Kartik Bose

Pankaj Gupta, Priya Mudgil, Niharika Dutta et al.

Background: Pancreatic cancer is one of the most aggressive cancers, with poor survival rates. Endoscopic ultrasound (EUS) is a key diagnostic modality, but its effectiveness is constrained by operator subjectivity. This study evaluates a Vision Transformer-based deep learning segmentation model for pancreatic tumors. Methods: A segmentation model using the USFM framework with a Vision Transformer backbone was trained and validated with 17,367 EUS images (from two public datasets) in 5-fold cross-validation. The model was tested on an independent dataset of 350 EUS images from another public dataset, manually segmented by radiologists. Preprocessing included grayscale conversion, cropping, and resizing to 512x512 pixels. Metrics included Dice similarity coefficient (DSC), intersection over union (IoU), sensitivity, specificity, and accuracy. Results: In 5-fold cross-validation, the model achieved a mean DSC of 0.651 +/- 0.738, IoU of 0.579 +/- 0.658, sensitivity of 69.8%, specificity of 98.8%, and accuracy of 97.5%. For the external validation set, the model achieved a DSC of 0.657 (95% CI: 0.634-0.769), IoU of 0.614 (95% CI: 0.590-0.689), sensitivity of 71.8%, and specificity of 97.7%. Results were consistent, but 9.7% of cases exhibited erroneous multiple predictions. Conclusions: The Vision Transformer-based model demonstrated strong performance for pancreatic tumor segmentation in EUS images. However, dataset heterogeneity and limited external validation highlight the need for further refinement, standardization, and prospective studies.

Pankaj Gupta, Kartik Bose

Large language models (LLMs) show promise in radiology but their deployment is limited by computational requirements that preclude use in resource-constrained clinical environments. We investigate whether small language models (SLMs) of 3-4 billion parameters can achieve strong multi-task radiology performance through LoRA fine-tuning, enabling deployment on consumer-grade CPUs. We train Qwen2.5-3B-Instruct and Qwen3-4B on 162K samples spanning 9 radiology tasks - RADS classification across 10 systems, impression generation, temporal comparison, radiology NLI, NER, abnormality detection, N/M staging, and radiology Q&A - compiled from 12 public datasets. Both models are evaluated on up to 500 held-out test samples per task with standardized metrics. Our key findings are: (1) LoRA fine-tuning dramatically improves performance over zero-shot baselines (RADS accuracy +53%, NLI +60%, N-staging +89%); (2) the two models exhibit complementary strengths - Qwen2.5 excels at structured generation tasks while Qwen3 dominates extractive tasks; (3) a task-outed oracle ensemble combining both models achieves the best performance across all tasks; (4) few-shot prompting with fine-tuned models hurts performance, demonstrating that LoRA adaptation is more effective than in-context learning for specialized domains; and (5) models can be quantized to GGUF format (~1.8-2.4GB) for CPU deployment at 4-8 tokens/second on consumer hardware. Our work demonstrates that small, efficiently fine-tuned models - which we collectively call RadLite - can serve as practical multi-task radiology AI assistants deployable entirely on consumer hardware without GPU requirements.

Shivika, Kartik Bose, Pankaj Gupta

Vision-language models trained with contrastive learning on paired medical images and reports show strong zero-shot diagnostic capabilities, yet the effect of training batch composition on learned representations remains unexplored for 3D medical imaging. We reproduce Merlin, a dual-encoder model that aligns 3D abdominal CT volumes with radiology reports using symmetric InfoNCE loss, achieving a zero-shot macro F1 of 74.45% across 30 findings (original: 73.00%). We then investigate two axes of variation. First, we control the normal-to-abnormal ratio within training batches at 25:75, 50:50, and 75:25 using section-level balanced sampling on the full dataset. All three configurations underperform the unbalanced baseline by 2.4 to 2.8 points, with 75:25 achieving the best result (72.02%) among balanced variants. Second, we conduct data scaling ablations on a 4,362-study subset, training with 20%, 40%, and 100% of the data. Performance scales sub-linearly from 65.26% to 71.88%, with individual findings varying dramatically in data sensitivity. Enforcing 50:50 balanced sampling on the same subset further degrades performance to 68.01%, confirming that explicit class balancing hurts regardless of dataset or balancing granularity. Our results indicate that the stochastic diversity of random sampling, combined with Merlin's alternating batching over anatomical subsections, provides more effective regularization than engineered class ratios at the small batch sizes required by 3D medical volumes.