P. Soda

Daniele Molino, Camillo Maria Caruso, Paolo Soda et al.

Text-conditioned generative models for volumetric medical imaging provide semantic control but lack explicit anatomical guidance, often resulting in outputs that are spatially ambiguous or anatomically inconsistent. In contrast, structure-driven methods ensure strong anatomical consistency but typically assume access to ground-truth annotations, which are unavailable when the target image is to be synthesized. We propose a retrieval-augmented approach for Text-to-CT generation that integrates semantic and anatomical information under a realistic inference setting. Given a radiology report, our method retrieves a semantically related clinical case using a 3D vision-language encoder and leverages its associated anatomical annotation as a structural proxy. This proxy is injected into a text-conditioned latent diffusion model via a ControlNet branch, providing coarse anatomical guidance while maintaining semantic flexibility. Experiments on the CT-RATE dataset show that retrieval-augmented generation improves image fidelity and clinical consistency compared to text-only baselines, while additionally enabling explicit spatial controllability, a capability inherently absent in such approaches. Further analysis highlights the importance of retrieval quality, with semantically aligned proxies yielding consistent gains across all evaluation axes. This work introduces a principled and scalable mechanism to bridge semantic conditioning and anatomical plausibility in volumetric medical image synthesis. Code is available at https://github.com/arco-group/RAGText2CT.

Alessandro Pesci, Valerio Guarrasi, Marco Alì et al.

The translation from Magnetic resonance imaging (MRI) to Computed tomography (CT) has been proposed as an effective solution to facilitate MRI-only clinical workflows while limiting exposure to ionizing radiation. Although numerous Generative Adversarial Network (GAN) architectures have been proposed for MRI-to-CT translation, systematic and fair comparisons across heterogeneous models remain limited. We present a comprehensive benchmark of ten GAN architectures evaluated on the SynthRAD2025 dataset across three anatomical districts (abdomen, thorax, head-and-neck). All models were trained under a unified validation protocol with identical preprocessing and optimization settings. Performance was assessed using complementary metrics capturing voxel-wise accuracy, structural fidelity, perceptual quality, and distribution-level realism, alongside an analysis of computational complexity. Supervised Paired models consistently outperformed Unpaired approaches, confirming the importance of voxel-wise supervision. Pix2Pix achieved the most balanced performance across districts while maintaining a favorable quality-to-complexity trade-off. Multi-district training improved structural robustness, whereas intra-district training maximized voxel-wise fidelity. This benchmark provides quantitative and computational guidance for model selection in MRI-only radiotherapy workflows and establishes a reproducible framework for future comparative studies. To ensure the reproducibility of our experiments we make our code public, together with the overall results, at the following link:https://github.com/arco-group/MRI_TO_CT.git

Irene Iele, Giulia Romoli, Daniele Molino et al.

Short-term forecasting of vegetation dynamics is a key enabler for data-driven decision support in precision agriculture. Normalized Difference Vegetation Index (NDVI) forecasting from satellite observations, however, remains challenging due to sparse and irregular sampling caused by cloud masking, as well as the heterogeneous climatic conditions under which crops evolve. In this work, we propose a probabilistic forecasting framework for field-level NDVI prediction under sparse, irregular clear-sky acquisitions. The architecture separates the encoding of historical NDVI and meteorological observations from future exogenous covariates, fusing both representations for multi-step quantile prediction. To address irregular revisit patterns and horizon-dependent uncertainty, we introduce a temporal-distance weighted quantile loss that aligns the training objective with the effective forecasting horizon. In addition, we incorporate cumulative and extreme-weather feature engineering to capture delayed meteorological effects relevant to vegetation response. Experiments on European satellite data show that the proposed approach outperforms statistical, deep learning, and time-series baselines on both pointwise and probabilistic evaluation metrics. Ablation studies confirm that target history is the primary driver of performance, with meteorological covariates providing additional gains in the full multimodal setting. The code is available at https://github.com/arco-group/ndvi-forecasting.

Massimiliano Mantegna, Elena Mulero Ayllón, Alice Natalina Caragliano et al.

Predicting tumor evolution during radiotherapy is a clinically critical challenge, particularly when longitudinal changes are driven by both anatomy and treatment. In this work, we introduce a Virtual Treatment (VT) framework that formulates non-small cell lung cancer (NSCLC) progression as a dose-aware multimodal conditional image-to-image translation problem. Given a CT scan, baseline clinical variables, and a specified radiation dose increment, VT aims to synthesize plausible follow-up CT images reflecting treatment-induced anatomical changes. We evaluate the proposed framework on a longitudinal dataset of 222 stage III NSCLC patients, comprising 895 CT scans acquired during radiotherapy under irregular clinical schedules. The generative process is conditioned on delivered dose increments together with demographic and tumor-related clinical variables. Representative GAN-based and diffusion-based models are benchmarked across 2D and 2.5D configurations. Quantitative and qualitative results indicate that diffusion-based models benefit more consistently from multimodal, dose-aware conditioning and produce more stable and anatomically plausible tumor evolution trajectories than GAN-based baselines, supporting the potential of VT as a tool for in-silico treatment monitoring and adaptive radiotherapy research in NSCLC.

Alice Natalina Caragliano, Giulia Farina, Fatih Aksu et al.

