Radiology report generation is critical for efficiency, but current models often lack the structured reasoning of experts and the ability to explicitly ground findings in anatomical evidence, which limits clinical trust and explainability. This paper introduces BoxMed-RL, a unified training framework to generate spatially verifiable and explainable chest X-ray reports. BoxMed-RL advances chest X-ray report generation through two integrated phases: (1) Pretraining Phase. BoxMed-RL learns radiologist-like reasoning through medical concept learning and enforces spatial grounding with reinforcement learning. (2) Downstream Adapter Phase. Pretrained weights are frozen while a lightweight adapter ensures fluency and clinical credibility. Experiments on two widely used public benchmarks (MIMIC-CXR and IU X-Ray) demonstrate that BoxMed-RL achieves an average 7 % improvement in both METEOR and ROUGE-L metrics compared to state-of-the-art methods. An average 5 % improvement in large language model-based metrics further underscores BoxMed-RL's robustness in generating high-quality reports. Related code and training templates are publicly available at https://github.com/ayanglab/BoxMed-RL.

Automated airway segmentation in computerized tomography (CT) images is crucial for the accurate diagnosis of lung diseases. However, the scarcity of manual annotations hinders the efficacy of supervised learning, while unconstrained intensities and sample imbalance lead to discontinuity and false-negative issues. To address these challenges, we propose a novel airway segmentation model named Dynamical Multi-order responses and Global Semantic-infused Adversarial network (DMGSA), integrating the unsupervised and supervised learning in parallel to alleviate the label scarcity of airway. In the unsupervised branch, (1) we propose several novel strategies of Dynamic Mask-Ratio (DMR) to empower the model to perceive context information of varying sizes, mimicking the laws of human learning vividly; (2) we present a novel target of Multi-Order Normalized Responses (MONR), exploiting the distinct order exponential operation of raw images and oriented gradients to enhance the textural representations of bronchioles; (3) we introduce the Adversarial Learning (AL) on the top of MONR module to discern nuances between real and fake images, focusing on capturing the textural features of terminal bronchioles. For the supervised branch, we propose an innovative Generalized Mean pooling based Global Semantic-infused (GMGS) module to ulteriorly improve the robustness. Ultimately, we have verified the method performance and robustness by training on normal lung disease datasets, while testing on lung cancer, COVID-19 and Lung fibrosis datasets. All experimental results have proved that our method exceeds state-of-the-art methods significantly.

Over the past five years, artificial intelligence (AI) has introduced new models and methods for addressing the challenges associated with the broader adoption of AI models and systems in medicine. This paper reviews recent advances in AI for medical image and video analysis, outlines emerging paradigms, highlights pathways for successful clinical translation, and provides recommendations for future work. Hybrid Convolutional Neural Network (CNN) Transformer architectures now deliver state-of-the-art results in segmentation, classification, reconstruction, synthesis, and registration. Foundation and generative AI models enable the use of transfer learning to smaller datasets with limited ground truth. Federated learning supports privacy-preserving collaboration across institutions. Explainable and trustworthy AI approaches have become essential to foster clinician trust, ensure regulatory compliance, and facilitate ethical deployment. Together, these developments pave the way for integrating AI into radiology, pathology, and wider healthcare workflows.

