Multimodal RGB-HSI Feature Fusion with Patient-Aware Incremental Heuristic Meta-Learning for Oral Lesion Classification

Early detection of oral cancer and potentially malignant disorders is challenging in low-resource settings due to limited annotated data. We present a unified four-class oral lesion classifier that integrates deep RGB embeddings, hyperspectral reconstruction, handcrafted spectral-textural descriptors, and demographic metadata. A pathologist-verified subset of oral cavity images was curated and processed using a fine-tuned ConvNeXt-v2 encoder, followed by RGB-to-HSI reconstruction into 31-band hyperspectral cubes. Haemoglobin-sensitive indices, texture features, and spectral-shape measures were extracted and fused with deep and clinical features. Multiple machine-learning models were assessed with patient-wise validation. We further introduce an incremental heuristic meta-learner (IHML) that combines calibrated base classifiers through probabilistic stacking and patient-level posterior smoothing. On an unseen patient split, the proposed framework achieved a macro F1 of 66.23% and an accuracy of 64.56%. Results demonstrate that hyperspectral reconstruction and uncertainty-aware meta-learning substantially improve robustness for real-world oral lesion screening.

NodMAISI: Nodule-Oriented Medical AI for Synthetic Imaging

Objective: Although medical imaging datasets are increasingly available, abnormal and annotation-intensive findings critical to lung cancer screening, particularly small pulmonary nodules, remain underrepresented and inconsistently curated. Methods: We introduce NodMAISI, an anatomically constrained, nodule-oriented CT synthesis and augmentation framework trained on a unified multi-source cohort (7,042 patients, 8,841 CTs, 14,444 nodules). The framework integrates: (i) a standardized curation and annotation pipeline linking each CT with organ masks and nodule-level annotations, (ii) a ControlNet-conditioned rectified-flow generator built on MAISI-v2's foundational blocks to enforce anatomy- and lesion-consistent synthesis, and (iii) lesion-aware augmentation that perturbs nodule masks (controlled shrinkage) while preserving surrounding anatomy to generate paired CT variants. Results: Across six public test datasets, NodMAISI improved distributional fidelity relative to MAISI-v2 (real-to-synthetic FID range 1.18 to 2.99 vs 1.69 to 5.21). In lesion detectability analysis using a MONAI nodule detector, NodMAISI substantially increased average sensitivity and more closely matched clinical scans (IMD-CT: 0.69 vs 0.39; DLCS24: 0.63 vs 0.20), with the largest gains for sub-centimeter nodules where MAISI-v2 frequently failed to reproduce the conditioned lesion. In downstream nodule-level malignancy classification trained on LUNA25 and externally evaluated on LUNA16, LNDbv4, and DLCS24, NodMAISI augmentation improved AUC by 0.07 to 0.11 at <=20% clinical data and by 0.12 to 0.21 at 10%, consistently narrowing the performance gap under data scarcity.

Adapted Foundation Models for Breast MRI Triaging in Contrast-Enhanced and Non-Contrast Enhanced Protocols

