David J. Foran

Xiao Qi, David J. Foran, John L. Nosher et al.

The role of chest X-ray (CXR) imaging, due to being more cost-effective, widely available, and having a faster acquisition time compared to CT, has evolved during the COVID-19 pandemic. To improve the diagnostic performance of CXR imaging a growing number of studies have investigated whether supervised deep learning methods can provide additional support. However, supervised methods rely on a large number of labeled radiology images, which is a time-consuming and complex procedure requiring expert clinician input. Due to the relative scarcity of COVID-19 patient data and the costly labeling process, self-supervised learning methods have gained momentum and has been proposed achieving comparable results to fully supervised learning approaches. In this work, we study the effectiveness of self-supervised learning in the context of diagnosing COVID-19 disease from CXR images. We propose a multi-feature Vision Transformer (ViT) guided architecture where we deploy a cross-attention mechanism to learn information from both original CXR images and corresponding enhanced local phase CXR images. We demonstrate the performance of the baseline self-supervised learning models can be further improved by leveraging the local phase-based enhanced CXR images. By using 10\% labeled CXR scans, the proposed model achieves 91.10\% and 96.21\% overall accuracy tested on total 35,483 CXR images of healthy (8,851), regular pneumonia (6,045), and COVID-19 (18,159) scans and shows significant improvement over state-of-the-art techniques. Code is available https://github.com/endiqq/Multi-Feature-ViT

Moein Heidari, Ali Mehrabian, Mohammad Amin Roohi et al.

Echocardiography interpretation requires integrating multi-view temporal evidence with quantitative measurements and guideline-grounded reasoning, yet existing foundation-model pipelines largely solve isolated subtasks and fail when tool outputs are noisy or values fall near clinical cutoffs. We propose Echo-CoPilot, an end-to-end agentic framework that combines a multi-perspective workflow with knowledge-graph guided measurement selection. Echo-CoPilot runs three independent ReAct-style agents, structural, pathological, and quantitative, that invoke specialized echocardiography tools to extract parameters while querying EchoKG to determine which measurements are required for the clinical question and which should be avoided. A self-contrast language model then compares the evidence-grounded perspectives, generates a discrepancy checklist, and re-queries EchoKG to apply the appropriate guideline thresholds and resolve conflicts, reducing hallucinated measurement selection and borderline flip-flops. On MIMICEchoQA, Echo-CoPilot provides higher accuracy compared to SOTA baselines and, under a stochasticity stress test, achieves higher reliability through more consistent conclusions and fewer answer changes across repeated runs. Our code is publicly available at~\href{https://github.com/moeinheidari7829/Echo-CoPilot}{\textcolor{magenta}{GitHub}}.

Betina Idnay, Zihan Xu, William G. Adams et al.

This study reports a comprehensive environmental scan of the generative AI (GenAI) infrastructure in the national network for clinical and translational science across 36 institutions supported by the Clinical and Translational Science Award (CTSA) Program led by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) at the United States. With the rapid advancement of GenAI technologies, including large language models (LLMs), healthcare institutions face unprecedented opportunities and challenges. This research explores the current status of GenAI integration, focusing on stakeholder roles, governance structures, and ethical considerations by administering a survey among leaders of health institutions (i.e., representing academic medical centers and health systems) to assess the institutional readiness and approach towards GenAI adoption. Key findings indicate a diverse range of institutional strategies, with most organizations in the experimental phase of GenAI deployment. The study highlights significant variations in governance models, with a strong preference for centralized decision-making but notable gaps in workforce training and ethical oversight. Moreover, the results underscore the need for a more coordinated approach to GenAI governance, emphasizing collaboration among senior leaders, clinicians, information technology staff, and researchers. Our analysis also reveals concerns regarding GenAI bias, data security, and stakeholder trust, which must be addressed to ensure the ethical and effective implementation of GenAI technologies. This study offers valuable insights into the challenges and opportunities of GenAI integration in healthcare, providing a roadmap for institutions aiming to leverage GenAI for improved quality of care and operational efficiency.

Xiao Qi, David J. Foran, John L. Nosher et al.

Under the global COVID-19 crisis, accurate diagnosis of COVID-19 from Chest X-ray (CXR) images is critical. To reduce intra- and inter-observer variability, during the radiological assessment, computer-aided diagnostic tools have been utilized to supplement medical decision-making and subsequent disease management. Computational methods with high accuracy and robustness are required for rapid triaging of patients and aiding radiologists in the interpretation of the collected data. In this study, we propose a novel multi-feature fusion network using parallel attention blocks to fuse the original CXR images and local-phase feature-enhanced CXR images at multi-scales. We examine our model on various COVID-19 datasets acquired from different organizations to assess the generalization ability. Our experiments demonstrate that our method achieves state-of-art performance and has improved generalization capability, which is crucial for widespread deployment.

Xiao Qi, Lloyd Brown, David J. Foran et al.

