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Oct 16

Generating synthetic computed tomography for radiotherapy: SynthRAD2025 challenge report

Radiation therapy (RT) requires precise dose delivery over multiple fractions, with CT fundamental for treatment planning due to its electron density information. Repeated CT acquisitions impose radiation exposure and logistical burdens, MRI lacks electron density, and cone-beam CT (CBCT) requires correction for dose calculation. Synthetic CT (sCT) generation addresses these by converting MRI or CBCT into CT-equivalent images with accurate Hounsfield Unit (HU) values, enabling MRI-only RT and CBCT-based adaptive workflows. Building on SynthRAD2023, SynthRAD2025 benchmarked sCT methods on 2,362 patients from five European centers across head and neck, thorax, and abdomen. Two tasks: MRI-to-CT (890 cases) and CBCT-to-CT (1,472 cases), evaluated via image similarity (MAE, PSNR, MS-SSIM), segmentation (Dice, HD95), and dosimetric metrics from photon and proton plans. With 803 participants and 12/13 valid submissions, Task 1 top performance reached MAE 64.8pm21.3 HU, PSNR sim30 dB, MS-SSIM sim0.936, Dice 0.79, photon γ_{2%/2mm}>98%, proton γapprox85%. Task 2 improved: MAE 48.3pm13.4 HU, PSNR 32.6 dB, MS-SSIM 0.968, Dice 0.86, photon γ>99%, proton γapprox89%. Strong image--segmentation correlations (ρ=0.78--0.79) but moderate dose correlations confirmed image quality is insufficient as a dosimetric surrogate. Head-and-neck cases were most consistent; thoracic and abdominal cases showed greater variability. Residual errors at tissue interfaces propagate along beam paths, affecting proton dose more than photon. SynthRAD2025 demonstrates that deep learning yields clinically relevant sCTs, especially for CBCT-to-CT, while identifying persistent MRI-to-CT challenges and underscoring dose-based evaluation as essential for clinical validation.

  • 33 authors
·
May 12

Proton Irradiation Characterization of an Open-Source ML Accelerator on a Zynq UltraScale+ MPSoC

As spaceborne computing systems increasingly rely on neural network (NN) accelerators, the opacity of commercial, black-box architectures severely restricts the development of verifiable radiation mitigation strategies. Open-source, register-transfer level (RTL)-accessible accelerators resolve this limitation by enabling user-defined instrumentation, yet few have empirical radiation-response baselines. This work establishes a foundational system-level proton-irradiation baseline for an unmitigated open-source Tensil NN accelerator deployed on a Zynq UltraScale+ SoC executing ResNet-20 inference. Under 20 to 58 MeV proton irradiation, we delivered 4.29 times 10^{10} p/cm^{2} within monitored operational windows. Seven workload interruptions required two restarts of the notebook process, four reboots or board resets, and one power-cycle sequence. Two output-corruption events returned incorrect CIFAR-10 classes without loss of service. In the longer event, the accelerator returned a class absent from the ten-image CIFAR-10 pool for 39 consecutive inputs at normal cadence. The process remained alive, while the kernel log, limited memory test, and sampled power showed no anomaly. Observation of the stuck-class sequence ended with scheduled bitstream reconfiguration. All nine onsets occurred under the nominal 4 cm beam, which exposed the SoC, LPDDR4, and additional board circuitry; none occurred under the 2 cm SoC-centered field. This pattern shows a field association but does not establish LPDDR4 as the cause because field size was confounded with run order and dose. Linux-managed accelerators require end-to-end content checks and recovery that reaches the state in which corruption can persist. This baseline documents availability loss and silent output corruption, supporting future software hardening of COTS FPGA-SoCs for neural-network inference in space systems.

  • 6 authors
·
Sep 3

Patient-Specific Autoregressive Models for Organ Motion Prediction in Radiotherapy

Radiotherapy often involves a prolonged treatment period. During this time, patients may experience organ motion due to breathing and other physiological factors. Predicting and modeling this motion before treatment is crucial for ensuring precise radiation delivery. However, existing pre-treatment organ motion prediction methods primarily rely on deformation analysis using principal component analysis (PCA), which is highly dependent on registration quality and struggles to capture periodic temporal dynamics for motion modeling.In this paper, we observe that organ motion prediction closely resembles an autoregressive process, a technique widely used in natural language processing (NLP). Autoregressive models predict the next token based on previous inputs, naturally aligning with our objective of predicting future organ motion phases. Building on this insight, we reformulate organ motion prediction as an autoregressive process to better capture patient-specific motion patterns. Specifically, we acquire 4D CT scans for each patient before treatment, with each sequence comprising multiple 3D CT phases. These phases are fed into the autoregressive model to predict future phases based on prior phase motion patterns. We evaluate our method on a real-world test set of 4D CT scans from 50 patients who underwent radiotherapy at our institution and a public dataset containing 4D CT scans from 20 patients (some with multiple scans), totaling over 1,300 3D CT phases. The performance in predicting the motion of the lung and heart surpasses existing benchmarks, demonstrating its effectiveness in capturing motion dynamics from CT images. These results highlight the potential of our method to improve pre-treatment planning in radiotherapy, enabling more precise and adaptive radiation delivery.

  • 4 authors
·
May 17, 2025

Uncertainty quantification for improving radiomic-based models in radiation pneumonitis prediction

Background and Objective: Radiation pneumonitis (RP) is a side effect of thoracic radiation therapy. Recently, Machine learning (ML) models enhanced with radiomic and dosiomic features provide better predictions by incorporating spatial information beyond DVHs. However, to improve the clinical decision process, we propose to use uncertainty quantification (UQ) to improve the confidence in model prediction. This study evaluates the impact of post hoc UQ methods on the discriminative performance and calibration of ML models for RP prediction. Methods: This study evaluated four ML models: logistic regression (LR), support vector machines (SVM), extreme gradient boosting (XGB), and random forest (RF), using radiomic, dosiomic, and dosimetric features to predict RP. We applied UQ methods, including Patt scaling, isotonic regression, Venn-ABERS predictor, and Conformal Prediction, to quantify uncertainty. Model performance was assessed through Area Under the Receiver Operating Characteristic curve (AUROC), Area Under the Precision-Recall Curve (AUPRC), and Adaptive Calibration Error (ACE) using Leave-One-Out Cross-Validation (LOO-CV). Results: UQ methods enhanced predictive performance, particularly for high-certainty predictions, while also improving calibration. Radiomic and dosiomic features increased model accuracy but introduced calibration challenges, especially for non-linear models like XGB and RF. Performance gains from UQ methods were most noticeable at higher certainty thresholds. Conclusion: Integrating UQ into ML models with radiomic and dosiomic features improves both predictive accuracy and calibration, supporting more reliable clinical decision-making. The findings emphasize the value of UQ methods in enhancing applicability of predictive models for RP in healthcare settings.

