The ethical and legal imperative to share research data without causing harm requires careful attention to privacy risks. While mounting evidence demonstrates that data sharing benefits science, legitimate concerns persist regarding the potential leakage of personal information that could lead to reidentification and subsequent harm. We reviewed metadata accompanying neuroimaging datasets from six heterogeneous studies openly available on OpenNeuro, involving participants across the lifespan, from children to older adults, with and without clinical diagnoses, and including associated clinical score data. Using metaprivBIDS (this https URL), a novel tool for the systematic assessment of privacy in tabular data, we found that privacy is generally well maintained, with serious vulnerabilities being rare. Nonetheless, minor issues were identified in nearly all datasets and warrant mitigation. Notably, clinical score data (e.g., neuropsychological results) posed minimal reidentification risk, whereas demographic variables (age, sex, race, income, and geolocation) represented the principal privacy vulnerabilities. We outline practical measures to address these risks, enabling safer data sharing practices.

Humans are highly dependent on the ability to process audio in order to interact through conversation and navigate from sound. For this, the shape of the ear acts as a mechanical audio filter. The anatomy of the outer human ear canal to approximately 15-20 mm beyond the Tragus is well described because of its importance for customized hearing aid production. This is however not the case for the part of the ear canal that is embedded in the skull, until the typanic membrane. Due to the sensitivity of the outer ear, this part, referred to as the bony part, has only been described in a few population studies and only ex-vivo. We present a study of the entire ear canal including the bony part and the tympanic membrane. We form an average ear canal from a number of MRI scans using standard image registration methods. We show that the obtained representation is realistic in the sense that it has acoustical properties almost identical to a real ear.

Large language models (LLMs) such as GPT-4 have recently demonstrated impressive results across a wide range of tasks. LLMs are still limited, however, in that they frequently fail at complex reasoning, their reasoning processes are opaque, they are prone to 'hallucinate' facts, and there are concerns about their underlying biases. Letting models verbalize reasoning steps as natural language, a technique known as chain-of-thought prompting, has recently been proposed as a way to address some of these issues. Here we present ThoughtSource, a meta-dataset and software library for chain-of-thought (CoT) reasoning. The goal of ThoughtSource is to improve future artificial intelligence systems by facilitating qualitative understanding of CoTs, enabling empirical evaluations, and providing training data. This first release of ThoughtSource integrates seven scientific/medical, three general-domain and five math word question answering datasets.

Curvilinear structure segmentation is important in medical imaging, quantifying structures such as vessels, airways, neurons, or organ boundaries in 2D slices. Segmentation via pixel-wise classification often fails to capture the small and low-contrast curvilinear structures. Prior topological information is typically used to address this problem, often at an expensive computational cost, and sometimes requiring prior knowledge of the expected topology. We present DTU-Net, a data-driven approach to topology-preserving curvilinear structure segmentation. DTU-Net consists of two sequential, lightweight U-Nets, dedicated to texture and topology, respectively. While the texture net makes a coarse prediction using image texture information, the topology net learns topological information from the coarse prediction by employing a triplet loss trained to recognize false and missed splits in the structure. We conduct experiments on a challenging multi-class ultrasound scan segmentation dataset as well as a well-known retinal imaging dataset. Results show that our model outperforms existing approaches in both pixel-wise segmentation accuracy and topological continuity, with no need for prior topological knowledge.

Radiology reports contain rich clinical information that can be used to train imaging models without relying on costly manual annotation. However, existing approaches face critical limitations: rule-based methods struggle with linguistic variability, supervised models require large annotated datasets, and recent LLM-based systems depend on closed-source or resource-intensive models that are unsuitable for clinical use. Moreover, current solutions are largely restricted to English and single-modality, single-taxonomy datasets. We introduce MOSAIC, a multilingual, taxonomy-agnostic, and computationally efficient approach for radiological report classification. Built on a compact open-access language model (MedGemma-4B), MOSAIC supports both zero-/few-shot prompting and lightweight fine-tuning, enabling deployment on consumer-grade GPUs. We evaluate MOSAIC across seven datasets in English, Spanish, French, and Danish, spanning multiple imaging modalities and label taxonomies. The model achieves a mean macro F1 score of 88 across five chest X-ray datasets, approaching or exceeding expert-level performance, while requiring only 24 GB of GPU memory. With data augmentation, as few as 80 annotated samples are sufficient to reach a weighted F1 score of 82 on Danish reports, compared to 86 with the full 1600-sample training set. MOSAIC offers a practical alternative to large or proprietary LLMs in clinical settings. Code and models are open-source. We invite the community to evaluate and extend MOSAIC on new languages, taxonomies, and modalities.

