Daily Papers

MLLMs are increasingly deployed in multi-turn settings, where attackers can escalate unsafe intent through the evolving visual-text history and exploit long-context safety decay. Yet safety alignment is still dominated by single-turn data and fixed-template dialogues, leaving a mismatch between training and deployment. To bridge this gap, we propose SaFeR-Steer, a progressive multi-turn alignment framework that combines staged synthetic bootstrapping with tutor-in-the-loop GRPO to train a single student under adaptive, on-policy attacks. We also introduce Trajectory-Consistent Summative Reward (TCSR), which aggregates the historical minimum and average of turn rewards so that any low-quality turn affects the trajectory-level return. I. Dataset. We release STEER, a multi-turn multimodal safety dataset with STEER-SFT (12,934), STEER-RL (2,000), and STEER-Bench (3,227) dialogues spanning 2-10 turns. II. Experiment. Starting from Qwen2.5-VL-3B/7B, SaFeR-Steer substantially improves Safety/Helpfulness on both single-turn (48.30/45.86 rightarrow 81.84/70.77 for 3B; 56.21/60.32 rightarrow 87.89/77.40 for 7B) and multi-turn benchmarks (12.55/27.13 rightarrow 55.58/70.27 for 3B; 24.66/46.48 rightarrow 64.89/72.35 for 7B), shifting failures to later turns and yielding robustness beyond scaling alone. Code is available at https://anonymous.4open.science/r/SaFeR-Steer

Solving the inverse problem is the key step in evaluating the capacity of a physical model to describe real phenomena. In medical image computing, it aligns with the classical theme of image-based model personalization. Traditionally, a solution to the problem is obtained by performing either sampling or variational inference based methods. Both approaches aim to identify a set of free physical model parameters that results in a simulation best matching an empirical observation. When applied to brain tumor modeling, one of the instances of image-based model personalization in medical image computing, the overarching drawback of the methods is the time complexity for finding such a set. In a clinical setting with limited time between imaging and diagnosis or even intervention, this time complexity may prove critical. As the history of quantitative science is the history of compression, we align in this paper with the historical tendency and propose a method compressing complex traditional strategies for solving an inverse problem into a simple database query task. We evaluated different ways of performing the database query task assessing the trade-off between accuracy and execution time. On the exemplary task of brain tumor growth modeling, we prove that the proposed method achieves one order speed-up compared to existing approaches for solving the inverse problem. The resulting compute time offers critical means for relying on more complex and, hence, realistic models, for integrating image preprocessing and inverse modeling even deeper, or for implementing the current model into a clinical workflow.

User Stories record what must be built in projects that use agile practices. User Stories serve both to estimate effort, generally measured in Story Points, and to plan what should be done in a Sprint. Therefore, it is essential to train software engineers on how to create simple, easily readable, and comprehensive User Stories. For that reason, we designed, implemented, applied, and evaluated a web application called User Story Tutor (UST). UST checks the description of a given User Story for readability, and if needed, recommends appropriate practices for improvement. UST also estimates a User Story effort in Story Points using Machine Learning techniques. As such UST may support the continuing education of agile development teams when writing and reviewing User Stories. UST's ease of use was evaluated by 40 agile practitioners according to the Technology Acceptance Model (TAM) and AttrakDiff. The TAM evaluation averages were good in almost all considered variables. Application of the AttrakDiff evaluation framework produced similar good results. Apparently, UST can be used with good reliability. Applying UST to assist in the construction of User Stories is a viable technique that, at the very least, can be used by agile developments to complement and enhance current User Story creation.

Large Language Models (LLMs), such as ChatGPT, are quickly advancing AI to the frontiers of practical consumer use and leading industries to re-evaluate how they allocate resources for content production. Authoring of open educational resources and hint content within adaptive tutoring systems is labor intensive. Should LLMs like ChatGPT produce educational content on par with human-authored content, the implications would be significant for further scaling of computer tutoring system approaches. In this paper, we conduct the first learning gain evaluation of ChatGPT by comparing the efficacy of its hints with hints authored by human tutors with 77 participants across two algebra topic areas, Elementary Algebra and Intermediate Algebra. We find that 70% of hints produced by ChatGPT passed our manual quality checks and that both human and ChatGPT conditions produced positive learning gains. However, gains were only statistically significant for human tutor created hints. Learning gains from human-created hints were substantially and statistically significantly higher than ChatGPT hints in both topic areas, though ChatGPT participants in the Intermediate Algebra experiment were near ceiling and not even with the control at pre-test. We discuss the limitations of our study and suggest several future directions for the field. Problem and hint content used in the experiment is provided for replicability.

We study multi-domain LLM training in which two models, each stronger in a different domain, co-evolve by tutoring each other through on-policy feedback. Unlike one-way distillation or single-model fine-tuning, our goal is mutual Pareto improvement: each model improves across domains without losing its original strength. To this end, we propose On-Policy Co-Distillation (OPCoD), where each student's self-distillation is conditioned on its own correct rollout and feedback from its peer. To make feedback exchange effective, OPCoD uses cognizance-based gating to decide when to give feedback and feedback anchoring to ground feedback in the problem. On Science Q\&A tasks, OPCoD consistently outperforms baselines and achieves Pareto improvement across all evaluated domain pairs and students.

Several educational domains rely heavily on diagrams and visual cues, yet most existing tutoring datasets are limited to text-only interactions. This limits the development of AI tutors that can teach in visually grounded ways used by human instructors. Thus, we introduce GeoDial, a multimodal tutoring dataset of over 1.3K teacher-student dialogs in the domain of geometry collected from experienced math teachers, where instructional turns are explicitly grounded in diagram highlights. We propose a scalable annotation protocol that integrates dialog acts, visual highlighting, and feedback, enabling fine-grained supervision of both language and visual tutoring behavior. To illustrate the challenges posed by this setting, we fine-tune several vision-language models on GeoDial and evaluate their ability to generate tutoring utterances and diagram highlights. While supervised fine-tuning substantially improves the quality of generated dialog, it struggles to produce accurate diagram highlights, revealing a key limitation of current methods and highlighting the need for approaches that more effectively integrate visual reasoning with pedagogical interaction.

We explore the automatic generation of interactive, scenario-based lessons designed to train novice human tutors who teach middle school mathematics online. Employing prompt engineering through a Retrieval-Augmented Generation approach with GPT-4o, we developed a system capable of creating structured tutor training lessons. Our study generated lessons in English for three key topics: Encouraging Students' Independence, Encouraging Help-Seeking Behavior, and Turning on Cameras, using a task decomposition prompting strategy that breaks lesson generation into sub-tasks. The generated lessons were evaluated by two human evaluators, who provided both quantitative and qualitative evaluations using a comprehensive rubric informed by lesson design research. Results demonstrate that the task decomposition strategy led to higher-rated lessons compared to single-step generation. Human evaluators identified several strengths in the LLM-generated lessons, including well-structured content and time-saving potential, while also noting limitations such as generic feedback and a lack of clarity in some instructional sections. These findings underscore the potential of hybrid human-AI approaches for generating effective lessons in tutor training.

Reinforcement learning (RL) for non-verifiable instruction following increasingly relies on LLM judges with prompt-specific rubrics as reward signals. While recent methods adapt these rubrics to the evolving policy during training, the training prompts themselves remain static, drawn from fixed corpora. This static approach often results in a critical misalignment between prompt difficulty and policy capability, leaving the judge unable to recover a discriminative reward signal when prompts fail to elicit quality variance among rollouts. To address this misalignment, we introduce LLM-as-a-Tutor, a framework that extends the LLM's role from judge to tutor: a single model serves as an examiner that pairwise-compares policy rollouts to detect non-challenging prompts, and as a generator that appends atomic constraints to them. This append-only design monotonically raises difficulty in step with the policy's capability, producing a self-calibrating training signal without external difficulty schedules. On three complex instruction-following benchmarks, our method consistently outperforms both policy-unaware baselines and prior policy-adaptive methods that adapt rubrics or rewrite prompts, suggesting prompt adaptation as a missing axis of policy-awareness in non-verifiable RL.

In this paper, we propose Tutoring bot, a generative chatbot trained on a large scale of tutor-student conversations for English-language learning. To mimic a human tutor's behavior in language education, the tutor bot leverages diverse educational instructions and grounds to each instruction as additional input context for the tutor response generation. As a single instruction generally involves multiple dialogue turns to give the student sufficient speaking practice, the tutor bot is required to monitor and capture when the current instruction should be kept or switched to the next instruction. For that, the tutor bot is learned to not only generate responses but also infer its teaching action and progress on the current conversation simultaneously by a multi-task learning scheme. Our Tutoring bot is deployed under a non-commercial use license at https://tutoringai.com.

We present a design framework called Conversational Learning with Analytical Step-by-Step Strategies (CLASS) for developing high-performance Intelligent Tutoring Systems (ITS). The CLASS framework aims to empower ITS with with two critical capabilities: imparting tutor-like step-by-step guidance and enabling tutor-like conversations in natural language to effectively engage learners. To empower ITS with the aforementioned capabilities, the CLASS framework employs two carefully curated synthetic datasets. The first scaffolding dataset encompasses a variety of elements, including problems, their corresponding subproblems, hints, incorrect solutions, and tailored feedback. This dataset provides ITS with essential problem-solving strategies necessary for guiding students through each step of the conversation. The second conversational dataset contains simulated student-tutor conversations that involve the application of problem-solving strategies learned from the first dataset. In the second dataset, the tutoring system adheres to a pre-defined response template, which helps to maintain consistency and structure in ITS's responses during its interactions. This structured methodology facilitates seamless integration of user feedback and yields valuable insights into ITS's internal decision-making process, allowing for continuous refinement and improvement of the system. We also present a proof-of-concept ITS, referred to as SPOCK, trained using the CLASS framework with a focus on college level introductory biology content. A carefully constructed protocol was developed for SPOCK's preliminary evaluation, examining aspects such as the factual accuracy and relevance of its responses. Experts in the field of biology offered favorable remarks, particularly highlighting SPOCK's capability to break down questions into manageable subproblems and provide step-by-step guidance to students.

Generative AI and large language models hold great promise in enhancing programming education by automatically generating individualized feedback for students. We investigate the role of generative AI models in providing human tutor-style programming hints to help students resolve errors in their buggy programs. Recent works have benchmarked state-of-the-art models for various feedback generation scenarios; however, their overall quality is still inferior to human tutors and not yet ready for real-world deployment. In this paper, we seek to push the limits of generative AI models toward providing high-quality programming hints and develop a novel technique, GPT4Hints-GPT3.5Val. As a first step, our technique leverages GPT-4 as a ``tutor'' model to generate hints -- it boosts the generative quality by using symbolic information of failing test cases and fixes in prompts. As a next step, our technique leverages GPT-3.5, a weaker model, as a ``student'' model to further validate the hint quality -- it performs an automatic quality validation by simulating the potential utility of providing this feedback. We show the efficacy of our technique via extensive evaluation using three real-world datasets of Python programs covering a variety of concepts ranging from basic algorithms to regular expressions and data analysis using pandas library.

Generative AI, particularly Language Models (LMs), has the potential to transform real-world domains with societal impact, particularly where access to experts is limited. For example, in education, training novice educators with expert guidance is important for effectiveness but expensive, creating significant barriers to improving education quality at scale. This challenge disproportionately harms students from under-served communities, who stand to gain the most from high-quality education. We introduce Tutor CoPilot, a novel Human-AI approach that leverages a model of expert thinking to provide expert-like guidance to tutors as they tutor. This study is the first randomized controlled trial of a Human-AI system in live tutoring, involving 900 tutors and 1,800 K-12 students from historically under-served communities. Following a preregistered analysis plan, we find that students working with tutors that have access to Tutor CoPilot are 4 percentage points (p.p.) more likely to master topics (p<0.01). Notably, students of lower-rated tutors experienced the greatest benefit, improving mastery by 9 p.p. We find that Tutor CoPilot costs only $20 per-tutor annually. We analyze 550,000+ messages using classifiers to identify pedagogical strategies, and find that tutors with access to Tutor CoPilot are more likely to use high-quality strategies to foster student understanding (e.g., asking guiding questions) and less likely to give away the answer to the student. Tutor interviews highlight how Tutor CoPilot's guidance helps tutors to respond to student needs, though they flag issues in Tutor CoPilot, such as generating suggestions that are not grade-level appropriate. Altogether, our study of Tutor CoPilot demonstrates how Human-AI systems can scale expertise in real-world domains, bridge gaps in skills and create a future where high-quality education is accessible to all students.

Expert writing feedback from experienced researchers is critical for early-career scholars to improve their manuscripts, yet high-quality feedback often remains scarce because reviewing research papers is labor-intensive. Emerging AI-powered writing assistants largely focus on grammar fixes or simulating peer review with final scores, yet they fall short of providing concrete, actionable suggestions that help students improve their papers during drafting. We present PaperMentor, a human-centered writing assistant system that delivers actionable suggestions as Overleaf-native inline comments while leaving the actual writing entirely to human authors. PaperMentor integrates an expert skill library carefully curated from established researchers' writing advice with 12 specialized agents covering different aspects of paper writing, such as formatting compliance, phrasing accuracy, and terminology consistency. In a user study (n=14), 90.6% of the generated comments were rated actionable and 67.5% were rated valid, significantly outperforming a GPT-5.2 baseline uswithout the skill library. We release PaperMentor as open source for public use. Our code is publicly available under the AGPL-3.0 license at https://github.com/jiarui-liu/overleaf

This paper presents our system for Track 1: Mistake Identification in the BEA 2025 Shared Task on Pedagogical Ability Assessment of AI-powered Tutors. The task involves evaluating whether a tutor's response correctly identifies a mistake in a student's mathematical reasoning. We explore four approaches: (1) an ensemble of machine learning models over pooled token embeddings from multiple pretrained language models (LMs); (2) a frozen sentence-transformer using [CLS] embeddings with an MLP classifier; (3) a history-aware model with multi-head attention between token-level history and response embeddings; and (4) a retrieval-augmented few-shot prompting system with a large language model (LLM) i.e. GPT 4o. Our final system retrieves semantically similar examples, constructs structured prompts, and uses schema-guided output parsing to produce interpretable predictions. It outperforms all baselines, demonstrating the effectiveness of combining example-driven prompting with LLM reasoning for pedagogical feedback assessment. Our code is available at https://github.com/NaumanNaeem/BEA_2025.

This paper considers the development of an AI-based provably-correct mathematical proof tutor. While Large Language Models (LLMs) allow seamless communication in natural language, they are error prone. Theorem provers such as Lean allow for provable-correctness, but these are hard for students to learn. We present a proof-of-concept system (LeanTutor) by combining the complementary strengths of LLMs and theorem provers. LeanTutor is composed of three modules: (i) an autoformalizer/proof-checker, (ii) a next-step generator, and (iii) a natural language feedback generator. To evaluate the system, we introduce PeanoBench, a dataset of 371 Peano Arithmetic proofs in human-written natural language and formal language, derived from the Natural Numbers Game.

Artificial intelligence is transforming education through data-driven, personalized learning solutions. This paper introduces AI Tutor, an innovative web application that provides personalized tutoring in any subject using state-of-the-art Large Language Model (LLM). AI Tutor ingests course materials to construct an adaptive knowledge base tailored to the course. When students pose questions, it retrieves the most relevant information and generates detailed, conversational responses citing supporting evidence. The system is powered by advanced large language models and Retrieval-Augmented Generation (RAG) techniques for accurate, natural question answering. We present a fully-functional web interface and video demonstration that showcase AI Tutor's versatility across diverse subjects and its ability to produce pedagogically cogent responses. While an initial prototype, this work represents a pioneering step toward AI-enabled tutoring systems that can democratize access to high-quality, customized educational support.