  • 3 authors
·
Dec 27, 2024

Predictive Radiomics for Evaluation of Cancer Immune SignaturE in Glioblastoma: the PRECISE-GBM study

Background: Radiogenomics allows identification of radiological biomarkers for genomic phenotypes. In glioblastoma, these biomarkers could potentially complement patient stratification strategies. We aim to develop and analytically validate radiological biomarkers that capture immune cell signatures within IDH-wildtype glioblastoma microenvironment using radiogenomic analysis. Methods: This was a retrospective multicenter study using curated open-access anonymized imaging and genomic data from TCGA-GBM, CPTAC, IvyGAP, REMBRANDT and CGGA datasets. Imaging data consisted of MRI-based radiomic features extracted from necrotic core, enhancing and edema regions of deep learning-based auto-segmented tumors. Radiomic feature selections were performed using nested cross-validated LASSO. Support vector machine and ensemble models were trained using seventeen immune and cell-specific score labels extracted from deconvoluted transcriptomic data using pan-cancer and glioblastoma immune signature matrices as reference standards. Seventeen classifier models trained in three cross-cohort strategies were validated on three held-out datasets assessing stability and generalizability. Results: One-hundred-and-seventy-six patients were included in the study. The immune-related radiomic signatures obtained after feature selection were shape, first order and higher order radiomic features. Models predicting macrophage subtype immune signature showed stable mean performance on balanced accuracy (0.67) and precision (0.89) metrics for three independent holdout datasets with ensemble model outperforming support vector machine model. Conclusion: Radiogenomic models non-invasively predicted the macrophage subtype M0 immune signature in IDH-wildtype glioblastoma. These biomarkers have the potential to stratify patients for immunotherapy within prospective glioblastoma clinical trials.

  • 5 authors
·
May 10

BrainAnytime: Anatomy-Aware Cross-Modal Pretraining for Brain Image Analysis with Arbitrary Modality Availability

Clinical diagnostic workups typically follow a modality escalation pathway: after initial clinical evaluation, clinicians begin with routine structural imaging (e.g., MRI), selectively add sequences such as FLAIR or T2 to refine the differential, and reserve molecular imaging (e.g., amyloid-PET) for cases that remain uncertain after standard evaluation. Consequently, patients are observed with heterogeneous and often incomplete modality subsets. However, most current AI models assume fixed data modalities as the model inputs. In this paper, we present BrainAnytime, a unified pretraining framework pretrained on 34,899 3D brain scans from five datasets that support brain image analysis under arbitrary modality availability spanning multi-sequence MRI and amyloid-PET. A single model accepts whatever imaging is available, from a lone T1 scan to a full multimodal workup. Pretraining learns structural-molecular correspondences between MRI and PET via cross-modal distillation (RCMD) and prioritizes disease-vulnerable anatomy via atlas-guided curriculum masking (PACM), all within a shared 3D masked autoencoder (Multi-MAE3D). Across four downstream tasks and five clinically motivated modality settings, BrainAnytime largely outperforms modality-specific models, missing-modality baselines, and large-scale brain MRI pretrained foundation models on most modality settings. Notably, it surpasses the strongest missing-modality baselines with relative improvements of 6.2% and 7.0% in average accuracy on CN vs. AD and CN vs. MCI classification, respectively. Code is available at https://github.com/SDH-Lab/BrainAnytime.

  • 7 authors
·
May 12

Radiogenomic biomarkers for immunotherapy in glioblastoma: A systematic review of magnetic resonance imaging studies

Immunotherapy is an effective precision medicine treatment for several cancers. Imaging signatures of the underlying genome (radiogenomics) in glioblastoma patients may serve as preoperative biomarkers of the tumor-host immune apparatus. Validated biomarkers would have the potential to stratify patients during immunotherapy clinical trials, and if trials are beneficial, facilitate personalized neo-adjuvant treatment. The increased use of whole genome sequencing data, and the advances in bioinformatics and machine learning make such developments plausible. We performed a systematic review to determine the extent of development and validation of immune-related radiogenomic biomarkers for glioblastoma. A systematic review was performed following PRISMA guidelines using the PubMed, Medline, and Embase databases. Qualitative analysis was performed by incorporating the QUADAS 2 tool and CLAIM checklist. PROSPERO registered CRD42022340968. Extracted data were insufficiently homogenous to perform a meta-analysis. Results Nine studies, all retrospective, were included. Biomarkers extracted from magnetic resonance imaging volumes of interest included apparent diffusion coefficient values, relative cerebral blood volume values, and image-derived features. These biomarkers correlated with genomic markers from tumor cells or immune cells or with patient survival. The majority of studies had a high risk of bias and applicability concerns regarding the index test performed. Radiogenomic immune biomarkers have the potential to provide early treatment options to patients with glioblastoma. Targeted immunotherapy, stratified by these biomarkers, has the potential to allow individualized neo-adjuvant precision treatment options in clinical trials. However, there are no prospective studies validating these biomarkers, and interpretation is limited due to study bias with little evidence of generalizability.

