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Aug 11

Age Progression/Regression by Conditional Adversarial Autoencoder

"If I provide you a face image of mine (without telling you the actual age when I took the picture) and a large amount of face images that I crawled (containing labeled faces of different ages but not necessarily paired), can you show me what I would look like when I am 80 or what I was like when I was 5?" The answer is probably a "No." Most existing face aging works attempt to learn the transformation between age groups and thus would require the paired samples as well as the labeled query image. In this paper, we look at the problem from a generative modeling perspective such that no paired samples is required. In addition, given an unlabeled image, the generative model can directly produce the image with desired age attribute. We propose a conditional adversarial autoencoder (CAAE) that learns a face manifold, traversing on which smooth age progression and regression can be realized simultaneously. In CAAE, the face is first mapped to a latent vector through a convolutional encoder, and then the vector is projected to the face manifold conditional on age through a deconvolutional generator. The latent vector preserves personalized face features (i.e., personality) and the age condition controls progression vs. regression. Two adversarial networks are imposed on the encoder and generator, respectively, forcing to generate more photo-realistic faces. Experimental results demonstrate the appealing performance and flexibility of the proposed framework by comparing with the state-of-the-art and ground truth.

  • 3 authors
·
Feb 27, 2017

PRETI: Patient-Aware Retinal Foundation Model via Metadata-Guided Representation Learning

Retinal foundation models have significantly advanced retinal image analysis by leveraging self-supervised learning to reduce dependence on labeled data while achieving strong generalization. Many recent approaches enhance retinal image understanding using report supervision, but obtaining clinical reports is often costly and challenging. In contrast, metadata (e.g., age, gender) is widely available and serves as a valuable resource for analyzing disease progression. To effectively incorporate patient-specific information, we propose PRETI, a retinal foundation model that integrates metadata-aware learning with robust self-supervised representation learning. We introduce Learnable Metadata Embedding (LME), which dynamically refines metadata representations. Additionally, we construct patient-level data pairs, associating images from the same individual to improve robustness against non-clinical variations. To further optimize retinal image representation, we propose Retina-Aware Adaptive Masking (RAAM), a strategy that selectively applies masking within the retinal region and dynamically adjusts the masking ratio during training. PRETI captures both global structures and fine-grained pathological details, resulting in superior diagnostic performance. Extensive experiments demonstrate that PRETI achieves state-of-the-art results across diverse diseases and biomarker predictions using in-house and public data, indicating the importance of metadata-guided foundation models in retinal disease analysis. Our code and pretrained model are available at https://github.com/MICV-yonsei/PRETI

  • 6 authors
·
May 17, 2025

Estimating sex and age for forensic applications using machine learning based on facial measurements from frontal cephalometric landmarks

Facial analysis permits many investigations some of the most important of which are craniofacial identification, facial recognition, and age and sex estimation. In forensics, photo-anthropometry describes the study of facial growth and allows the identification of patterns in facial skull development by using a group of cephalometric landmarks to estimate anthropological information. In several areas, automation of manual procedures has achieved advantages over and similar measurement confidence as a forensic expert. This manuscript presents an approach using photo-anthropometric indexes, generated from frontal faces cephalometric landmarks, to create an artificial neural network classifier that allows the estimation of anthropological information, in this specific case age and sex. The work is focused on four tasks: i) sex estimation over ages from 5 to 22 years old, evaluating the interference of age on sex estimation; ii) age estimation from photo-anthropometric indexes for four age intervals (1 year, 2 years, 4 years and 5 years); iii) age group estimation for thresholds of over 14 and over 18 years old; and; iv) the provision of a new data set, available for academic purposes only, with a large and complete set of facial photo-anthropometric points marked and checked by forensic experts, measured from over 18,000 faces of individuals from Brazil over the last 4 years. The proposed classifier obtained significant results, using this new data set, for the sex estimation of individuals over 14 years old, achieving accuracy values greater than 0.85 by the F_1 measure. For age estimation, the accuracy results are 0.72 for measure with an age interval of 5 years. For the age group estimation, the measures of accuracy are greater than 0.93 and 0.83 for thresholds of 14 and 18 years, respectively.