Zero-shot learning models achieve remarkable results on image classification for samples from classes that were not seen during training. However, such models must be trained from scratch with specialised methods: therefore, access to a training dataset is required when the need for zero-shot classification arises. In this paper, we aim to equip pre-trained models with zero-shot classification capabilities without the use of image data. We achieve this with our proposed Image-free Classifier Injection with Semantics (ICIS) that injects classifiers for new, unseen classes into pre-trained classification models in a post-hoc fashion without relying on image data. Instead, the existing classifier weights and simple class-wise descriptors, such as class names or attributes, are used. ICIS has two encoder-decoder networks that learn to reconstruct classifier weights from descriptors (and vice versa), exploiting (cross-)reconstruction and cosine losses to regularise the decoding process. Notably, ICIS can be cheaply trained and applied directly on top of pre-trained classification models. Experiments on benchmark ZSL datasets show that ICIS produces unseen classifier weights that achieve strong (generalised) zero-shot classification performance. Code is available at this https URL .

Datasets play a critical role in medical imaging research, yet issues such as label quality, shortcuts, and metadata are often overlooked. This lack of attention may harm the generalizability of algorithms and, consequently, negatively impact patient outcomes. While existing medical imaging literature reviews mostly focus on machine learning (ML) methods, with only a few focusing on datasets for specific applications, these reviews remain static -- they are published once and not updated thereafter. This fails to account for emerging evidence, such as biases, shortcuts, and additional annotations that other researchers may contribute after the dataset is published. We refer to these newly discovered findings of datasets as research artifacts. To address this gap, we propose a living review that continuously tracks public datasets and their associated research artifacts across multiple medical imaging applications. Our approach includes a framework for the living review to monitor data documentation artifacts, and an SQL database to visualize the citation relationships between research artifact and dataset. Lastly, we discuss key considerations for creating medical imaging datasets, review best practices for data annotation, discuss the significance of shortcuts and demographic diversity, and emphasize the importance of managing datasets throughout their entire lifecycle. Our demo is publicly available at this http URL.

Diffusion models may be viewed as hierarchical variational autoencoders (VAEs) with two improvements: parameter sharing for the conditional distributions in the generative process and efficient computation of the loss as independent terms over the hierarchy. We consider two changes to the diffusion model that retain these advantages while adding flexibility to the model. Firstly, we introduce a data- and depth-dependent mean function in the diffusion process, which leads to a modified diffusion loss. Our proposed framework, DiffEnc, achieves a statistically significant improvement in likelihood on CIFAR-10. Secondly, we let the ratio of the noise variance of the reverse encoder process and the generative process be a free weight parameter rather than being fixed to 1. This leads to theoretical insights: For a finite depth hierarchy, the evidence lower bound (ELBO) can be used as an objective for a weighted diffusion loss approach and for optimizing the noise schedule specifically for inference. For the infinite-depth hierarchy, on the other hand, the weight parameter has to be 1 to have a well-defined ELBO.

Domain randomization through synthesis is a powerful strategy to train networks that are unbiased with respect to the domain of the input images. Randomization allows networks to see a virtually infinite range of intensities and artifacts during training, thereby minimizing overfitting to appearance and maximizing generalization to unseen data. Although powerful, this approach relies on the accurate tuning of a large set of hyperparameters that govern the probabilistic distribution of the synthesized images. Instead of manually tuning these parameters, we introduce Learn2Synth, a novel procedure in which synthesis parameters are learned using a small set of real labeled data. Unlike methods that impose constraints to align synthetic data with real data (e.g., contrastive or adversarial techniques), which risk misaligning the image and its label map, we tune an augmentation engine such that a segmentation network trained on synthetic data has optimal accuracy when applied to real data. This approach allows the training procedure to benefit from real labeled examples, without ever using these real examples to train the segmentation network, which avoids biasing the network towards the properties of the training set. Specifically, we develop parametric and nonparametric strategies to enhance synthetic images in a way that improves the performance of the segmentation network. We demonstrate the effectiveness of this learning strategy on synthetic and real-world brain scans. Code is available at: this https URL.

We present FOMO60K, a large-scale, heterogeneous dataset of 60,529 brain Magnetic Resonance Imaging (MRI) scans from 13,900 sessions and 11,187 subjects, aggregated from 16 publicly available sources. The dataset includes both clinical- and research-grade images, multiple MRI sequences, and a wide range of anatomical and pathological variability, including scans with large brain anomalies. Minimal preprocessing was applied to preserve the original image characteristics while reducing barriers to entry for new users. Accompanying code for self-supervised pretraining and finetuning is provided. FOMO60K is intended to support the development and benchmarking of self-supervised learning methods in medical imaging at scale.