Major pathological response (pR) following neoadjuvant therapy is a clinically meaningful endpoint in non-small cell lung cancer, strongly associated with improved survival. However, accurate preoperative prediction of pR remains challenging, particularly in real-world clinical settings characterized by limited data availability and incomplete clinical profiles. In this study, we propose a multimodal deep learning framework designed to address these constraints by integrating foundation model-based CT feature extraction with a missing-aware architecture for clinical variables. This approach enables robust learning from small cohorts while explicitly modeling missing clinical information, without relying on conventional imputation strategies. A weighted fusion mechanism is employed to leverage the complementary contributions of imaging and clinical modalities, yielding a multimodal model that consistently outperforms both unimodal imaging and clinical baselines. These findings underscore the added value of integrating heterogeneous data sources and highlight the potential of multimodal, missing-aware systems to support pR prediction under realistic clinical conditions.

Marco Salmè, Federico Siciliano, Fabrizio Silvestri et al.

Radiology Report Generation (RRG) through Vision-Language Models (VLMs) promises to reduce documentation burden, improve reporting consistency, and accelerate clinical workflows. However, their clinical adoption remains limited by the lack of interpretability and the tendency to hallucinate findings misaligned with imaging evidence. Existing research typically treats interpretability and accuracy as separate objectives, with concept-based explainability techniques focusing primarily on transparency, while Retrieval-Augmented Generation (RAG) methods targeting factual grounding through external retrieval. We present Concept-Enhanced Multimodal RAG (CEMRAG), a unified framework that decomposes visual representations into interpretable clinical concepts and integrates them with multimodal RAG. This approach exploits enriched contextual prompts for RRG, improving both interpretability and factual accuracy. Experiments on MIMIC-CXR and IU X-Ray across multiple VLM architectures, training regimes, and retrieval configurations demonstrate consistent improvements over both conventional RAG and concept-only baselines on clinical accuracy metrics and standard NLP measures. These results challenge the assumed trade-off between interpretability and performance, showing that transparent visual concepts can enhance rather than compromise diagnostic accuracy in medical VLMs. Our modular design decomposes interpretability into visual transparency and structured language model conditioning, providing a principled pathway toward clinically trustworthy AI-assisted radiology.

Filippo Ruffini, Camillo Maria Caruso, Claudia Tacconi et al.

Accurate survival prediction in Non-Small Cell Lung Cancer (NSCLC) requires the integration of heterogeneous clinical, radiological, and histopathological information. While Multimodal Deep Learning (MDL) offers a promises for precision prognosis and survival prediction, its clinical applicability is severely limited by small cohort sizes and the presence of missing modalities, often forcing complete-case filtering or aggressive imputation. In this work, we present a missing-aware multimodal survival framework that integrates Computed Tomography (CT), Whole-Slide Histopathology (WSI) Images, and structured clinical variables for overall survival modeling in unresectable stage II-III NSCLC. By leveraging Foundation Models (FM) for modality-specific feature extraction and a missing-aware encoding strategy, the proposed approach enables intermediate multimodal fusion under naturally incomplete modality profiles. The proposed architecture is resilient to missing modalities by design, allowing the model to utilize all available data without being forced to drop patients during training or inference. Experimental results demonstrate that intermediate fusion consistently outperforms unimodal baselines as well as early and late fusion strategies, with the strongest performance achieved by the fusion of WSI and clinical modalities (73.30 C-index). Further analyses of modality importance reveal an adaptive behavior in which less informative modalities, i.e., CT modality, are automatically down-weighted and contribute less to the final survival prediction.

Irene Iele, Elena Mulero Ayllón, Paolo Soda et al.

Vegetation monitoring under climate stress requires answering not only how it will evolve given the expected weather, but how it would respond to alternative meteorological conditions. Forecasting models return the expected vegetation state for the observed weather and cannot answer these scenario-conditioned questions, because future weather is fixed to the recorded trajectory. We present VegSim, a geospatial world model for scenario-conditioned vegetation simulation. VegSim infers a latent vegetation state from sparse satellite-derived NDVI histories, past meteorological covariates, and static spatial context, propagates it forward under future weather forcing through recurrent latent dynamics, and decodes predictive NDVI quantiles at each lead time. Because future forcing enters as a controllable input, the same trained model supports probabilistic forecasting under observed weather and conditional simulation under user-defined meteorological forcing, without supervision on scenario responses. We evaluate VegSim on GreenEarthNet across in-distribution data and spatial, temporal, and joint spatial-temporal shift, where it achieves strong point and probabilistic accuracy against time series and Earth observation forecasting baselines while using a compact architecture. We then simulate vegetation responses across Europe under four meteorological scenarios, and in a France summer 2022 case study, obtaining spatially coherent patterns consistent with known sensitivity to temperature and precipitation. The code is available at https://github.com/arco-group/vegsim.

Irene Iele, Floriano Caprio, Paolo Soda et al.

Forecasting physiological signals can support proactive monitoring and timely clinical intervention by anticipating critical changes in patient status. In this work, we address multivariate multi-horizon forecasting of physiological time series by jointly predicting heart rate, oxygen saturation, pulse rate, and respiratory rate at forecasting horizons of 15, 30, and 60 seconds. We propose a hybrid quantum-classical architecture that integrates a Variational Quantum Circuit (VQC) within a recurrent neural backbone. A GRU encoder summarizes the historical observation window into a latent representation, which is then projected into quantum angles used to parameterize the VQC. The quantum layer acts as a learnable non-linear feature mixer, modeling cross-variable interactions before the final prediction stage. We evaluate the proposed approach on the BIDMC PPG and Respiration dataset under a Leave-One-Patient-Out protocol. The results show competitive accuracy compared with classical and deep learning baselines, together with greater robustness to noise and missing inputs. These findings suggest that hybrid quantum layers can provide useful inductive biases for physiological time series forecasting in small-cohort clinical settings.