  • 7 authors
·
Aug 6, 2019

Can a Teenager Fool an AI? Evaluating Low-Cost Cosmetic Attacks on Age Estimation Systems

Age estimation systems are increasingly deployed as gatekeepers for age-restricted online content, yet their robustness to cosmetic modifications has not been systematically evaluated. We investigate whether simple, household-accessible cosmetic changes, including beards, grey hair, makeup, and simulated wrinkles, can cause AI age estimators to classify minors as adults. To study this threat at scale without ethical concerns, we simulate these physical attacks on 329 facial images of individuals aged 10 to 21 using a VLM image editor (Gemini 2.5 Flash Image). We then evaluate eight models from our prior benchmark: five specialized architectures (MiVOLO, Custom-Best, Herosan, MiViaLab, DEX) and three vision-language models (Gemini 3 Flash, Gemini 2.5 Flash, GPT-5-Nano). We introduce the Attack Conversion Rate (ACR), defined as the fraction of images predicted as minor at baseline that flip to adult after attack, a population-agnostic metric that does not depend on the ratio of minors to adults in the test set. Our results reveal that a synthetic beard alone achieves 28 to 69 percent ACR across all eight models; combining all four attacks shifts predicted age by +7.7 years on average across all 329 subjects and reaches up to 83 percent ACR; and vision-language models exhibit lower ACR (59 to 71 percent) than specialized models (63 to 83 percent) under the full attack, although the ACR ranges overlap and the difference is not statistically tested. These findings highlight a critical vulnerability in deployed age-verification pipelines and call for adversarial robustness evaluation as a mandatory criterion for model selection.

  • 9 authors
·
Feb 22

Enhancing Spatiotemporal Disease Progression Models via Latent Diffusion and Prior Knowledge

In this work, we introduce Brain Latent Progression (BrLP), a novel spatiotemporal disease progression model based on latent diffusion. BrLP is designed to predict the evolution of diseases at the individual level on 3D brain MRIs. Existing deep generative models developed for this task are primarily data-driven and face challenges in learning disease progressions. BrLP addresses these challenges by incorporating prior knowledge from disease models to enhance the accuracy of predictions. To implement this, we propose to integrate an auxiliary model that infers volumetric changes in various brain regions. Additionally, we introduce Latent Average Stabilization (LAS), a novel technique to improve spatiotemporal consistency of the predicted progression. BrLP is trained and evaluated on a large dataset comprising 11,730 T1-weighted brain MRIs from 2,805 subjects, collected from three publicly available, longitudinal Alzheimer's Disease (AD) studies. In our experiments, we compare the MRI scans generated by BrLP with the actual follow-up MRIs available from the subjects, in both cross-sectional and longitudinal settings. BrLP demonstrates significant improvements over existing methods, with an increase of 22% in volumetric accuracy across AD-related brain regions and 43% in image similarity to the ground-truth scans. The ability of BrLP to generate conditioned 3D scans at the subject level, along with the novelty of integrating prior knowledge to enhance accuracy, represents a significant advancement in disease progression modeling, opening new avenues for precision medicine. The code of BrLP is available at the following link: https://github.com/LemuelPuglisi/BrLP.

  • 3 authors
·
May 6, 2024

Artificial Intelligence-derived Vascular Age from Photoplethysmography: A Novel Digital Biomarker for Cardiovascular Health

With the increasing availability of wearable devices, photoplethysmography (PPG) has emerged as a promising non-invasive tool for monitoring human hemodynamics. We propose a deep learning framework to estimate vascular age (AI-vascular age) from PPG signals, incorporating a distribution-aware loss to address biases caused by imbalanced data. The model was developed using data from the UK Biobank (UKB), with 98,672 participants in the development cohort and 113,559 participants (144,683 data pairs) for clinical evaluation. After adjusting for key confounders, individuals with a vascular age gap (AI-vascular age minus calendar age) exceeding 9 years had a significantly higher risk of major adverse cardiovascular and cerebrovascular events (MACCE) (HR = 2.37, p < 0.005) and secondary outcomes, including diabetes (HR = 2.69, p < 0.005), hypertension (HR = 2.88, p < 0.005), coronary heart disease (HR = 2.20, p < 0.005), heart failure (HR = 2.15, p < 0.005), myocardial infarction (HR = 2.51, p < 0.005), stroke (HR = 2.55, p < 0.005), and all-cause mortality (HR = 2.51, p < 0.005). Conversely, participants with a vascular age gap below -9 years exhibited a significantly lower incidence of these outcomes. We further evaluated the longitudinal applicability of AI-vascular age using serial PPG data from the UKB, demonstrating its value in risk stratification by leveraging AI-vascular age at two distinct time points to predict future MACCE incidence. External validation was performed on a MIMIC-III-derived cohort (n = 2,343), where each one-year increase in vascular age gap was significantly associated with elevated in-hospital mortality risk (OR = 1.02, p < 0.005). In conclusion, our study establishes AI-vascular age as a novel, non-invasive digital biomarker for cardiovascular health assessment.

