Search

Accurate segmentation of breast masses in mammogram images is essential for early cancer diagnosis and treatment planning. Several deep learning (DL) models have been proposed for whole mammogram segmentation and mass patch/crop segmentation. However, current DL models for breast mammogram mass segmentation face several limitations, including false positives (FPs), false negatives (FNs), and challenges with the end‐to‐end approach. This paper presents a novel two‐stage end‐to‐end cascaded breast mass segmentation framework that incorporates a saliency map of potential mass regions to guide the DL models for breast mass segmentation. The first‐stage segmentation model of the cascade framework is used to generate a saliency map to establish a coarse region of interest (ROI), effectively narrowing the focus to probable mass regions. The proposed presegmenter attention (PSA) blocks are introduced in the second‐stage segmentation model to enable dynamic adaptation to the most informative regions within the mammogram images based on the generated saliency map. Comparative analysis of the Attention U‐net model with and without the cascade framework is provided in terms of dice scores, precision, recall, FP rates (FPRs), and FN outcomes. Experimental results consistently demonstrate enhanced breast mass segmentation performance by the proposed cascade framework across all three datasets: INbreast, CSAW‐S, and DMID. The cascade framework shows superior segmentation performance by improving the dice score by about 6% for the INbreast dataset, 3% for the CSAW‐S dataset, and 2% for the DMID dataset. Similarly, the FN outcomes were reduced by 10% for the INbreast dataset, 19% for the CSAW‐S dataset, and 4% for the DMID dataset. Moreover, the proposed cascade framework's performance is validated with varying state‐of‐the‐art segmentation models such as DeepLabV3+ and Swin transformer U‐net. The presegmenter cascade framework has the potential to improve segmentation performance and mitigate FNs when integrated with any medical image segmentation framework, irrespective of the choice of the model. [ABSTRACT FROM AUTHOR]

Chronic rhinosinusitis (CRS) is a global disease characterized by poor treatment outcomes and high recurrence rates, significantly affecting patients' quality of life. Due to its complex pathophysiology and diverse clinical presentations, CRS is categorized into various subtypes to facilitate more precise diagnosis, treatment, and prognosis prediction. Among these, CRS with nasal polyps (CRSwNP) is further divided into eosinophilic CRSwNP (eCRSwNP) and noneosinophilic CRSwNP (non‐eCRSwNP). However, there is a lack of precise predictive diagnostic and treatment methods, making research into accurate diagnostic techniques for CRSwNP endotypes crucial for achieving precision medicine in CRSwNP. This paper proposes a method using multiangle sinus computed tomography (CT) images combined with artificial intelligence (AI) to predict CRSwNP endotypes, distinguishing between patients with eCRSwNP and non‐eCRSwNP. The considered dataset comprises 22,265 CT images from 192 CRSwNP patients, including 13,203 images from non‐eCRSwNP patients and 9,062 images from eCRSwNP patients. Test results from the network model demonstrate that multiangle images provide more useful information for the network, achieving an accuracy of 98.43%, precision of 98.1%, recall of 98.1%, specificity of 98.7%, and an AUC value of 0.984. Compared to the limited learning capacity of single‐channel neural networks, our proposed multichannel feature adaptive fusion model captures multiscale spatial features, enhancing the model's focus on crucial sinus information within the CT images to maximize detection accuracy. This deep learning‐based diagnostic model for CRSwNP endotypes offers excellent classification performance, providing a noninvasive method for accurately predicting CRSwNP endotypes before treatment and paving the way for precision medicine in the new era of CRSwNP. [ABSTRACT FROM AUTHOR]

This paper extends our previous method for COVID-19 diagnosis, proposing an enhanced solution for detecting COVID-19 from computed tomography (CT) images using a lean transfer learning-based model. To decrease model misclassifications, two key steps of image processing were employed. Firstly, the uppermost and lowermost slices were removed, preserving sixty percent of each patient's slices. Secondly, all slices underwent manual cropping to emphasize the lung areas. Subsequently, resized CT scans (224 × 224) were input into an Xception transfer learning model with a modified output. Both Xception's architecture and pretrained weights were leveraged in the method. A big and rigorously annotated database of CT images was used to verify the method. The number of patients/subjects in the dataset is more than 5000, and the number and shape of the slices in each CT scan varies greatly. Verification was made both on the validation partition and on the test partition of unseen images. Results on the COV19-CT database showcased not only improvement from our previous solution and the baseline but also comparable performance to the highest-achieving methods on the same dataset. Further validation studies could explore the scalability and adaptability of the developed methodologies across diverse healthcare settings and patient populations. Additionally, investigating the integration of advanced image processing techniques, such as automated region of interest detection and segmentation algorithms, could enhance the efficiency and accuracy of COVID-19 diagnosis. [ABSTRACT FROM AUTHOR]