  • 8 authors
·
May 12, 2024

ProtoPathway: Biologically Structured Prototype-Pathway Fusion for Multimodal Cancer Survival Prediction

We introduce ProtoPathway, an interpretable-by-design multimodal framework for cancer survival prediction that unifies whole slide imaging and transcriptomics through encoders producing biologically grounded representations on both sides of the fusion. On the histopathology side, K learnable morphological prototypes, trained end-to-end with the survival objective, serve as the slide representation itself: patches flow into prototype tokens via soft assignment, compressing variable-length patch sets into fixed task-adaptive tokens. On the genomic side, a bipartite graph neural network encodes gene expression within the Reactome pathway hierarchy, producing pathway embeddings that reflect both constituent genes and their broader biological context through bidirectional message passing over a shared gene--pathway graph. Cross-modal attention then operates over a compact prototype times pathway matrix in which prototypes query pathways, modeling the biological direction in which molecular programs give rise to tissue morphology. Because both axes carry stable task-learned identity, the attention matrix is itself an interpretability output, yielding native inference-time attribution across the full biological hierarchy, from genes through pathways and prototypes to spatial tissue maps. We evaluate on five TCGA cancer cohorts, demonstrating competitive or superior survival prediction with substantially improved biological interpretability and reduced computational cost, with interpretability claims validated through fold-stratified rank-based population-level analysis. Our source code, model weights, and Reactome pathways, together with a unified codebase reimplementing all multimodal survival baselines under identical preprocessing and evaluation, are available at: https://github.com/AmayaGS/ProtoPathway.

  • 5 authors
·
May 19

Inverse Bayesian Inference for Extracting Lesion Dynamics from Longitudinal Spectral CT

Longitudinal medical imaging captures temporal evolution of lesions, yet extracting the underlying dynamical parameters governing this evolution remains challenging. We propose an inverse Bayesian framework for inferring lesion dynamics from longitudinal spectral CT. We decompose spectral feature (x) evolution into three components: equation* dx_i{dt} = A_i x_i + B \cdot n + C \cdot Δx_{sat} equation* where A_i captures intrinsic dynamics (lesion-autonomous evolution), B captures local environment tumour burden (organ tumour burden through satellite count coupling), and C captures environment/satellite state change (i.e., whether surrounding lesions move similarly or not). We demonstrate the framework on photon-counting NSCLC CT data from metastases, recovering distinct dynamical regimes: lung lesions exhibit significant satellite count coupling (B=-0.34, p<0.05) suggesting competitive dynamics, while liver lesions show synergistic satellite behaviour coupling (Capprox+1.0, p<0.05). Synthetic validation confirms parameter recovery, and cross-coupling analysis validates that our method detects non-zero coupling when present. This work establishes inverse dynamical inference as a principled methodology for extracting interpretable parameters from longitudinal imaging, moving beyond static feature extraction toward mechanistic characterisation of lesion behaviour. The code and data are available at: https://github.com/lukasf98/inverse-bayesian-inference

  • 9 authors
·
Jul 24

Motion simulation of radio-labeled cells in whole-body positron emission tomography

Cell tracking is a subject of active research gathering great interest in medicine and biology. Positron emission tomography (PET) is well suited for tracking radio-labeled cells in vivo due to its exceptional sensitivity and whole-body capability. For validation, ground-truth data are desirable that realistically mimic the flow of cells in a clinical situation. This study develops a workflow (CeFloPS) for simulating moving radio-labeled cells in a human phantom. From the XCAT phantom, the blood vessels are reduced to nodal networks along which cells can move and distribute to organs and tissues. The movement is directed by the blood flow, which is calculated in each node using the Hagen-Pooiseuille equation and Kirchhoff's laws assuming laminar flow. Organs are voxelized and movement of cells from artery entry to vein exit is generated via a biased 3D random walk. The probabilities of cells moving or remaining in tissues are derived from rate constants of tracer kinetic-based compartment modeling. PET listmode data is generated using the Monte-Carlo simulation framework GATE based on the definition of a large-body PET scanner with cell paths as moving radioactive sources and the XCAT phantom providing attenuation data. From the flow simulation of 100,000 cells, 100 sample cells were further processed by GATE and listmode data was reconstructed into images for comparison. As demonstrated by comparisons of simulated and reconstructed cell distributions, CeFloPS is capable of simulating cell behavior in whole-body PET. It achieves this simulation in a way that is anatomically and physiologically reasonable, thereby providing valuable data for the development and validation of cell tracking algorithms.

  • 5 authors
·
Jul 10, 2024

Automating High Quality RT Planning at Scale

Radiotherapy (RT) planning is complex, subjective, and time-intensive. Advances in artificial intelligence (AI) promise to improve its precision, efficiency, and consistency, but progress is often limited by the scarcity of large, standardized datasets. To address this, we introduce the Automated Iterative RT Planning (AIRTP) system, a scalable solution for generating high-quality treatment plans. This scalable solution is designed to generate substantial volumes of consistently high-quality treatment plans, overcoming a key obstacle in the advancement of AI-driven RT planning. Our AIRTP pipeline adheres to clinical guidelines and automates essential steps, including organ-at-risk (OAR) contouring, helper structure creation, beam setup, optimization, and plan quality improvement, using AI integrated with RT planning software like Eclipse of Varian. Furthermore, a novel approach for determining optimization parameters to reproduce 3D dose distributions, i.e. a method to convert dose predictions to deliverable treatment plans constrained by machine limitations. A comparative analysis of plan quality reveals that our automated pipeline produces treatment plans of quality comparable to those generated manually, which traditionally require several hours of labor per plan. Committed to public research, the first data release of our AIRTP pipeline includes nine cohorts covering head-and-neck and lung cancer sites to support an AAPM 2025 challenge. This data set features more than 10 times the number of plans compared to the largest existing well-curated public data set to our best knowledge. Repo:{https://github.com/RiqiangGao/GDP-HMM_AAPMChallenge}

  • 13 authors
·
Jan 20, 2025

Towards a deep learning approach for classifying treatment response in glioblastomas