  • 5 authors
·
Feb 18, 2025

Gender-Dependent Diagnostic Substitution in LLM Medical Triage: Same Symptoms, Unequal Urgency

We investigate whether large language models produce different medical triage recommendations for identical neurological symptoms when only the patient's stated gender and age vary. Using three model families--Gemini 3.5 Flash, Claude Sonnet 4.6, and GPT-5.4-mini--we present a standardized symptom profile (persistent headache, blurred vision, morning nausea, visual disturbances) across seven demographic conditions: three age groups (25, 38, 65) x two genders (male, female), plus a gender-unspecified baseline (n = 30 per condition per model, 630 total trials). We find a stark, systemic gender-dependent triage disparity: young women receive significantly lower emergency room (ER) referral rates than age-matched men (Gemini: 0% vs. 23.3%; Claude: 6.7% vs. 96.7%; GPT: 6.7% vs. 66.7%, all p < 0.001). The disparity disappears at age 65 for all models. The primary mechanism is diagnostic substitution: the models anchor on a gender-associated diagnosis, preferentially classifying young women with Idiopathic Intracranial Hypertension (IIH)--a condition epidemiologically linked to women of childbearing age--while diagnosing men with generic increased intracranial pressure with space-occupying lesions in the differential. This diagnostic closure routes female patients to lower-urgency care (outpatient doctor appointments) despite comparable severity ratings (7-9/10). Our findings demonstrate that clinical LLMs replicate documented human clinical biases by using epidemiological priors to suppress triage urgency, suggesting that AI triage engines must decouple urgency assessment from probabilistic diagnostic priors. We release all code, prompts, and raw results.

  • 1 authors
·
Jun 1

SynthBA: Reliable Brain Age Estimation Across Multiple MRI Sequences and Resolutions

Brain age is a critical measure that reflects the biological ageing process of the brain. The gap between brain age and chronological age, referred to as brain PAD (Predicted Age Difference), has been utilized to investigate neurodegenerative conditions. Brain age can be predicted using MRIs and machine learning techniques. However, existing methods are often sensitive to acquisition-related variabilities, such as differences in acquisition protocols, scanners, MRI sequences, and resolutions, significantly limiting their application in highly heterogeneous clinical settings. In this study, we introduce Synthetic Brain Age (SynthBA), a robust deep-learning model designed for predicting brain age. SynthBA utilizes an advanced domain randomization technique, ensuring effective operation across a wide array of acquisition-related variabilities. To assess the effectiveness and robustness of SynthBA, we evaluate its predictive capabilities on internal and external datasets, encompassing various MRI sequences and resolutions, and compare it with state-of-the-art techniques. Additionally, we calculate the brain PAD in a large cohort of subjects with Alzheimer's Disease (AD), demonstrating a significant correlation with AD-related measures of cognitive dysfunction. SynthBA holds the potential to facilitate the broader adoption of brain age prediction in clinical settings, where re-training or fine-tuning is often unfeasible. The SynthBA source code and pre-trained models are publicly available at https://github.com/LemuelPuglisi/SynthBA.