Medical imaging models have been shown to encode information about patient demographics such as age, race, and sex in their latent representation, raising concerns about their potential for discrimination. Here, we ask whether requiring models not to encode demographic attributes is desirable. We point out that marginal and class-conditional representation invariance imply the standard group fairness notions of demographic parity and equalized odds, respectively. In addition, however, they require matching the risk distributions, thus potentially equalizing away important group differences. Enforcing the traditional fairness notions directly instead does not entail these strong constraints. Moreover, representationally invariant models may still take demographic attributes into account for deriving predictions, implying unequal treatment - in fact, achieving representation invariance may require doing so. In theory, this can be prevented using counterfactual notions of (individual) fairness or invariance. We caution, however, that properly defining medical image counterfactuals with respect to demographic attributes is fraught with challenges. Finally, we posit that encoding demographic attributes may even be advantageous if it enables learning a task-specific encoding of demographic features that does not rely on social constructs such as 'race' and 'gender.' We conclude that demographically invariant representations are neither necessary nor sufficient for fairness in medical imaging. Models may need to encode demographic attributes, lending further urgency to calls for comprehensive model fairness assessments in terms of predictive performance across diverse patient groups.

The rhythmic pumping motion of the heart stands as a cornerstone in life, as it circulates blood to the entire human body through a series of carefully timed contractions of the individual chambers. Changes in the size, shape and movement of the chambers can be important markers for cardiac disease and modeling this in relation to clinical demography or disease is therefore of interest. Existing methods for spatio-temporal modeling of the human heart require shape correspondence over time or suffer from large memory requirements, making it difficult to use for complex anatomies. We introduce a novel conditional generative model, where the shape and movement is modeled implicitly in the form of a spatio-temporal neural distance field and conditioned on clinical demography. The model is based on an auto-decoder architecture and aims to disentangle the individual variations from that related to the clinical demography. It is tested on the left atrium (including the left atrial appendage), where it outperforms current state-of-the-art methods for anatomical sequence completion and generates synthetic sequences that realistically mimics the shape and motion of the real left atrium. In practice, this means we can infer functional measurements from a static image, generate synthetic populations with specified demography or disease and investigate how non-imaging clinical data effect the shape and motion of cardiac anatomies.

Medical image segmentation is often considered as the task of labelling each pixel or voxel as being inside or outside a given anatomy. Processing the images at their original size and resolution often result in insuperable memory requirements, but downsampling the images leads to a loss of important details. Instead of aiming to represent a smooth and continuous surface in a binary voxel-grid, we propose to learn a Neural Unsigned Distance Field (NUDF) directly from the image. The small memory requirements of NUDF allow for high resolution processing, while the continuous nature of the distance field allows us to create high resolution 3D mesh models of shapes of any topology (i.e. open surfaces). We evaluate our method on the task of left atrial appendage (LAA) segmentation from Computed Tomography (CT) images. The LAA is a complex and highly variable shape, being thus difficult to represent with traditional segmentation methods using discrete labelmaps. With our proposed method, we are able to predict 3D mesh models that capture the details of the LAA and achieve accuracy in the order of the voxel spacing in the CT images.

Spherical or omni-directional images offer an immersive visual format appealing to a wide range of computer vision applications. However, geometric properties of spherical images pose a major challenge for models and metrics designed for ordinary 2D images. Here, we show that direct application of Fréchet Inception Distance (FID) is insufficient for quantifying geometric fidelity in spherical images. We introduce two quantitative metrics accounting for geometric constraints, namely Omnidirectional FID (OmniFID) and Discontinuity Score (DS). OmniFID is an extension of FID tailored to additionally capture field-of-view requirements of the spherical format by leveraging cubemap projections. DS is a kernel-based seam alignment score of continuity across borders of 2D representations of spherical images. In experiments, OmniFID and DS quantify geometry fidelity issues that are undetected by FID.

In recent years, the use of deep learning (DL) methods, including convolutional neural networks (CNNs) and vision transformers (ViTs), has significantly advanced computational pathology, enhancing both diagnostic accuracy and efficiency. Hematoxylin and Eosin (H&E) Whole Slide Images (WSI) plays a crucial role by providing detailed tissue samples for the analysis and training of DL models. However, WSIs often contain regions with artifacts such as tissue folds, blurring, as well as non-tissue regions (background), which can negatively impact DL model performance. These artifacts are diagnostically irrelevant and can lead to inaccurate results. This paper proposes a fully automatic supervised DL pipeline for WSI Quality Assessment (WSI-QA) that uses a fused model combining CNNs and ViTs to detect and exclude WSI regions with artifacts, ensuring that only qualified WSI regions are used to build DL-based computational pathology applications. The proposed pipeline employs a pixel-based segmentation model to classify WSI regions as either qualified or non- qualified based on the presence of artifacts. The proposed model was trained on a large and diverse dataset and validated with internal and external data from various human organs, scanners, and H&E staining procedures. Quantitative and qualitative evaluations demonstrate the superiority of the proposed model, which outperforms state- of-the-art methods in WSI artifact detection. The proposed model consistently achieved over 95% accuracy, precision, recall, and F1 score across all artifact types. Furthermore, the WSI-QA pipeline shows strong generalization across different tissue types and scanning conditions.