Glioblastomas are the most aggressive type of glioma, having a 5-year survival rate of 6.9%. Treatment typically involves surgery, followed by radiotherapy and chemotherapy, and frequent magnetic resonance imaging (MRI) scans to monitor disease progression. To assess treatment response, radiologists use the Response Assessment in Neuro-Oncology (RANO) criteria to categorize the tumor into one of four labels based on imaging and clinical features: complete response, partial response, stable disease, and progressive disease. This assessment is very complex and time-consuming. Since deep learning (DL) has been widely used to tackle classification problems, this work aimed to implement the first DL pipeline for the classification of RANO criteria based on two consecutive MRI acquisitions. The models were trained and tested on the open dataset LUMIERE. Five approaches were tested: 1) subtraction of input images, 2) different combinations of modalities, 3) different model architectures, 4) different pretraining tasks, and 5) adding clinical data. The pipeline that achieved the best performance used a Densenet264 considering only T1-weighted, T2-weighted, and Fluid Attenuated Inversion Recovery (FLAIR) images as input without any pretraining. A median Balanced Accuracy of 50.96% was achieved. Additionally, explainability methods were applied. Using Saliency Maps, the tumor region was often successfully highlighted. In contrast, Grad-CAM typically failed to highlight the tumor region, with some exceptions observed in the Complete Response and Progressive Disease classes, where it effectively identified the tumor region. These results set a benchmark for future studies on glioblastoma treatment response assessment based on the RANO criteria while emphasizing the heterogeneity of factors that might play a role when assessing the tumor's response to treatment.

  • 6 authors
·
Apr 25, 2025

Beyond the Transcriptome: Chromatin-Informed Prediction of Cell-State-Dependent Perturbation Responses

Predicting transcriptional responses to genetic perturbations is central to understanding gene function. Existing predictors primarily rely on transcriptomic measurements, although chromatin accessibility provides complementary information about the cellular context in which perturbations act. Using this information requires linking chromatin context to specific perturbations and accounting for baseline differences between independently sampled control and perturbed populations. We propose ChromaPert, a chromatin-informed framework for predicting state-dependent perturbation responses. ChromaPert combines molecular and DNA-informed locus priors with paired control RNA--ATAC features to jointly represent target identity and measured cellular context. Its Chromatin-Guided Response Router (CGRR) builds a source bank of control-derived expression offsets and retrieves relevant sources using perturbation/locus or control-ATAC similarity. These offsets account for baseline differences, while conditional transport flow learns the remaining response. Across three unseen-target and held-out-state settings on K562 CAT-ATAC and Perturb-Multiome, ChromaPert achieves the highest all-gene response correlation among evaluated methods. When transferring known perturbations to held-out states, it improves correlation by 23.2% across all genes and 46.2% for the twenty most responsive genes over the strongest respective baselines. Correct RNA--ATAC pairing improves recovery of chromatin-associated response slopes over shuffled pairing, while cross-state predictions retain state-specific responses to the same perturbation.

  • 6 authors
·
Oct 5

GRCD: Grounded Region Change Detection for Multi-Finding Chest X-Ray Pairs

Radiologists routinely compare current and prior chest X-rays to track disease progression, producing follow-up reports that describe multiple findings, each localised to an anatomical region and annotated with a temporal change status. Existing automated methods either generate reports from a single image without modelling temporal context, or incorporate temporal information but do not ground their outputs spatially. The few approaches that combine temporal reasoning with spatial grounding are restricted to single-finding descriptions, leaving multi-finding reports with mixed change directions unaddressed. We present GRCD, a framework for grounded report generation from chest X-ray pairs in the multi-finding setting. We first construct a rigorously cleaned dataset of temporal chest X-ray pairs by identifying and correcting two systematic labelling errors in the source annotations. We then introduce a Region-Guided Change Token module that encodes per-region temporal change across anatomical structures and injects this signal into a language model through a dual-pathway strategy combining prepended spatial tokens with gated cross-attention. On a multi-finding test set, GRCD outperforms existing baselines on text generation and clinical accuracy metrics, with gains in change detection. Ablation studies confirm that the dual-pathway design outperforms either integration strategy in isolation on text and clinical metrics, and that region-level change encoding is necessary for multi-finding generation. Code is available at https://github.com/UTSA-VIRLab/GRCD

  • 3 authors
·
Jul 1

A protocol for evaluating robustness to H&E staining variation in computational pathology models

Sensitivity to staining variation remains a major barrier to deploying computational pathology (CPath) models as hematoxylin and eosin (H&E) staining varies across laboratories, requiring systematic assessment of how this variability affects model prediction. In this work, we developed a three-step protocol for evaluating robustness to H&E staining variation in CPath models. Step 1: Select reference staining conditions, Step 2: Characterize test set staining properties, Step 3: Apply CPath model(s) under simulated reference staining conditions. Here, we first created a new reference staining library based on the PLISM dataset. As an exemplary use case, we applied the protocol to assess the robustness properties of 306 microsatellite instability (MSI) classification models on the unseen SurGen colorectal cancer dataset (n=738), including 300 attention-based multiple instance learning models trained on the TCGA-COAD/READ datasets across three feature extractors (UNI2-h, H-Optimus-1, Virchow2), alongside six public MSI classification models. Classification performance was measured as AUC, and robustness as the min-max AUC range across four simulated staining conditions (low/high H&E intensity, low/high H&E color similarity). Across models and staining conditions, classification performance ranged from AUC 0.769-0.911 (Δ = 0.142). Robustness ranged from 0.007-0.079 (Δ = 0.072), and showed a weak inverse correlation with classification performance (Pearson r=-0.22, 95% CI [-0.34, -0.11]). Thus, we show that the proposed evaluation protocol enables robustness-informed CPath model selection and provides insight into performance shifts across H&E staining conditions, supporting the identification of operational ranges for reliable model deployment. Code is available at https://github.com/CTPLab/staining-robustness-evaluation .

  • 8 authors
·
Mar 13

Standardized Benchmark Dataset for Localized Exposure to a Realistic Source at 10-90 GHz

The lack of freely available standardized datasets represents an aggravating factor during the development and testing the performance of novel computational techniques in exposure assessment and dosimetry research. This hinders progress as researchers are required to generate numerical data (field, power and temperature distribution) anew using simulation software for each exposure scenario. Other than being time consuming, this approach is highly susceptible to errors that occur during the configuration of the electromagnetic model. To address this issue, in this paper, the limited available data on the incident power density and resultant maximum temperature rise on the skin surface considering various steady-state exposure scenarios at 10-90 GHz have been statistically modeled. The synthetic data have been sampled from the fitted statistical multivariate distribution with respect to predetermined dosimetric constraints. We thus present a comprehensive and open-source dataset compiled of the high-fidelity numerical data considering various exposures to a realistic source. Furthermore, different surrogate models for predicting maximum temperature rise on the skin surface were fitted based on the synthetic dataset. All surrogate models were tested on the originally available data where satisfactory predictive performance has been demonstrated. A simple technique of combining quadratic polynomial and tensor-product spline surrogates, each operating on its own cluster of data, has achieved the lowest mean absolute error of 0.058 {\deg}C. Therefore, overall experimental results indicate the validity of the proposed synthetic dataset.