Program repair techniques offer cost-saving benefits for debugging within software development and programming education scenarios. With the proven effectiveness of Large Language Models (LLMs) in code-related tasks, researchers have explored their potential for program repair. However, it is crucial to recognize that existing repair benchmarks may have influenced LLM training data, potentially causing data leakage. To evaluate LLMs' realistic repair capabilities, (1) we introduce an extensive, non-crawled benchmark, referred to as TutorCode, comprising 1,239 C++ defect codes and associated information such as tutor guidance, solution description, failing test cases, and the corrected code. Our work assesses the repair performance of 12 LLMs on TutorCode, measuring repair correctness (TOP-5 and AVG-5) and patch precision (RPSR). (2) We then provide a comprehensive investigation into which types of extra information can help LLMs improve their performance in repairing defects. Among these types, tutor guidance was found to be the most effective information in enhancing LLM repair capabilities. To fully harness LLMs' conversational capabilities and the benefits of augmented information, (3) we introduce a novel conversational semi-automatic repair framework CREF assisting human tutor. It demonstrates a remarkable AVG-5 improvement of 17.2%-24.6% compared to the baseline, achieving an impressive AVG-5 of 76.6% when utilizing GPT-4. These results highlight the potential for enhancing LLMs' repair capabilities through interactions with tutors and historical conversations involving incorrect responses. The successful application of CREF in a real-world educational setting demonstrates its effectiveness in reducing tutors' workload and improving students' learning experience, while also showcasing its promise for facilitating other software engineering tasks, such as code review.

Breast cancer survival prediction in computational pathology presents a remarkable challenge due to tumor heterogeneity. For instance, different regions of the same tumor in the pathology image can show distinct morphological and molecular characteristics. This makes it difficult to extract representative features from whole slide images (WSIs) that truly reflect the tumor's aggressive potential and likely survival outcomes. In this paper, we present PathoHR, a novel pipeline for accurate breast cancer survival prediction that enhances any size of pathological images to enable more effective feature learning. Our approach entails (1) the incorporation of a plug-and-play high-resolution Vision Transformer (ViT) to enhance patch-wise WSI representation, enabling more detailed and comprehensive feature extraction, (2) the systematic evaluation of multiple advanced similarity metrics for comparing WSI-extracted features, optimizing the representation learning process to better capture tumor characteristics, (3) the demonstration that smaller image patches enhanced follow the proposed pipeline can achieve equivalent or superior prediction accuracy compared to raw larger patches, while significantly reducing computational overhead. Experimental findings valid that PathoHR provides the potential way of integrating enhanced image resolution with optimized feature learning to advance computational pathology, offering a promising direction for more accurate and efficient breast cancer survival prediction. Code will be available at https://github.com/AIGeeksGroup/PathoHR.

Gliomas are the most common primary brain malignancies, with different degrees of aggressiveness, variable prognosis and various heterogeneous histologic sub-regions, i.e., peritumoral edematous/invaded tissue, necrotic core, active and non-enhancing core. This intrinsic heterogeneity is also portrayed in their radio-phenotype, as their sub-regions are depicted by varying intensity profiles disseminated across multi-parametric magnetic resonance imaging (mpMRI) scans, reflecting varying biological properties. Their heterogeneous shape, extent, and location are some of the factors that make these tumors difficult to resect, and in some cases inoperable. The amount of resected tumor is a factor also considered in longitudinal scans, when evaluating the apparent tumor for potential diagnosis of progression. Furthermore, there is mounting evidence that accurate segmentation of the various tumor sub-regions can offer the basis for quantitative image analysis towards prediction of patient overall survival. This study assesses the state-of-the-art machine learning (ML) methods used for brain tumor image analysis in mpMRI scans, during the last seven instances of the International Brain Tumor Segmentation (BraTS) challenge, i.e., 2012-2018. Specifically, we focus on i) evaluating segmentations of the various glioma sub-regions in pre-operative mpMRI scans, ii) assessing potential tumor progression by virtue of longitudinal growth of tumor sub-regions, beyond use of the RECIST/RANO criteria, and iii) predicting the overall survival from pre-operative mpMRI scans of patients that underwent gross total resection. Finally, we investigate the challenge of identifying the best ML algorithms for each of these tasks, considering that apart from being diverse on each instance of the challenge, the multi-institutional mpMRI BraTS dataset has also been a continuously evolving/growing dataset.

Brain tumors, particularly gliomas, pose significant chall-enges due to their complex growth patterns, infiltrative nature, and the variability in brain structure across individuals, which makes accurate diagnosis and monitoring difficult. Deep learning models have been developed to accurately delineate these tumors. However, most of these models were trained on relatively homogenous high-resource datasets, limiting their robustness when deployed in underserved regions. In this study, we performed segmentation-aware offline data augmentation on the BraTS-Africa dataset to increase the data sample size and diversity to enhance generalization. We further constructed an ensemble of three distinct architectures, MedNeXt, SegMamba, and Residual-Encoder U-Net, to leverage their complementary strengths. Our best-performing model, MedNeXt, was trained on 1000 epochs and achieved the highest average lesion-wise dice and normalized surface distance scores of 0.86 and 0.81 respectively. However, the ensemble model trained for 500 epochs produced the most balanced segmentation performance across the tumour subregions. This work demonstrates that a combination of advanced augmentation and model ensembling can improve segmentation accuracy and robustness on diverse and underrepresented datasets. Code available at: https://github.com/SPARK-Academy-2025/SPARK-2025/tree/main/SPARK2025_BraTs_MODELS/SPARK_NeuroAshanti

During the radiotherapy treatment of patients with lung cancer, the radiation delivered to healthy tissue around the tumor needs to be minimized, which is difficult because of respiratory motion and the latency of linear accelerator systems. In the proposed study, we first use the Lucas-Kanade pyramidal optical flow algorithm to perform deformable image registration of chest computed tomography scan images of four patients with lung cancer. We then track three internal points close to the lung tumor based on the previously computed deformation field and predict their position with a recurrent neural network (RNN) trained using real-time recurrent learning (RTRL) and gradient clipping. The breathing data is quite regular, sampled at approximately 2.5Hz, and includes artificial drift in the spine direction. The amplitude of the motion of the tracked points ranged from 12.0mm to 22.7mm. Finally, we propose a simple method for recovering and predicting 3D tumor images from the tracked points and the initial tumor image based on a linear correspondence model and Nadaraya-Watson non-linear regression. The root-mean-square error, maximum error, and jitter corresponding to the RNN prediction on the test set were smaller than the same performance measures obtained with linear prediction and least mean squares (LMS). In particular, the maximum prediction error associated with the RNN, equal to 1.51mm, is respectively 16.1% and 5.0% lower than the maximum error associated with linear prediction and LMS. The average prediction time per time step with RTRL is equal to 119ms, which is less than the 400ms marker position sampling time. The tumor position in the predicted images appears visually correct, which is confirmed by the high mean cross-correlation between the original and predicted images, equal to 0.955.

In this work, we address the TrackRAD2025 challenge of real-time tumor tracking in cine-MRI sequences of the thoracic and abdominal regions under strong data scarcity constraints. Two complementary strategies were explored: (i) unsupervised registration with the IMPACT similarity metric and (ii) foundation model-based segmentation leveraging SAM 2.1 and its recent variants through prompt-based interaction. Due to the one-second runtime constraint, the SAM-based method was ultimately selected. The final configuration used SAM2.1 b+ with mask-based prompts from the first annotated slice, fine-tuned solely on the small labeled subset from TrackRAD2025. Training was configured to minimize overfitting, using 1024x1024 patches (batch size 1), standard augmentations, and a balanced Dice + IoU loss. A low uniform learning rate (0.0001) was applied to all modules (prompt encoder, decoder, Hiera backbone) to preserve generalization while adapting to annotator-specific styles. Training lasted 300 epochs (~12h on RTX A6000, 48GB). The same inference strategy was consistently applied across all anatomical sites and MRI field strengths. Test-time augmentation was considered but ultimately discarded due to negligible performance gains. The final model was selected based on the highest Dice Similarity Coefficient achieved on the validation set after fine-tuning. On the hidden test set, the model reached a Dice score of 0.8794, ranking 6th overall in the TrackRAD2025 challenge. These results highlight the strong potential of foundation models for accurate and real-time tumor tracking in MRI-guided radiotherapy.

Brain tumor detection in multiplane Magnetic Resonance Imaging (MRI) slices is a challenging task due to the various appearances and relationships in the structure of the multiplane images. In this paper, we propose a new You Only Look Once (YOLO)-based detection model that incorporates Pretrained Knowledge (PK), called PK-YOLO, to improve the performance for brain tumor detection in multiplane MRI slices. To our best knowledge, PK-YOLO is the first pretrained knowledge guided YOLO-based object detector. The main components of the new method are a pretrained pure lightweight convolutional neural network-based backbone via sparse masked modeling, a YOLO architecture with the pretrained backbone, and a regression loss function for improving small object detection. The pretrained backbone allows for feature transferability of object queries on individual plane MRI slices into the model encoders, and the learned domain knowledge base can improve in-domain detection. The improved loss function can further boost detection performance on small-size brain tumors in multiplanar two-dimensional MRI slices. Experimental results show that the proposed PK-YOLO achieves competitive performance on the multiplanar MRI brain tumor detection datasets compared to state-of-the-art YOLO-like and DETR-like object detectors. The code is available at https://github.com/mkang315/PK-YOLO.

Tumor documentation in Germany is largely done manually, requiring reading patient records and entering data into structured databases. Large language models (LLMs) could potentially enhance this process by improving efficiency and reliability. This evaluation tests eleven different open source LLMs with sizes ranging from 1-70 billion model parameters on three basic tasks of the tumor documentation process: identifying tumor diagnoses, assigning ICD-10 codes, and extracting the date of first diagnosis. For evaluating the LLMs on these tasks, a dataset of annotated text snippets based on anonymized doctors' notes from urology was prepared. Different prompting strategies were used to investigate the effect of the number of examples in few-shot prompting and to explore the capabilities of the LLMs in general. The models Llama 3.1 8B, Mistral 7B, and Mistral NeMo 12 B performed comparably well in the tasks. Models with less extensive training data or having fewer than 7 billion parameters showed notably lower performance, while larger models did not display performance gains. Examples from a different medical domain than urology could also improve the outcome in few-shot prompting, which demonstrates the ability of LLMs to handle tasks needed for tumor documentation. Open source LLMs show a strong potential for automating tumor documentation. Models from 7-12 billion parameters could offer an optimal balance between performance and resource efficiency. With tailored fine-tuning and well-designed prompting, these models might become important tools for clinical documentation in the future. The code for the evaluation is available from https://github.com/stefan-m-lenz/UroLlmEval. We also release the dataset as a new valuable resource that addresses the shortage of authentic and easily accessible benchmarks in German-language medical NLP.

Breast cancer is one of the most common causes of death among women worldwide. Early detection helps in reducing the number of deaths. Automated 3D Breast Ultrasound (ABUS) is a newer approach for breast screening, which has many advantages over handheld mammography such as safety, speed, and higher detection rate of breast cancer. Tumor detection, segmentation, and classification are key components in the analysis of medical images, especially challenging in the context of 3D ABUS due to the significant variability in tumor size and shape, unclear tumor boundaries, and a low signal-to-noise ratio. The lack of publicly accessible, well-labeled ABUS datasets further hinders the advancement of systems for breast tumor analysis. Addressing this gap, we have organized the inaugural Tumor Detection, Segmentation, and Classification Challenge on Automated 3D Breast Ultrasound 2023 (TDSC-ABUS2023). This initiative aims to spearhead research in this field and create a definitive benchmark for tasks associated with 3D ABUS image analysis. In this paper, we summarize the top-performing algorithms from the challenge and provide critical analysis for ABUS image examination. We offer the TDSC-ABUS challenge as an open-access platform at https://tdsc-abus2023.grand-challenge.org/ to benchmark and inspire future developments in algorithmic research.

Tumor protein P53 is believed to be involved in over half of human cancers cases, the prediction of malignancies plays essential roles not only in advance detection for cancer, but also in discovering effective prevention and treatment of cancer, till now there isn't approach be able in prediction the mutated in tumor protein P53 which is caused high ratio of human cancers like breast, Blood, skin, liver, lung, bladder etc. This research proposed a new approach for prediction pre-cancer via detection malignant mutations in tumor protein P53 using bioinformatics tools like FASTA, BLAST, CLUSTALW and TP53 databases worldwide. Implement and apply this new approach of prediction pre-cancer through mutations at tumor protein P53 shows an effective result when used more specific parameters/features to extract the prediction result that means when the user increase the number of filters of the results which obtained from the database gives more specific diagnosis and classify, addition that the detecting pre-cancer via prediction mutated tumor protein P53 will reduces a person's cancers in the future by avoiding exposure to toxins, radiation or monitoring themselves at older ages by change their food, environment, even the pace of living. Also that new approach of prediction pre-cancer will help if there is any treatment can give for that person to therapy the mutated tumor protein P53. Index Terms (Normal Homology TP53 gene, Tumor Protein P53, Oncogene Labs, GC and AT content, FASTA, BLAST, ClustalW)

In this paper, we present PRISM, a Promptable and Robust Interactive Segmentation Model, aiming for precise segmentation of 3D medical images. PRISM accepts various visual inputs, including points, boxes, and scribbles as sparse prompts, as well as masks as dense prompts. Specifically, PRISM is designed with four principles to achieve robustness: (1) Iterative learning. The model produces segmentations by using visual prompts from previous iterations to achieve progressive improvement. (2) Confidence learning. PRISM employs multiple segmentation heads per input image, each generating a continuous map and a confidence score to optimize predictions. (3) Corrective learning. Following each segmentation iteration, PRISM employs a shallow corrective refinement network to reassign mislabeled voxels. (4) Hybrid design. PRISM integrates hybrid encoders to better capture both the local and global information. Comprehensive validation of PRISM is conducted using four public datasets for tumor segmentation in the colon, pancreas, liver, and kidney, highlighting challenges caused by anatomical variations and ambiguous boundaries in accurate tumor identification. Compared to state-of-the-art methods, both with and without prompt engineering, PRISM significantly improves performance, achieving results that are close to human levels. The code is publicly available at https://github.com/MedICL-VU/PRISM.

Extracranial tissues visible on brain magnetic resonance imaging (MRI) may hold significant value for characterizing health conditions and clinical decision-making, yet they are rarely quantified. Current tools have not been widely validated, particularly in settings of developing brains or underlying pathology. We present TissUnet, a deep learning model that segments skull bone, subcutaneous fat, and muscle from routine three-dimensional T1-weighted MRI, with or without contrast enhancement. The model was trained on 155 paired MRI-computed tomography (CT) scans and validated across nine datasets covering a wide age range and including individuals with brain tumors. In comparison to AI-CT-derived labels from 37 MRI-CT pairs, TissUnet achieved a median Dice coefficient of 0.79 [IQR: 0.77-0.81] in a healthy adult cohort. In a second validation using expert manual annotations, median Dice was 0.83 [IQR: 0.83-0.84] in healthy individuals and 0.81 [IQR: 0.78-0.83] in tumor cases, outperforming previous state-of-the-art method. Acceptability testing resulted in an 89% acceptance rate after adjudication by a tie-breaker(N=108 MRIs), and TissUnet demonstrated excellent performance in the blinded comparative review (N=45 MRIs), including both healthy and tumor cases in pediatric populations. TissUnet enables fast, accurate, and reproducible segmentation of extracranial tissues, supporting large-scale studies on craniofacial morphology, treatment effects, and cardiometabolic risk using standard brain T1w MRI.

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.

This paper presents the challenge report for the 2021 Kidney and Kidney Tumor Segmentation Challenge (KiTS21) held in conjunction with the 2021 international conference on Medical Image Computing and Computer Assisted Interventions (MICCAI). KiTS21 is a sequel to its first edition in 2019, and it features a variety of innovations in how the challenge was designed, in addition to a larger dataset. A novel annotation method was used to collect three separate annotations for each region of interest, and these annotations were performed in a fully transparent setting using a web-based annotation tool. Further, the KiTS21 test set was collected from an outside institution, challenging participants to develop methods that generalize well to new populations. Nonetheless, the top-performing teams achieved a significant improvement over the state of the art set in 2019, and this performance is shown to inch ever closer to human-level performance. An in-depth meta-analysis is presented describing which methods were used and how they faired on the leaderboard, as well as the characteristics of which cases generally saw good performance, and which did not. Overall KiTS21 facilitated a significant advancement in the state of the art in kidney tumor segmentation, and provides useful insights that are applicable to the field of semantic segmentation as a whole.