Generative models such as Generative Adversarial Networks (GANs) and Variational Autoencoders (VAEs) play an increasingly important role in medical image analysis. The latent spaces of these models often show semantically meaningful directions corresponding to human-interpretable image transformations. However, until now, their exploration for medical images has been limited due to the requirement of supervised data. Several methods for unsupervised discovery of interpretable directions in GAN latent spaces have shown interesting results on natural images. This work explores the potential of applying these techniques on medical images by training a GAN and a VAE on thoracic CT scans and using an unsupervised method to discover interpretable directions in the resulting latent space. We find several directions corresponding to non-trivial image transformations, such as rotation or breast size. Furthermore, the directions show that the generative models capture 3D structure despite being presented only with 2D data. The results show that unsupervised methods to discover interpretable directions in GANs generalize to VAEs and can be applied to medical images. This opens a wide array of future work using these methods in medical image analysis.

Congenital malformations of the brain are among the most common fetal abnormalities that impact fetal development. Previous anomaly detection methods on ultrasound images are based on supervised learning, rely on manual annotations, and risk missing underrepresented categories. In this work, we frame fetal brain anomaly detection as an unsupervised task using diffusion models. To this end, we employ an inpainting-based Noise Agnostic Anomaly Detection approach that identifies the abnormality using diffusion-reconstructed fetal brain images from multiple noise levels. Our approach only requires normal fetal brain ultrasound images for training, addressing the limited availability of abnormal data. Our experiments on a real-world clinical dataset show the potential of using unsupervised methods for fetal brain anomaly detection. Additionally, we comprehensively evaluate how different noise types affect diffusion models in the fetal anomaly detection domain.

High-resolution colon segmentation is crucial for clinical and research applications, such as digital twins and personalized medicine. However, the leading open-source abdominal segmentation tool, TotalSegmentator, struggles with accuracy for the colon, which has a complex and variable shape, requiring time-intensive labeling. Here, we present the first fully automatic high-resolution colon segmentation method. To develop it, we first created a high resolution colon dataset using a pipeline that combines region growing with interactive machine learning to efficiently and accurately label the colon on CT colonography (CTC) images. Based on the generated dataset consisting of 435 labeled CTC images we trained an nnU-Net model for fully automatic colon segmentation. Our fully automatic model achieved an average symmetric surface distance of 0.2 mm (vs. 4.0 mm from TotalSegmentator) and a 95th percentile Hausdorff distance of 1.0 mm (vs. 18 mm from TotalSegmentator). Our segmentation accuracy substantially surpasses TotalSegmentator. We share our trained model and pipeline code, providing the first and only open-source tool for high-resolution colon segmentation. Additionally, we created a large-scale dataset of publicly available high-resolution colon labels.

OBJECTIVE: Assessing the biomechanical behaviour of the aortic wall in vivo can potentially improve the diagnosis and prognosis of patients with abdominal aortic aneurysms (AAA). With ultrasound, AAA wall stiffness can be estimated as the diameter change in response to blood pressure. However, this measurement has shown limited reproducibility, possibly influenced by the unknown effects of the highly variable ultrasound probe pressure. This study addressed this gap by analyzing time-resolved ultrasound sequences from AAA patients.METHOD: Two-dimensional ultrasound sequences were acquired from AAA patients, alternatively applying light and firm probe pressure. Diameter variations and stiffness were evaluated and compared. An in silico simulation was performed to support the in vivo observations.RESULTS: It was found that half of the AAAs were particularly responsive to the probe pressure: in these patients, the cyclic diameter variation between diastole and systole changed from 1% at light probe pressure to 5% at firm probe pressure and the estimated stiffness decreases by a factor of 6.3. Conversely, the other half of the patients were less responsive: diameter variations increased marginally and stiffness decreased by a factor of 1.5 when transitioning from light to firm probe pressure. Through numerical simulations, we were able to show that the rather counter-intuitive stiffness decrease observed in the responsive cohort is actually consistent with a biomechanical model.CONCLUSION: We conclude that probe pressure has an important effect on the estimation of AAA wall stiffness. Ultimately, our findings suggest potential implications for AAA mechanical characterization via ultrasound imaging.