Accurate prediction of breast cancer recurrence after treatment is essential for improving long-term outcomes. However, existing models are limited by three key challenges: (1) they typically rely on single-modal data, missing cross-modal interactions; (2) they analyze static snapshots, failing to capture disease progression over time; and (3) they often perform coarse feature fusion, lacking semantic disentanglement and interpretability. To address these issues, we propose LUMIN (Longitudinal Multi-modal Knowledge Decomposition Network), a novel framework that integrates longitudinal mammograms and electronic health records (EHRs) for recurrence prediction. LUMIN leverages a vision-language contrastive pretraining backbone to align multi-modal representations and introduces two knowledge extraction modules: (1) a Cross-Modal Disentangled Knowledge Extractor (CM-DKE) that separates shared, complementary, and modality-specific information across imaging and text; and (2) a Temporal Evolution Disentangled Knowledge Extractor (TE-DKE) that captures time-invariant, time-varying, and time-specific features to model disease dynamics. Experiments on a large-scale dataset of 3,924 patients and 19,684 exams show that LUMIN significantly outperforms state-of-the-art baselines, demonstrating its effectiveness in capturing both multi-modal semantics and temporal heterogeneity for recurrence prediction.

Longitudinal medical imaging is crucial for monitoring neoadjuvant therapy (NAT) response in clinical practice. However, mainstream artificial intelligence (AI) methods for disease monitoring commonly rely on extensive segmentation labels to evaluate lesion progression. While self-supervised vision-language (VL) learning efficiently captures medical knowledge from radiology reports, existing methods focus on single time points, missing opportunities to leverage temporal self-supervision for disease progression tracking. In addition, extracting dynamic progression from longitudinal unannotated images with corresponding textual data poses challenges. In this work, we explicitly account for longitudinal NAT examinations and accompanying reports, encompassing scans before NAT and follow-up scans during mid-/post-NAT. We introduce the multi-modal longitudinal representation learning pipeline (MLRL), a temporal foundation model, that employs multi-scale self-supervision scheme, including single-time scale vision-text alignment (VTA) learning and multi-time scale visual/textual progress (TVP/TTP) learning to extract temporal representations from each modality, thereby facilitates the downstream evaluation of tumor progress. Our method is evaluated against several state-of-the-art self-supervised longitudinal learning and multi-modal VL methods. Results from internal and external datasets demonstrate that our approach not only enhances label efficiency across the zero-, few- and full-shot regime experiments but also significantly improves tumor response prediction in diverse treatment scenarios. Furthermore, MLRL enables interpretable visual tracking of progressive areas in temporal examinations, offering insights into longitudinal VL foundation tools and potentially facilitating the temporal clinical decision-making process.

Three-dimensional organ and cancer segmentation based on multi-sequence MRI is crucial for assisting clinical diagnosis. However, current automated segmentation methods often focus on specific sequences, specific organs, and specific cancers, i.e., lack of generality. To address this issue, we propose a universal segmentation network for multi-sequence MRI (UniMRISegNet) that can segment multiple organs and cancers. UniMRISegNet features a shared encoder-decoder architecture equipped with contextual prompt generation (CPG) and prompt-conditioned dynamic convolution (PCDC) modules. The CPG module encodes sequence-specific, position-specific, and organ/cancer-specific text prompts as prior information to inform UniMRISegNet about the specific task to be executed. The PCDC module can adaptively generate model weights based on the assigned prompts, enhancing the segmentation capabilities of the UniMRISegNet for specific tasks. To mitigate discrepancies between different sequences of the same organ and capture similarities between related sequences, we design a novel loss function called Semantic-Aware Cosine Similarity Loss (SACSL), which integrates the cosine similarity of text embeddings to reconcile discrepancies and similarities between MRI sequences of the same organ. We created a large-scale annotated multi-sequence, multi-organ, and multi-cancer segmentation workflow (MSOCS), and demonstrated that our UniMRISegNet outperforms other universal networks and single-task networks on MSOCS. Furthermore, the universal weights from MSOCS can be transferred to never-before-seen downstream tasks, achieving superior performance compared to training from scratch.