This manuscript describes the first challenge on Federated Learning, namely the Federated Tumor Segmentation (FeTS) challenge 2021. International challenges have become the standard for validation of biomedical image analysis methods. However, the actual performance of participating (even the winning) algorithms on "real-world" clinical data often remains unclear, as the data included in challenges are usually acquired in very controlled settings at few institutions. The seemingly obvious solution of just collecting increasingly more data from more institutions in such challenges does not scale well due to privacy and ownership hurdles. Towards alleviating these concerns, we are proposing the FeTS challenge 2021 to cater towards both the development and the evaluation of models for the segmentation of intrinsically heterogeneous (in appearance, shape, and histology) brain tumors, namely gliomas. Specifically, the FeTS 2021 challenge uses clinically acquired, multi-institutional magnetic resonance imaging (MRI) scans from the BraTS 2020 challenge, as well as from various remote independent institutions included in the collaborative network of a real-world federation (https://www.fets.ai/). The goals of the FeTS challenge are directly represented by the two included tasks: 1) the identification of the optimal weight aggregation approach towards the training of a consensus model that has gained knowledge via federated learning from multiple geographically distinct institutions, while their data are always retained within each institution, and 2) the federated evaluation of the generalizability of brain tumor segmentation models "in the wild", i.e. on data from institutional distributions that were not part of the training datasets.

We present WeakSTIL, an interpretable two-stage weak label deep learning pipeline for scoring the percentage of stromal tumor infiltrating lymphocytes (sTIL%) in H&E-stained whole-slide images (WSIs) of breast cancer tissue. The sTIL% score is a prognostic and predictive biomarker for many solid tumor types. However, due to the high labeling efforts and high intra- and interobserver variability within and between expert annotators, this biomarker is currently not used in routine clinical decision making. WeakSTIL compresses tiles of a WSI using a feature extractor pre-trained with self-supervised learning on unlabeled histopathology data and learns to predict precise sTIL% scores for each tile in the tumor bed by using a multiple instance learning regressor that only requires a weak WSI-level label. By requiring only a weak label, we overcome the large annotation efforts required to train currently existing TIL detection methods. We show that WeakSTIL is at least as good as other TIL detection methods when predicting the WSI-level sTIL% score, reaching a coefficient of determination of 0.45pm0.15 when compared to scores generated by an expert pathologist, and an AUC of 0.89pm0.05 when treating it as the clinically interesting sTIL-high vs sTIL-low classification task. Additionally, we show that the intermediate tile-level predictions of WeakSTIL are highly interpretable, which suggests that WeakSTIL pays attention to latent features related to the number of TILs and the tissue type. In the future, WeakSTIL may be used to provide consistent and interpretable sTIL% predictions to stratify breast cancer patients into targeted therapy arms.

Automated slice classification is clinically relevant since it can be incorporated into medical image segmentation workflows as a preprocessing step that would flag slices with a higher probability of containing tumors, thereby directing physicians attention to the important slices. In this work, we train a ResNet-18 network to classify axial slices of lymphoma PET/CT images (collected from two institutions) depending on whether the slice intercepted a tumor (positive slice) in the 3D image or if the slice did not (negative slice). Various instances of the network were trained on 2D axial datasets created in different ways: (i) slice-level split and (ii) patient-level split; inputs of different types were used: (i) only PET slices and (ii) concatenated PET and CT slices; and different training strategies were employed: (i) center-aware (CAW) and (ii) center-agnostic (CAG). Model performances were compared using the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC), and various binary classification metrics. We observe and describe a performance overestimation in the case of slice-level split as compared to the patient-level split training. The model trained using patient-level split data with the network input containing only PET slices in the CAG training regime was the best performing/generalizing model on a majority of metrics. Our models were additionally more closely compared using the sensitivity metric on the positive slices from their respective test sets.

Breast cancer is the most frequently diagnosed malignancy among women worldwide and a leading cause of cancer-related mortality. Dynamic contrast-enhanced magnetic resonance imaging plays a central role in tumor characterization and treatment monitoring, particularly in patients receiving neoadjuvant chemotherapy. However, existing artificial intelligence models for breast magnetic resonance imaging are typically developed and evaluated using heterogeneous datasets, study populations, and assessment protocols, making direct comparison difficult and limiting understanding of model robustness across institutions and clinically relevant patient subgroups. The MAMA-MIA Challenge was designed to address these challenges by providing a standardized benchmark for the joint evaluation of primary tumor segmentation and prediction of pathologic complete response using pre-treatment magnetic resonance imaging only. The training cohort comprised 1,506 patients from multiple institutions in the United States, while evaluation was conducted on an external test set of 574 patients from three independent European centers to assess cross-continental and cross-institutional generalization. A unified scoring framework combined predictive performance with subgroup consistency across age, menopausal status, and breast density. Twenty-six international teams participated in the final evaluation phase. Results demonstrate substantial performance variability under a common external evaluation framework and reveal trade-offs between overall accuracy and subgroup fairness. The challenge provides standardized datasets, evaluation protocols, and public resources to promote the development of robust and equitable artificial intelligence systems for breast cancer imaging.

In the radiation therapy of nasopharyngeal carcinoma (NPC), clinicians typically delineate the gross tumor volume (GTV) using non-contrast planning computed tomography to ensure accurate radiation dose delivery. However, the low contrast between tumors and adjacent normal tissues necessitates that radiation oncologists manually delineate the tumors, often relying on diagnostic MRI for guidance. % In this study, we propose a novel approach to directly segment NPC gross tumors on non-contrast planning CT images, circumventing potential registration errors when aligning MRI or MRI-derived tumor masks to planning CT. To address the low contrast issues between tumors and adjacent normal structures in planning CT, we introduce a 3D Semantic Asymmetry Tumor segmentation (SATs) method. Specifically, we posit that a healthy nasopharyngeal region is characteristically bilaterally symmetric, whereas the emergence of nasopharyngeal carcinoma disrupts this symmetry. Then, we propose a Siamese contrastive learning segmentation framework that minimizes the voxel-wise distance between original and flipped areas without tumor and encourages a larger distance between original and flipped areas with tumor. Thus, our approach enhances the sensitivity of features to semantic asymmetries. % Extensive experiments demonstrate that the proposed SATs achieves the leading NPC GTV segmentation performance in both internal and external testing, e.g., with at least 2\% absolute Dice score improvement and 12\% average distance error reduction when compared to other state-of-the-art methods in the external testing.

Meningiomas are the most common primary intracranial tumor in adults and can be associated with significant morbidity and mortality. Radiologists, neurosurgeons, neuro-oncologists, and radiation oncologists rely on multiparametric MRI (mpMRI) for diagnosis, treatment planning, and longitudinal treatment monitoring; yet automated, objective, and quantitative tools for non-invasive assessment of meningiomas on mpMRI are lacking. The BraTS meningioma 2023 challenge will provide a community standard and benchmark for state-of-the-art automated intracranial meningioma segmentation models based on the largest expert annotated multilabel meningioma mpMRI dataset to date. Challenge competitors will develop automated segmentation models to predict three distinct meningioma sub-regions on MRI including enhancing tumor, non-enhancing tumor core, and surrounding nonenhancing T2/FLAIR hyperintensity. Models will be evaluated on separate validation and held-out test datasets using standardized metrics utilized across the BraTS 2023 series of challenges including the Dice similarity coefficient and Hausdorff distance. The models developed during the course of this challenge will aid in incorporation of automated meningioma MRI segmentation into clinical practice, which will ultimately improve care of patients with meningioma.

Efficient, reliable and reproducible target volume delineation is a key step in the effective planning of breast radiotherapy. However, post-operative breast target delineation is challenging as the contrast between the tumor bed volume (TBV) and normal breast tissue is relatively low in CT images. In this study, we propose to mimic the marker-guidance procedure in manual target delineation. We developed a saliency-based deep learning segmentation (SDL-Seg) algorithm for accurate TBV segmentation in post-operative breast irradiation. The SDL-Seg algorithm incorporates saliency information in the form of markers' location cues into a U-Net model. The design forces the model to encode the location-related features, which underscores regions with high saliency levels and suppresses low saliency regions. The saliency maps were generated by identifying markers on CT images. Markers' locations were then converted to probability maps using a distance-transformation coupled with a Gaussian filter. Subsequently, the CT images and the corresponding saliency maps formed a multi-channel input for the SDL-Seg network. Our in-house dataset was comprised of 145 prone CT images from 29 post-operative breast cancer patients, who received 5-fraction partial breast irradiation (PBI) regimen on GammaPod. The performance of the proposed method was compared against basic U-Net. Our model achieved mean (standard deviation) of 76.4 %, 6.76 mm, and 1.9 mm for DSC, HD95, and ASD respectively on the test set with computation time of below 11 seconds per one CT volume. SDL-Seg showed superior performance relative to basic U-Net for all the evaluation metrics while preserving low computation cost. The findings demonstrate that SDL-Seg is a promising approach for improving the efficiency and accuracy of the on-line treatment planning procedure of PBI, such as GammaPod based PBI.

Pancreatic cancer carries a poor prognosis and relies on endoscopic ultrasound (EUS) for targeted biopsy and radiotherapy. However, the speckle noise, low contrast, and unintuitive appearance of EUS make segmentation of pancreatic tumors with fully supervised deep learning (DL) models both error-prone and dependent on large, expert-curated annotation datasets. To address these challenges, we present TextSAM-EUS, a novel, lightweight, text-driven adaptation of the Segment Anything Model (SAM) that requires no manual geometric prompts at inference. Our approach leverages text prompt learning (context optimization) through the BiomedCLIP text encoder in conjunction with a LoRA-based adaptation of SAM's architecture to enable automatic pancreatic tumor segmentation in EUS, tuning only 0.86% of the total parameters. On the public Endoscopic Ultrasound Database of the Pancreas, TextSAM-EUS with automatic prompts attains 82.69% Dice and 85.28% normalized surface distance (NSD), and with manual geometric prompts reaches 83.10% Dice and 85.70% NSD, outperforming both existing state-of-the-art (SOTA) supervised DL models and foundation models (e.g., SAM and its variants). As the first attempt to incorporate prompt learning in SAM-based medical image segmentation, TextSAM-EUS offers a practical option for efficient and robust automatic EUS segmentation. Code is available at https://github.com/HealthX-Lab/TextSAM-EUS .

We study growth of solid tumors in a partial differential equation model introduced by Hillen et al for the interaction between tumor cells (TCs) and cancer stem cells (CSCs). We find that invasion into the cancer-free state may be separated into two regimes, depending on the death rate of tumor cells. In the first, staged invasion regime, invasion into the cancer-free state is lead by tumor cells, which are then subsequently invaded at a slower speed by cancer stem cells. In the second, TC extinction regime, cancer stem cells directly invade the cancer-free state. Relying on recent results establishing front selection propagation under marginal stability assumptions, we use geometric singular perturbation theory to establish existence and selection properties of front solutions which describe both the primary and secondary invasion processes. With rigorous predictions for the invasion speeds, we are then able to heuristically predict how the total cancer mass as a function of time depends on the TC death rate, finding in some situations a tumor invasion paradox, in which increasing the TC death rate leads to an increase in the total cancer mass. Our methods give a general approach for verifying linear determinacy of spreading speeds of invasion fronts in systems with fast-slow structure.

In this work, we report the set-up and results of the Liver Tumor Segmentation Benchmark (LiTS), which was organized in conjunction with the IEEE International Symposium on Biomedical Imaging (ISBI) 2017 and the International Conferences on Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2017 and 2018. The image dataset is diverse and contains primary and secondary tumors with varied sizes and appearances with various lesion-to-background levels (hyper-/hypo-dense), created in collaboration with seven hospitals and research institutions. Seventy-five submitted liver and liver tumor segmentation algorithms were trained on a set of 131 computed tomography (CT) volumes and were tested on 70 unseen test images acquired from different patients. We found that not a single algorithm performed best for both liver and liver tumors in the three events. The best liver segmentation algorithm achieved a Dice score of 0.963, whereas, for tumor segmentation, the best algorithms achieved Dices scores of 0.674 (ISBI 2017), 0.702 (MICCAI 2017), and 0.739 (MICCAI 2018). Retrospectively, we performed additional analysis on liver tumor detection and revealed that not all top-performing segmentation algorithms worked well for tumor detection. The best liver tumor detection method achieved a lesion-wise recall of 0.458 (ISBI 2017), 0.515 (MICCAI 2017), and 0.554 (MICCAI 2018), indicating the need for further research. LiTS remains an active benchmark and resource for research, e.g., contributing the liver-related segmentation tasks in http://medicaldecathlon.com/. In addition, both data and online evaluation are accessible via www.lits-challenge.com.

Precise segmentation of brain tumors, particularly contrast-enhancing regions visible in post-contrast MRI (areas highlighted by contrast agent injection), is crucial for accurate clinical diagnosis and treatment planning but remains challenging. However, current methods exhibit notable performance degradation in segmenting these enhancing brain tumor areas, largely due to insufficient consideration of MRI-specific tumor features such as complex textures and directional variations. To address this, we propose the Harmonized Frequency Fusion Network (HFF-Net), which rethinks brain tumor segmentation from a frequency-domain perspective. To comprehensively characterize tumor regions, we develop a Frequency Domain Decomposition (FDD) module that separates MRI images into low-frequency components, capturing smooth tumor contours and high-frequency components, highlighting detailed textures and directional edges. To further enhance sensitivity to tumor boundaries, we introduce an Adaptive Laplacian Convolution (ALC) module that adaptively emphasizes critical high-frequency details using dynamically updated convolution kernels. To effectively fuse tumor features across multiple scales, we design a Frequency Domain Cross-Attention (FDCA) integrating semantic, positional, and slice-specific information. We further validate and interpret frequency-domain improvements through visualization, theoretical reasoning, and experimental analyses. Extensive experiments on four public datasets demonstrate that HFF-Net achieves an average relative improvement of 4.48\% (ranging from 2.39\% to 7.72\%) in the mean Dice scores across the three major subregions, and an average relative improvement of 7.33% (ranging from 5.96% to 8.64%) in the segmentation of contrast-enhancing tumor regions, while maintaining favorable computational efficiency and clinical applicability. Code: https://github.com/VinyehShaw/HFF.

Distribution shifts -- where the training distribution differs from the test distribution -- can substantially degrade the accuracy of machine learning (ML) systems deployed in the wild. Despite their ubiquity in the real-world deployments, these distribution shifts are under-represented in the datasets widely used in the ML community today. To address this gap, we present WILDS, a curated benchmark of 10 datasets reflecting a diverse range of distribution shifts that naturally arise in real-world applications, such as shifts across hospitals for tumor identification; across camera traps for wildlife monitoring; and across time and location in satellite imaging and poverty mapping. On each dataset, we show that standard training yields substantially lower out-of-distribution than in-distribution performance. This gap remains even with models trained by existing methods for tackling distribution shifts, underscoring the need for new methods for training models that are more robust to the types of distribution shifts that arise in practice. To facilitate method development, we provide an open-source package that automates dataset loading, contains default model architectures and hyperparameters, and standardizes evaluations. Code and leaderboards are available at https://wilds.stanford.edu.

As online shopping is growing, the ability for buyers to virtually visualize products in their settings-a phenomenon we define as "Virtual Try-All"-has become crucial. Recent diffusion models inherently contain a world model, rendering them suitable for this task within an inpainting context. However, traditional image-conditioned diffusion models often fail to capture the fine-grained details of products. In contrast, personalization-driven models such as DreamPaint are good at preserving the item's details but they are not optimized for real-time applications. We present "Diffuse to Choose," a novel diffusion-based image-conditioned inpainting model that efficiently balances fast inference with the retention of high-fidelity details in a given reference item while ensuring accurate semantic manipulations in the given scene content. Our approach is based on incorporating fine-grained features from the reference image directly into the latent feature maps of the main diffusion model, alongside with a perceptual loss to further preserve the reference item's details. We conduct extensive testing on both in-house and publicly available datasets, and show that Diffuse to Choose is superior to existing zero-shot diffusion inpainting methods as well as few-shot diffusion personalization algorithms like DreamPaint.

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.

