Yihui Cao

Wei Fang, Chiyao Wang, Wenshuai Ma et al.

Background: While intravascular imaging, particularly optical coherence tomography (OCT), improves percutaneous coronary intervention (PCI) outcomes, its interpretation is operator-dependent. General-purpose artificial intelligence (AI) shows promise but lacks domain-specific reliability. We evaluated the performance of CA-GPT, a novel large model deployed on an AI-OCT system, against that of the general-purpose ChatGPT-5 and junior physicians for OCT-guided PCI planning and assessment. Methods: In this single-center analysis of 96 patients who underwent OCT-guided PCI, the procedural decisions generated by the CA-GPT, ChatGPT-5, and junior physicians were compared with an expert-derived procedural record. Agreement was assessed using ten pre-specified metrics across pre-PCI and post-PCI phases. Results: For pre-PCI planning, CA-GPT demonstrated significantly higher median agreement scores (5[IQR 3.75-5]) compared to both ChatGPT-5 (3[2-4], P<0.001) and junior physicians (4[3-4], P<0.001). CA-GPT significantly outperformed ChatGPT-5 across all individual pre-PCI metrics and showed superior performance to junior physicians in stent diameter (90.3% vs. 72.2%, P<0.05) and length selection (80.6% vs. 52.8%, P<0.01). In post-PCI assessment, CA-GPT maintained excellent overall agreement (5[4.75-5]), significantly higher than both ChatGPT-5 (4[4-5], P<0.001) and junior physicians (5[4-5], P<0.05). Subgroup analysis confirmed CA-GPT's robust performance advantage in complex scenarios. Conclusion: The CA-GPT-based AI-OCT system achieved superior decision-making agreement versus a general-purpose large language model and junior physicians across both PCI planning and assessment phases. This approach provides a standardized and reliable method for intravascular imaging interpretation, demonstrating significant potential to augment operator expertise and optimize OCT-guided PCI.

Jiawen Yang, Yihui Cao, Xuanyu Tian et al.

Orthognathic surgery is a crucial intervention for correcting dentofacial skeletal deformities to enhance occlusal functionality and facial aesthetics. Accurate postoperative facial appearance prediction remains challenging due to the complex nonlinear interactions between skeletal movements and facial soft tissue. Existing biomechanical, parametric models and deep-learning approaches either lack computational efficiency or fail to fully capture these intricate interactions. To address these limitations, we propose Neural Implicit Craniofacial Model (NICE) which employs implicit neural representations for accurate anatomical reconstruction and surgical outcome prediction. NICE comprises a shape module, which employs region-specific implicit Signed Distance Function (SDF) decoders to reconstruct the facial surface, maxilla, and mandible, and a surgery module, which employs region-specific deformation decoders. These deformation decoders are driven by a shared surgical latent code to effectively model the complex, nonlinear biomechanical response of the facial surface to skeletal movements, incorporating anatomical prior knowledge. The deformation decoders output point-wise displacement fields, enabling precise modeling of surgical outcomes. Extensive experiments demonstrate that NICE outperforms current state-of-the-art methods, notably improving prediction accuracy in critical facial regions such as lips and chin, while robustly preserving anatomical integrity. This work provides a clinically viable tool for enhanced surgical planning and patient consultation in orthognathic procedures.