  • 6 authors
·
Jun 1, 2024

TotalSegmentator: robust segmentation of 104 anatomical structures in CT images

We present a deep learning segmentation model that can automatically and robustly segment all major anatomical structures in body CT images. In this retrospective study, 1204 CT examinations (from the years 2012, 2016, and 2020) were used to segment 104 anatomical structures (27 organs, 59 bones, 10 muscles, 8 vessels) relevant for use cases such as organ volumetry, disease characterization, and surgical or radiotherapy planning. The CT images were randomly sampled from routine clinical studies and thus represent a real-world dataset (different ages, pathologies, scanners, body parts, sequences, and sites). The authors trained an nnU-Net segmentation algorithm on this dataset and calculated Dice similarity coefficients (Dice) to evaluate the model's performance. The trained algorithm was applied to a second dataset of 4004 whole-body CT examinations to investigate age dependent volume and attenuation changes. The proposed model showed a high Dice score (0.943) on the test set, which included a wide range of clinical data with major pathologies. The model significantly outperformed another publicly available segmentation model on a separate dataset (Dice score, 0.932 versus 0.871, respectively). The aging study demonstrated significant correlations between age and volume and mean attenuation for a variety of organ groups (e.g., age and aortic volume; age and mean attenuation of the autochthonous dorsal musculature). The developed model enables robust and accurate segmentation of 104 anatomical structures. The annotated dataset (https://doi.org/10.5281/zenodo.6802613) and toolkit (https://www.github.com/wasserth/TotalSegmentator) are publicly available.

  • 12 authors
·
Aug 11, 2022

Out of the box age estimation through facial imagery: A Comprehensive Benchmark of Vision-Language Models vs. out-of-the-box Traditional Architectures

Facial age estimation plays a critical role in content moderation, age verification, and deepfake detection. However, no prior benchmark has systematically compared modern vision-language models (VLMs) with specialized age estimation architectures. We present the first large-scale cross-paradigm benchmark, evaluating 34 models - 22 specialized architectures with publicly available pretrained weights and 12 general-purpose VLMs - across eight standard datasets (UTKFace, IMDB-WIKI, MORPH, AFAD, CACD, FG-NET, APPA-REAL, and AgeDB), totaling 1,100 test images per model. Our key finding is striking: zero-shot VLMs significantly outperform most specialized models, achieving an average mean absolute error (MAE) of 5.65 years compared to 9.88 years for non-LLM models. The best-performing VLM (Gemini 3 Flash Preview, MAE 4.32) surpasses the strongest non-LLM model (MiVOLO, MAE 5.10) by 15%. MiVOLO - unique in combining face and body features using Vision Transformers - is the only specialized model that remains competitive with VLMs. We further analyze age verification at the 18-year threshold and find that most non-LLM models exhibit false adult rates between 39% and 100% for minors, whereas VLMs reduce this to 16%-29%. Additionally, coarse age binning (8-9 classes) consistently increases MAE beyond 13 years. Stratified analysis across 14 age groups reveals that all models struggle most at extreme ages (under 5 and over 65). Overall, these findings challenge the assumption that task-specific architectures are necessary for high-performance age estimation and suggest that future work should focus on distilling VLM capabilities into efficient specialized models.

  • 11 authors
·
Feb 10

From Cradle to Cane: A Two-Pass Framework for High-Fidelity Lifespan Face Aging

Face aging has become a crucial task in computer vision, with applications ranging from entertainment to healthcare. However, existing methods struggle with achieving a realistic and seamless transformation across the entire lifespan, especially when handling large age gaps or extreme head poses. The core challenge lies in balancing age accuracy and identity preservation--what we refer to as the Age-ID trade-off. Most prior methods either prioritize age transformation at the expense of identity consistency or vice versa. In this work, we address this issue by proposing a two-pass face aging framework, named Cradle2Cane, based on few-step text-to-image (T2I) diffusion models. The first pass focuses on solving age accuracy by introducing an adaptive noise injection (AdaNI) mechanism. This mechanism is guided by including prompt descriptions of age and gender for the given person as the textual condition. Also, by adjusting the noise level, we can control the strength of aging while allowing more flexibility in transforming the face. However, identity preservation is weakly ensured here to facilitate stronger age transformations. In the second pass, we enhance identity preservation while maintaining age-specific features by conditioning the model on two identity-aware embeddings (IDEmb): SVR-ArcFace and Rotate-CLIP. This pass allows for denoising the transformed image from the first pass, ensuring stronger identity preservation without compromising the aging accuracy. Both passes are jointly trained in an end-to-end way. Extensive experiments on the CelebA-HQ test dataset, evaluated through Face++ and Qwen-VL protocols, show that our Cradle2Cane outperforms existing face aging methods in age accuracy and identity consistency. Code is available at https://github.com/byliutao/Cradle2Cane.

