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KRAS is a pathogenic gene frequently implicated in non-small cell lung cancer (NSCLC). However, biopsy as a diagnostic method has practical limitations. Therefore, it is important to accurately determine the mutation status of the KRAS gene non-invasively by combining NSCLC CT images and genetic data for early diagnosis and subsequent targeted therapy of patients. This paper proposes a Semi-supervised Multimodal Multiscale Attention Model (S2MMAM). S2MMAM comprises a Supervised Multilevel Fusion Segmentation Network (SMF-SN) and a Semi-supervised Multimodal Fusion Classification Network (S2MF-CN). S2MMAM facilitates the execution of the classification task by transferring the useful information captured in SMF-SN to the S2MF-CN to improve the model prediction accuracy. In SMF-SN, we propose a Triple Attention-guided Feature Aggregation module for obtaining segmentation features that incorporate high-level semantic abstract features and low-level semantic detail features. Segmentation features provide pre-guidance and key information expansion for S2MF-CN. S2MF-CN shares the encoder and decoder parameters of SMF-SN, which enables S2MF-CN to obtain rich classification features. S2MF-CN uses the proposed Intra and Inter Mutual Guidance Attention Fusion (I2MGAF) module to first guide segmentation and classification feature fusion to extract hidden multi-scale contextual information. I2MGAF then guides the multidimensional fusion of genetic data and CT image data to compensate for the lack of information in single modality data. S2MMAM achieved 83.27% AUC and 81.67% accuracy in predicting KRAS gene mutation status in NSCLC. This method uses medical image CT and genetic data to effectively improve the accuracy of predicting KRAS gene mutation status in NSCLC. [ABSTRACT FROM AUTHOR]

The in-depth combination and application of AI technology and medical imaging, especially high- definition CT imaging technology, make accurate diagnosis and treatment possible. Retrieving similar CT image(CI)s to an input one from the large-scale CI database of labeled diseases is helpful to realize a precise computer-aided diagnosis. In this paper, we take lung CI as an example and propose progressive content-based similarity retrieval(CBSR) method of the lung CIs based on a Weakly Supervised Similarity LearningNetwork (WSSLN) model. Two enabling techniques (i.e., the WSSLN model and the distance- based pruning scheme) are proposed to facilitate the CBSR processing of the large lung CIs. The main result of our paper is that, our approach is about 45% more effective than the state-of-the-art methods in terms of the mean average precision(mAP). Moreover, for the retrieval efficiency, the WSSLN-based CBSR method is about 150% more efficient than the sequential scan. [ABSTRACT FROM AUTHOR]

Brain extraction is an important prerequisite for the automated diagnosis of intracranial lesions and determines, to a certain extent, the accuracy of subsequent lesion identification, localization, and segmentation. To address the problem that the current traditional image segmentation methods are fast in extraction but poor in robustness, while the Full Convolutional Neural Network (FCN) is robust and accurate but relatively slow in extraction, this paper proposes an adaptive mask-based brain extraction method, namely AMBBEM, to achieve brain extraction better. The method first uses threshold segmentation, median filtering, and closed operations for segmentation, generates a mask for the first time, then combines the ResNet50 model, region growing algorithm, and image properties analysis to further segment the mask, and finally complete brain extraction by multiplying the original image and the mask. The algorithm was tested on 22 test sets containing different lesions, and the results showed MPA = 0.9963, MIoU = 0.9924, and MBF = 0.9914, which were equivalent to the extraction effect of the Deeplabv3+ model. However, the method can complete brain extraction of approximately 6.16 head CT images in 1 second, much faster than Deeplabv3+, U-net, and SegNet models. In summary, this method can achieve accurate brain extraction from head CT images more quickly, creating good conditions for subsequent brain volume measurement and feature extraction of intracranial lesions. [ABSTRACT FROM AUTHOR]

Background: Lung cancer screening (LCS) using low-dose computed tomography (LDCT) is a strategy for early-stage diagnosis. The implementation of LDCT screening in countries with a high prevalence/incidence of tuberculosis (TB) is controversial. This systematic review and meta-analysis aim to identify whether LCS using LDCT increases early-stage diagnosis and decreases mortality, as well as the false-positive rate, in regions with a high prevalence of TB. Methods/Design: Studies were identified by searching BVS, PUBMED, EMBASE, and SCOPUS. RCT and cohort studies (CS) that show the effects of LDCT in LC screening on mortality and secondary outcomes were eligible. Two independent reviewers evaluated eligibility and a third judged disagreements. We used the Systematic Review Data Repository (SRDR+) to extract the metadata and record decisions. The analyses were stratified by study design and incidence of TB. We used the Cochrane "Risk of bias" assessment tool. Results: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were used. Thirty-seven papers were included, referring to 22 studies (10 RCTs and 12 cohorts). Few studies were from regions with a high incidence of TB (One RCT and four cohorts). Nonetheless, the evidence is compatible with European and USA studies. RCTs and CS also had consistent results. There is an increase in early-stage (I-II) diagnoses and reduced LC mortality in the LCDT arm compared to the control. Although false-positive rates varied, they stayed within the 20 to 30% range. Discussion: This is the first meta-analysis of LDCT for LCS focused on its benefits in regions with an increased incidence/prevalence of TB. Although the specificity of Lung-RADS was higher in participants without TB sequelae than in those with TB sequelae, our findings point out that the difference does not invalidate implementing LDCT LCS in these regions. Trial registration: Systematic review registration Systematic review registration PROSPERO CRD42022309581. [ABSTRACT FROM AUTHOR]

