Background: Serious gaming has increasingly gained attention as a potential new component in clinical practice. Specifically, its use in the rehabilitation of motor dysfunctions has been intensively researched during the past three decades. Objective: The aim of this scoping review was to evaluate the current role of serious games in upper extremity rehabilitation, and to identify common methods and practice as well as technology patterns. This objective was approached via the exploration of published research efforts over time. Methods: The literature search, using the PubMed and Scopus databases, included articles published from 1999 to 2019. The eligibility criteria were (i) any form of game-based arm rehabilitation; (ii) published in a peer-reviewed journal or conference; (iii) introduce a game in an electronic format; (iv) published in English; and (v) not a review, meta-analysis, or conference The search strategy identified 169 relevant articles. Results: The results indicated an increasing research trend in the domain of serious gaming deployment in upper extremity rehabilitation. Furthermore, differences regarding the number of publications and the game approach were noted between studies that used commercial devices in their rehabilitation systems and those that proposed a custom-made robotic arm, glove, or other devices for the connection and interaction with the game platform. A particularly relevant observation concerns the evaluation of the introduced systems. Although one-third of the studies evaluated their implementations with patients, in most cases, there is the need for a larger number of participants and better testing of the rehabilitation scheme efficiency over time. Most of the studies that included some form of assessment for the introduced rehabilitation game mentioned user experience as one of the factors considered for evaluation of the system. Besides user experience assessment, the most common evaluation method involving patients was the use of standard medical tests. Finally, a few studies attempted to extract game features to introduce quantitative measurements for the evaluation of patient improvement. Conclusions: This paper presents an overview of a significant research topic and highlights the current state of the field. Despite extensive attempts for the development of gamified rehabilitation systems, there is no definite answer as to whether a serious game is a favorable means for upper extremity functionality improvement; however, this certainly constitutes a supplementary means for motivation. The development of a unified performance quantification framework and more extensive experiments could generate richer evidence and contribute toward this direction.

Motor learning is based on the correct repetition of specific movements for their permanent storage in the central nervous system (CNS). Rehabilitation relies heavily on the repetition of specific movements, and game scenarios are ideal environments to build routines of repetitive exercises that have entertaining characteristics. In this respect, the gamification of the rehabilitation program, through the introduction of game-specific techniques and design concepts, has gained attention as a complementary or alternative to routine rehabilitation programs. A gamified rehabilitation program promises to gain the patient's attention, to reduce the monotony of the process and preserve motivation to attend, and to create virtual incentives through the game, toward maintaining compliance to the “prescribed” program. This is often achieved through goal-oriented tasks and real-time feedback in the form of points and other in-game rewards. This paper describes MILORD rehabilitation platform, an affordable technological solution, which aims to support health professionals and enable remote rehabilitation, while maintaining health service characteristics and monitoring. MILORD is an end-to-end platform that consists of an interactive computer game, utilizing a leap motion sensor, a centralized user management system, an analysis platform that processes the data generated by the game, and an analysis dashboard presenting a set of meaningful features that describe upper limb movement. Our solution facilitates the monitoring of the patients' progress and provides an alternative way to analyze hand movement. The system was tested with normal subjects and patients and experts to record user's experience, receive feedback, identify any problems, and understand the system's value in monitoring and support motion defect and progress. This small-scale study indicated the capacity of the analysis to quantify the movement in a meaningful way and express the differences between normal and pathological movement, and the user experience was positive with both patients and normal subjects.

Prostate cancer (PCa) is the second more common cancer type in men, and the need for a non-invasive PCa diagnostic and stratification tool can now be met via quantified analysis of Multiparametric MRI. Radiomics analysis can quantify imaging information on a Region of Interest (ROI), not visible by clinicians and thus improve cancer detection. However, the delineation of cancer lesions is both challenging and time consuming. In this paper, we consider as area in focus the whole prostate gland as segmented by high performance deep learning algorithms, calculate whole gland radiomics features and employ them to develop machine learning models for the identification of clinically significant Pca (csPCa). T2 weighted and diffusion weighted images from 1500 patients were used for model development and validation. The radiomic features from the prostate gland’s core, periphery and whole volume were extracted. The radiomic features were harmonized against vendor batch effect using statistical methods and a robust repeated elastic net method was employed for feature selection. Clinical data were also considered to improve model performance. Finally, Support Vector Machines and Balanced Random Forest (BRF) models were developed, and the validation step was repeated 5 times by splitting the whole dataset in 1:3 ratio in each iteration. A balanced accuracy of 79% was achieved for the SVM using radiomics from the whole prostate gland. The final model’s good performance highlights the value of whole gland radiomics for the identification of csPCa.

