal liver metastases (CRLM) are a major cause of cancer-related mortality, and reliable detection on CT remains challenging in multi-centre settings. We developed a foundation model-based AI pipeline for patient-level classification and lesion-level detection of CRLM on contrast-enhanced CT, integrating uncertainty quantification and explainability. CT data from the EuCanImage consortium (n=2437) and an external TCIA cohort (n=197) were used. Among several pretrained models, UMedPT achieved the best performance and was fine-tuned with an MLP head for classification and an FCOS-based head for lesion detection. The classification model achieved an AUC of 0.90 and a sensitivity of 0.82 on the combined test set, with a sensitivity of 0.85 on the external cohort. Excluding the most uncertain 20 percent of cases improved AUC to 0.91 and balanced accuracy to 0.86. Decision curve analysis showed clinical benefit for threshold probabilities between 0.30 and 0.40. The detection model identified 69.1 percent of lesions overall, increasing from 30 percent to 98 percent across lesion size quartiles. Grad-CAM highlighted lesion-corresponding regions in high-confidence cases. These results demonstrate that foundation model-based pipelines can support robust and interpretable CRLM detection and classification across heterogeneous CT data.

Nodule-DETR: A Novel DETR Architecture with Frequency-Channel Attention for Ultrasound Thyroid Nodule Detection

Thyroid cancer is the most common endocrine malignancy, and its incidence is rising globally. While ultrasound is the preferred imaging modality for detecting thyroid nodules, its diagnostic accuracy is often limited by challenges such as low image contrast and blurred nodule boundaries. To address these issues, we propose Nodule-DETR, a novel detection transformer (DETR) architecture designed for robust thyroid nodule detection in ultrasound images. Nodule-DETR introduces three key innovations: a Multi-Spectral Frequency-domain Channel Attention (MSFCA) module that leverages frequency analysis to enhance features of low-contrast nodules; a Hierarchical Feature Fusion (HFF) module for efficient multi-scale integration; and Multi-Scale Deformable Attention (MSDA) to flexibly capture small and irregularly shaped nodules. We conducted extensive experiments on a clinical dataset of real-world thyroid ultrasound images. The results demonstrate that Nodule-DETR achieves state-of-the-art performance, outperforming the baseline model by a significant margin of 0.149 in mAP@0.5:0.95. The superior accuracy of Nodule-DETR highlights its significant potential for clinical application as an effective tool in computer-aided thyroid diagnosis. The code of work is available at https://github.com/wjj1wjj/Nodule-DETR.

Physical Limits of Proximal Tumor Detection via MAGE-A Extracellular Vesicles

Early cancer detection relies on invasive tissue biopsies or liquid biopsies limited by biomarker dilution. In contrast, tumour-derived extracellular vesicles (EVs) carrying biomarkers like melanoma-associated antigen-A (MAGE-A) are highly concentrated in the peri-tumoral interstitial space, offering a promising near-field target. However, at micrometre scales, EV transport is governed by stochastic diffusion in a low copy number regime, increasing the risk of false negatives. We theoretically assess the feasibility of a smart-needle sensor detecting MAGE-A-positive microvesicles near a tumour. We use a hybrid framework combining particle-based Brownian dynamics (Smoldyn) to quantify stochastic arrival and false negative probabilities, and a reaction-diffusion PDE for mean concentration profiles. Formulating detection as a threshold-based binary hypothesis test, we find a maximum feasible detection radius of approximately 275 micrometers for a 6000 s sensing window. These results outline the physical limits of proximal EV-based detection and inform the design of minimally invasive peri-tumoral sensors.

The Impact of Lesion Focus on the Performance of AI-Based Melanoma Classification

Melanoma is the most lethal subtype of skin cancer, and early and accurate detection of this disease can greatly improve patients' outcomes. Although machine learning models, especially convolutional neural networks (CNNs), have shown great potential in automating melanoma classification, their diagnostic reliability still suffers due to inconsistent focus on lesion areas. In this study, we analyze the relationship between lesion attention and diagnostic performance, involving masked images, bounding box detection, and transfer learning. We used multiple explainability and sensitivity analysis approaches to investigate how well models aligned their attention with lesion areas and how this alignment correlated with precision, recall, and F1-score. Results showed that models with a higher focus on lesion areas achieved better diagnostic performance, suggesting the potential of interpretable AI in medical diagnostics. This study provides a foundation for developing more accurate and trustworthy melanoma classification models in the future.