Medical image registration is a critical task that estimates the spatial correspondence between pairs of images. However, current traditional and deep-learning-based methods rely on similarity measures to generate a deforming field, which often results in disproportionate volume changes in dissimilar regions, especially in tumor regions. These changes can significantly alter the tumor size and underlying anatomy, which limits the practical use of image registration in clinical diagnosis. To address this issue, we have formulated image registration with tumors as a constraint problem that preserves tumor volumes while maximizing image similarity in other normal regions. Our proposed strategy involves a two-stage process. In the first stage, we use similarity-based registration to identify potential tumor regions by their volume change, generating a soft tumor mask accordingly. In the second stage, we propose a volume-preserving registration with a novel adaptive volume-preserving loss that penalizes the change in size adaptively based on the masks calculated from the previous stage. Our approach balances image similarity and volume preservation in different regions, i.e., normal and tumor regions, by using soft tumor masks to adjust the imposition of volume-preserving loss on each one. This ensures that the tumor volume is preserved during the registration process. We have evaluated our strategy on various datasets and network architectures, demonstrating that our method successfully preserves the tumor volume while achieving comparable registration results with state-of-the-art methods. Our codes is available at: https://dddraxxx.github.io/Volume-Preserving-Registration/.

Multimodal magnetic resonance imaging (MRI) provides complementary information for sub-region analysis of brain tumors. Plenty of methods have been proposed for automatic brain tumor segmentation using four common MRI modalities and achieved remarkable performance. In practice, however, it is common to have one or more modalities missing due to image corruption, artifacts, acquisition protocols, allergy to contrast agents, or simply cost. In this work, we propose a novel two-stage framework for brain tumor segmentation with missing modalities. In the first stage, a multimodal masked autoencoder (M3AE) is proposed, where both random modalities (i.e., modality dropout) and random patches of the remaining modalities are masked for a reconstruction task, for self-supervised learning of robust multimodal representations against missing modalities. To this end, we name our framework M3AE. Meanwhile, we employ model inversion to optimize a representative full-modal image at marginal extra cost, which will be used to substitute for the missing modalities and boost performance during inference. Then in the second stage, a memory-efficient self distillation is proposed to distill knowledge between heterogenous missing-modal situations while fine-tuning the model for supervised segmentation. Our M3AE belongs to the 'catch-all' genre where a single model can be applied to all possible subsets of modalities, thus is economic for both training and deployment. Extensive experiments on BraTS 2018 and 2020 datasets demonstrate its superior performance to existing state-of-the-art methods with missing modalities, as well as the efficacy of its components. Our code is available at: https://github.com/ccarliu/m3ae.

To improve patient survival and treatment outcomes, early diagnosis of brain tumors is an essential task. It is a difficult task to evaluate the magnetic resonance imaging (MRI) images manually. Thus, there is a need for digital methods for tumor diagnosis with better accuracy. However, it is still a very challenging task in assessing their shape, volume, boundaries, tumor detection, size, segmentation, and classification. In this proposed work, we propose a hybrid ensemble method using Random Forest (RF), K-Nearest Neighbour, and Decision Tree (DT) (KNN-RF-DT) based on Majority Voting Method. It aims to calculate the area of the tumor region and classify brain tumors as benign and malignant. In the beginning, segmentation is done by using Otsu's Threshold method. Feature Extraction is done by using Stationary Wavelet Transform (SWT), Principle Component Analysis (PCA), and Gray Level Co-occurrence Matrix (GLCM), which gives thirteen features for classification. The classification is done by hybrid ensemble classifier (KNN-RF-DT) based on the Majority Voting method. Overall it aimed at improving the performance by traditional classifiers instead of going to deep learning. Traditional classifiers have an advantage over deep learning algorithms because they require small datasets for training and have low computational time complexity, low cost to the users, and can be easily adopted by less skilled people. Overall, our proposed method is tested upon dataset of 2556 images, which are used in 85:15 for training and testing respectively and gives good accuracy of 97.305%.

Automatic segmentation of the liver and hepatic lesions is an important step towards deriving quantitative biomarkers for accurate clinical diagnosis and computer-aided decision support systems. This paper presents a method to automatically segment liver and lesions in CT and MRI abdomen images using cascaded fully convolutional neural networks (CFCNs) enabling the segmentation of a large-scale medical trial or quantitative image analysis. We train and cascade two FCNs for a combined segmentation of the liver and its lesions. In the first step, we train a FCN to segment the liver as ROI input for a second FCN. The second FCN solely segments lesions within the predicted liver ROIs of step 1. CFCN models were trained on an abdominal CT dataset comprising 100 hepatic tumor volumes. Validations on further datasets show that CFCN-based semantic liver and lesion segmentation achieves Dice scores over 94% for liver with computation times below 100s per volume. We further experimentally demonstrate the robustness of the proposed method on an 38 MRI liver tumor volumes and the public 3DIRCAD dataset.

Precise breast cancer classification on histopathological images has the potential to greatly improve the diagnosis and patient outcome in oncology. The data imbalance problem largely stems from the inherent imbalance within medical image datasets, where certain tumor subtypes may appear much less frequently. This constitutes a considerable limitation in biased model predictions that can overlook critical but rare classes. In this work, we adopted EfficientNet, a state-of-the-art convolutional neural network (CNN) model that balances high accuracy with computational cost efficiency. To address data imbalance, we introduce an intensive data augmentation pipeline and cost-sensitive learning, improving representation and ensuring that the model does not overly favor majority classes. This approach provides the ability to learn effectively from rare tumor types, improving its robustness. Additionally, we fine-tuned the model using transfer learning, where weights in the beginning trained on a binary classification task were adopted to multi-class classification, improving the capability to detect complex patterns within the BreakHis dataset. Our results underscore significant improvements in the binary classification performance, achieving an exceptional recall increase for benign cases from 0.92 to 0.95, alongside an accuracy enhancement from 97.35 % to 98.23%. Our approach improved the performance of multi-class tasks from 91.27% with regular augmentation to 94.54% with intensive augmentation, reaching 95.04% with transfer learning. This framework demonstrated substantial gains in precision in the minority classes, such as Mucinous carcinoma and Papillary carcinoma, while maintaining high recall consistently across these critical subtypes, as further confirmed by confusion matrix analysis.

Brain cancer's severity necessitates precise brain tumor segmentation, which is crucial for effective brain tumor diagnosis. Manual identification, burdened by high costs, labor, and error risks, highlights the need for automated methods. In this study, we introduce the Global Context-aware Squeeze and Excite Residual UNet (GCSER-UNet), which facilitates a fusion of spatial and channel-wise attention and thus enhances the model's capacity to capture intricate spatial dependencies and contextual information. GCSER-UNet efficiently extracts tumor segments from multimodal MRI slices, delivering exceptional performance. Evaluations on benchmark databases exhibit its superiority, achieving a notable 94 percent dice score on the TCGA LGG dataset, surpassing the state-of-the-art dice score of 91.8 percent. In the BraTS 2020 dataset, the proposed GCSER-UNet ensemble approach yielded dice scores of 95 percent, 92 percent, and 90 percent for the tumor regions - Whole Tumor (W), Tumor Core (T), and Enhancing Tumor (E), respectively. The current state-of-the-art dice scores were 94 percent, 93 percent, and 88 percent. These compelling outcomes highlight the efficacy of GCSER-UNet in precise brain tumor segmentation and thus can aid neurologists in effective brain cancer management and treatment planning.

Head and neck tumor segmentation challenge (HECKTOR) 2022 offers a platform for researchers to compare their solutions to segmentation of tumors and lymph nodes from 3D CT and PET images. In this work, we describe our solution to HECKTOR 2022 segmentation task. We re-sample all images to a common resolution, crop around head and neck region, and train SegResNet semantic segmentation network from MONAI. We use 5-fold cross validation to select best model checkpoints. The final submission is an ensemble of 15 models from 3 runs. Our solution (team name NVAUTO) achieves the 1st place on the HECKTOR22 challenge leaderboard with an aggregated dice score of 0.78802.

In the field of medical sciences, reliable detection and classification of brain tumors from images remains a formidable challenge due to the rarity of tumors within the population of patients. Therefore, the ability to detect tumors in anomaly scenarios is paramount for ensuring timely interventions and improved patient outcomes. This study addresses the issue by leveraging deep learning (DL) techniques to detect and classify brain tumors in challenging situations. The curated data set from the National Brain Mapping Lab (NBML) comprises 81 patients, including 30 Tumor cases and 51 Normal cases. The detection and classification pipelines are separated into two consecutive tasks. The detection phase involved comprehensive data analysis and pre-processing to modify the number of image samples and the number of patients of each class to anomaly distribution (9 Normal per 1 Tumor) to comply with real world scenarios. Next, in addition to common evaluation metrics for the testing, we employed a novel performance evaluation method called Patient to Patient (PTP), focusing on the realistic evaluation of the model. In the detection phase, we fine-tuned a YOLOv8n detection model to detect the tumor region. Subsequent testing and evaluation yielded competitive performance both in Common Evaluation Metrics and PTP metrics. Furthermore, using the Data Efficient Image Transformer (DeiT) module, we distilled a Vision Transformer (ViT) model from a fine-tuned ResNet152 as a teacher in the classification phase. This approach demonstrates promising strides in reliable tumor detection and classification, offering potential advancements in tumor diagnosis for real-world medical imaging scenarios.

Automated segmentation of brain tumors from 3D magnetic resonance images (MRIs) is necessary for the diagnosis, monitoring, and treatment planning of the disease. Manual delineation practices require anatomical knowledge, are expensive, time consuming and can be inaccurate due to human error. Here, we describe a semantic segmentation network for tumor subregion segmentation from 3D MRIs based on encoder-decoder architecture. Due to a limited training dataset size, a variational auto-encoder branch is added to reconstruct the input image itself in order to regularize the shared decoder and impose additional constraints on its layers. The current approach won 1st place in the BraTS 2018 challenge.

Identifying key pathological features in brain MRIs is crucial for the long-term survival of glioma patients. However, manual segmentation is time-consuming, requiring expert intervention and is susceptible to human error. Therefore, significant research has been devoted to developing machine learning methods that can accurately segment tumors in 3D multimodal brain MRI scans. Despite their progress, state-of-the-art models are often limited by the data they are trained on, raising concerns about their reliability when applied to diverse populations that may introduce distribution shifts. Such shifts can stem from lower quality MRI technology (e.g., in sub-Saharan Africa) or variations in patient demographics (e.g., children). The BraTS-2024 challenge provides a platform to address these issues. This study presents our methodology for segmenting tumors in the BraTS-2024 SSA and Pediatric Tumors tasks using MedNeXt, comprehensive model ensembling, and thorough postprocessing. Our approach demonstrated strong performance on the unseen validation set, achieving an average Dice Similarity Coefficient (DSC) of 0.896 on the BraTS-2024 SSA dataset and an average DSC of 0.830 on the BraTS Pediatric Tumor dataset. Additionally, our method achieved an average Hausdorff Distance (HD95) of 14.682 on the BraTS-2024 SSA dataset and an average HD95 of 37.508 on the BraTS Pediatric dataset. Our GitHub repository can be accessed here: Project Repository : https://github.com/python-arch/BioMbz-Optimizing-Brain-Tumor-Segmentation-with-MedNeXt-BraTS-2024-SSA-and-Pediatrics

The integration of large language models (LLMs) into education presents unprecedented opportunities for scalable personalized learning. However, standard LLMs often function as generic information providers, lacking alignment with fundamental pedagogical principles such as helpfulness, student-centered personalization, and creativity cultivation. To bridge this gap, we propose EduAlign, a novel framework designed to guide LLMs toward becoming more effective and responsible educational assistants. EduAlign consists of two main stages. In the first stage, we curate a dataset of 8k educational interactions and annotate them-both manually and automatically-along three key educational dimensions: Helpfulness, Personalization, and Creativity (HPC). These annotations are used to train HPC-RM, a multi-dimensional reward model capable of accurately scoring LLM outputs according to these educational principles. We further evaluate the consistency and reliability of this reward model. In the second stage, we leverage HPC-RM as a reward signal to fine-tune a pre-trained LLM using Group Relative Policy Optimization (GRPO) on a set of 2k diverse prompts. We then assess the pre- and post-finetuning models on both educational and general-domain benchmarks across the three HPC dimensions. Experimental results demonstrate that the fine-tuned model exhibits significantly improved alignment with pedagogical helpfulness, personalization, and creativity stimulation. This study presents a scalable and effective approach to aligning LLMs with nuanced and desirable educational traits, paving the way for the development of more engaging, pedagogically aligned AI tutors.

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.

Understanding how deep learning models predict oncology patient risk can provide critical insights into disease progression, support clinical decision-making, and pave the way for trustworthy and data-driven precision medicine. Building on recent advances in the spatial modeling of the tumor microenvironment using graph neural networks, we present an explainable cell graph (xCG) approach for survival prediction. We validate our model on a public cohort of imaging mass cytometry (IMC) data for 416 cases of lung adenocarcinoma. We explain survival predictions in terms of known phenotypes on the cell level by computing risk attributions over cell graphs, for which we propose an efficient grid-based layer-wise relevance propagation (LRP) method. Our ablation studies highlight the importance of incorporating the cancer stage and model ensembling to improve the quality of risk estimates. Our xCG method, together with the IMC data, is made publicly available to support further research.

Lack of large expert annotated MR datasets makes training deep learning models difficult. Therefore, a cross-modality (MR-CT) deep learning segmentation approach that augments training data using pseudo MR images produced by transforming expert-segmented CT images was developed. Eighty-One T2-weighted MRI scans from 28 patients with non-small cell lung cancers were analyzed. Cross-modality prior encoding the transformation of CT to pseudo MR images resembling T2w MRI was learned as a generative adversarial deep learning model. This model augmented training data arising from 6 expert-segmented T2w MR patient scans with 377 pseudo MRI from non-small cell lung cancer CT patient scans with obtained from the Cancer Imaging Archive. A two-dimensional Unet implemented with batch normalization was trained to segment the tumors from T2w MRI. This method was benchmarked against (a) standard data augmentation and two state-of-the art cross-modality pseudo MR-based augmentation and (b) two segmentation networks. Segmentation accuracy was computed using Dice similarity coefficient (DSC), Hausdroff distance metrics, and volume ratio. The proposed approach produced the lowest statistical variability in the intensity distribution between pseudo and T2w MR images measured as Kullback-Leibler divergence of 0.069. This method produced the highest segmentation accuracy with a DSC of 0.75 and the lowest Hausdroff distance on the test dataset. This approach produced highly similar estimations of tumor growth as an expert (P = 0.37). A novel deep learning MR segmentation was developed that overcomes the limitation of learning robust models from small datasets by leveraging learned cross-modality priors to augment training. The results show the feasibility of the approach and the corresponding improvement over the state-of-the-art methods.

With over 85 million CT scans performed annually in the United States, creating tumor-related reports is a challenging and time-consuming task for radiologists. To address this need, we present RadGPT, an Anatomy-Aware Vision-Language AI Agent for generating detailed reports from CT scans. RadGPT first segments tumors, including benign cysts and malignant tumors, and their surrounding anatomical structures, then transforms this information into both structured reports and narrative reports. These reports provide tumor size, shape, location, attenuation, volume, and interactions with surrounding blood vessels and organs. Extensive evaluation on unseen hospitals shows that RadGPT can produce accurate reports, with high sensitivity/specificity for small tumor (<2 cm) detection: 80/73% for liver tumors, 92/78% for kidney tumors, and 77/77% for pancreatic tumors. For large tumors, sensitivity ranges from 89% to 97%. The results significantly surpass the state-of-the-art in abdominal CT report generation. RadGPT generated reports for 17 public datasets. Through radiologist review and refinement, we have ensured the reports' accuracy, and created the first publicly available image-text 3D medical dataset, comprising over 1.8 million text tokens and 2.7 million images from 9,262 CT scans, including 2,947 tumor scans/reports of 8,562 tumor instances. Our reports can: (1) localize tumors in eight liver sub-segments and three pancreatic sub-segments annotated per-voxel; (2) determine pancreatic tumor stage (T1-T4) in 260 reports; and (3) present individual analyses of multiple tumors--rare in human-made reports. Importantly, 948 of the reports are for early-stage tumors.