  • 3 authors
·
May 3, 2023

BioRefusalAudit: Auditing Biosecurity Refusal Depth Using General and Domain-Fine-Tuned Sparse Autoencoders

Biosecurity evaluations of language models typically ask whether models produce hazardous output. This paper asks a complementary question: when a model refuses, is that refusal structurally sound, or does it disappear under modest changes to prompt framing, formatting, or output length? Across five architectures, no model cleanly discriminated benign from hazard. Gemma 2 2B-IT never genuinely refused across 75 prompts, hedging on every hazard-adjacent query. Gemma 4 E2B-IT refused 65/75 prompts with chat-template formatting and 0/75 without it. Both Gemma models collapsed to 0% under an 80-token cap. Qwen 2.5 1.5B and Phi-3-mini over-refused, flagging 83-87% of benign biology as hazardous. Llama 3.2 1B showed the only meaningful tier gradient (61-point spread). To probe what drives such over-refusal, we tested a panel of Schedule I but biologically non-toxic compounds (notably psilocybin cultivation, with FDA Breakthrough Therapy status). Some models refused these at rates exceeding genuinely hazardous biology, suggesting refusal tracks legality and cultural salience over CBRN hazard. To measure the internal side, we introduce a divergence score D comparing a model's surface response label to its internal sparse autoencoder (SAE) feature activations. Full D was computed on Gemma 2 2B-IT (Gemma Scope 1) and Gemma 4 E2B-IT (author-trained bio SAE). Two fine-tuned Gemma 2 domain SAEs were released. On Gemma 4, comply and refuse responses separated by a 0.647-point gap with zero overlap (n=75), though this is preliminary, with a narrow catalog, within-sample calibration, and Gemma-family-only SAE coverage. Built over one hackathon weekend on consumer hardware (GTX 1650 Ti Max-Q, plus Colab T4 for SAE training), this preliminary evidence suggests activation-level auditing may surface failure modes invisible to behavioral evaluation, with substantial variation across architectures.

  • 1 authors
·
May 27

Cost-effectiveness analysis for therapy sequence in advanced cancer: A microsimulation approach with application to metastatic prostate cancer

Purpose. Patients with advanced cancer may undergo multiple lines of treatment, switching therapies as their disease progresses. Motivated by a study of metastatic prostate cancer, we develop a microsimulation framework to study therapy sequence. Methods. We propose a discrete-time state transition model to study two lines of anti-cancer therapy. Based on digitized published progression-free survival (PFS) and overall survival (OS) curves, we infer event types (progression or death), and estimate transition probabilities using cumulative incidence functions with competing risks. Our model incorporates within-patient dependence over time, such that response to first-line therapy informs subsequent event probabilities. Parameters governing the degree of within-patient dependence can be used to calibrate the model-based results to those of a target trial. We demonstrate these methods in a study of two therapy sequences for metastatic prostate cancer, where Docetaxel (DCT) and Abiraterone Acetate (AA) are both appropriate for use in either first or second line treatment. We assess costs, Quality-Adjusted Life Years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) for two treatment strategies: DCT then AA vs AA then DCT. Results. Using digitized survival curves from relevant clinical trials, we identified 8.6-13.9% of PFS times that should be categorized as deaths, allowing for estimation of cumulative incidence functions. Models assuming within-patient independence overestimated OS time, corrected with our calibration approach. Correction resulted in meaningful changes in the difference in QALYs between treatment strategies (0.07 vs 0.15) and the ICER (-\76,836/QALY vs -21,030/QALY). Conclusions. Microsimulation models can be successfully used to study cost-effectiveness of therapy sequences, taking care to account correctly for within-patient dependence.

  • 5 authors
·
Oct 10, 2022

Spectroscopic measurements and models of energy deposition in the substrate of quantum circuits by natural ionizing radiation

Naturally occurring background radiation is a source of correlated decoherence events in superconducting qubits that will challenge error-correction schemes. To characterize the radiation environment in an unshielded laboratory, we performed broadband, spectroscopic measurements of background events in silicon substrates located inside a millikelvin refrigerator, an environment representative of superconducting qubit systems. We measured the background spectra in silicon substrates of two thicknesses, 0.5 mm and 1.5 mm, and obtained the average event rate and the integrated power deposition. In a 25 mm^2 area and the thinner substrate, these values are 0.023 events per second and 4.9 keV/s, counting events that deposit at least 40 keV. We find the background spectrum to be nearly featureless. Its intensity decreases by a factor of 40,000 between 100 keV and 3 MeV for silicon substrates 0.5 mm thick. We find the cryogenic measurements to be in good agreement with predictions based on measurements of the terrestrial gamma-ray flux, published models of cosmic-ray fluxes, a crude model of the cryostat, and radiation-transport simulations. No free parameters are required to predict the background spectra in the silicon substrates. The good agreement between measurements and predictions allow assessment of the relative contributions of terrestrial and cosmic background sources and their dependence on substrate thickness. Our spectroscopic measurements are performed with superconducting microresonators that transduce deposited energy to a readily detectable electrical signal. We find that gamma-ray emissions from radioisotopes are responsible for the majority of events depositing E<1.5 MeV, while nucleons among the cosmic-ray secondary particles cause most events that deposit more energy. These results suggest several paths to reducing the impact of background radiation on quantum circuits.