Immunofluorescent (IF) imaging is crucial for visualising biomarker expressions, cell morphology and assessing the effects of drug treatments on sub-cellular components. IF imaging needs extra staining process and often requiring cell fixation, therefore it may also introduce artefacts and alter endogenous cell morphology. Some IF stains are expensive or not readily available hence hindering experiments. Recent diffusion models, which synthesise high-fidelity IF images from easy-to-acquire brightfield (BF) images, offer a promising solution but are hindered by training instability and slow inference times due to the noise diffusion process. This paper presents a novel method for the conditional synthesis of IF images directly from BF images along with cell segmentation masks. Our approach employs a Residual Diffusion process that enhances stability and significantly reduces inference time. We performed a critical evaluation against other image-to-image synthesis models, including UNets, GANs, and advanced diffusion models. Our model demonstrates significant improvements in image quality ( p < 0 . 05 in MSE, PSNR, and SSIM), inference speed (26 times faster than competing diffusion models), and accurate segmentation results for both nuclei and cell bodies (0.77 and 0.63 mean IOU for nuclei and cell true positives, respectively). This paper is a substantial advancement in the field, providing robust and efficient tools for cell image analysis. • We introduce a novel diffusion model to synthesise fluorescence images from brightfield images. • CellResDM improves quality, speed, and segmentation accuracy, surpassing existing models. • CellResDM model can simultaneously generates IF images and cell/nuclei segmentation.

As artificial intelligence and digital medicine increasingly permeate healthcare systems, robust governance frameworks are essential to ensure ethical, secure, and effective implementation. In this context, medical image retrieval becomes a critical component of clinical data management, playing a vital role in decision-making and safeguarding patient information. Existing methods usually learn hash functions using bottleneck features, which fail to produce representative hash codes from blended embeddings. Although contrastive hashing has shown superior performance, current approaches often treat image retrieval as a classification task, using category labels to create positive/negative pairs. Moreover, many methods fail to address the out-of-distribution (OOD) issue when models encounter external OOD queries or adversarial attacks. In this work, we propose a novel method to consolidate knowledge of hierarchical features and optimization functions. We formulate the knowledge consolidation by introducing Depth-aware Representation Fusion (DaRF) and Structure-aware Contrastive Hashing (SCH). DaRF adaptively integrates shallow and deep representations into blended features, and SCH incorporates image fingerprints to enhance the adaptability of positive/negative pairings. These blended features further facilitate OOD detection and content-based recommendation, contributing to a secure AI-driven healthcare environment. Moreover, we present a content-guided ranking to improve the robustness and reproducibility of retrieval results. Our comprehensive assessments demonstrate that the proposed method could effectively recognize OOD samples and significantly outperform existing approaches in medical image retrieval (p < 0 . 05 ). In particular, our method achieves a 5.6–38.9% improvement in mean Average Precision on the anatomical radiology dataset. • Structure-aware pairing using image fingerprints to address over-centralized issues. • A novel model to consolidate hierarchical embeddings for representation learning. • Addressing ill-posed gradient issues introduced by relaxed Hamming distance. • A self-supervised OOD detection module by evaluating image reconstruction disparity. • Content-guided ranking mechanism for robust and precise retrieval.

Generative AI has revolutionised visual content editing, empowering users to effortlessly modify images and videos. However, not all edits are equal. To perform realistic edits in domains such as natural image or medical imaging, modifications must respect causal relationships inherent to the data generation process. Such image editing falls into the counterfactual image generation regime. Evaluating counterfactual image generation is substantially complex: not only it lacks observable ground truths, but also requires adherence to causal constraints. Although several counterfactual image generation methods and evaluation metrics exist a comprehensive comparison within a unified setting is lacking. We present a comparison framework to thoroughly benchmark counterfactual image generation methods. We evaluate the performance of three conditional image generation model families developed within the Structural Causal Model (SCM) framework. We incorporate several metrics that assess diverse aspects of counterfactuals, such as composition, effectiveness, minimality of interventions, and image realism. We integrate all models that have been used for the task at hand and expand them to novel datasets and causal graphs, demonstrating the superiority of Hierarchical VAEs across most datasets and metrics. Our framework is implemented in a user-friendly Python package that can be extended to incorporate additional SCMs, causal methods, generative models, and datasets for the community to build on. Code: https://github.com/gulnazaki/counterfactual-benchmark.

