Theodoros N. Arvanitis

Jim Achterberg, Bram Van Dijk, Jing Meng et al.

This study presents OpenExtract, an open-source pipeline for automated data extraction in large-scale systematic literature reviews. The pipeline queries large language models (LLMs) to predict data entries based on relevant sections of scientific articles. To test the efficacy of OpenExtract, we apply it to a systematic literature review in digital health and compare its outputs with those of human researchers. OpenExtract achieves precision and recall scores of > 0.8 in this task, indicating that it can be effective at extracting data automatically and efficiently. OpenExtract: https://github.com/JimAchterbergLUMC/OpenExtract.

Haofan Wu, Nay Aung, Theodoros N. Arvanitis et al.

A clinically actionable Cardiac Digital Twin (CDT) should reconstruct individualised cardiac anatomy and physiology, update its internal state from multimodal signals, and enable a broad range of downstream simulations beyond isolated tasks. However, existing CDT frameworks remain limited to task-specific predictors rather than building a patient-specific, manipulable virtual heart. In this work, we introduce Chain of Flow (COF), a foundational ECG-driven generative framework that reconstructs full 4D cardiac structure and motion from a single cardiac cycle. The method integrates cine-CMR and 12-lead ECG during training to learn a unified representation of cardiac geometry, electrophysiology, and motion dynamics. We evaluate Chain of Flow on diverse cohorts and demonstrate accurate recovery of cardiac anatomy, chamber-wise function, and dynamic motion patterns. The reconstructed 4D hearts further support downstream CDT tasks such as volumetry, regional function analysis, and virtual cine synthesis. By enabling full 4D organ reconstruction directly from ECG, COF transforms cardiac digital twins from narrow predictive models into fully generative, patient-specific virtual hearts. Code will be released after review.

Kedi Sun, Chaohui Dang, Yue Feng et al.

Automated, clinician-grade assessment reports for surgical procedures could reduce documentation burden and provide objective feedback, yet remain challenging due to the difficulty of aligning dense spatio-temporal video representations with language-based reasoning and the scarcity of high-quality, privacy-preserving datasets. To address this gap, we establish a benchmark comprising 214 high-quality simulated surgical videos paired with surgeon-authored evaluation reports. Building on this resource, we propose a Perception-Alignment-Reasoning framework for surgical video report generation, featuring Hi-GaTA, a novel lightweight temporal adapter that efficiently compresses long video sequences into compact, LLM-compatible visual prefix tokens through short-to-long-range temporal aggregation. For robust visual perception, we pretrain Sur40k, a surgical-specific ViViT-style video encoder on 40,000 minutes of public surgical videos to capture fine-grained spatio-temporal procedural priors. Hi-GaTA employs a temporal pyramid with text-conditioned dual cross-attention, and improves multi-scale consistency through cross-level gated fusion and an increasing-depth strategy. Finally, we fine-tune the LLM backbone using LoRA to enable coherent and stylistically consistent surgical report generation under limited supervision. Experiments show our approach achieves the best overall performance, with consistent gains over strong Multimodal Large Language Model (MLLM) baselines. Ablation studies further validate the effectiveness of each proposed component.

Junkai Liu, Nay Aung, Theodoros N. Arvanitis et al.

Missing data problems, such as missing modalities in multi-modal brain MRI and missing slices in cardiac MRI, pose significant challenges in clinical practice. Existing methods rely on external guidance to supply detailed missing state for instructing generative models to synthesize missing MRIs. However, manual indicators are not always available or reliable in real-world scenarios due to the unpredictable nature of clinical environments. Moreover, these explicit masks are not informative enough to provide guidance for improving semantic consistency. In this work, we argue that generative models should infer and recognize missing states in a self-perceptive manner, enabling them to better capture subtle anatomical and pathological variations. Towards this goal, we propose CoPeDiT, a general-purpose latent diffusion model equipped with completeness perception for unified synthesis of 3D MRIs. Specifically, we incorporate dedicated pretext tasks into our tokenizer, CoPeVAE, empowering it to learn completeness-aware discriminative prompts, and design MDiT3D, a specialized diffusion transformer architecture for 3D MRI synthesis, that effectively uses the learned prompts as guidance to enhance semantic consistency in 3D space. Comprehensive evaluations on three large-scale MRI datasets demonstrate that CoPeDiT significantly outperforms state-of-the-art methods, achieving superior robustness, generalizability, and flexibility. The code is available at https://github.com/JK-Liu7/CoPeDiT .

Tianli Tao, Ziyang Wang, Han Zhang et al.

Brain tumors delay the standard preprocessing workflow for further examination. Brain inpainting offers a viable, although difficult, solution for tumor tissue processing, which is necessary to improve the precision of the diagnosis and treatment. Most conventional U-Net-based generative models, however, often face challenges in capturing the complex, nonlinear latent representations inherent in brain imaging. In order to accomplish high-quality healthy brain tissue reconstruction, this work proposes DiffKAN-Inpainting, an innovative method that blends diffusion models with the Kolmogorov-Arnold Networks architecture. During the denoising process, we introduce the RePaint method and tumor information to generate images with a higher fidelity and smoother margin. Both qualitative and quantitative results demonstrate that as compared to the state-of-the-art methods, our proposed DiffKAN-Inpainting inpaints more detailed and realistic reconstructions on the BraTS dataset. The knowledge gained from ablation study provide insights for future research to balance performance with computing cost.

Junkai Liu, Nay Aung, Theodoros N. Arvanitis et al.

Magnetic resonance imaging (MRI) provides detailed soft-tissue characteristics that assist in disease diagnosis and screening. However, the accuracy of clinical practice is often hindered by missing or unusable slices due to various factors. Volumetric MRI synthesis methods have been developed to address this issue by imputing missing slices from available ones. The inherent 3D nature of volumetric MRI data, such as cardiac magnetic resonance (CMR), poses significant challenges for missing slice imputation approaches, including (1) the difficulty of modeling local inter-slice correlations and dependencies of volumetric slices, and (2) the limited exploration of crucial 3D spatial information and global context. In this study, to mitigate these issues, we present Spatial-Aware Graph Completion Network (SAGCNet) to overcome the dependency on complete volumetric data, featuring two main innovations: (1) a volumetric slice graph completion module that incorporates the inter-slice relationships into a graph structure, and (2) a volumetric spatial adapter component that enables our model to effectively capture and utilize various forms of 3D spatial context. Extensive experiments on cardiac MRI datasets demonstrate that SAGCNet is capable of synthesizing absent CMR slices, outperforming competitive state-of-the-art MRI synthesis methods both quantitatively and qualitatively. Notably, our model maintains superior performance even with limited slice data.

Anghong Du, Nay Aung, Theodoros N. Arvanitis et al.

High-quality pixel-level annotations of medical images are essential for supervised segmentation tasks, but obtaining such annotations is costly and requires medical expertise. To address this challenge, we propose a novel coarse-to-fine segmentation framework that relies entirely on coarse-level annotations, encompassing both target and complementary drawings, despite their inherent noise. The framework works by introducing transition matrices in order to model the inaccurate and incomplete regions in the coarse annotations. By jointly training on multiple sets of coarse annotations, it progressively refines the network's outputs and infers the true segmentation distribution, achieving a robust approximation of precise labels through matrix-based modeling. To validate the flexibility and effectiveness of the proposed method, we demonstrate the results on two public cardiac imaging datasets, ACDC and MSCMRseg, and further evaluate its performance on the UK Biobank dataset. Experimental results indicate that our approach surpasses the state-of-the-art weakly supervised methods and closely matches the fully supervised approach.