Beyond Occlusion: In Search for Near Real-Time Explainability of CNN-Based Prostate Cancer Classification

Deep neural networks are starting to show their worth in critical applications such as assisted cancer diagnosis. However, for their outputs to get accepted in practice, the results they provide should be explainable in a way easily understood by pathologists. A well-known and widely used explanation technique is occlusion, which, however, can take a long time to compute, thus slowing the development and interaction with pathologists. In this work, we set out to find a faster replacement for occlusion in a successful system for detecting prostate cancer. Since there is no established framework for comparing the performance of various explanation methods, we first identified suitable comparison criteria and selected corresponding metrics. Based on the results, we were able to choose a different explanation method, which cut the previously required explanation time at least by a factor of 10, without any negative impact on the quality of outputs. This speedup enables rapid iteration in model development and debugging and brings us closer to adopting AI-assisted prostate cancer detection in clinical settings. We propose that our approach to finding the replacement for occlusion can be used to evaluate candidate methods in other related applications.

MedGemma vs GPT-4: Open-Source and Proprietary Zero-shot Medical Disease Classification from Images

Multimodal Large Language Models (LLMs) introduce an emerging paradigm for medical imaging by interpreting scans through the lens of extensive clinical knowledge, offering a transformative approach to disease classification. This study presents a critical comparison between two fundamentally different AI architectures: the specialized open-source agent MedGemma and the proprietary large multimodal model GPT-4 for diagnosing six different diseases. The MedGemma-4b-it model, fine-tuned using Low-Rank Adaptation (LoRA), demonstrated superior diagnostic capability by achieving a mean test accuracy of 80.37% compared to 69.58% for the untuned GPT-4. Furthermore, MedGemma exhibited notably higher sensitivity in high-stakes clinical tasks, such as cancer and pneumonia detection. Quantitative analysis via confusion matrices and classification reports provides comprehensive insights into model performance across all categories. These results emphasize that domain-specific fine-tuning is essential for minimizing hallucinations in clinical implementation, positioning MedGemma as a sophisticated tool for complex, evidence-based medical reasoning.

Prior-Guided DETR for Ultrasound Nodule Detection

Accurate detection of ultrasound nodules is essential for the early diagnosis and treatment of thyroid and breast cancers. However, this task remains challenging due to irregular nodule shapes, indistinct boundaries, substantial scale variations, and the presence of speckle noise that degrades structural visibility. To address these challenges, we propose a prior-guided DETR framework specifically designed for ultrasound nodule detection. Instead of relying on purely data-driven feature learning, the proposed framework progressively incorporates different prior knowledge at multiple stages of the network. First, a Spatially-adaptive Deformable FFN with Prior Regularization (SDFPR) is embedded into the CNN backbone to inject geometric priors into deformable sampling, stabilizing feature extraction for irregular and blurred nodules. Second, a Multi-scale Spatial-Frequency Feature Mixer (MSFFM) is designed to extract multi-scale structural priors, where spatial-domain processing emphasizes contour continuity and boundary cues, while frequency-domain modeling captures global morphology and suppresses speckle noise. Furthermore, a Dense Feature Interaction (DFI) mechanism propagates and exploits these prior-modulated features across all encoder layers, enabling the decoder to enhance query refinement under consistent geometric and structural guidance. Experiments conducted on two clinically collected thyroid ultrasound datasets (Thyroid I and Thyroid II) and two public benchmarks (TN3K and BUSI) for thyroid and breast nodules demonstrate that the proposed method achieves superior accuracy compared with 18 detection methods, particularly in detecting morphologically complex nodules.The source code is publicly available at https://github.com/wjj1wjj/Ultrasound-DETR.