Early tumor detection save lives. Each year, more than 300 million computed tomography (CT) scans are performed worldwide, offering a vast opportunity for effective cancer screening. However, detecting small or early-stage tumors on these CT scans remains challenging, even for experts. Artificial intelligence (AI) models can assist by highlighting suspicious regions, but training such models typically requires extensive tumor masks--detailed, voxel-wise outlines of tumors manually drawn by radiologists. Drawing these masks is costly, requiring years of effort and millions of dollars. In contrast, nearly every CT scan in clinical practice is already accompanied by medical reports describing the tumor's size, number, appearance, and sometimes, pathology results--information that is rich, abundant, and often underutilized for AI training. We introduce R-Super, which trains AI to segment tumors that match their descriptions in medical reports. This approach scales AI training with large collections of readily available medical reports, substantially reducing the need for manually drawn tumor masks. When trained on 101,654 reports, AI models achieved performance comparable to those trained on 723 masks. Combining reports and masks further improved sensitivity by +13% and specificity by +8%, surpassing radiologists in detecting five of the seven tumor types. Notably, R-Super enabled segmentation of tumors in the spleen, gallbladder, prostate, bladder, uterus, and esophagus, for which no public masks or AI models previously existed. This study challenges the long-held belief that large-scale, labor-intensive tumor mask creation is indispensable, establishing a scalable and accessible path toward early detection across diverse tumor types. We plan to release our trained models, code, and dataset at https://github.com/MrGiovanni/R-Super

Evaluating the pedagogical capabilities of AI-based tutoring models is critical for making guided progress in the field. Yet, we lack a reliable, easy-to-use, and simple-to-run evaluation that reflects the pedagogical abilities of models. To fill this gap, we present MathTutorBench, an open-source benchmark for holistic tutoring model evaluation. MathTutorBench contains a collection of datasets and metrics that broadly cover tutor abilities as defined by learning sciences research in dialog-based teaching. To score the pedagogical quality of open-ended teacher responses, we train a reward model and show it can discriminate expert from novice teacher responses with high accuracy. We evaluate a wide set of closed- and open-weight models on MathTutorBench and find that subject expertise, indicated by solving ability, does not immediately translate to good teaching. Rather, pedagogy and subject expertise appear to form a trade-off that is navigated by the degree of tutoring specialization of the model. Furthermore, tutoring appears to become more challenging in longer dialogs, where simpler questioning strategies begin to fail. We release the benchmark, code, and leaderboard openly to enable rapid benchmarking of future models.

Accurate segmentation of tumors in PET/CT images is important in computer-aided diagnosis and treatment of cancer. The key issue of such a segmentation problem lies in the effective integration of complementary information from PET and CT images. However, the quality of PET and CT images varies widely in clinical settings, which leads to uncertainty in the modality information extracted by networks. To take the uncertainty into account in multi-modal information fusion, this paper proposes a novel Multi-modal Evidential Fusion Network (MEFN) comprising a Cross-Modal Feature Learning (CFL) module and a Multi-modal Trusted Fusion (MTF) module. The CFL module reduces the domain gap upon modality conversion and highlights common tumor features, thereby alleviating the needs of the segmentation module to handle modality specificity. The MTF module utilizes mutual attention mechanisms and an uncertainty calibrator to fuse modality features based on modality uncertainty and then fuse the segmentation results under the guidance of Dempster-Shafer Theory. Besides, a new uncertainty perceptual loss is introduced to force the model focusing on uncertain features and hence improve its ability to extract trusted modality information. Extensive comparative experiments are conducted on two publicly available PET/CT datasets to evaluate the performance of our proposed method whose results demonstrate that our MEFN significantly outperforms state-of-the-art methods with improvements of 2.15% and 3.23% in DSC scores on the AutoPET dataset and the Hecktor dataset, respectively. More importantly, our model can provide radiologists with credible uncertainty of the segmentation results for their decision in accepting or rejecting the automatic segmentation results, which is particularly important for clinical applications. Our code will be available at https://github.com/QPaws/MEFN.

Multimodal magnetic resonance imaging (MRI) constitutes the first line of investigation for clinicians in the care of brain tumors, providing crucial insights for surgery planning, treatment monitoring, and biomarker identification. Pre-training on large datasets have been shown to help models learn transferable representations and adapt with minimal labeled data. This behavior is especially valuable in medical imaging, where annotations are often scarce. However, applying this paradigm to multimodal medical data introduces a challenge: most existing approaches assume that all imaging modalities are available during both pre-training and fine-tuning. In practice, missing modalities often occur due to acquisition issues, specialist unavailability, or specific experimental designs on small in-house datasets. Consequently, a common approach involves training a separate model for each desired modality combination, making the process both resource-intensive and impractical for clinical use. Therefore, we introduce BM-MAE, a masked image modeling pre-training strategy tailored for multimodal MRI data. The same pre-trained model seamlessly adapts to any combination of available modalities, extracting rich representations that capture both intra- and inter-modal information. This allows fine-tuning on any subset of modalities without requiring architectural changes, while still benefiting from a model pre-trained on the full set of modalities. Extensive experiments show that the proposed pre-training strategy outperforms or remains competitive with baselines that require separate pre-training for each modality subset, while substantially surpassing training from scratch on several downstream tasks. Additionally, it can quickly and efficiently reconstruct missing modalities, highlighting its practical value. Code and trained models are available at: https://github.com/Lucas-rbnt/BM-MAE

Accurate segmentation of brain tumors plays a key role in the diagnosis and treatment of brain tumor diseases. It serves as a critical technology for quantifying tumors and extracting their features. With the increasing application of deep learning methods, the computational burden has become progressively heavier. To achieve a lightweight model with good segmentation performance, this study proposes the MBDRes-U-Net model using the three-dimensional (3D) U-Net codec framework, which integrates multibranch residual blocks and fused attention into the model. The computational burden of the model is reduced by the branch strategy, which effectively uses the rich local features in multimodal images and enhances the segmentation performance of subtumor regions. Additionally, during encoding, an adaptive weighted expansion convolution layer is introduced into the multi-branch residual block, which enriches the feature expression and improves the segmentation accuracy of the model. Experiments on the Brain Tumor Segmentation (BraTS) Challenge 2018 and 2019 datasets show that the architecture could maintain a high precision of brain tumor segmentation while considerably reducing the calculation overhead.Our code is released at https://github.com/Huaibei-normal-university-cv-laboratory/mbdresunet

Extent of resection after surgery is one of the main prognostic factors for patients diagnosed with glioblastoma. To achieve this, accurate segmentation and classification of residual tumor from post-operative MR images is essential. The current standard method for estimating it is subject to high inter- and intra-rater variability, and an automated method for segmentation of residual tumor in early post-operative MRI could lead to a more accurate estimation of extent of resection. In this study, two state-of-the-art neural network architectures for pre-operative segmentation were trained for the task. The models were extensively validated on a multicenter dataset with nearly 1000 patients, from 12 hospitals in Europe and the United States. The best performance achieved was a 61\% Dice score, and the best classification performance was about 80\% balanced accuracy, with a demonstrated ability to generalize across hospitals. In addition, the segmentation performance of the best models was on par with human expert raters. The predicted segmentations can be used to accurately classify the patients into those with residual tumor, and those with gross total resection.

Liver cancer is one of the leading causes of cancer death. To assist doctors in hepatocellular carcinoma diagnosis and treatment planning, an accurate and automatic liver and tumor segmentation method is highly demanded in the clinical practice. Recently, fully convolutional neural networks (FCNs), including 2D and 3D FCNs, serve as the back-bone in many volumetric image segmentation. However, 2D convolutions can not fully leverage the spatial information along the third dimension while 3D convolutions suffer from high computational cost and GPU memory consumption. To address these issues, we propose a novel hybrid densely connected UNet (H-DenseUNet), which consists of a 2D DenseUNet for efficiently extracting intra-slice features and a 3D counterpart for hierarchically aggregating volumetric contexts under the spirit of the auto-context algorithm for liver and tumor segmentation. We formulate the learning process of H-DenseUNet in an end-to-end manner, where the intra-slice representations and inter-slice features can be jointly optimized through a hybrid feature fusion (HFF) layer. We extensively evaluated our method on the dataset of MICCAI 2017 Liver Tumor Segmentation (LiTS) Challenge and 3DIRCADb Dataset. Our method outperformed other state-of-the-arts on the segmentation results of tumors and achieved very competitive performance for liver segmentation even with a single model.

Purpose: Automating tasks such as lung tumor localization and segmentation in radiological images can free valuable time for radiologists and other clinical personnel. Convolutional neural networks may be suited for such tasks, but require substantial amounts of labeled data to train. Obtaining labeled data is a challenge, especially in the medical domain. Methods: This paper investigates the use of a teacher-student design to utilize datasets with different types of supervision to train an automatic model performing pulmonary tumor segmentation on computed tomography images. The framework consists of two models: the student that performs end-to-end automatic tumor segmentation and the teacher that supplies the student additional pseudo-annotated data during training. Results: Using only a small proportion of semantically labeled data and a large number of bounding box annotated data, we achieved competitive performance using a teacher-student design. Models trained on larger amounts of semantic annotations did not perform better than those trained on teacher-annotated data. Conclusions: Our results demonstrate the potential of utilizing teacher-student designs to reduce the annotation load, as less supervised annotation schemes may be performed, without any real degradation in segmentation accuracy.

Artificial intelligence-assisted imaging analysis has made substantial strides in tumor diagnosis and management. Here we present PASTA, a pan-tumor CT foundation model that achieves state-of-the-art performance on 45 of 46 representative oncology tasks -- including lesion segmentation, tumor detection in plain CT, tumor staging, survival prediction, structured report generation, and cross-modality transfer learning, significantly outperforming the second-best models on 35 tasks. This remarkable advancement is driven by our development of PASTA-Gen, an innovative synthetic tumor generation framework that produces a comprehensive dataset of 30,000 CT scans with pixel-level annotated lesions and paired structured reports, encompassing malignancies across ten organs and five benign lesion types. By leveraging this rich, high-quality synthetic data, we overcome a longstanding bottleneck in the development of CT foundation models -- specifically, the scarcity of publicly available, high-quality annotated datasets due to privacy constraints and the substantial labor required for scaling precise data annotation. Encouragingly, PASTA demonstrates exceptional data efficiency with promising practical value, markedly improving performance on various tasks with only a small amount of real-world data. The open release of both the synthetic dataset and PASTA foundation model effectively addresses the challenge of data scarcity, thereby advancing oncological research and clinical translation.

Recent research shows that Large Language Models (LLMs) exhibit a compelling level of proficiency in Theory of Mind (ToM) tasks. This ability to impute unobservable mental states to others is vital to human social cognition and may prove equally important in principal-agent relations between individual humans and Artificial Intelligences (AIs). In this paper, we explore how a mechanism studied in developmental psychology known as Violation of Expectation (VoE) can be implemented to reduce errors in LLM prediction about users by leveraging emergent ToM affordances. And we introduce a metacognitive prompting framework to apply VoE in the context of an AI tutor. By storing and retrieving facts derived in cases where LLM expectation about the user was violated, we find that LLMs are able to learn about users in ways that echo theories of human learning. Finally, we discuss latent hazards and augmentative opportunities associated with modeling user psychology and propose ways to mitigate risk along with possible directions for future inquiry.

We demonstrate that AI models can accurately segment liver tumors without the need for manual annotation by using synthetic tumors in CT scans. Our synthetic tumors have two intriguing advantages: (I) realistic in shape and texture, which even medical professionals can confuse with real tumors; (II) effective for training AI models, which can perform liver tumor segmentation similarly to the model trained on real tumors -- this result is exciting because no existing work, using synthetic tumors only, has thus far reached a similar or even close performance to real tumors. This result also implies that manual efforts for annotating tumors voxel by voxel (which took years to create) can be significantly reduced in the future. Moreover, our synthetic tumors can automatically generate many examples of small (or even tiny) synthetic tumors and have the potential to improve the success rate of detecting small liver tumors, which is critical for detecting the early stages of cancer. In addition to enriching the training data, our synthesizing strategy also enables us to rigorously assess the AI robustness.

Brain tumor diagnosis is largely dependent on Magnetic Resonance Imaging (MRI) evaluation, which requires radiologists to synthesize thousands of images across multiple 3D sequences and longitudinal studies. This process requires advanced neuro-radiology training, poses substantial cognitive load, and is highly time-consuming. Despite increasing demands in radiology, this expertise is difficult to scale, straining the current health systems. Vision-Language Models (VLMs) provide an opportunity to reduce this burden through a semi-automated, interactive interpretation of complex brain MRIs. However, they are currently underutilized in neuro-oncology due to a lack of specialized benchmarks for evaluating them. We introduce a clinically relevant visual question answering (VQA) benchmark -- the UCSF-PDGM-VQA dataset -- consisting of 2,387 QA pairs from 473 glioma-related MRI studies in the public UCSF-PDGM dataset. We further establish a performance baseline for six state-of-the-art vision-language models (VLMs) and one large language model on this dataset. We find that current models are incapable of effectively processing multi-sequence, 3-dimensional MRI scans, thus resulting in a suppression of visual features and over-reliance on language priors, causing modality collapse. These findings underscore a critical deficiency in current model reliability and safety within clinical settings, necessitating the development of robust, domain-specific VLMs.

U-shaped networks and its variants have demonstrated exceptional results for medical image segmentation. In this paper, we propose a novel dual self-distillation (DSD) framework in U-shaped networks for volumetric medical image segmentation. DSD distills knowledge from the ground-truth segmentation labels to the decoder layers. Additionally, DSD also distills knowledge from the deepest decoder and encoder layer to the shallower decoder and encoder layers respectively of a single U-shaped network. DSD is a general training strategy that could be attached to the backbone architecture of any U-shaped network to further improve its segmentation performance. We attached DSD on several state-of-the-art U-shaped backbones, and extensive experiments on various public 3D medical image segmentation datasets (cardiac substructure, brain tumor and Hippocampus) demonstrated significant improvement over the same backbones without DSD. On average, after attaching DSD to the U-shaped backbones, we observed an increase of 2.82\%, 4.53\% and 1.3\% in Dice similarity score, a decrease of 7.15 mm, 6.48 mm and 0.76 mm in the Hausdorff distance, for cardiac substructure, brain tumor and Hippocampus segmentation, respectively. These improvements were achieved with negligible increase in the number of trainable parameters and training time. Our proposed DSD framework also led to significant qualitative improvements for cardiac substructure, brain tumor and Hippocampus segmentation over the U-shaped backbones. The source code is publicly available at https://github.com/soumbane/DualSelfDistillation.

To date, there exist almost no culturally-specific evaluation benchmarks for large language models (LLMs) that cover a large number of languages and cultures. In this paper, we present Global PIQA, a participatory commonsense reasoning benchmark for over 100 languages, constructed by hand by 335 researchers from 65 countries around the world. The 116 language varieties in Global PIQA cover five continents, 14 language families, and 23 writing systems. In the non-parallel split of Global PIQA, over 50% of examples reference local foods, customs, traditions, or other culturally-specific elements. We find that state-of-the-art LLMs perform well on Global PIQA in aggregate, but they exhibit weaker performance in lower-resource languages (up to a 37% accuracy gap, despite random chance at 50%). Open models generally perform worse than proprietary models. Global PIQA highlights that in many languages and cultures, everyday knowledge remains an area for improvement, alongside more widely-discussed capabilities such as complex reasoning and expert knowledge. Beyond its uses for LLM evaluation, we hope that Global PIQA provides a glimpse into the wide diversity of cultures in which human language is embedded.

Query performance prediction (QPP) is an important and actively studied information retrieval task, having various applications, such as query reformulation, query expansion, and retrieval system selection, among many others. The task has been primarily studied in the context of text and image retrieval, whereas QPP for content-based video retrieval (CBVR) remains largely underexplored. To this end, we propose the first benchmark for video query performance prediction (VQPP), comprising two text-to-video retrieval datasets and two CBVR systems, respectively. VQPP contains a total of 56K text queries and 51K videos, and comes with official training, validation and test splits, fostering direct comparisons and reproducible results. We explore multiple pre-retrieval and post-retrieval performance predictors, creating a representative benchmark for future exploration of QPP in the video domain. Our results show that pre-retrieval predictors obtain competitive performance, enabling applications before performing the retrieval step. We also demonstrate the applicability of VQPP by employing the best performing pre-retrieval predictor as reward model for training a large language model (LLM) on the query reformulation task via direct preference optimization (DPO). We release our benchmark and code at https://github.com/AdrianLutu/VQPP.