Medical imaging is a key component in clinical diagnosis, treatment planning and clinical trial design, accounting for almost 90% of all healthcare data. CNNs achieved performance gains in medical image analysis (MIA) over the last years. CNNs can efficiently model local pixel interactions and be trained on small-scale MI data. Despite their important advances, typical CNN have relatively limited capabilities in modelling "global" pixel interactions, which restricts their generalisation ability to understand out-of-distribution data with different "global" information. The recent progress of Artificial Intelligence gave rise to Transformers, which can learn global relationships from data. However, full Transformer models need to be trained on large-scale data and involve tremendous computational complexity. Attention and Transformer compartments ("Transf/Attention") which can well maintain properties for modelling global relationships, have been proposed as lighter alternatives of full Transformers. Recently, there is an increasing trend to co-pollinate complementary local-global properties from CNN and Transf/Attention architectures, which led to a new era of hybrid models. The past years have witnessed substantial growth in hybrid CNN-Transf/Attention models across diverse MIA problems. In this systematic review, we survey existing hybrid CNN-Transf/Attention models, review and unravel key architectural designs, analyse breakthroughs, and evaluate current and future opportunities as well as challenges. We also introduced an analysis framework on generalisation opportunities of scientific and clinical impact, based on which new data-driven domain generalisation and adaptation methods can be stimulated.

As a pragmatic data augmentation tool, data synthesis has generally returned dividends in performance for deep learning based medical image analysis. However, generating corresponding segmentation masks for synthetic medical images is laborious and subjective. To obtain paired synthetic medical images and segmentations, conditional generative models that use segmentation masks as synthesis conditions were proposed. However, these segmentation mask-conditioned generative models still relied on large, varied, and labeled training datasets, and they could only provide limited constraints on human anatomical structures, leading to unrealistic image features. Moreover, the invariant pixel-level conditions could reduce the variety of synthetic lesions and thus reduce the efficacy of data augmentation. To address these issues, in this work, we propose a novel strategy for medical image synthesis, namely Unsupervised Mask (UM)-guided synthesis, to obtain both synthetic images and segmentations using limited manual segmentation labels. We first develop a superpixel based algorithm to generate unsupervised structural guidance and then design a conditional generative model to synthesize images and annotations simultaneously from those unsupervised masks in a semi-supervised multi-task setting. In addition, we devise a multi-scale multi-task Fréchet Inception Distance (MM-FID) and multi-scale multi-task standard deviation (MM-STD) to harness both fidelity and variety evaluations of synthetic CT images. With multiple analyses on different scales, we could produce stable image quality measurements with high reproducibility. Compared with the segmentation mask guided synthesis, our UM-guided synthesis provided high-quality synthetic images with significantly higher fidelity, variety, and utility ( by Wilcoxon Signed Ranked test).

Magnetic resonance imaging (MRI) benefits from the acquisition of multiple sequences (thereafter, referred to as “modalities”) under a single imaging session. Each modality offers different complementary spatial and functional information in the clinical setting. Inter- and intra (across MR sequence slices)-modality image registration is an important pre-processing step across multiple applications in routine clinical workflows, such as when visual or quantitative imaging biomarkers need to be assessed across multi-sequence/multi-slice MRI data. This paper presents an unsupervised deep learning-based registration network that can learn affine and non-rigid transformations, simultaneously. Inverse-consistency is an important property that is commonly ignored in recent deep learning-based inter-modality registration algorithms. We address this issue through our proposed multi-task, cross-domain image synthesis architecture, in which we incorporated a new comprehensive transformation network. The proposed model learns a modality-independent latent representation to perform cycle-consistent cross-modality synthesis and uses an inverse-consistency loss to learn paired transformations, to align the synthesized with the target image. We name this proposed framework as “FIRE” due to the shape of its structure and we focus on interpreting model components to enhance model interpretability for clinical MR applications. Our method shows comparable and better performances against a well-established baseline method in experiments on multi-sequence brain MR data and intra-modality 4D cardiac Cine-MR data.