  • 19 authors
·
Oct 10, 2024

Quality Is Not a Safety Proxy Under Quantization

Quantized checkpoints are often screened first with quality metrics and only later, if at all, with direct safety tests. This paper audits that shortcut on a matched 51-row matrix spanning 6 models, 4 families, a 7-level GGUF ladder, and AWQ/GPTQ INT4 checkpoints. In this matrix the shortcut fails: all 36 quality-safety pairings split direction across models, and 9 hidden-danger rows plus 1 near-hidden-danger row show quality stable or improved while refusal falls by 12-68 percentage points. Seven of the 11 AWQ/GPTQ rows are hidden-danger. A four-probe mechanistic follow-up over the 17 Hugging Face-backed FP16/AWQ/GPTQ cells does not rescue it: entropy, refusal-direction, and calibration probes are weak or null separators of dangerous rows, and although probe-identified safety-associated neurons absorb 1.39times more quantization error overall (p < 5 times 10^{-7}), the effect is not regime-specific. Claude Sonnet 4 relabels 11,470 items in a predefined stratified set, agrees with the primary gemma3:12b judge on 89.9\% of rows (κ= 0.873, 95\% CI [0.866, 0.881]), and changes 0/10 hidden-danger cells. A calibrated study-internal behavioral screen -- the Refusal Template Stability Index (RTSI), built from four refusal-template drift features and calibrated on this matrix -- routes 10/10 hidden- or near-hidden-danger rows to direct safety testing (Wilson 95\% CI lower bound 0.72) while leaving 23 of 45 non-baseline rows in a low-risk bucket under both in-sample scoring and row-level leave-one-out validation; on the same matrix, the best single-feature baselines (unique-prefix-rate-delta, raw refusal-rate delta) recover 9/10 and 8/10 respectively at matched bucket size, and cross-stack transfer requires recalibration. For the quantized checkpoints, model families, and safety outcomes studied here, retained quality cannot waive direct safety evaluation.

  • 1 authors
·
Jun 7

Persistent Depth Ordering amid Shifting Block-Bypass Responses in Language Model Pretraining

Layer interventions are widely used to probe the internal organization of language models, yet most analyses examine a single training checkpoint even though model representations and computations evolve throughout pretraining. This leaves open which depth-dependent intervention responses reflect persistent organization and which are transient consequences of training. We study this question using single-block identity bypass on fixed teacher-forced contexts across five released trajectories and 11 model-domain combinations. We find that block-bypass responses retain recognizable depth ordering while their magnitudes redistribute: nearby checkpoints preserve stronger rank correspondence than distant ones, and large changes concentrate at positions that recur across text samples and transfer across evaluation domains. Controlled experiments further show that changes in the natural bypass effect cannot be reduced to a single downstream sensitivity: in replicated Pythia runs, local missing-update magnitude grows while the pooled matched downstream response decreases, whereas OLMo-2 7B exhibits a different balance. These matched responses also depend on perturbation strength and direction, without identifying targeted compensation. Together, our results show that longitudinal layer sensitivity is structured but not static, and that single-checkpoint intervention responses should be interpreted in the context of how the underlying perturbation pathway evolves during training.

  • 3 authors
·
Sep 30

A Flexible Parametric Modelling Framework for Survival Analysis

We introduce a general, flexible, parametric survival modelling framework which encompasses key shapes of hazard function (constant, increasing, decreasing, up-then-down, down-then-up), various common survival distributions (log-logistic, Burr type XII, Weibull, Gompertz), and includes defective distributions (i.e., cure models). This generality is achieved using four basic distributional parameters: two scale-type parameters and two shape parameters. Generalising to covariate dependence, the scale-type regression components correspond to accelerated failure time (AFT) and proportional hazards (PH) models. Therefore, this general formulation unifies the most popular survival models which allows us to consider the practical value of possible modelling choices for survival data. Furthermore, in line with our proposed flexible baseline distribution, we advocate the use of multi-parameter regression in which more than one distributional parameter depends on covariates - rather than the usual convention of having a single covariate-dependent (scale) parameter. While many choices are available, we suggest introducing covariates through just one or other of the two scale parameters, which covers AFT and PH models, in combination with a `power' shape parameter, which allows for more complex non-AFT/non-PH effects, while the other shape parameter remains covariate-independent, and handles automatic selection of the baseline distribution. We explore inferential issues in simulations, both with and without a covariate, with particular focus on evidence concerning the need, or otherwise, to include both AFT and PH parameters. We illustrate the efficacy of our modelling framework by investigating differences between treatment groups using data from a lung cancer study and a melanoma study. Censoring is accommodated throughout.

  • 3 authors
·
Jan 10, 2019

Radiology Report Generation with Layer-Wise Anatomical Attention

Automatic radiology report generation is a promising application of multimodal deep learning, aiming to reduce reporting workload and improve consistency. However, current state-of-the-art (SOTA) systems - such as Multimodal AI for Radiology Applications (MAIRA-2) and Medical Pathways Language Model-Multimodal (MedPaLM-M) - depend on large-scale multimodal training, clinical metadata, and multiple imaging views, making them resource-intensive and inaccessible for most settings. We introduce a compact image-to-text architecture that generates the Findings section of chest X-ray reports from a single frontal image. The model combines a frozen Self-Distillation with No Labels v3 (DINOv3) Vision Transformer (ViT) encoder with a Generative Pre-trained Transformer 2 (GPT-2) decoder enhanced by layer-wise anatomical attention. This mechanism integrates lung and heart segmentation masks through hierarchical Gaussian smoothing, biasing attention toward clinically relevant regions without adding trainable parameters. Evaluated on the official Medical Information Mart for Intensive Care-Chest X-ray (MIMIC-CXR) dataset using Chest Radiograph Expert (CheXpert) and Radiology Graph (RadGraph) metrics, our approach achieved substantial gains: CheXpert Macro-F1 for five key pathologies increased by 168% (0.083 -> 0.238) and Micro-F1 by 146% (0.137 -> 0.337), while broader performance across 14 observations improved by 86% (0.170 -> 0.316). Structural coherence also improved, with RadGraph F1 rising by 9.7%. Despite its small size and purely image-conditioned design, the model demonstrates that decoder-level anatomical guidance improves spatial grounding and enhances coherence in clinically relevant regions. The source code is publicly available at: https://github.com/devMuniz02/UDEM-CXR-Reporting-Thesis-2025.