Direct Preference Optimization (DPO) has been proposed as an effective and efficient alternative to reinforcement learning from human feedback (RLHF). In this paper, we propose a novel and enhanced version of DPO based on curriculum learning for text-to-image generation. Our method is divided into two training stages. First, a ranking of the examples generated for each prompt is obtained by employing a reward model. Then, increasingly difficult pairs of examples are sampled and provided to a text-to-image generative (diffusion or consistency) model. Generated samples that are far apart in the ranking are considered to form easy pairs, while those that are close in the ranking form hard pairs. In other words, we use the rank difference between samples as a measure of difficulty. The sampled pairs are split into batches according to their difficulty levels, which are gradually used to train the generative model. Our approach, Curriculum DPO, is compared against state-of-the-art fine-tuning approaches on nine benchmarks, outperforming the competing methods in terms of text alignment, aesthetics and human preference. Our code is available at https://github.com/CroitoruAlin/Curriculum-DPO.

Recent works exploring deep learning application to dynamical systems modeling have demonstrated that embedding physical priors into neural networks can yield more effective, physically-realistic, and data-efficient models. However, in the absence of complete prior knowledge of a dynamical system's physical characteristics, determining the optimal structure and optimization strategy for these models can be difficult. In this work, we explore methods for discovering neural state space dynamics models for system identification. Starting with a design space of block-oriented state space models and structured linear maps with strong physical priors, we encode these components into a model genome alongside network structure, penalty constraints, and optimization hyperparameters. Demonstrating the overall utility of the design space, we employ an asynchronous genetic search algorithm that alternates between model selection and optimization and obtains accurate physically consistent models of three physical systems: an aerodynamics body, a continuous stirred tank reactor, and a two tank interacting system.

Machine Learning (ML) models have been utilized for malware detection for over two decades. Consequently, this ignited an ongoing arms race between malware authors and antivirus systems, compelling researchers to propose defenses for malware-detection models against evasion attacks. However, most if not all existing defenses against evasion attacks suffer from sizable performance degradation and/or can defend against only specific attacks, which makes them less practical in real-world settings. In this work, we develop a certified defense, DRSM (De-Randomized Smoothed MalConv), by redesigning the de-randomized smoothing technique for the domain of malware detection. Specifically, we propose a window ablation scheme to provably limit the impact of adversarial bytes while maximally preserving local structures of the executables. After showing how DRSM is theoretically robust against attacks with contiguous adversarial bytes, we verify its performance and certified robustness experimentally, where we observe only marginal accuracy drops as the cost of robustness. To our knowledge, we are the first to offer certified robustness in the realm of static detection of malware executables. More surprisingly, through evaluating DRSM against 9 empirical attacks of different types, we observe that the proposed defense is empirically robust to some extent against a diverse set of attacks, some of which even fall out of the scope of its original threat model. In addition, we collected 15.5K recent benign raw executables from diverse sources, which will be made public as a dataset called PACE (Publicly Accessible Collection(s) of Executables) to alleviate the scarcity of publicly available benign datasets for studying malware detection and provide future research with more representative data of the time.

This work studies a central extremal graph theory problem inspired by a 1975 conjecture of Erdos, which aims to find graphs with a given size (number of nodes) that maximize the number of edges without having 3- or 4-cycles. We formulate this problem as a sequential decision-making problem and compare AlphaZero, a neural network-guided tree search, with tabu search, a heuristic local search method. Using either method, by introducing a curriculum -- jump-starting the search for larger graphs using good graphs found at smaller sizes -- we improve the state-of-the-art lower bounds for several sizes. We also propose a flexible graph-generation environment and a permutation-invariant network architecture for learning to search in the space of graphs.

Recent advances in audio generation led to an increasing number of deepfakes, making the general public more vulnerable to financial scams, identity theft, and misinformation. Audio deepfake detectors promise to alleviate this issue, with many recent studies reporting accuracy rates close to 99%. However, these methods are typically tested in an in-domain setup, where the deepfake samples from the training and test sets are produced by the same generative models. To this end, we introduce XMAD-Bench, a large-scale cross-domain multilingual audio deepfake benchmark comprising 668.8 hours of real and deepfake speech. In our novel dataset, the speakers, the generative methods, and the real audio sources are distinct across training and test splits. This leads to a challenging cross-domain evaluation setup, where audio deepfake detectors can be tested ``in the wild''. Our in-domain and cross-domain experiments indicate a clear disparity between the in-domain performance of deepfake detectors, which is usually as high as 100%, and the cross-domain performance of the same models, which is sometimes similar to random chance. Our benchmark highlights the need for the development of robust audio deepfake detectors, which maintain their generalization capacity across different languages, speakers, generative methods, and data sources. Our benchmark is publicly released at https://github.com/ristea/xmad-bench/.

For many segmentation tasks, especially for the biomedical image, the topological prior is vital information which is useful to exploit. The containment/nesting is a typical inter-class geometric relationship. In the MICCAI Brain tumor segmentation challenge, with its three hierarchically nested classes 'whole tumor', 'tumor core', 'active tumor', the nested classes relationship is introduced into the 3D-residual-Unet architecture. The network comprises a context aggregation pathway and a localization pathway, which encodes increasingly abstract representation of the input as going deeper into the network, and then recombines these representations with shallower features to precisely localize the interest domain via a localization path. The nested-class-prior is combined by proposing the multi-class activation function and its corresponding loss function. The model is trained on the training dataset of Brats2018, and 20% of the dataset is regarded as the validation dataset to determine parameters. When the parameters are fixed, we retrain the model on the whole training dataset. The performance achieved on the validation leaderboard is 86%, 77% and 72% Dice scores for the whole tumor, enhancing tumor and tumor core classes without relying on ensembles or complicated post-processing steps. Based on the same start-of-the-art network architecture, the accuracy of nested-class (enhancing tumor) is reasonably improved from 69% to 72% compared with the traditional Softmax-based method which blind to topological prior.

We investigate a new dynamical system that describes tumor-host interaction. The equation that describes the untreated tumor growth is based on non-extensive statistical mechanics. Recently, this model has been shown to fit successfully exponential, Gompertz, logistic, and power-law tumor growths. We have been able to include as many hallmarks of cancer as possible. We study also the dynamic response of cancer under therapy. Using our model, we can make predictions about the different outcomes when we change the parameters, and/or the initial conditions. We can determine the importance of different factors to influence tumor growth. We discover synergistic therapeutic effects of different treatments and drugs. Cancer is generally untreatable using conventional monotherapy. We consider conventional therapies, oncogene-targeted therapies, tumor-suppressors gene-targeted therapies, immunotherapies, anti-angiogenesis therapies, virotherapy, among others. We need therapies with the potential to target both tumor cells and the tumors' microenvironment. Drugs that target oncogenes and tumor-suppressor genes can be effective in the treatment of some cancers. However, most tumors do reoccur. We have found that the success of the new therapeutic agents can be seen when used in combination with other cancer-cell-killing therapies. Our results have allowed us to design a combinational therapy that can lead to the complete eradication of cancer.

An expansion of aberrant brain cells is referred to as a brain tumor. The brain's architecture is extremely intricate, with several regions controlling various nervous system processes. Any portion of the brain or skull can develop a brain tumor, including the brain's protective coating, the base of the skull, the brainstem, the sinuses, the nasal cavity, and many other places. Over the past ten years, numerous developments in the field of computer-aided brain tumor diagnosis have been made. Recently, instance segmentation has attracted a lot of interest in numerous computer vision applications. It seeks to assign various IDs to various scene objects, even if they are members of the same class. Typically, a two-stage pipeline is used to perform instance segmentation. This study shows brain cancer segmentation using YOLOv5. Yolo takes dataset as picture format and corresponding text file. You Only Look Once (YOLO) is a viral and widely used algorithm. YOLO is famous for its object recognition properties. You Only Look Once (YOLO) is a popular algorithm that has gone viral. YOLO is well known for its ability to identify objects. YOLO V2, V3, V4, and V5 are some of the YOLO latest versions that experts have published in recent years. Early brain tumor detection is one of the most important jobs that neurologists and radiologists have. However, it can be difficult and error-prone to manually identify and segment brain tumors from Magnetic Resonance Imaging (MRI) data. For making an early diagnosis of the condition, an automated brain tumor detection system is necessary. The model of the research paper has three classes. They are respectively Meningioma, Pituitary, Glioma. The results show that, our model achieves competitive accuracy, in terms of runtime usage of M2 10 core GPU.

Multi-modality magnetic resonance imaging data with various sequences facilitate the early diagnosis, tumor segmentation, and disease staging in the management of nasopharyngeal carcinoma (NPC). The lack of publicly available, comprehensive datasets limits advancements in diagnosis, treatment planning, and the development of machine learning algorithms for NPC. Addressing this critical need, we introduce the first comprehensive NPC MRI dataset, encompassing MR axial imaging of 277 primary NPC patients. This dataset includes T1-weighted, T2-weighted, and contrast-enhanced T1-weighted sequences, totaling 831 scans. In addition to the corresponding clinical data, manually annotated and labeled segmentations by experienced radiologists offer high-quality data resources from untreated primary NPC.

Breast Cancer is a major public health problem and the most common diagnosed malignancy in woman. There have been significant developments in clinical approaches and theoretical experimental to understand the interactions of cancer cells dynamics with the immune system, also developments on analytical and computational models to help provide insights into clinical observations for a better understanding of cancer cells, but more are needed, especially at the genetic and molecular levels mathematically. Treatments such as immunotherapy, chemotherapy, hormone therapy, radiotherapy, and gene therapy are the main strategies in the fight against breast cancer. The present study aims at investigating the effects of estrogen derived from recent models, but this time combined with immunotherapy as a way to treat or inhibit the cancer growth by a mathematical model of breast cancer in situ, governed by a simplified model of nonlinear-coupled ordinary differential equations, that combines important interactions between natural cells, tumor cells, immune cells, ketogenic diet in the presence of an anticancer drug. Another contribution was to introduce the inhibition effect epsilon for new results and conclusions, A qualitative study was performed and biological interpretations were included to understand the conditions of stability in a realistic way.

Pediatric tumors of the central nervous system are the most common cause of cancer-related death in children. The five-year survival rate for high-grade gliomas in children is less than 20%. Due to their rarity, the diagnosis of these entities is often delayed, their treatment is mainly based on historic treatment concepts, and clinical trials require multi-institutional collaborations. Here we present the CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs challenge, focused on pediatric brain tumors with data acquired across multiple international consortia dedicated to pediatric neuro-oncology and clinical trials. The CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs challenge brings together clinicians and AI/imaging scientists to lead to faster development of automated segmentation techniques that could benefit clinical trials, and ultimately the care of children with brain tumors.

AI-driven tumor analysis has garnered increasing attention in healthcare. However, its progress is significantly hindered by the lack of annotated tumor cases, which requires radiologists to invest a lot of effort in collecting and annotation. In this paper, we introduce a highly practical solution for robust tumor synthesis and segmentation, termed FreeTumor, which refers to annotation-free synthetic tumors and our desire to free patients that suffering from tumors. Instead of pursuing sophisticated technical synthesis modules, we aim to design a simple yet effective tumor synthesis paradigm to unleash the power of large-scale data. Specifically, FreeTumor advances existing methods mainly from three aspects: (1) Existing methods only leverage small-scale labeled data for synthesis training, which limits their ability to generalize well on unseen data from different sources. To this end, we introduce the adversarial training strategy to leverage large-scale and diversified unlabeled data in synthesis training, significantly improving tumor synthesis. (2) Existing methods largely ignored the negative impact of low-quality synthetic tumors in segmentation training. Thus, we employ an adversarial-based discriminator to automatically filter out the low-quality synthetic tumors, which effectively alleviates their negative impact. (3) Existing methods only used hundreds of cases in tumor segmentation. In FreeTumor, we investigate the data scaling law in tumor segmentation by scaling up the dataset to 11k cases. Extensive experiments demonstrate the superiority of FreeTumor, e.g., on three tumor segmentation benchmarks, average +8.9% DSC over the baseline that only using real tumors and +6.6% DSC over the state-of-the-art tumor synthesis method. Code will be available.

Building trusted datasets is critical for transparent and responsible Medical AI (MAI) research, but creating even small, high-quality datasets can take years of effort from multidisciplinary teams. This process often delays AI benefits, as human-centric data creation and AI-centric model development are treated as separate, sequential steps. To overcome this, we propose ScaleMAI, an agent of AI-integrated data curation and annotation, allowing data quality and AI performance to improve in a self-reinforcing cycle and reducing development time from years to months. We adopt pancreatic tumor detection as an example. First, ScaleMAI progressively creates a dataset of 25,362 CT scans, including per-voxel annotations for benign/malignant tumors and 24 anatomical structures. Second, through progressive human-in-the-loop iterations, ScaleMAI provides Flagship AI Model that can approach the proficiency of expert annotators (30-year experience) in detecting pancreatic tumors. Flagship Model significantly outperforms models developed from smaller, fixed-quality datasets, with substantial gains in tumor detection (+14%), segmentation (+5%), and classification (72%) on three prestigious benchmarks. In summary, ScaleMAI transforms the speed, scale, and reliability of medical dataset creation, paving the way for a variety of impactful, data-driven applications.

Providing effective treatment and making informed clinical decisions are essential goals of modern medicine and clinical care. We are interested in simulating disease dynamics for clinical decision-making, leveraging recent advances in large generative models. To this end, we introduce the Medical World Model (MeWM), the first world model in medicine that visually predicts future disease states based on clinical decisions. MeWM comprises (i) vision-language models to serve as policy models, and (ii) tumor generative models as dynamics models. The policy model generates action plans, such as clinical treatments, while the dynamics model simulates tumor progression or regression under given treatment conditions. Building on this, we propose the inverse dynamics model that applies survival analysis to the simulated post-treatment tumor, enabling the evaluation of treatment efficacy and the selection of the optimal clinical action plan. As a result, the proposed MeWM simulates disease dynamics by synthesizing post-treatment tumors, with state-of-the-art specificity in Turing tests evaluated by radiologists. Simultaneously, its inverse dynamics model outperforms medical-specialized GPTs in optimizing individualized treatment protocols across all metrics. Notably, MeWM improves clinical decision-making for interventional physicians, boosting F1-score in selecting the optimal TACE protocol by 13%, paving the way for future integration of medical world models as the second readers.

Background: Pancreatic cancer is one of the most aggressive cancers, with poor survival rates. Endoscopic ultrasound (EUS) is a key diagnostic modality, but its effectiveness is constrained by operator subjectivity. This study evaluates a Vision Transformer-based deep learning segmentation model for pancreatic tumors. Methods: A segmentation model using the USFM framework with a Vision Transformer backbone was trained and validated with 17,367 EUS images (from two public datasets) in 5-fold cross-validation. The model was tested on an independent dataset of 350 EUS images from another public dataset, manually segmented by radiologists. Preprocessing included grayscale conversion, cropping, and resizing to 512x512 pixels. Metrics included Dice similarity coefficient (DSC), intersection over union (IoU), sensitivity, specificity, and accuracy. Results: In 5-fold cross-validation, the model achieved a mean DSC of 0.651 +/- 0.738, IoU of 0.579 +/- 0.658, sensitivity of 69.8%, specificity of 98.8%, and accuracy of 97.5%. For the external validation set, the model achieved a DSC of 0.657 (95% CI: 0.634-0.769), IoU of 0.614 (95% CI: 0.590-0.689), sensitivity of 71.8%, and specificity of 97.7%. Results were consistent, but 9.7% of cases exhibited erroneous multiple predictions. Conclusions: The Vision Transformer-based model demonstrated strong performance for pancreatic tumor segmentation in EUS images. However, dataset heterogeneity and limited external validation highlight the need for further refinement, standardization, and prospective studies.