Recently, the outbreak of the novel Coronavirus disease 2019 (COVID-19) pandemic has seriously endangered human health and life. Due to limited availability of test kits, the need for auxiliary diagnostic approach has increased. Recent research has shown radiography of COVID-19 patient, such as CT and X-ray, contains salient information about the COVID-19 virus and could be used as an alternative diagnosis method. Chest X-ray (CXR) due to its faster imaging time, wide availability, low cost and portability gains much attention and becomes very promising. Computational methods with high accuracy and robustness are required for rapid triaging of patients and aiding radiologist in the interpretation of the collected data. In this study, we design a novel multi-feature convolutional neural network (CNN) architecture for multi-class improved classification of COVID-19 from CXR images. CXR images are enhanced using a local phase-based image enhancement method. The enhanced images, together with the original CXR data, are used as an input to our proposed CNN architecture. Using ablation studies, we show the effectiveness of the enhanced images in improving the diagnostic accuracy. We provide quantitative evaluation on two datasets and qualitative results for visual inspection. Quantitative evaluation is performed on data consisting of 8,851 normal (healthy), 6,045 pneumonia, and 3,323 Covid-19 CXR scans. In Dataset-1, our model achieves 95.57\% average accuracy for a three classes classification, 99\% precision, recall, and F1-scores for COVID-19 cases. For Dataset-2, we have obtained 94.44\% average accuracy, and 95\% precision, recall, and F1-scores for detection of COVID-19. Our proposed multi-feature guided CNN achieves improved results compared to single-feature CNN proving the importance of the local phase-based CXR image enhancement (https://github.com/endiqq/Fus-CNNs_COVID-19).

Moein Heidari, Ehsan Khodapanah Aghdam, Alexander Manzella et al.

The retroperitoneum hosts a variety of tumors, including rare benign and malignant types, which pose diagnostic and treatment challenges due to their infrequency and proximity to vital structures. Estimating tumor volume is difficult due to their irregular shapes, and manual segmentation is time-consuming. Automatic segmentation using U-Net and its variants, incorporating Vision Transformer (ViT) elements, has shown promising results but struggles with high computational demands. To address this, architectures like the Mamba State Space Model (SSM) and Extended Long-Short Term Memory (xLSTM) offer efficient solutions by handling long-range dependencies with lower resource consumption. This study evaluates U-Net enhancements, including CNN, ViT, Mamba, and xLSTM, on a new in-house CT dataset and a public organ segmentation dataset. The proposed ViLU-Net model integrates Vi-blocks for improved segmentation. Results highlight xLSTM's efficiency in the U-Net framework. The code is publicly accessible on GitHub.

Jian Ren, Zhe Li, Jianchao Yang et al.

Designing the structure of neural networks is considered one of the most challenging tasks in deep learning, especially when there is few prior knowledge about the task domain. In this paper, we propose an Ecologically-Inspired GENetic (EIGEN) approach that uses the concept of succession, extinction, mimicry, and gene duplication to search neural network structure from scratch with poorly initialized simple network and few constraints forced during the evolution, as we assume no prior knowledge about the task domain. Specifically, we first use primary succession to rapidly evolve a population of poorly initialized neural network structures into a more diverse population, followed by a secondary succession stage for fine-grained searching based on the networks from the primary succession. Extinction is applied in both stages to reduce computational cost. Mimicry is employed during the entire evolution process to help the inferior networks imitate the behavior of a superior network and gene duplication is utilized to duplicate the learned blocks of novel structures, both of which help to find better network structures. Experimental results show that our proposed approach can achieve similar or better performance compared to the existing genetic approaches with dramatically reduced computation cost. For example, the network discovered by our approach on CIFAR-100 dataset achieves 78.1% test accuracy under 120 GPU hours, compared to 77.0% test accuracy in more than 65, 536 GPU hours in [35].

Jian Ren, Jianchao Yang, Ning Xu et al.

In this paper, we propose Factorized Adversarial Networks (FAN) to solve unsupervised domain adaptation problems for image classification tasks. Our networks map the data distribution into a latent feature space, which is factorized into a domain-specific subspace that contains domain-specific characteristics and a task-specific subspace that retains category information, for both source and target domains, respectively. Unsupervised domain adaptation is achieved by adversarial training to minimize the discrepancy between the distributions of two task-specific subspaces from source and target domains. We demonstrate that the proposed approach outperforms state-of-the-art methods on multiple benchmark datasets used in the literature for unsupervised domain adaptation. Furthermore, we collect two real-world tagging datasets that are much larger than existing benchmark datasets, and get significant improvement upon baselines, proving the practical value of our approach.

Jian Ren, Ilker Hacihaliloglu, Eric A. Singer et al.

Automatic and accurate Gleason grading of histopathology tissue slides is crucial for prostate cancer diagnosis, treatment, and prognosis. Usually, histopathology tissue slides from different institutions show heterogeneous appearances because of different tissue preparation and staining procedures, thus the predictable model learned from one domain may not be applicable to a new domain directly. Here we propose to adopt unsupervised domain adaptation to transfer the discriminative knowledge obtained from the source domain to the target domain without requiring labeling of images at the target domain. The adaptation is achieved through adversarial training to find an invariant feature space along with the proposed Siamese architecture on the target domain to add a regularization that is appropriate for the whole-slide images. We validate the method on two prostate cancer datasets and obtain significant classification improvement of Gleason scores as compared with the baseline models.