Background: Magnetic resonance imaging (MRI) has high sensitivity for breast cancer detection, but interpretation is time-consuming. Artificial intelligence may aid in pre-screening. Purpose: To evaluate the DINOv2-based Medical Slice Transformer (MST) for ruling out significant findings (Breast Imaging Reporting and Data System [BI-RADS] >=4) in contrast-enhanced and non-contrast-enhanced abbreviated breast MRI. Materials and Methods: This institutional review board approved retrospective study included 1,847 single-breast MRI examinations (377 BI-RADS >=4) from an in-house dataset and 924 from an external validation dataset (Duke). Four abbreviated protocols were tested: T1-weighted early subtraction (T1sub), diffusion-weighted imaging with b=1500 s/mm2 (DWI1500), DWI1500+T2-weighted (T2w), and T1sub+T2w. Performance was assessed at 90%, 95%, and 97.5% sensitivity using five-fold cross-validation and area under the receiver operating characteristic curve (AUC) analysis. AUC differences were compared with the DeLong test. False negatives were characterized, and attention maps of true positives were rated in the external dataset. Results: A total of 1,448 female patients (mean age, 49 +/- 12 years) were included. T1sub+T2w achieved an AUC of 0.77 +/- 0.04; DWI1500+T2w, 0.74 +/- 0.04 (p=0.15). At 97.5% sensitivity, T1sub+T2w had the highest specificity (19% +/- 7%), followed by DWI1500+T2w (17% +/- 11%). Missed lesions had a mean diameter <10 mm at 95% and 97.5% thresholds for both T1sub and DWI1500, predominantly non-mass enhancements. External validation yielded an AUC of 0.77, with 88% of attention maps rated good or moderate. Conclusion: At 97.5% sensitivity, the MST framework correctly triaged cases without BI-RADS >=4, achieving 19% specificity for contrast-enhanced and 17% for non-contrast-enhanced MRI. Further research is warranted before clinical implementation.

Topological Conditioning for Mammography Models via a Stable Wavelet-Persistence Vectorization

Breast cancer is the most commonly diagnosed cancer in women and a leading cause of cancer death worldwide. Screening mammography reduces mortality, yet interpretation still suffers from substantial false negatives and false positives, and model accuracy often degrades when deployed across scanners, modalities, and patient populations. We propose a simple conditioning signal aimed at improving external performance based on a wavelet based vectorization of persistent homology. Using topological data analysis, we summarize image structure that persists across intensity thresholds and convert this information into spatial, multi scale maps that are provably stable to small intensity perturbations. These maps are integrated into a two stage detection pipeline through input level channel concatenation. The model is trained and validated on the CBIS DDSM digitized film mammography cohort from the United States and evaluated on two independent full field digital mammography cohorts from Portugal (INbreast) and China (CMMD), with performance reported at the patient level. On INbreast, augmenting ConvNeXt Tiny with wavelet persistence channels increases patient level AUC from 0.55 to 0.75 under a limited training budget.

Configurable γ Photon Spectrometer to Enable Precision Radioguided Tumor Resection

Surgical tumor resection aims to remove all cancer cells in the tumor margin and at centimeter-scale depths below the tissue surface. During surgery, microscopic clusters of disease are intraoperatively difficult to visualize and are often left behind, significantly increasing the risk of cancer recurrence. Radioguided surgery (RGS) has shown the ability to selectively tag cancer cells with gamma (γ) photon emitting radioisotopes to identify them, but require a mm-scale γ photon spectrometer to localize the position of these cells in the tissue margin (i.e., a function of incident γ photon energy) with high specificity. Here we present a 9.9 mm2 integrated circuit (IC)-based γ spectrometer implemented in 180 nm CMOS, to enable the measurement of single γ photons and their incident energy with sub-keV energy resolution. We use small 2 2 um reverse-biased diodes that have low depletion region capacitance, and therefore produce millivolt-scale voltage signals in response to the small charge generated by incident γ photons. A low-power energy spectrometry method is implemented by measuring the decay time it takes for the generated voltage signal to settle back to DC after a γ detection event, instead of measuring the voltage drop directly. This spectrometry method is implemented in three different pixel architectures that allow for configurable pixel sensitivity, energy-resolution, and energy dynamic range based on the widely heterogenous surgical and patient presentation in RGS. The spectrometer was tested with three common γ-emitting radioisotopes (64Cu, 133Ba, 177Lu), and is able to resolve activities down to 1 uCi with sub-keV energy resolution and 1.315 MeV energy dynamic range, using 5-minute acquisitions.