Histopathology has played an essential role in cancer diagnosis. With the rapid advances in convolutional neural networks (CNN). Various CNN-based automated pathological image segmentation approaches have been developed in computer-assisted pathological image analysis. In the past few years, Transformer neural networks (Transformer) have shown the unique merit of capturing the global long-distance dependencies across the entire image as a new deep learning paradigm. Such merit is appealing for exploring spatially heterogeneous pathological images. However, there have been very few, if any, studies that have systematically evaluated the current Transformer-based approaches in pathological image segmentation. To assess the performance of Transformer segmentation models on whole slide images (WSI), we quantitatively evaluated six prevalent transformer-based models on tumor segmentation, using the widely used PAIP liver histopathological dataset. For a more comprehensive analysis, we also compare the transformer-based models with six major traditional CNN-based models. The results show that the Transformer-based models exhibit a general superior performance over the CNN-based models. In particular, Segmenter, Swin-Transformer and TransUNet-all transformer-based-came out as the best performers among the twelve evaluated models.

Accurate tumor size measurement is a cornerstone of evaluating cancer treatment response. The most widely adopted standard for this purpose is the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, which relies on measuring the longest tumor diameter in a single plane. However, volumetric measurements have been shown to provide a more reliable assessment of treatment effect. Their clinical adoption has been limited, though, due to the labor-intensive nature of manual volumetric annotation. In this paper, we present Lite ENSAM, a lightweight adaptation of the ENSAM architecture designed for efficient volumetric tumor segmentation from CT scans annotated with RECIST annotations. Lite ENSAM was submitted to the MICCAI FLARE 2025 Task 1: Pan-cancer Segmentation in CT Scans, Subtask 2, where it achieved a Dice Similarity Coefficient (DSC) of 60.7% and a Normalized Surface Dice (NSD) of 63.6% on the hidden test set, and an average total RAM time of 50.6 GBs and an average inference time of 14.4 s on CPU on the public validation dataset.

Human readers or radiologists routinely perform full-body multi-organ multi-disease detection and diagnosis in clinical practice, while most medical AI systems are built to focus on single organs with a narrow list of a few diseases. This might severely limit AI's clinical adoption. A certain number of AI models need to be assembled non-trivially to match the diagnostic process of a human reading a CT scan. In this paper, we construct a Unified Tumor Transformer (UniT) model to detect (tumor existence and location) and diagnose (tumor characteristics) eight major cancer-prevalent organs in CT scans. UniT is a query-based Mask Transformer model with the output of multi-organ and multi-tumor semantic segmentation. We decouple the object queries into organ queries, detection queries and diagnosis queries, and further establish hierarchical relationships among the three groups. This clinically-inspired architecture effectively assists inter- and intra-organ representation learning of tumors and facilitates the resolution of these complex, anatomically related multi-organ cancer image reading tasks. UniT is trained end-to-end using a curated large-scale CT images of 10,042 patients including eight major types of cancers and occurring non-cancer tumors (all are pathology-confirmed with 3D tumor masks annotated by radiologists). On the test set of 631 patients, UniT has demonstrated strong performance under a set of clinically relevant evaluation metrics, substantially outperforming both multi-organ segmentation methods and an assembly of eight single-organ expert models in tumor detection, segmentation, and diagnosis. Such a unified multi-cancer image reading model (UniT) can significantly reduce the number of false positives produced by combined multi-system models. This moves one step closer towards a universal high-performance cancer screening tool.

Medical vision-language models (VLMs) and AI agents have made significant progress in learning to analyze and reason about clinical images. However, existing medical visual question answering (VQA) benchmarks collapse model capabilities into a single accuracy score, obscuring where and why models fail. We propose DeepTumorVQA, a hierarchical benchmark that follows the multi-stage evidence chain in tumor diagnosis and decomposes 3D CT reasoning into four stages: recognition, measurement, visual reasoning, and medical reasoning. Higher-level questions remain independently scorable, while their ground-truth evidence chains are defined over lower-level primitives. The benchmark contains 476K questions across 42 clinical subtypes on 9,262 3D CT volumes. In addition to a direct reasoning mode for VLMs, DeepTumorVQA provides tool-interaction environments for agent evaluation, where a model can call external tools, including segmentation models, measurement programs, and medical knowledge modules, before answering the question. Evaluating over 30 model configurations, we find that reliable quantitative measurement is the primary bottleneck, making later-stage visual and medical reasoning harder for VLMs, while tool augmentation substantially mitigates this issue. When tools are available, leveraging medical knowledge and tools to reason about medical images becomes a new challenge. We further show that ground-truth step-by-step tool-use traces from DeepTumorVQA can supervise agents and reduce tool-use and reasoning failures. This stage-wise progression from recognition to measurement to visual and medical reasoning provides a concrete roadmap for future medical VLM and AI agent studies. All data and code are released at https://github.com/Schuture/DeepTumorVQA.

Scientific discovery relies on scientists generating novel hypotheses that undergo rigorous experimental validation. To augment this process, we introduce an AI co-scientist, a multi-agent system built on Gemini 2.0. The AI co-scientist is intended to help uncover new, original knowledge and to formulate demonstrably novel research hypotheses and proposals, building upon prior evidence and aligned to scientist-provided research objectives and guidance. The system's design incorporates a generate, debate, and evolve approach to hypothesis generation, inspired by the scientific method and accelerated by scaling test-time compute. Key contributions include: (1) a multi-agent architecture with an asynchronous task execution framework for flexible compute scaling; (2) a tournament evolution process for self-improving hypotheses generation. Automated evaluations show continued benefits of test-time compute, improving hypothesis quality. While general purpose, we focus development and validation in three biomedical areas: drug repurposing, novel target discovery, and explaining mechanisms of bacterial evolution and anti-microbial resistance. For drug repurposing, the system proposes candidates with promising validation findings, including candidates for acute myeloid leukemia that show tumor inhibition in vitro at clinically applicable concentrations. For novel target discovery, the AI co-scientist proposed new epigenetic targets for liver fibrosis, validated by anti-fibrotic activity and liver cell regeneration in human hepatic organoids. Finally, the AI co-scientist recapitulated unpublished experimental results via a parallel in silico discovery of a novel gene transfer mechanism in bacterial evolution. These results, detailed in separate, co-timed reports, demonstrate the potential to augment biomedical and scientific discovery and usher an era of AI empowered scientists.

Cell detection, segmentation and classification are essential for analyzing tumor microenvironments (TME) on hematoxylin and eosin (H&E) slides. Existing methods suffer from poor performance on understudied cell types (rare or not present in public datasets) and limited cross-domain generalization. To address these shortcomings, we introduce HistoPLUS, a state-of-the-art model for cell analysis, trained on a novel curated pan-cancer dataset of 108,722 nuclei covering 13 cell types. In external validation across 4 independent cohorts, HistoPLUS outperforms current state-of-the-art models in detection quality by 5.2% and overall F1 classification score by 23.7%, while using 5x fewer parameters. Notably, HistoPLUS unlocks the study of 7 understudied cell types and brings significant improvements on 8 of 13 cell types. Moreover, we show that HistoPLUS robustly transfers to two oncology indications unseen during training. To support broader TME biomarker research, we release the model weights and inference code at https://github.com/owkin/histoplus/.

PanTS is a large-scale, multi-institutional dataset curated to advance research in pancreatic CT analysis. It contains 36,390 CT scans from 145 medical centers, with expert-validated, voxel-wise annotations of over 993,000 anatomical structures, covering pancreatic tumors, pancreas head, body, and tail, and 24 surrounding anatomical structures such as vascular/skeletal structures and abdominal/thoracic organs. Each scan includes metadata such as patient age, sex, diagnosis, contrast phase, in-plane spacing, slice thickness, etc. AI models trained on PanTS achieve significantly better performance in pancreatic tumor detection, localization, and segmentation compared to those trained on existing public datasets. Our analysis indicates that these gains are directly attributable to the 16x larger-scale tumor annotations and indirectly supported by the 24 additional surrounding anatomical structures. As the largest and most comprehensive resource of its kind, PanTS offers a new benchmark for developing and evaluating AI models in pancreatic CT analysis.

Brain tumors can lead to neurological dysfunction, cognitive and psychological changes, increased intracranial pressure, and seizures, posing significant risks to health. The You Only Look Once (YOLO) series has shown superior accuracy in medical imaging object detection. This paper presents a novel SCC-YOLO architecture that integrates the SCConv module into YOLOv9. The SCConv module optimizes convolutional efficiency by reducing spatial and channel redundancy, enhancing image feature learning. We examine the effects of different attention mechanisms with YOLOv9 for brain tumor detection using the Br35H dataset and our custom dataset (Brain_Tumor_Dataset). Results indicate that SCC-YOLO improved mAP50 by 0.3% on the Br35H dataset and by 0.5% on our custom dataset compared to YOLOv9. SCC-YOLO achieves state-of-the-art performance in brain tumor detection.

This paper presents a mathematical framework for optimizing drug delivery in cancer treatment using a nonlocal model of solid tumor growth. We present a coupled system of partial differential equations that incorporate long-range cellular interactions through integral terms and drug-induced cell death. The model accounts for spatial heterogeneity in both tumor cell density and drug concentration while capturing the complex dynamics of drug resistance development. We first establish the well-posedness of the coupled system by proving the existence and uniqueness of a solution under appropriate regularity conditions. The optimal control problem is then formulated to minimize tumor size while accounting for drug toxicity constraints. Using variational methods, we derive the necessary optimality conditions and characterize the optimal control through an adjoint system. Theoretical results can help to design effective chemotherapy schedules that balance treatment efficacy with adverse effects.

The BraTS 2021 challenge celebrates its 10th anniversary and is jointly organized by the Radiological Society of North America (RSNA), the American Society of Neuroradiology (ASNR), and the Medical Image Computing and Computer Assisted Interventions (MICCAI) society. Since its inception, BraTS has been focusing on being a common benchmarking venue for brain glioma segmentation algorithms, with well-curated multi-institutional multi-parametric magnetic resonance imaging (mpMRI) data. Gliomas are the most common primary malignancies of the central nervous system, with varying degrees of aggressiveness and prognosis. The RSNA-ASNR-MICCAI BraTS 2021 challenge targets the evaluation of computational algorithms assessing the same tumor compartmentalization, as well as the underlying tumor's molecular characterization, in pre-operative baseline mpMRI data from 2,040 patients. Specifically, the two tasks that BraTS 2021 focuses on are: a) the segmentation of the histologically distinct brain tumor sub-regions, and b) the classification of the tumor's O[6]-methylguanine-DNA methyltransferase (MGMT) promoter methylation status. The performance evaluation of all participating algorithms in BraTS 2021 will be conducted through the Sage Bionetworks Synapse platform (Task 1) and Kaggle (Task 2), concluding in distributing to the top ranked participants monetary awards of $60,000 collectively.

Clinical monitoring of metastatic disease to the brain can be a laborious and time-consuming process, especially in cases involving multiple metastases when the assessment is performed manually. The Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) guideline, which utilizes the unidimensional longest diameter, is commonly used in clinical and research settings to evaluate response to therapy in patients with brain metastases. However, accurate volumetric assessment of the lesion and surrounding peri-lesional edema holds significant importance in clinical decision-making and can greatly enhance outcome prediction. The unique challenge in performing segmentations of brain metastases lies in their common occurrence as small lesions. Detection and segmentation of lesions that are smaller than 10 mm in size has not demonstrated high accuracy in prior publications. The brain metastases challenge sets itself apart from previously conducted MICCAI challenges on glioma segmentation due to the significant variability in lesion size. Unlike gliomas, which tend to be larger on presentation scans, brain metastases exhibit a wide range of sizes and tend to include small lesions. We hope that the BraTS-METS dataset and challenge will advance the field of automated brain metastasis detection and segmentation.

One of the primary challenges in brain tumor segmentation arises from the uncertainty of voxels close to tumor boundaries. However, the conventional process of generating ground truth segmentation masks fails to treat such uncertainties properly. Those "hard labels" with 0s and 1s conceptually influenced the majority of prior studies on brain image segmentation. As a result, tumor segmentation is often solved through voxel classification. In this work, we instead view this problem as a voxel-level regression, where the ground truth represents a certainty mapping from any pixel to the border of the tumor. We propose a novel ground truth label transformation, which is based on a signed geodesic transform, to capture the uncertainty in brain tumors' vicinity. We combine this idea with a Focal-like regression L1-loss that enables effective regression learning in high-dimensional output space by appropriately weighting voxels according to their difficulty. We thoroughly conduct an experimental evaluation to validate the components of our proposed method, compare it to a diverse array of state-of-the-art segmentation models, and show that it is architecture-agnostic. The code of our method is made publicly available (https://github.com/Oulu-IMEDS/SiNGR/).

Large language models (LLMs) present an opportunity to scale high-quality personalized education to all. A promising approach towards this means is to build dialog tutoring models that scaffold students' problem-solving. However, even though existing LLMs perform well in solving reasoning questions, they struggle to precisely detect student's errors and tailor their feedback to these errors. Inspired by real-world teaching practice where teachers identify student errors and customize their response based on them, we focus on verifying student solutions and show how grounding to such verification improves the overall quality of tutor response generation. We collect a dataset of 1K stepwise math reasoning chains with the first error step annotated by teachers. We show empirically that finding the mistake in a student solution is challenging for current models. We propose and evaluate several verifiers for detecting these errors. Using both automatic and human evaluation we show that the student solution verifiers steer the generation model towards highly targeted responses to student errors which are more often correct with less hallucinations compared to existing baselines.

Deep learning presents novel opportunities for the auto-segmentation of gross tumor volume (GTV) in head and neck cancer (HNC), yet fully automatic methods usually necessitate significant manual refinement. This study investigates the Segment Anything Model (SAM), recognized for requiring minimal human prompting and its zero-shot generalization ability across natural images. We specifically examine MedSAM, a version of SAM fine-tuned with large-scale public medical images. Despite its progress, the integration of multi-modality images (CT, PET, MRI) for effective GTV delineation remains a challenge. Focusing on SAM's application in HNC GTV segmentation, we assess its performance in both zero-shot and fine-tuned scenarios using single (CT-only) and fused multi-modality images. Our study demonstrates that fine-tuning SAM significantly enhances its segmentation accuracy, building upon the already effective zero-shot results achieved with bounding box prompts. These findings open a promising avenue for semi-automatic HNC GTV segmentation.

Deep learning has demonstrated remarkable success in medical image segmentation and computer-aided diagnosis. In particular, numerous advanced methods have achieved state-of-the-art performance in brain tumor segmentation from MRI scans. While recent studies in other medical imaging domains have revealed that integrating textual reports with visual data can enhance segmentation accuracy, the field of brain tumor analysis lacks a comprehensive dataset that combines radiological images with corresponding textual annotations. This limitation has hindered the exploration of multimodal approaches that leverage both imaging and textual data. To bridge this critical gap, we introduce the TextBraTS dataset, the first publicly available volume-level multimodal dataset that contains paired MRI volumes and rich textual annotations, derived from the widely adopted BraTS2020 benchmark. Building upon this novel dataset, we propose a novel baseline framework and sequential cross-attention method for text-guided volumetric medical image segmentation. Through extensive experiments with various text-image fusion strategies and templated text formulations, our approach demonstrates significant improvements in brain tumor segmentation accuracy, offering valuable insights into effective multimodal integration techniques. Our dataset, implementation code, and pre-trained models are publicly available at https://github.com/Jupitern52/TextBraTS.

Accurate and efficient segmentation of brain tumors is critical for diagnosis, treatment planning, and monitoring in clinical practice. In this study, we present an enhanced ResUNet architecture for automatic brain tumor segmentation, integrating an EfficientNetB0 encoder, a channel attention mechanism, and an Atrous Spatial Pyramid Pooling (ASPP) module. The EfficientNetB0 encoder leverages pre-trained features to improve feature extraction efficiency, while the channel attention mechanism enhances the model's focus on tumor-relevant features. ASPP enables multiscale contextual learning, crucial for handling tumors of varying sizes and shapes. The proposed model was evaluated on two benchmark datasets: TCGA LGG and BraTS 2020. Experimental results demonstrate that our method consistently outperforms the baseline ResUNet and its EfficientNet variant, achieving Dice coefficients of 0.903 and 0.851 and HD95 scores of 9.43 and 3.54 for whole tumor and tumor core regions on the BraTS 2020 dataset, respectively. compared with state-of-the-art methods, our approach shows competitive performance, particularly in whole tumor and tumor core segmentation. These results indicate that combining a powerful encoder with attention mechanisms and ASPP can significantly enhance brain tumor segmentation performance. The proposed approach holds promise for further optimization and application in other medical image segmentation tasks.

