Xiaolong Niu

Zanting Ye, Xuanbin Wu, Guoqing Zhong et al.

Routine oncologic computed tomography (CT) presents an ideal opportunity for screening spinal instability, yet prophylactic stabilization windows are frequently missed due to the complex geometric reasoning required by the Spinal Instability Neoplastic Score (SINS). Automating SINS is fundamentally hindered by metastatic osteolysis, which induces topological ambiguity that confounds standard segmentation and black-box AI. We propose Topology-Guided Biomechanical Profiling (TGBP), an auditable white-box framework decoupling anatomical perception from structural reasoning. TGBP anchors SINS assessment on two deterministic geometric innovations: (i) canal-referenced partitioning to resolve posterolateral boundary ambiguity, and (ii) context-aware morphometric normalization via covariance-based oriented bounding boxes (OBB) to quantify vertebral collapse. Integrated with auxiliary radiomic and large language model (LLM) modules, TGBP provides an end-to-end, interpretable SINS evaluation. Validated on a multi-center, multi-cancer cohort ($N=482$), TGBP achieved 90.2\% accuracy in 3-tier stability triage. In a blinded reader study ($N=30$), TGBP significantly outperformed medical oncologists on complex structural features ($κ=0.857$ vs.\ $0.570$) and prevented compounding errors in Total Score estimation ($κ=0.625$ vs.\ $0.207$), democratizing expert-level opportunistic screening.

Xiaolong Niu, Zanting Ye, Xu Han et al.

Acquiring high-quality Positron Emission Tomography (PET) images requires administering high-dose radiotracers, which increases radiation exposure risks. Generating standard-dose PET (SPET) from low-dose PET (LPET) has become a potential solution. However, previous studies have primarily focused on single low-dose PET denoising, neglecting two critical factors: discrepancies in dose response caused by inter-patient variability, and complementary anatomical constraints derived from CT images. In this work, we propose a novel CT-Guided Multi-dose Adaptive Attention Denoising Diffusion Model (MDAA-Diff) for multi-dose PET denoising. Our approach integrates anatomical guidance and dose-level adaptation to achieve superior denoising performance under low-dose conditions. Specifically, this approach incorporates a CT-Guided High-frequency Wavelet Attention (HWA) module, which uses wavelet transforms to separate high-frequency anatomical boundary features from CT images. These extracted features are then incorporated into PET imaging through an adaptive weighted fusion mechanism to enhance edge details. Additionally, we propose the Dose-Adaptive Attention (DAA) module, a dose-conditioned enhancement mechanism that dynamically integrates dose levels into channel-spatial attention weight calculation. Extensive experiments on 18F-FDG and 68Ga-FAPI datasets demonstrate that MDAA-Diff outperforms state-of-the-art approaches in preserving diagnostic quality under reduced-dose conditions. Our code is publicly available.

Zanting Ye, Xiaolong Niu, Xu Han et al.

Organ segmentation in Positron Emission Tomography (PET) plays a vital role in cancer quantification. Low-dose PET (LDPET) provides a safer alternative by reducing radiation exposure. However, the inherent noise and blurred boundaries make organ segmentation more challenging. Additionally, existing PET organ segmentation methods rely on coregistered Computed Tomography (CT) annotations, overlooking the problem of modality mismatch. In this study, we propose LDOS, a novel CT-free ultra-LDPET organ segmentation pipeline. Inspired by Masked Autoencoders (MAE), we reinterpret LDPET as a naturally masked version of Full-Dose PET (FDPET). LDOS adopts a simple yet effective architecture: a shared encoder extracts generalized features, while task-specific decoders independently refine outputs for denoising and segmentation. By integrating CT-derived organ annotations into the denoising process, LDOS improves anatomical boundary recognition and alleviates the PET/CT misalignments. Experiments demonstrate that LDOS achieves state-of-the-art performance with mean Dice scores of 73.11% (18F-FDG) and 73.97% (68Ga-FAPI) across 18 organs in 5% dose PET. Our code will be available at https://github.com/yezanting/LDOS.

Zanting Ye, Xiaolong Niu, Xuanbin Wu et al.

Deep learning-based medical image segmentation has shown remarkable success; however, it typically requires extensive pixel-level annotations, which are both expensive and time-intensive. Semi-supervised medical image segmentation (SSMIS) offers a viable alternative, driven by advancements in CNNs and ViTs. However, these networks often rely on single fixed activation functions and linear modeling patterns, limiting their ability to effectively learn robust representations. Given the limited availability of labeled date, achieving robust representation learning becomes crucial. Inspired by Kolmogorov-Arnold Networks (KANs), we propose Semi-KAN, which leverages the untapped potential of KANs to enhance backbone architectures for representation learning in SSMIS. Our findings indicate that: (1) compared to networks with fixed activation functions, KANs exhibit superior representation learning capabilities with fewer parameters, and (2) KANs excel in high-semantic feature spaces. Building on these insights, we integrate KANs into tokenized intermediate representations, applying them selectively at the encoder's bottleneck and the decoder's top layers within a U-Net pipeline to extract high-level semantic features. Although learnable activation functions improve feature expansion, they introduce significant computational overhead with only marginal performance gains. To mitigate this, we reduce the feature dimensions and employ horizontal scaling to capture multiple pattern representations. Furthermore, we design a multi-branch U-Net architecture with uncertainty estimation to effectively learn diverse pattern representations. Extensive experiments on four public datasets demonstrate that Semi-KAN surpasses baseline networks, utilizing fewer KAN layers and lower computational cost, thereby underscoring the potential of KANs as a promising approach for SSMIS.