Dynamic Weight Adjustment for Knowledge Distillation: Leveraging Vision Transformer for High-Accuracy Lung Cancer Detection and Real-Time Deployment

This paper presents the FuzzyDistillViT-MobileNet model, a novel approach for lung cancer (LC) classification, leveraging dynamic fuzzy logic-driven knowledge distillation (KD) to address uncertainty and complexity in disease diagnosis. Unlike traditional models that rely on static KD with fixed weights, our method dynamically adjusts the distillation weight using fuzzy logic, enabling the student model to focus on high-confidence regions while reducing attention to ambiguous areas. This dynamic adjustment improves the model ability to handle varying uncertainty levels across different regions of LC images. We employ the Vision Transformer (ViT-B32) as the instructor model, which effectively transfers knowledge to the student model, MobileNet, enhancing the student generalization capabilities. The training process is further optimized using a dynamic wait adjustment mechanism that adapts the training procedure for improved convergence and performance. To enhance image quality, we introduce pixel-level image fusion improvement techniques such as Gamma correction and Histogram Equalization. The processed images (Pix1 and Pix2) are fused using a wavelet-based fusion method to improve image resolution and feature preservation. This fusion method uses the wavedec2 function to standardize images to a 224x224 resolution, decompose them into multi-scale frequency components, and recursively average coefficients at each level for better feature representation. To address computational efficiency, Genetic Algorithm (GA) is used to select the most suitable pre-trained student model from a pool of 12 candidates, balancing model performance with computational cost. The model is evaluated on two datasets, including LC25000 histopathological images (99.16% accuracy) and IQOTH/NCCD CT-scan images (99.54% accuracy), demonstrating robustness across different imaging domains.

MedFedPure: A Medical Federated Framework with MAE-based Detection and Diffusion Purification for Inference-Time Attacks

Artificial intelligence (AI) has shown great potential in medical imaging, particularly for brain tumor detection using Magnetic Resonance Imaging (MRI). However, the models remain vulnerable at inference time when they are trained collaboratively through Federated Learning (FL), an approach adopted to protect patient privacy. Adversarial attacks can subtly alter medical scans in ways invisible to the human eye yet powerful enough to mislead AI models, potentially causing serious misdiagnoses. Existing defenses often assume centralized data and struggle to cope with the decentralized and diverse nature of federated medical settings. In this work, we present MedFedPure, a personalized federated learning defense framework designed to protect diagnostic AI models at inference time without compromising privacy or accuracy. MedFedPure combines three key elements: (1) a personalized FL model that adapts to the unique data distribution of each institution; (2) a Masked Autoencoder (MAE) that detects suspicious inputs by exposing hidden perturbations; and (3) an adaptive diffusion-based purification module that selectively cleans only the flagged scans before classification. Together, these steps offer robust protection while preserving the integrity of normal, benign images. We evaluated MedFedPure on the Br35H brain MRI dataset. The results show a significant gain in adversarial robustness, improving performance from 49.50% to 87.33% under strong attacks, while maintaining a high clean accuracy of 97.67%. By operating locally and in real time during diagnosis, our framework provides a practical path to deploying secure, trustworthy, and privacy-preserving AI tools in clinical workflows. Index Terms: cancer, tumor detection, federated learning, masked autoencoder, diffusion, privacy

Dark-Field X-Ray Imaging Significantly Improves Deep-Learning based Detection of Synthetic Early-Stage Lung Tumors in Preclinical Models