Background. The deterministic fiber tracking method has the advantage of high computational efficiency and good repeatability, making it suitable for the noninvasive estimation of brain structural connectivity in clinical fields. To address the issue of the current classical deterministic method tending to deviate in the tracking direction in the region of crossing fiber region, in this paper, we propose an adaptive correction-based deterministic white matter fiber tracking method, named FTACTD. Methods. The proposed FTACTD method can accurately track white matter fibers by adaptively adjusting the deflection direction strategy based on the tensor matrix and the input fiber direction of adjacent voxels. The degree of correction direction changes adaptively according to the shape of the diffusion tensor, mimicking the actual tracking deflection angle and direction. Furthermore, both forward and reverse tracking techniques are employed to track the entire fiber. The effectiveness of the proposed method is validated and quantified using both simulated and real brain datasets. Various indicators such as invalid bundles (IB), valid bundles (VB), invalid connections (IC), no connections (NC), and valid connections (VC) are utilized to assess the performance of the proposed method on simulated data and real diffusion-weighted imaging (DWI) data. Results. The experimental results of the simulated data show that the FTACTD method tracks outperform existing methods, achieving the highest number of VB with a total of 13 bundles. Additionally, it identifies the least number of incorrect fiber bundles, with only 32 bundles identified as wrong. Compared to the FACT method, the FTACTD method reduces the number of NC by 36.38%. In terms of VC, the FTACTD method surpasses even the best performing SD_Stream method among deterministic methods by 1.64%. Extensive in vivo experiments demonstrate the superiority of the proposed method in terms of tracking more accurate and complete fiber paths, resulting in improved continuity. Conclusion. The FTACTD method proposed in this study indicates superior tracking results and provides a methodological basis for the investigating, diagnosis, and treatment of brain disorders associated with white matter fiber deficits and abnormalities. [ABSTRACT FROM AUTHOR]

Purpose. Surgical resection is the only curative option for pancreatic carcinoma, but disease‐free and overall survival times after surgery are limited due to early tumor recurrence, most often originating from local microscopic tumor residues (R1 resection). The intraoperative identification of microscopic tumor residues within the resection margin in situ could improve surgical performance. The aim of this study was to evaluate the effectiveness of fiber‐optic microscopy for detecting microscopic residues in vital pancreatic cancer tissues. Experimental Design. Fresh whole‐mount human pancreatic tissues, histological tissue slides, cell culture, and chorioallantoic membrane xenografts were analyzed. Specimens were stained with selected fluorophore‐conjugated antibodies and studied using conventional wide‐field and self‐designed multicolor fiber‐optic fluorescence microscopy instruments. Results. Whole‐mount vital human tissues and xenografts were stained and imaged using an in situ immunofluorescence protocol. Fiber‐optic microscopy enabled the detection of epitope‐based fluorescence in vital whole‐mount tissue using fluorophore‐conjugated antibodies and enabled visualization of microvascular, epithelial, and malignant tumor cells. Among the selected antigen‐antibody pairs, antibody clones WM59, AY13, and 9C4 were the most promising for fiber‐optic imaging in human tissue samples and for endothelial, tumor and epithelial cell detection. Conclusions. Fresh dissected whole‐mount tissue can be stained using direct exposure to selected antibody clones. Several antibody clones were identified that provided excellent immunofluorescence imaging of labeled structures, such as endothelial, epithelial, or EGFR‐expressing cells. The combination of in situ immunofluorescence staining and fiber‐optic microscopy visualizes structures in vital tissues and could be proposed as an useful tool for the in situ identification of residual tumor mass in patients with a high operative risk for incomplete resection. [ABSTRACT FROM AUTHOR]

We present a deep learning-based method that corrects motion artifacts and thus accelerates data acquisition and reconstruction of magnetic resonance images. The novel model, the Motion Artifact Correction by Swin Network (MACS-Net), uses a Swin transformer layer as the fundamental block and the Unet architecture as the neural network backbone. We employ a hierarchical transformer with shifted windows to extract multiscale contextual features during encoding. A new dual upsampling technique is employed to enhance the spatial resolutions of feature maps in the Swin transformer-based decoder layer. A raw magnetic resonance imaging dataset is used for network training and testing; the data contain various motion artifacts with ground truth images of the same subjects. The results were compared to six state-of-the-art MRI image motion correction methods using two types of motions. When motions were brief (within 5 s), the method reduced the average normalized root mean square error (NRMSE) from 45.25% to 17.51%, increased the mean structural similarity index measure (SSIM) from 79.43% to 91.72%, and increased the peak signal-to-noise ratio (PSNR) from 18.24 to 26.57 dB. Similarly, when motions were extended from 5 to 10 s, our approach decreased the average NRMSE from 60.30% to 21.04%, improved the mean SSIM from 33.86% to 90.33%, and increased the PSNR from 15.64 to 24.99 dB. The anatomical structures of the corrected images and the motion-free brain data were similar. [ABSTRACT FROM AUTHOR]

