Zhejia Zhang

Yuanye Liu, Nannan Shi, Zhejia Zhang et al.

Despite years of methodological progress, how far AI has come in liver fibrosis staging has never been systematically evaluated under the heterogeneous, multi-center conditions that define clinical practice. To address this gap, we introduce LiFS, a large-scale dataset and benchmark derived from the MICCAI 2025 CARE-Liver challenge, comprising 610 patients across multiple centers and scanners with multi-sequence MRI. To the best of our knowledge, LiFS is the first benchmark providing complete gadoxetic acid-enhanced sequences with histopathology-confirmed annotations from diverse real-world scanners. Through systematic evaluation of 9 independently developed methods selected from 96 registered teams against in-cohort radiologist reference results, our findings address how far current AI has progressed toward clinical-level liver fibrosis staging from three complementary perspectives. First, against radiologists, the best AI methods were broadly comparable to the senior radiologist and significantly exceeded the junior radiologist in selected settings, while median AI performance generally approached junior-radiologist levels. Second, from a data perspective, cross-center heterogeneity, label imbalance, and contrast-enhanced sequence variability emerge as the dominant challenges for AI methods. Third, from a technical perspective, methodological design choices, including spatial registration, input dimensionality, multi-modal fusion strategy, and backbone architecture, appear to modulate cross-center robustness, although no single choice alone closes the gap. Overall, LiFS provides a rigorous real-world benchmark for positioning the current state of AI in liver fibrosis staging and for enabling future research on the key challenges that limit clinically reliable deployment.

Zhejia Zhang, Junjie Wang, Le Zhang

In real-world clinical settings, magnetic resonance imaging (MRI) frequently suffers from missing modalities due to equipment variability or patient cooperation issues, which can significantly affect model performance. To address this issue, we propose a multimodal MRI classification model based on the mmFormer architecture with an adaptive module for handling arbitrary combinations of missing modalities. Specifically, this model retains the hybrid modality-specific encoders and the modality-correlated encoder from mmFormer to extract consistent lesion features across available modalities. In addition, we integrate a missing-modality compensation module which leverages zero-padding, modality availability masks, and a Delta Function with learnable statistical parameters to dynamically synthesize proxy features for recovering missing information. To further improve prediction performance, we adopt a cross-validation ensemble strategy by training multiple models on different folds and applying soft voting during inference. This method is evaluated on the test set of Comprehensive Analysis & Computing of REal-world medical images (CARE) 2025 challenge, targeting the Liver Fibrosis Staging (LiFS) task based on non-contrast dynamic MRI scans including T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and diffusion-weighted imaging (DWI). For Cirrhosis Detection and Substantial Fibrosis Detection on in-distribution vendors, our model obtains accuracies of 66.67%, and 74.17%, and corresponding area under the curve (AUC) scores of 71.73% and 68.48%, respectively.