Deep convoloutional networks have been widely deployed in modern cyber-physical systems performing different visual classification tasks. As the fog and edge devices have different computing capacity and perform different subtasks, models trained for one device may not be deployable on another. Knowledge distillation technique can effectively compress well trained convolutional neural networks into light-weight models suitable to different devices. However, due to privacy issue and transmission cost, manually annotated data for training the deep learning models are usually gradually collected and archived in different sites. Simply training a model on powerful cloud servers and compressing them for particular edge devices failed to use the distributed data stored at different sites. This offline training approach is also inefficient to deal with new data collected from the edge devices. To overcome these obstacles, in this article, we propose the heterogeneous brain storming (HBS) method for object recognition tasks in real-world Internet of Things (IoT) scenarios. Our method enables flexible bidirectional federated learning of heterogeneous models trained on distributed datasets with a new “brain storming” mechanism and optimizable temperature parameters. In our comparison experiments, this HBS method outperformed multiple state-of-the-art single-model compression methods, as well as the newest multinetwork knowledge distillation methods with both homogeneous and heterogeneous classifiers. The ablation experiment results proved that the trainable temperature parameter into the conventional knowledge distillation loss can effectively ease the learning process of student networks in different methods. To the best of authors' knowledge, this is the first IoT-oriented method that allows asynchronous bidirectional heterogeneous knowledge distillation in deep networks.

Magnetic resonance (MR) protocols rely on several sequences to assess pathology and organ status properly. Despite advances in image analysis, we tend to treat each sequence, here termed modality, in isolation. Taking advantage of the common information shared between modalities (an organ's anatomy) is beneficial for multi-modality processing and learning. However, we must overcome inherent anatomical misregistrations and disparities in signal intensity across the modalities to obtain this benefit. We present a method that offers improved segmentation accuracy of the modality of interest (over a single input model), by learning to leverage information present in other modalities, even if few (semi-supervised) or no (unsupervised) annotations are available for this specific modality. Core to our method is learning a disentangled decomposition into anatomical and imaging factors. Shared anatomical factors from the different inputs are jointly processed and fused to extract more accurate segmentation masks. Image misregistrations are corrected with a Spatial Transformer Network, which non-linearly aligns the anatomical factors. The imaging factor captures signal intensity characteristics across different modality data and is used for image reconstruction, enabling semi-supervised learning. Temporal and slice pairing between inputs are learned dynamically. We demonstrate applications in Late Gadolinium Enhanced (LGE) and Blood Oxygenation Level Dependent (BOLD) cardiac segmentation, as well as in T2 abdominal segmentation. Code is available at https://github.com/vios-s/multimodal_segmentation.

In modern Internet of Things (IoT), visual analysis and predictions are often performed by deep learning models. Salient object detection (SOD) is a fundamental preprocessing for these applications. Executing SOD on the fog devices is a challenging task due to the diversity of data and fog devices. To adopt convolutional neural networks (CNN) on fog-cloud infrastructures for SOD-based applications, we introduce a semisupervised adversarial learning method in this article. The proposed model, named as SaliencyGAN, is empowered by a novel concatenated generative adversarial network (GAN) framework with partially shared parameters. The backbone CNN can be chosen flexibly based on the specific devices and applications. In the meanwhile, our method uses both the labeled and unlabeled data from different problem domains for training. Using multiple popular benchmark datasets, we compared state-of-the-art baseline methods to our SaliencyGAN obtained with 10-100% labeled training data. SaliencyGAN gained performance comparable to the supervised baselines when the percentage of labeled data reached 30%, and outperformed the weakly supervised and unsupervised baselines. Furthermore, our ablation study shows that SaliencyGAN were more robust to the common “mode missing” (or “mode collapse”) issue compared to the selected popular GAN models. The visualized ablation results have proved that SaliencyGAN learned a better estimation of data distributions. To the best of our knowledge, this is the first IoT-oriented semisupervised SOD method.