Cancer remains a major global health challenge, affecting diverse populations across various demographics. Integrating Artificial Intelligence (AI) into clinical settings to enhance disease outcome prediction presents notable challenges. This study addresses the limitations of AI-driven cancer care due to low-quality datasets by proposing a comprehensive three-step methodology to ensure high data quality in large-scale cancer-imaging repositories. Our methodology encompasses (i) developing a Data Quality Conceptual Model with specific metrics for assessment, (ii) creating a detailed data-collection protocol and a rule set to ensure data homogeneity and proper integration of multi-source data, and (iii) implementing a Data Integration Quality Check Tool (DIQCT) to verify adherence to quality requirements and suggest corrective actions. These steps are designed to mitigate biases, enhance data integrity, and ensure that integrated data meets high-quality standards. We applied this methodology within the INCISIVE project, an EU-funded initiative aimed at a pan-European cancer-imaging repository. The use-case demonstrated the effectiveness of our approach in defining quality rules and assessing compliance, resulting in improved data integration and higher data quality. The proposed methodology can assist the deployment of big data centralized or distributed repositories with data from diverse data sources, thus facilitating the development of AI tools.

Background: Explainable artificial intelligence (xAI) is increasingly used in medical imaging to enhance transparency, clinical interpretability, and trust in artificial intelligence (AI)–assisted diagnostics, particularly in oncology. Evidence on how explainability is implemented, validated, and reported in cancer imaging remains fragmented. Objective: This scoping review aimed to systematically map research applying xAI methods to radiologic cancer imaging, summarize methodological and clinical trends, and identify persistent gaps in validation and integration. Methods: We conducted a structured search of PubMed and Scopus (final search executed on October 20, 2025), covering studies published from 2017 to December 2024. Eligible peer-reviewed articles using machine learning or deep learning were analyzed with a focus on xAI components. Data from 371 studies were extracted into predefined categories covering cancer type, imaging modality, AI model, xAI method, terminology, validation, code availability, and decision support system integration. Results: Studies focused primarily on breast (112/371, 30.2%), lung (87/371, 23.5%), and brain (56/371, 15.1%) cancers, with prostate, thyroid, and liver cancers also represented. The primary imaging modalities were computed tomography (139/371, 37.5%) and magnetic resonance imaging (104/371, 28%). Deep learning was used in 70.1% (260/371) of studies, classical machine learning in 18.1% (67/371), hybrid pipeline methods for 10% (37/371), and emerging concept-, prototype-, or causal-based approaches accounted for 1.9% (7/371) of studies. Post hoc xAI methods were dominant (305/371, 82.2%), with visualization (163/371, 53.4%), and feature relevance (111/371, 36.4%) as the most common subcategories. Hybrid post hoc or inherent approaches comprised 12.1% (45/371) and intrinsically interpretable methods 5.7% (21/371). Data sources were mostly public (149/371, 40.2%) or mixed (100/371, 26.9%); 22.9% (85/371) used private institutional datasets, and 7.8% (29/371) did not report data sources. Among validated studies, expert or user-based validation was most common (104/193, 53.9%), followed by mixed methods (74/193, 38.3%), while quantitative metrics (10/193, 5.2%) and clinical knowledge–based (8/193, 4.1%) validation remained rare. Only 17.5% (65/371) of studies provided code and 12.1% (45/371) reported decision support system integration, with few achieving actual clinical deployment. Conclusions: This scoping review maps xAI implementation across multiple cancer imaging modalities, revealing methodological inconsistency and insufficient validation. Most research emphasizes visualization over quantitative interpretability, and few models are reproducible or clinically implemented. These findings provide an evidence base for researchers, clinicians, and regulators to prioritize standardization of xAI reporting, quantitative validation, and user-centered frameworks to advance trustworthy AI in oncology imaging.

Background/Objectives: Cancer remains a leading global cause of death, with breast, lung, colorectal, and prostate cancers being among the most prevalent. The integration of Artificial Intelligence (AI) into cancer imaging research offers opportunities for earlier diagnosis and personalized treatment. However, the effectiveness of AI models depends critically on the quality, standardization, and fairness of the input data. The EU-funded INCISIVE project aimed to create a federated, pan-European repository of imaging and clinical data for cancer cases, with a key objective to develop a robust framework for pre-validating data prior to its use in AI development. Methods: We propose a data validation framework to assess clinical (meta)data and imaging data across five dimensions: completeness, validity, consistency, integrity, and fairness. The framework includes procedures for deduplication, annotation verification, DICOM metadata analysis, and anonymization compliance. Results: The pre-validation process identified key data quality issues, such as missing clinical information, inconsistent formatting, and subgroup imbalances, while also demonstrating the added value of structured data entry and standardized protocols. Conclusions: This structured framework addresses common challenges in curating large-scale, multimodal medical data. By applying this approach, the INCISIVE project ensures data quality, interoperability, and equity, providing a transferable model for future health data repositories supporting AI research in oncology.