  • 6 authors
·
Dec 18, 2025

Radiation-magnetohydrodynamics with MPI-AMRVAC using flux-limited diffusion

Context. Radiation plays a significant role in solar and astrophysical environments as it may constitute a sizeable fraction of the energy density, momentum flux, and the total pressure. Modelling the dynamic interaction between radiation and magnetized plasmas in such environments is an intricate and computationally costly task. Aims. The goal of this work is to demonstrate the capabilities of the open-source parallel, block-adaptive computational framework MPI-AMRVAC, in solving equations of radiation-magnetohydrodynamics (RMHD), and to present benchmark test cases relevant for radiation-dominated magnetized plasmas. Methods. The existing magnetohydrodynamics (MHD) and flux-limited diffusion (FLD) radiative-hydrodynamics physics modules are combined to solve the equations of radiation-magnetohydrodynamics (RMHD) on block-adaptive finite volume Cartesian meshes in any dimensionality. Results. We introduce and validate several benchmark test cases such as steady radiative MHD shocks, radiation-damped linear MHD waves, radiation-modified Riemann problems and a multi-dimensional radiative magnetoconvection case. We recall the basic governing Rankine-Hugoniot relations for shocks and the dispersion relation for linear MHD waves in the presence of optically thick radiation fields where the diffusion limit is reached. The RMHD system allows for 8 linear wave types, where the classical 7-wave MHD picture (entropy and three wave pairs for slow, Alfven and fast) is augmented with a radiative diffusion mode. Conclusions. The MPI-AMRVAC code now has the capability to perform multidimensional RMHD simulations with mesh adaptation making it well-suited for larger scientific applications to study magnetized matter-radiation interactions in solar and stellar interiors and atmospheres.

  • 5 authors
·
Mar 4, 2025

CP2K: An electronic structure and molecular dynamics software package - Dynamics, Transport, and Spectroscopic Response

One of the distinguishing aspects of CP2K is its seamless integration of diverse structural and transition-state optimization techniques with advanced sampling approaches including Monte Carlo, molecular dynamics, and metadynamics, enabling the efficient exploration of complex potential- and free-energy landscapes, including rare events. These capabilities are combined with a broad hierarchy of energy and force evaluation methods, ranging from classical and machine-learned interaction potentials and mixed quantum-classical multiscale and semiempirical schemes, to highly accurate quantum-mechanical electronic-structure approaches. At the heart of the latter lies the Gaussian and plane-wave framework, along with its augmented all-electron generalization, which have been described in detail in our previous code review [T. D. Kühne et al., J. Chem. Phys. 152, 194103 (2020)]. Building on this foundation, the present work revisits the methods within CP2K that turn electronic structure into dynamics, transport, and spectroscopic response. Particular emphasis is placed on the coupling between static response calculations and nuclear motion: spectra may be evaluated at optimized structures, averaged over thermally sampled configurations, obtained from time-correlation functions along ab-initio or path integral molecular trajectories, or followed in real time together with electronic and nuclear dynamics. The same modular structure also enables equilibrium and biased transport simulations, from Kubo-type linear response to open-boundary approaches under external potentials, highlighting CP2K's unique capability to unify quantum chemistry with quantum and statistical mechanics within a versatile, holistic simulation environment.

  • 42 authors
·
Jul 30

Frame forecasting in cine MRI using the PCA respiratory motion model: comparing recurrent neural networks trained online and transformers

Respiratory motion complicates accurate irradiation of thoraco-abdominal tumors during radiotherapy, as treatment-system latency entails target-location uncertainties. This work addresses frame forecasting in chest and liver cine MRI to compensate for such delays. We investigate RNNs trained with online learning algorithms, enabling adaptation to changing respiratory patterns via on-the-fly parameter updates, and transformers, increasingly common in time-series forecasting for their ability to capture long-term dependencies. Experiments used 12 sagittal thoracic and upper-abdominal cine-MRI sequences from ETH Zürich and OvGU; the OvGU data exhibited higher motion variability, noise, and lower contrast. PCA decomposes the Lucas-Kanade optical-flow field into static deformation modes and low-dimensional, time-dependent weights. We compare various methods for forecasting these weights: linear filters, population and sequence-specific transformer encoders, and RNNs trained with real-time recurrent learning (RTRL), unbiased online recurrent optimization, decoupled neural interfaces, and sparse one-step approximation (SnAp-1). Predicted displacements were used to warp the reference frame and generate future images. Prediction accuracy decreased with the horizon h. Linear regression performed best at short horizons (1.3mm geometrical error at h=0.32s, ETH Zürich dataset), while RTRL and SnAp-1 outperformed the other algorithms at medium-to-long horizons, with geometrical errors below 1.4mm and 2.8mm on the sequences from ETH Zürich and OvGU, respectively. The sequence-specific transformer was competitive for low-to-medium horizons, but transformers remained overall limited by data scarcity and domain shift between datasets. Predicted frames visually resembled the ground truth, with notable errors occurring near the diaphragm at end-inspiration and regions affected by out-of-plane motion.

  • 5 authors
·
Apr 14

PDRs4All. XII. FUV-driven formation of hydrocarbon radicals and their relation with PAHs

We present subarcsecond-resolution ALMA mosaics of the Orion Bar PDR in [CI] 609 um, C2H (4-3), and C18O (3-2) emission lines, complemented by JWST images of H2 and aromatic infrared band (AIB) emission. The rim of the Bar shows very corrugated structures made of small-scale H2 dissociation fronts (DFs). The [CI] 609 um emission peaks very close (~0.002 pc) to the main H2-emitting DFs, suggesting the presence of gas density gradients. These DFs are also bright and remarkably similar in C2H emission, which traces 'hydrocarbon radical peaks' characterized by very high C2H abundances, reaching up to several x10^-7. The high abundance of C2H and of related hydrocarbon radicals, such as CH3, CH2, and CH, can be attributed to gas-phase reactions driven by elevated temperatures, the presence of C+ and C, and the reactivity of FUV-pumped H2. The hydrocarbon radical peaks roughly coincide with maxima of the 3.4/3.3 um AIB intensity ratio, a proxy for the aliphatic-to-aromatic content of PAHs. This implies that the conditions triggering the formation of simple hydrocarbons also favor the formation (and survival) of PAHs with aliphatic side groups, potentially via the contribution of bottom-up processes in which abundant hydrocarbon radicals react in situ with PAHs. Ahead of the DFs, in the atomic PDR zone (where [H]>>[H2]), the AIB emission is brightest, but small PAHs and carbonaceous grains undergo photo-processing due to the stronger FUV field. Our detection of trace amounts of C2H in this zone may result from the photoerosion of these species. This study provides a spatially resolved view of the chemical stratification of key carbon carriers in a PDR. Overall, both bottom-up and top-down processes appear to link simple hydrocarbon molecules with PAHs in molecular clouds; however, the exact chemical pathways and their relative contributions remain to be quantified.