Low-dose computed tomography (LDCT) is the current standard for lung cancer screening, yet its adoption and accessibility remain limited. Many regions lack LDCT infrastructure, and even among those screened, early-stage cancer detection often yield false positives, as shown in the National Lung Screening Trial (NLST) with a sensitivity of 93.8 percent and a false-positive rate of 26.6 percent. We aim to investigate whether X-ray dark-field imaging (DFI) radiograph, a technique sensitive to small-angle scatter from alveolar microstructure and less susceptible to organ shadowing, can significantly improve early-stage lung tumor detection when coupled with deep-learning segmentation. Using paired attenuation (ATTN) and DFI radiograph images of euthanized mouse lungs, we generated realistic synthetic tumors with irregular boundaries and intensity profiles consistent with physical lung contrast. A U-Net segmentation network was trained on small patches using either ATTN, DFI, or a combination of ATTN and DFI channels. Results show that the DFI-only model achieved a true-positive detection rate of 83.7 percent, compared with 51 percent for ATTN-only, while maintaining comparable specificity (90.5 versus 92.9 percent). The combined ATTN and DFI input achieved 79.6 percent sensitivity and 97.6 percent specificity. In conclusion, DFI substantially improves early-tumor detectability in comparison to standard attenuation radiography and shows potential as an accessible, low-cost, low-dose alternative for pre-clinical or limited-resource screening where LDCT is unavailable.

MV-MLM: Bridging Multi-View Mammography and Language for Breast Cancer Diagnosis and Risk Prediction

Large annotated datasets are essential for training robust Computer-Aided Diagnosis (CAD) models for breast cancer detection or risk prediction. However, acquiring such datasets with fine-detailed annotation is both costly and time-consuming. Vision-Language Models (VLMs), such as CLIP, which are pre-trained on large image-text pairs, offer a promising solution by enhancing robustness and data efficiency in medical imaging tasks. This paper introduces a novel Multi-View Mammography and Language Model for breast cancer classification and risk prediction, trained on a dataset of paired mammogram images and synthetic radiology reports. Our MV-MLM leverages multi-view supervision to learn rich representations from extensive radiology data by employing cross-modal self-supervision across image-text pairs. This includes multiple views and the corresponding pseudo-radiology reports. We propose a novel joint visual-textual learning strategy to enhance generalization and accuracy performance over different data types and tasks to distinguish breast tissues or cancer characteristics(calcification, mass) and utilize these patterns to understand mammography images and predict cancer risk. We evaluated our method on both private and publicly available datasets, demonstrating that the proposed model achieves state-of-the-art performance in three classification tasks: (1) malignancy classification, (2) subtype classification, and (3) image-based cancer risk prediction. Furthermore, the model exhibits strong data efficiency, outperforming existing fully supervised or VLM baselines while trained on synthetic text reports and without the need for actual radiology reports.

A Density-Informed Multimodal Artificial Intelligence Framework for Improving Breast Cancer Detection Across All Breast Densities

Mammography, the current standard for breast cancer screening, has reduced sensitivity in women with dense breast tissue, contributing to missed or delayed diagnoses. Thermalytix, an AI-based thermal imaging modality, captures functional vascular and metabolic cues that may complement mammographic structural data. This study investigates whether a breast density-informed multi-modal AI framework can improve cancer detection by dynamically selecting the appropriate imaging modality based on breast tissue composition. A total of 324 women underwent both mammography and thermal imaging. Mammography images were analyzed using a multi-view deep learning model, while Thermalytix assessed thermal images through vascular and thermal radiomics. The proposed framework utilized Mammography AI for fatty breasts and Thermalytix AI for dense breasts, optimizing predictions based on tissue type. This multi-modal AI framework achieved a sensitivity of 94.55% (95% CI: 88.54-100) and specificity of 79.93% (95% CI: 75.14-84.71), outperforming standalone mammography AI (sensitivity 81.82%, specificity 86.25%) and Thermalytix AI (sensitivity 92.73%, specificity 75.46%). Importantly, the sensitivity of Mammography dropped significantly in dense breasts (67.86%) versus fatty breasts (96.30%), whereas Thermalytix AI maintained high and consistent sensitivity in both (92.59% and 92.86%, respectively). This demonstrates that a density-informed multi-modal AI framework can overcome key limitations of unimodal screening and deliver high performance across diverse breast compositions. The proposed framework is interpretable, low-cost, and easily deployable, offering a practical path to improving breast cancer screening outcomes in both high-resource and resource-limited settings.