In medical vision, different imaging modalities provide complementary information. However, in practice, not all modalities may be available during inference or even training. Previous approaches, e.g., knowledge distillation or image synthesis, often assume the availability of full modalities for all patients during training; this is unrealistic and impractical due to the variability in data collection across sites. We propose a novel approach to learn enhanced modality-agnostic representations by employing a meta-learning strategy in training, even when only limited full modality samples are available. Meta-learning enhances partial modality representations to full modality representations by meta-training on partial modality data and meta-testing on limited full modality samples. Additionally, we co-supervise this feature enrichment by introducing an auxiliary adversarial learning branch. More specifically, a missing modality detector is used as a discriminator to mimic the full modality setting. Our segmentation framework significantly outperforms state-of-the-art brain tumor segmentation techniques in missing modality scenarios.

Tissue phenotyping is a fundamental task in learning objective characterizations of histopathologic biomarkers within the tumor-immune microenvironment in cancer pathology. However, whole-slide imaging (WSI) is a complex computer vision in which: 1) WSIs have enormous image resolutions with precludes large-scale pixel-level efforts in data curation, and 2) diversity of morphological phenotypes results in inter- and intra-observer variability in tissue labeling. To address these limitations, current efforts have proposed using pretrained image encoders (transfer learning from ImageNet, self-supervised pretraining) in extracting morphological features from pathology, but have not been extensively validated. In this work, we conduct a search for good representations in pathology by training a variety of self-supervised models with validation on a variety of weakly-supervised and patch-level tasks. Our key finding is in discovering that Vision Transformers using DINO-based knowledge distillation are able to learn data-efficient and interpretable features in histology images wherein the different attention heads learn distinct morphological phenotypes. We make evaluation code and pretrained weights publicly-available at: https://github.com/Richarizardd/Self-Supervised-ViT-Path.

In this paper, we present a novel approach for segmenting pediatric brain tumors using a deep learning architecture, inspired by expert radiologists' segmentation strategies. Our model delineates four distinct tumor labels and is benchmarked on a held-out PED BraTS 2024 test set (i.e., pediatric brain tumor datasets introduced by BraTS). Furthermore, we evaluate our model's performance against the state-of-the-art (SOTA) model using a new external dataset of 30 patients from CBTN (Children's Brain Tumor Network), labeled in accordance with the PED BraTS 2024 guidelines and 2023 BraTS Adult Glioma dataset. We compare segmentation outcomes with the winning algorithm from the PED BraTS 2023 challenge as the SOTA model. Our proposed algorithm achieved an average Dice score of 0.642 and an HD95 of 73.0 mm on the CBTN test data, outperforming the SOTA model, which achieved a Dice score of 0.626 and an HD95 of 84.0 mm. Moreover, our model exhibits strong generalizability, attaining a 0.877 Dice score in whole tumor segmentation on the BraTS 2023 Adult Glioma dataset, surpassing existing SOTA. Our results indicate that the proposed model is a step towards providing more accurate segmentation for pediatric brain tumors, which is essential for evaluating therapy response and monitoring patient progress. Our source code is available at https://github.com/NUBagciLab/Pediatric-Brain-Tumor-Segmentation-Model.

The success of deep learning in visual recognition tasks has driven advancements in multiple fields of research. Particularly, increasing attention has been drawn towards its application in agriculture. Nevertheless, while visual pattern recognition on farmlands carries enormous economic values, little progress has been made to merge computer vision and crop sciences due to the lack of suitable agricultural image datasets. Meanwhile, problems in agriculture also pose new challenges in computer vision. For example, semantic segmentation of aerial farmland images requires inference over extremely large-size images with extreme annotation sparsity. These challenges are not present in most of the common object datasets, and we show that they are more challenging than many other aerial image datasets. To encourage research in computer vision for agriculture, we present Agriculture-Vision: a large-scale aerial farmland image dataset for semantic segmentation of agricultural patterns. We collected 94,986 high-quality aerial images from 3,432 farmlands across the US, where each image consists of RGB and Near-infrared (NIR) channels with resolution as high as 10 cm per pixel. We annotate nine types of field anomaly patterns that are most important to farmers. As a pilot study of aerial agricultural semantic segmentation, we perform comprehensive experiments using popular semantic segmentation models; we also propose an effective model designed for aerial agricultural pattern recognition. Our experiments demonstrate several challenges Agriculture-Vision poses to both the computer vision and agriculture communities. Future versions of this dataset will include even more aerial images, anomaly patterns and image channels. More information at https://www.agriculture-vision.com.

In this report, we present the latest model of the Gemini family, Gemini 1.5 Pro, a highly compute-efficient multimodal mixture-of-experts model capable of recalling and reasoning over fine-grained information from millions of tokens of context, including multiple long documents and hours of video and audio. Gemini 1.5 Pro achieves near-perfect recall on long-context retrieval tasks across modalities, improves the state-of-the-art in long-document QA, long-video QA and long-context ASR, and matches or surpasses Gemini 1.0 Ultra's state-of-the-art performance across a broad set of benchmarks. Studying the limits of Gemini 1.5 Pro's long-context ability, we find continued improvement in next-token prediction and near-perfect retrieval (>99%) up to at least 10M tokens, a generational leap over existing models such as Claude 2.1 (200k) and GPT-4 Turbo (128k). Finally, we highlight surprising new capabilities of large language models at the frontier; when given a grammar manual for Kalamang, a language with fewer than 200 speakers worldwide, the model learns to translate English to Kalamang at a similar level to a person who learned from the same content.

Hematoxylin and Eosin (H&E) staining is widely regarded as the standard in pathology for diagnosing diseases and tracking tumor recurrence. While H&E staining shows tissue structures, it lacks the ability to reveal specific proteins that are associated with disease severity and treatment response. Immunohistochemical (IHC) stains use antibodies to highlight the expression of these proteins on their respective cell types, improving diagnostic accuracy, and assisting with drug selection for treatment. Despite their value, IHC stains require additional time and resources, limiting their utilization in some clinical settings. Recent advances in deep learning have positioned Image-to-Image (I2I) translation as a computational, cost-effective alternative for IHC. I2I generates high fidelity stain transformations digitally, potentially replacing manual staining in IHC. Diffusion models, the current state of the art in image generation and conditional tasks, are particularly well suited for virtual IHC due to their ability to produce high quality images and resilience to mode collapse. However, these models require extensive and diverse datasets (often millions of samples) to achieve a robust performance, a challenge in virtual staining applications where only thousands of samples are typically available. Inspired by the success of multitask deep learning models in scenarios with limited data, we introduce STAINDIFFUSER, a novel multitask diffusion architecture tailored to virtual staining that achieves convergence with smaller datasets. STAINDIFFUSER simultaneously trains two diffusion processes: (a) generating cell specific IHC stains from H&E images and (b) performing H&E based cell segmentation, utilizing coarse segmentation labels exclusively during training. STAINDIFFUSER generates high-quality virtual stains for two markers, outperforming over twenty I2I baselines.

In this work, we present LesionLocator, a framework for zero-shot longitudinal lesion tracking and segmentation in 3D medical imaging, establishing the first end-to-end model capable of 4D tracking with dense spatial prompts. Our model leverages an extensive dataset of 23,262 annotated medical scans, as well as synthesized longitudinal data across diverse lesion types. The diversity and scale of our dataset significantly enhances model generalizability to real-world medical imaging challenges and addresses key limitations in longitudinal data availability. LesionLocator outperforms all existing promptable models in lesion segmentation by nearly 10 dice points, reaching human-level performance, and achieves state-of-the-art results in lesion tracking, with superior lesion retrieval and segmentation accuracy. LesionLocator not only sets a new benchmark in universal promptable lesion segmentation and automated longitudinal lesion tracking but also provides the first open-access solution of its kind, releasing our synthetic 4D dataset and model to the community, empowering future advancements in medical imaging. Code is available at: www.github.com/MIC-DKFZ/LesionLocator

Size measurements of tumor manifestations on follow-up CT examinations are crucial for evaluating treatment outcomes in cancer patients. Efficient lesion segmentation can speed up these radiological workflows. While numerous benchmarks and challenges address lesion segmentation in specific organs like the liver, kidneys, and lungs, the larger variety of lesion types encountered in clinical practice demands a more universal approach. To address this gap, we introduced the ULS23 benchmark for 3D universal lesion segmentation in chest-abdomen-pelvis CT examinations. The ULS23 training dataset contains 38,693 lesions across this region, including challenging pancreatic, colon and bone lesions. For evaluation purposes, we curated a dataset comprising 775 lesions from 284 patients. Each of these lesions was identified as a target lesion in a clinical context, ensuring diversity and clinical relevance within this dataset. The ULS23 benchmark is publicly accessible via uls23.grand-challenge.org, enabling researchers worldwide to assess the performance of their segmentation methods. Furthermore, we have developed and publicly released our baseline semi-supervised 3D lesion segmentation model. This model achieved an average Dice coefficient of 0.703 pm 0.240 on the challenge test set. We invite ongoing submissions to advance the development of future ULS models.

A myriad of algorithms for the automatic analysis of brain MR images is available to support clinicians in their decision-making. For brain tumor patients, the image acquisition time series typically starts with an already pathological scan. This poses problems, as many algorithms are designed to analyze healthy brains and provide no guarantee for images featuring lesions. Examples include, but are not limited to, algorithms for brain anatomy parcellation, tissue segmentation, and brain extraction. To solve this dilemma, we introduce the BraTS inpainting challenge. Here, the participants explore inpainting techniques to synthesize healthy brain scans from lesioned ones. The following manuscript contains the task formulation, dataset, and submission procedure. Later, it will be updated to summarize the findings of the challenge. The challenge is organized as part of the ASNR-BraTS MICCAI challenge.

Whole-Slide Image (WSI) is an important tool for evaluating the prognosis of cancer patients. Present WSI-based prognosis studies generally follow a conventional paradigm -- cancer-specific model development -- where one cancer disease corresponds to one model and this model cannot make use of the prognostic knowledge from others. Despite its notable success in recent years, this paradigm has inherent limitations and has always been struggling with practical requirements: (i) scaling to the rare tumor diseases with very limited samples and (ii) benefiting from the generalizable prognostic knowledge in other cancers. To this end, this paper presents the first systematic study on Prognostic Knowledge Transfer in Pathology, called Path-PKT. It comprises three main parts. (1) We curate a large dataset (UNI2-h-DSS) with 13 cancers and use it to evaluate the transferability of prognostic knowledge between different cancers computationally. (2) We design experiments to understand what factors affect knowledge transfer and what causes positive transfers. (3) Motivated by empirical findings, we propose a new baseline approach (MoE-PKT) with a routing mechanism to utilize the generalizable prognostic knowledge in other cancers. Finally, we show the transferability of source models to rare tumor diseases. This study could lay solid foundations for the study of knowledge transfer in WSI-based cancer prognosis. Source code is available at https://github.com/liupei101/Path-PKT.

The morphometry of a kidney tumor revealed by contrast-enhanced Computed Tomography (CT) imaging is an important factor in clinical decision making surrounding the lesion's diagnosis and treatment. Quantitative study of the relationship between kidney tumor morphology and clinical outcomes is difficult due to data scarcity and the laborious nature of manually quantifying imaging predictors. Automatic semantic segmentation of kidneys and kidney tumors is a promising tool towards automatically quantifying a wide array of morphometric features, but no sizeable annotated dataset is currently available to train models for this task. We present the KiTS19 challenge dataset: A collection of multi-phase CT imaging, segmentation masks, and comprehensive clinical outcomes for 300 patients who underwent nephrectomy for kidney tumors at our center between 2010 and 2018. 210 (70%) of these patients were selected at random as the training set for the 2019 MICCAI KiTS Kidney Tumor Segmentation Challenge and have been released publicly. With the presence of clinical context and surgical outcomes, this data can serve not only for benchmarking semantic segmentation models, but also for developing and studying biomarkers which make use of the imaging and semantic segmentation masks.

Intelligent tutoring agents powered by large language models (LLMs) have been increasingly explored to deliver personalized guidance in areas such as language learning and science education. However, their capabilities in guiding users to solve complex real-world tasks remain underexplored. To address this limitation, in this work, we focus on coding tutoring, a challenging problem that requires tutors to proactively guide students toward completing predefined coding tasks. We propose a novel agent workflow, Trace-and-Verify (TRAVER), which combines knowledge tracing to estimate a student's knowledge state and turn-by-turn verification to ensure effective guidance toward task completion. We introduce DICT, an automatic evaluation protocol that assesses tutor agents holistically using controlled student simulation and code generation tests. Extensive experiments reveal the challenges of coding tutoring and demonstrate that TRAVER achieves a significantly higher success rate. Although we use code tutoring as an example in this paper, our results and findings can be extended beyond coding, providing valuable insights into advancing tutoring agents for a variety of tasks.

There is a widening recognition that cancer cells are products of complex developmental processes. Carcinogenesis and metastasis formation are increasingly described as systems-level, network phenomena. Here we propose that malignant transformation is a two-phase process, where an initial increase of system plasticity is followed by a decrease of plasticity at late stages of carcinogenesis as a model of cellular learning. We describe the hallmarks of increased system plasticity of early, tumor initiating cells, such as increased noise, entropy, conformational and phenotypic plasticity, physical deformability, cell heterogeneity and network rearrangements. Finally, we argue that the large structural changes of molecular networks during cancer development necessitate a rather different targeting strategy in early and late phase of carcinogenesis. Plastic networks of early phase cancer development need a central hit, while rigid networks of late stage primary tumors or established metastases should be attacked by the network influence strategy, such as by edgetic, multi-target, or allo-network drugs. Cancer stem cells need special diagnosis and targeting, since their dormant and rapidly proliferating forms may have more rigid, or more plastic networks, respectively. The extremely high ability to change their rigidity/plasticity may be a key differentiating hallmark of cancer stem cells. The application of early stage-optimized anti-cancer drugs to late-stage patients may be a reason of many failures in anti-cancer therapies. Our hypotheses presented here underlie the need for patient-specific multi-target therapies applying the correct ratio of central hits and network influences -- in an optimized sequence.

The molecular characterization of tumor samples by multiple omics data sets of different types or modalities (e.g. gene expression, mutation, CpG methylation) has become an invaluable source of information for assessing the expected performance of individual drugs and their combinations. Merging the relevant information from the omics data modalities provides the statistical basis for determining suitable therapies for specific cancer patients. Different data modalities may each have their specific structures that need to be taken into account during inference. In this paper, we assume that each omics data modality has a low-rank structure with only few relevant features that affect the prediction and we propose to use a composite local nuclear norm penalization for learning drug sensitivity. Numerical results show that the composite low-rank structure can improve the prediction performance compared to using a global low-rank approach or elastic net regression.

In this work, we introduce the MOldavian and ROmanian Dialectal COrpus (MOROCO), which is freely available for download at https://github.com/butnaruandrei/MOROCO. The corpus contains 33564 samples of text (with over 10 million tokens) collected from the news domain. The samples belong to one of the following six topics: culture, finance, politics, science, sports and tech. The data set is divided into 21719 samples for training, 5921 samples for validation and another 5924 samples for testing. For each sample, we provide corresponding dialectal and category labels. This allows us to perform empirical studies on several classification tasks such as (i) binary discrimination of Moldavian versus Romanian text samples, (ii) intra-dialect multi-class categorization by topic and (iii) cross-dialect multi-class categorization by topic. We perform experiments using a shallow approach based on string kernels, as well as a novel deep approach based on character-level convolutional neural networks containing Squeeze-and-Excitation blocks. We also present and analyze the most discriminative features of our best performing model, before and after named entity removal.