  • 28 authors
·
Mar 5, 2025

Vision-Language Models for Automated 3D PET/CT Report Generation

Positron emission tomography/computed tomography (PET/CT) is essential in oncology, yet the rapid expansion of scanners has outpaced the availability of trained specialists, making automated PET/CT report generation (PETRG) increasingly important for reducing clinical workload. Compared with structural imaging (e.g., X-ray, CT, and MRI), functional PET poses distinct challenges: metabolic patterns vary with tracer physiology, and whole-body 3D contextual information is required rather than local-region interpretation. To advance PETRG, we propose PETRG-3D, an end-to-end 3D dual-branch framework that separately encodes PET and CT volumes and incorporates style-adaptive prompts to mitigate inter-hospital variability in reporting practices. We construct PETRG-Lym, a multi-center lymphoma dataset collected from four hospitals (824 reports w/ 245,509 paired PET/CT slices), and construct AutoPET-RG-Lym, a publicly accessible PETRG benchmark derived from open imaging data but equipped with new expert-written, clinically validated reports (135 cases). To assess clinical utility, we introduce PETRG-Score, a lymphoma-specific evaluation protocol that jointly measures metabolic and structural findings across curated anatomical regions. Experiments show that PETRG-3D substantially outperforms existing methods on both natural language metrics (e.g., +31.49\% ROUGE-L) and clinical efficacy metrics (e.g., +8.18\% PET-All), highlighting the benefits of volumetric dual-modality modeling and style-aware prompting. Overall, this work establishes a foundation for future PET/CT-specific models emphasizing disease-aware reasoning and clinically reliable evaluation. Codes, models, and AutoPET-RG-Lym will be released.

  • 11 authors
·
Nov 24, 2025

TrackRAD2025 challenge dataset: Real-time tumor tracking for MRI-guided radiotherapy

Purpose: Magnetic resonance imaging (MRI) to visualize anatomical motion is becoming increasingly important when treating cancer patients with radiotherapy. Hybrid MRI-linear accelerator (MRI-linac) systems allow real-time motion management during irradiation. This paper presents a multi-institutional real-time MRI time series dataset from different MRI-linac vendors. The dataset is designed to support developing and evaluating real-time tumor localization (tracking) algorithms for MRI-guided radiotherapy within the TrackRAD2025 challenge (https://trackrad2025.grand-challenge.org/). Acquisition and validation methods: The dataset consists of sagittal 2D cine MRIs in 585 patients from six centers (3 Dutch, 1 German, 1 Australian, and 1 Chinese). Tumors in the thorax, abdomen, and pelvis acquired on two commercially available MRI-linacs (0.35 T and 1.5 T) were included. For 108 cases, irradiation targets or tracking surrogates were manually segmented on each temporal frame. The dataset was randomly split into a public training set of 527 cases (477 unlabeled and 50 labeled) and a private testing set of 58 cases (all labeled). Data Format and Usage Notes: The data is publicly available under the TrackRAD2025 collection: https://doi.org/10.57967/hf/4539. Both the images and segmentations for each patient are available in metadata format. Potential Applications: This novel clinical dataset will enable the development and evaluation of real-time tumor localization algorithms for MRI-guided radiotherapy. By enabling more accurate motion management and adaptive treatment strategies, this dataset has the potential to advance the field of radiotherapy significantly.

  • 28 authors
·
Mar 24, 2025

Multi-RADS Synthetic Radiology Report Dataset and Head-to-Head Benchmarking of 41 Open-Weight and Proprietary Language Models

Background: Reporting and Data Systems (RADS) standardize radiology risk communication but automated RADS assignment from narrative reports is challenging because of guideline complexity, output-format constraints, and limited benchmarking across RADS frameworks and model sizes. Purpose: To create RXL-RADSet, a radiologist-verified synthetic multi-RADS benchmark, and compare validity and accuracy of open-weight small language models (SLMs) with a proprietary model for RADS assignment. Materials and Methods: RXL-RADSet contains 1,600 synthetic radiology reports across 10 RADS (BI-RADS, CAD-RADS, GB-RADS, LI-RADS, Lung-RADS, NI-RADS, O-RADS, PI-RADS, TI-RADS, VI-RADS) and multiple modalities. Reports were generated by LLMs using scenario plans and simulated radiologist styles and underwent two-stage radiologist verification. We evaluated 41 quantized SLMs (12 families, 0.135-32B parameters) and GPT-5.2 under a fixed guided prompt. Primary endpoints were validity and accuracy; a secondary analysis compared guided versus zero-shot prompting. Results: Under guided prompting GPT-5.2 achieved 99.8% validity and 81.1% accuracy (1,600 predictions). Pooled SLMs (65,600 predictions) achieved 96.8% validity and 61.1% accuracy; top SLMs in the 20-32B range reached ~99% validity and mid-to-high 70% accuracy. Performance scaled with model size (inflection between <1B and >=10B) and declined with RADS complexity primarily due to classification difficulty rather than invalid outputs. Guided prompting improved validity (99.2% vs 96.7%) and accuracy (78.5% vs 69.6%) compared with zero-shot. Conclusion: RXL-RADSet provides a radiologist-verified multi-RADS benchmark; large SLMs (20-32B) can approach proprietary-model performance under guided prompting, but gaps remain for higher-complexity schemes.

  • 25 authors
·
Jan 6