Zhengkang Fan

Renjie Liang, Yiling Ma, Yang Xing et al.

Automated radiology report generation from 3D CT volumes often suffers from incomplete pathology coverage. We provide empirical evidence that this limitation stems from a representational bottleneck: contrastive 3D CT embeddings encode discriminative pathology signals, yet exhibit severe dimensional concentration, with as few as 2 effective dimensions out of 512. Corroborating this, scaling the language model yields no measurable improvement, suggesting that the bottleneck lies in the visual representation rather than the generator. This bottleneck limits both generation and retrieval; naive static retrieval fails to improve clinical efficacy and can even degrade performance. We propose \textbf{AdaRAG-CT}, an adaptive augmentation framework that compensates for this visual bottleneck by introducing supplementary textual information through controlled retrieval and selectively integrating it during generation. On the CT-RATE benchmark, AdaRAG-CT achieves state-of-the-art clinical efficacy, improving Clinical F1 from 0.420 (CT-Agent) to 0.480 (+6 points); ablation studies confirm that both the retrieval and generation components contribute to the improvement. Code is available at https://github.com/renjie-liang/Adaptive-RAG-for-3DCT-Report-Generation.

Yu Huang, Jingchuan Guo, William T Donahoo et al.

Background: Racial and ethnic minority groups and individuals facing social disadvantages, which often stem from their social determinants of health (SDoH), bear a disproportionate burden of type 2 diabetes (T2D) and its complications. It is therefore crucial to implement effective social risk management strategies at the point of care. Objective: To develop an EHR-based machine learning (ML) analytical pipeline to identify the unmet social needs associated with hospitalization risk in patients with T2D. Methods: We identified 10,192 T2D patients from the EHR data (from 2012 to 2022) from the University of Florida Health Integrated Data Repository, including contextual SDoH (e.g., neighborhood deprivation) and individual-level SDoH (e.g., housing stability). We developed an electronic health records (EHR)-based machine learning (ML) analytic pipeline, namely individualized polysocial risk score (iPsRS), to identify high social risk associated with hospitalizations in T2D patients, along with explainable AI (XAI) techniques and fairness assessment and optimization. Results: Our iPsRS achieved a C statistic of 0.72 in predicting 1-year hospitalization after fairness optimization across racial-ethnic groups. The iPsRS showed excellent utility for capturing individuals at high hospitalization risk; the actual 1-year hospitalization rate in the top 5% of iPsRS was ~13 times as high as the bottom decile. Conclusion: Our ML pipeline iPsRS can fairly and accurately screen for patients who have increased social risk leading to hospitalization in T2D patients.

Renjie Liang, Zhengkang Fan, Jinqian Pan et al.

Objective Renal cancer is a common malignancy and a major cause of cancer-related deaths. Computed tomography (CT) is central to early detection, staging, and treatment planning. However, the growing CT workload increases radiologists' burden and risks incomplete documentation. Automatically generating accurate reports remains challenging because it requires integrating visual interpretation with clinical reasoning. Advances in artificial intelligence (AI), especially large language and vision-language models, offer potential to reduce workload and enhance diagnostic quality. Methods We propose a clinically informed, two-stage framework for automatic renal CT report generation. In Stage 1, a multi-task learning model detects structured clinical features from each 2D image. In Stage 2, a vision-language model generates free-text reports conditioned on the image and the detected features. To evaluate clinical fidelity, generated clinical features are extracted from the reports and compared with expert-annotated ground truth. Results Experiments on an expert-labeled dataset show that incorporating detected features improves both report quality and clinical accuracy. The model achieved an average AUC of 0.75 for key imaging features and a METEOR score of 0.33, demonstrating higher clinical consistency and fewer template-driven errors. Conclusion Linking structured feature detection with conditioned report generation provides a clinically grounded approach to integrate structured prediction and narrative drafting for renal CT reporting. This method enhances interpretability and clinical faithfulness, underscoring the value of domain-relevant evaluation metrics for medical AI development.