  • 10 authors
·
Jun 25, 2025

Enforcing temporal consistency in Deep Learning segmentation of brain MR images

Longitudinal analysis has great potential to reveal developmental trajectories and monitor disease progression in medical imaging. This process relies on consistent and robust joint 4D segmentation. Traditional techniques are dependent on the similarity of images over time and the use of subject-specific priors to reduce random variation and improve the robustness and sensitivity of the overall longitudinal analysis. This is however slow and computationally intensive as subject-specific templates need to be rebuilt every time. The focus of this work to accelerate this analysis with the use of deep learning. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The proposed approach is based on deep CNNs and incorporates semantic segmentation and provides a longitudinal relationship for the same subject. The state of art using 3D patches as inputs to modified Unet provides results around {0.91 pm 0.5} Dice and using multi-view atlas in CNNs provide around the same results. In this work, different models are explored, each offers better accuracy and fast results while increasing the segmentation quality. These methods are evaluated on 135 scans from the EADC-ADNI Harmonized Hippocampus Protocol. Proposed CNN based segmentation approaches demonstrate how 2D segmentation using prior slices can provide similar results to 3D segmentation while maintaining good continuity in the 3D dimension and improved speed. Just using 2D modified sagittal slices provide us a better Dice and longitudinal analysis for a given subject. For the ADNI dataset, using the simple UNet CNN technique gives us {0.84 pm 0.5} and while using modified CNN techniques on the same input yields {0.89 pm 0.5}. Rate of atrophy and RMS error are calculated for several test cases using various methods and analyzed.

  • 2 authors
·
Jun 13, 2019

Predicting life satisfaction using machine learning and explainable AI

Life satisfaction is a crucial facet of human well-being. Hence, research on life satisfaction is incumbent for understanding how individuals experience their lives and influencing interventions targeted at enhancing mental health and well-being. Life satisfaction has traditionally been measured using analog, complicated, and frequently error-prone methods. These methods raise questions concerning validation and propagation. However, this study demonstrates the potential for machine learning algorithms to predict life satisfaction with a high accuracy of 93.80% and a 73.00% macro F1-score. The dataset comes from a government survey of 19000 people aged 16-64 years in Denmark. Using feature learning techniques, 27 significant questions for assessing contentment were extracted, making the study highly reproducible, simple, and easily interpretable. Furthermore, clinical and biomedical large language models (LLMs) were explored for predicting life satisfaction by converting tabular data into natural language sentences through mapping and adding meaningful counterparts, achieving an accuracy of 93.74% and macro F1-score of 73.21%. It was found that life satisfaction prediction is more closely related to the biomedical domain than the clinical domain. Ablation studies were also conducted to understand the impact of data resampling and feature selection techniques on model performance. Moreover, the correlation between primary determinants with different age brackets was analyzed, and it was found that health condition is the most important determinant across all ages. This study demonstrates how machine learning, large language models and XAI can jointly contribute to building trust and understanding in using AI to investigate human behavior, with significant ramifications for academics and professionals working to quantify and comprehend subjective well-being.

  • 5 authors
·
Oct 17, 2025

SynthRAD2023 Grand Challenge dataset: generating synthetic CT for radiotherapy

Purpose: Medical imaging has become increasingly important in diagnosing and treating oncological patients, particularly in radiotherapy. Recent advances in synthetic computed tomography (sCT) generation have increased interest in public challenges to provide data and evaluation metrics for comparing different approaches openly. This paper describes a dataset of brain and pelvis computed tomography (CT) images with rigidly registered CBCT and MRI images to facilitate the development and evaluation of sCT generation for radiotherapy planning. Acquisition and validation methods: The dataset consists of CT, CBCT, and MRI of 540 brains and 540 pelvic radiotherapy patients from three Dutch university medical centers. Subjects' ages ranged from 3 to 93 years, with a mean age of 60. Various scanner models and acquisition settings were used across patients from the three data-providing centers. Details are available in CSV files provided with the datasets. Data format and usage notes: The data is available on Zenodo (https://doi.org/10.5281/zenodo.7260705) under the SynthRAD2023 collection. The images for each subject are available in nifti format. Potential applications: This dataset will enable the evaluation and development of image synthesis algorithms for radiotherapy purposes on a realistic multi-center dataset with varying acquisition protocols. Synthetic CT generation has numerous applications in radiation therapy, including diagnosis, treatment planning, treatment monitoring, and surgical planning.

  • 9 authors
·
Mar 28, 2023