Min Kang

Mingxuan Liu, Yingqi Hao, Yi Liao et al.

Background: Prenatal germinal matrix-intraventricular hemorrhage (GMH-IVH) is a leading cause of infant mortality and neurodevelopmental impairment. Manual diagnosis and lesion segmentation are labor-intensive and error-prone. Deep learning models offer potential for automation but typically require large annotated datasets, which are challenging to obtain. Purpose: To develop and validate an annotation-free deep learning framework for automated detection and segmentation of GMH-IVH on brain MRI. Materials and Methods: This retrospective study analyzed 2D T2-weighted MRI data from pregnant women collected from October 2015 to October 2023 at one hospital (internal validation) and two hospitals (external validation). Eligible participants included healthy fetuses and those with GMH-IVH. FreeHemoSeg was developed and trained using pseudo GMH-IVH images synthesized from normal fetal data guided by medical priors. Primary outcomes included diagnostic accuracy (area under the ROC curve [AUROC], sensitivity, specificity) and segmentation accuracy (Dice similarity coefficient [DSC]). A reader study evaluated clinical utility. Results: A total of 1674 stacks from 558 pregnant women were analyzed. FreeHemoSeg achieved the highest performance in both internal (sensitivity: 0.914, 95% CI 0.869-0.945; specificity: 0.966, 95% CI 0.946-0.978; DSC: 0.559, 95% CI 0.546-0.571) and external validation (sensitivity: 0.824, 95% CI 0.739-0.885; specificity: 0.943, 95% CI 0.913-0.964; DSC: 0.512, 95% CI 0.497-0.526), outperforming supervised and unsupervised methods. FreeHemoSeg assistance improved radiologists' sensitivity (from 0.882 to 0.941-1.000) and diagnostic confidence while reducing interpretation time by 16.0-52.7%. Conclusion: FreeHemoSeg accurately detects and localizes fetal brain hemorrhages without annotated training data, enabling earlier diagnosis and supporting timely clinical management.

Huan Zhao, Qian Ling, Yi Pan et al.

In recent years, pre-trained large language models (LLMs) have achieved tremendous success in the field of Natural Language Processing (NLP). Prior studies have primarily focused on general and generic domains, with relatively less research on specialized LLMs in the medical field. The specialization and high accuracy requirements for diagnosis in the medical field, as well as the challenges in collecting large-scale data, have constrained the application and development of LLMs in medical scenarios. In the field of ophthalmology, clinical diagnosis mainly relies on doctors' interpretation of reports and making diagnostic decisions. In order to take advantage of LLMs to provide decision support for doctors, we collected three modalities of ophthalmic report data and fine-tuned the LLaMA2 model, successfully constructing an LLM termed the "Ophtha-LLaMA2" specifically tailored for ophthalmic disease diagnosis. Inference test results show that even with a smaller fine-tuning dataset, Ophtha-LLaMA2 performs significantly better in ophthalmic diagnosis compared to other LLMs. It demonstrates that the Ophtha-LLaMA2 exhibits satisfying accuracy and efficiency in ophthalmic disease diagnosis, making it a valuable tool for ophthalmologists to provide improved diagnostic support for patients. This research provides a useful reference for the application of LLMs in the field of ophthalmology, while showcasing the immense potential and prospects in this domain.