A challenge in accurately identifying and classifying left ventricular hypertrophy (LVH) is distinguishing it from hypertrophic cardiomyopathy (HCM) and Fabry disease. The reliance on imaging techniques often requires the expertise of multiple specialists, including cardiologists, radiologists, and geneticists. This variability in the interpretation and classification of LVH leads to inconsistent diagnoses. LVH, HCM, and Fabry cardiomyopathy can be differentiated using T1 mapping on cardiac magnetic resonance imaging (MRI). However, differentiation between HCM and Fabry cardiomyopathy using echocardiography or MRI cine images is challenging for cardiologists. Our proposed system named the MRI short-axis view left ventricular hypertrophy classifier (MSLVHC) is a high-accuracy standardized imaging classification model developed using AI and trained on MRI short-axis (SAX) view cine images to distinguish between HCM and Fabry disease. The model achieved impressive performance, with an F 1 -score of 0.846, an accuracy of 0.909, and an AUC of 0.914 when tested on the Taipei Veterans General Hospital (TVGH) dataset. Additionally, a single-blinding study and external testing using data from the Taichung Veterans General Hospital (TCVGH) demonstrated the reliability and effectiveness of the model, achieving an F 1 -score of 0.727, an accuracy of 0.806, and an AUC of 0.918, demonstrating the model's reliability and usefulness. This AI model holds promise as a valuable tool for assisting specialists in diagnosing LVH diseases. [ABSTRACT FROM AUTHOR]

Background. Ferumoxytol (Ferahame, AMAG Pharmaceuticals, Waltham, MA) is increasingly used off-label as an MR contrast agent due to its relaxivity and safety profiles. However, its potent T2 ∗ relaxivity limits achievable T1-weighted positive contrast and leads to artifacts in standard MRI protocols. Optimization of protocols for ferumoxytol deployment is necessary to realize its potential. Methods. We present first-in-human clinical results of the Quantitative Ultrashort Time-to-Echo Contrast Enhanced (QUTE-CE) MRA technique using the superparamagnetic iron oxide nanoparticle agent ferumoxytol for vascular imaging of the head/brain in 15 subjects at 3.0T. The QUTE-CE MRA method was implemented on a 3T scanner using a stack-of-spirals 3D Ultrashort Time-to-Echo sequence. Time-of-flight MRA and standard TE T1-weighted (T1w) images were also collected. For comparison, gadolinium-enhanced blood pool phase images were obtained retrospectively from clinical practice. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and intraluminal signal heterogeneity (ISH) were assessed and compared across approaches with Welch's two-sided t -test. Results. Fifteen volunteers (54 ± 17 years old, 9 women) participated. QUTE-CE MRA provided high-contrast snapshots of the arterial and venous networks with lower intraluminal heterogeneity. QUTE-CE demonstrated significantly higher SNR (1707 ± 226), blood-tissue CNR (1447 ± 189), and lower ISH (0.091 ± 0.031) compared to ferumoxytol T1-weighted (551 ± 171 ; 319 ± 144 ; 0.186 ± 0.066 , respectively) and time-of-flight (343 ± 104 ; 269 ± 82 ; 0.190 ± 0.016 , respectively), with p < 0.001 in each comparison. The high CNR increased the depth of vessel visualization. Vessel lumina were captured with lower heterogeneity. Conclusion. Quantitative Ultrashort Time-to-Echo Contrast-Enhanced MR angiography provides approximately 5-fold superior contrast with fewer artifacts compared to other contrast-enhanced vascular imaging techniques using ferumoxytol or gadolinium, and to noncontrast time-of-flight MR angiography, for clinical vascular imaging. This trial is registered with NCT03266848. [ABSTRACT FROM AUTHOR]

Background. MRI is an important tool for accurate detection and targeted biopsy of prostate lesions. However, the imaging appearances of some prostate cancers are similar to those of the surrounding normal tissue on MRI, which are referred to as MRI-invisible prostate cancers (MIPCas). The detection of MIPCas remains challenging and requires extensive systematic biopsy for identification. In this study, we developed a weakly supervised UNet (WSUNet) to detect MIPCas. Methods. The study included 777 patients (training set: 600; testing set: 177), all of them underwent comprehensive prostate biopsies using an MRI-ultrasound fusion system. MIPCas were identified in MRI based on the Gleason grade (≥7) from known systematic biopsy results. Results. The WSUNet model underwent validation through systematic biopsy in the testing set with an AUC of 0.764 (95% CI: 0.728-0.798). Furthermore, WSUNet exhibited a statistically significant precision improvement of 91.3% (p < 0.01) over conventional systematic biopsy methods in the testing set. This improvement resulted in a substantial 47.6% (p < 0.01) decrease in unnecessary biopsy needles, while maintaining the same number of positively identified cores as in the original systematic biopsy. Conclusions. In conclusion, the proposed WSUNet could effectively detect MIPCas, thereby reducing unnecessary biopsies. [ABSTRACT FROM AUTHOR]

Background. Artificial intelligence (AI) applications are rapidly advancing in the field of medical imaging. This study is aimed at investigating the perception and knowledge of radiographers towards artificial intelligence. Methods. An online survey employing Google Forms consisting of 20 questions regarding the radiographers' perception of AI. The questionnaire was divided into two parts. The first part consisted of demographic information as well as whether the participants think AI should be part of medical training, their previous knowledge of the technologies used in AI, and whether they prefer to receive training on AI. The second part of the questionnaire consisted of two fields. The first one consisted of 16 questions regarding radiographers' perception of AI applications in radiology. Descriptive analysis and logistic regression analysis were used to evaluate the effect of gender on the items of the questionnaire. Results. Familiarity with AI was low, with only 52 out of 100 respondents (52%) reporting good familiarity with AI. Many participants considered AI useful in the medical field (74%). The findings of the study demonstrate that nearly most of the participants (98%) believed that AI should be integrated into university education, with 87% of the respondents preferring to receive training on AI, with some already having prior knowledge of AI used in technologies. The logistic regression analysis indicated a significant association between male gender and experience within the range of 23-27 years with the degree of familiarity with AI technology, exhibiting respective odds ratios of 1.89 (COR = 1.89) and 1.87 (COR = 1.87). Conclusions. This study suggests that medical practices have a favorable attitude towards AI in the radiology field. Most participants surveyed believed that AI should be part of radiography education. AI training programs for undergraduate and postgraduate radiographers may be necessary to prepare them for AI tools in radiology development. [ABSTRACT FROM AUTHOR]

Superresolution, structured illumination microscopy (SIM) is an ideal modality for imaging live cells due to its relatively high speed and low photon-induced damage to the cells. The rate-limiting step in observing a superresolution image in SIM is often the reconstruction speed of the algorithm used to form a single image from as many as nine raw images. Reconstruction algorithms impose a significant computing burden due to an intricate workflow and a large number of often complex calculations to produce the final image. Further adding to the computing burden is that the code, even within the MATLAB environment, can be inefficiently written by microscopists who are noncomputer science researchers. In addition, they do not take into consideration the processing power of the graphics processing unit (GPU) of the computer. To address these issues, we present simple but efficient approaches to first revise MATLAB code, followed by conversion to GPU-optimized code. When combined with cost-effective, high-performance GPU-enabled computers, a 4- to 500-fold improvement in algorithm execution speed is observed as shown for the image denoising Hessian-SIM algorithm. Importantly, the improved algorithm produces images identical in quality to the original. [ABSTRACT FROM AUTHOR]

Skin cancer is a significant health concern worldwide, and early and accurate diagnosis plays a crucial role in improving patient outcomes. In recent years, deep learning models have shown remarkable success in various computer vision tasks, including image classification. In this research study, we introduce an approach for skin cancer classification using vision transformer, a state-of-the-art deep learning architecture that has demonstrated exceptional performance in diverse image analysis tasks. The study utilizes the HAM10000 dataset; a publicly available dataset comprising 10,015 skin lesion images classified into two categories: benign (6705 images) and malignant (3310 images). This dataset consists of high-resolution images captured using dermatoscopes and carefully annotated by expert dermatologists. Preprocessing techniques, such as normalization and augmentation, are applied to enhance the robustness and generalization of the model. The vision transformer architecture is adapted to the skin cancer classification task. The model leverages the self-attention mechanism to capture intricate spatial dependencies and long-range dependencies within the images, enabling it to effectively learn relevant features for accurate classification. Segment Anything Model (SAM) is employed to segment the cancerous areas from the images; achieving an IOU of 96.01% and Dice coefficient of 98.14% and then various pretrained models are used for classification using vision transformer architecture. Extensive experiments and evaluations are conducted to assess the performance of our approach. The results demonstrate the superiority of the vision transformer model over traditional deep learning architectures in skin cancer classification in general with some exceptions. Upon experimenting on six different models, ViT-Google, ViT-MAE, ViT-ResNet50, ViT-VAN, ViT-BEiT, and ViT-DiT, we found out that the ML approach achieves 96.15% accuracy using Google's ViT patch-32 model with a low false negative ratio on the test dataset, showcasing its potential as an effective tool for aiding dermatologists in the diagnosis of skin cancer. [ABSTRACT FROM AUTHOR]