Background and aim: Calibrated pelvic X-ray images are needed in the preoperative planning of total hip arthroplasty (THA) to predict component sizes. Errors and mismatch in the size of one or more components are reported, which can lead to clinically relevant complications. Our aim is to investigate whether we can solve the fundamental problem of X-ray calibration and whether traditional X-ray still has a place in preoperative planning despite improved radiological alternatives. Methods: Based on geometric and radiographic principles, we estimate that the magnification factor is adapted to the X-ray device and depends strongly on the source-image distance of the device. We analyse the errors of the various calibration methods and investigate which narrow range can be expected to show that the center of rotation is sufficiently accurate. Based on the results of several CT-scans we defined an adapted magnification factor and validated the degree of measurement accuracy. Results: The true magnification of objects on X-ray images depends mainly on the device settings. Stem size prediction is possible to a limited extent, with an error margin of 4.3%. Components can be predicted with a safety margin of one size up and down as with CT or 3D images. The prerequisite is that the source-image distance is greater than or equal to 120 cm, the table-image distance is known, and the object-image distance is estimated according to the patient's BMI. We defined a device-adapted magnification factor that simplifies the templating routine and can be used to obtain the most reliable preoperative dimensional measurements that can be expected from X-ray images. We found the error margin of the magnification factor with the highest degrees of prediction and precision. Conclusion: Preoperative planning is reliable and reproducible using X-ray images if calibration is performed with the device-adapted magnification factor suggested in this paper. [ABSTRACT FROM AUTHOR]

This paper presents an artificial intelligence-based classification model for the detection of pulmonary embolism in computed tomography angiography. The proposed model, developed from public data and validated on a large dataset from a tertiary hospital, uses a two-dimensional approach that integrates temporal series to classify each slice of the examination and make predictions at both slice and examination levels. The training process consists of two stages: first using a convolutional neural network InceptionResNet V2 and then a recurrent neural network long short-term memory model. This approach achieved an accuracy of 93% at the slice level and 77% at the examination level. External validation using a hospital dataset resulted in a precision of 86% for positive pulmonary embolism cases and 69% for negative pulmonary embolism cases. Notably, the model excels in excluding pulmonary embolism, achieving a precision of 73% and a recall of 82%, emphasizing its clinical value in reducing unnecessary interventions. In addition, the diverse demographic distribution in the validation dataset strengthens the model's generalizability. Overall, this model offers promising potential for accurate detection and exclusion of pulmonary embolism, potentially streamlining diagnosis and improving patient outcomes. [ABSTRACT FROM AUTHOR]

Spatial neglect is the dominant behavioral disorder after right hemisphere brain lesions. Reliabel diagnosis by formal neuropsychological testing is often achieved only later during hospitalization, leading to delays in targeted therapies. We propose a way to diagnose spatial neglect right at admission. We measured the conjugated eye deviation (CED) on the initial computed tomography (CT) scans, in combination with the verbal instruction "Please look straight ahead" during the scan. The command was implemented in the scanner program and automatically played before a cranial CT started. This prospective study included a total 46 consecutive subjects (16 patients with first ever right brain damage and no spatial neglect, 12 patients with first ever right brain damage and spatial neglect, and 18 healthy controls). The right brain damaged groups were submitted to paper pencil tests to access the diagnosis of a spatial neglect after radiological confirmation of the brain damage during the initial phase of their hospitalisation. This procedure allowed us to define a cut-off value of 14.1 degrees of CED to the ipsilesional side to differentiate right hemispheric stroke patients with versus without spatial neglect with a confidence interval of 99%. This simple addition to a radiological routine procedure provides a new tool to help diagnose spatial neglect at the earliest stage possible and thus offers the possibility of providing patients with optimized rehabilitative therapy from a very early stage on. [ABSTRACT FROM AUTHOR]

Introduction: Anastomotic leakage is a major concern following total mesorectal excision for rectal cancer, affecting oncological outcomes, morbidity an treatment costs. Body composition has been suggested to influence anastomotic leakage rates. However, literature on how body composition impact anastomotic leakage rates is conflicting. This systematic review aims to evaluate the role of computed tomography derived body composition metrics on anastomotic leakage rates in rectal cancer patients. Methods: Databases PubMed/MEDLINE, Cochrane Library, web of science, and EMBASE, will be systematically searched for papers from January 2010 onwards. Study selection, data collection and quality assessment will be independently performed by three research fellows. Outcomes described in three or more studies will be included in the meta-analysis. The Q-test and I2 statistic will be used to assess statistical heterogeneity between studies. Publication bias will be examined by visual inspection of funnel plots and quantified by Egger's test. Sensitivity analyses will be conducted to examine the robustness of the meta-analysis. Reporting of the findings will be in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Conclusions: This systematic review will synthesize the current evidence and will identify knowledge gaps. Results of the systematic review will aid health care professional in pre-operative decision making and will be distributed through a peer-reviewed publication and presentation of results at international meetings. Trial registration: PROSPERO protocol number: CRD42023471537. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, pneumonia was the leading cause of respiratory failure and death. In addition to SARS-COV-2, it can be caused by several other bacterial and viral agents. Even today, variants of SARS-COV-2 are endemic and COVID-19 cases are common in many places. The symptoms of COVID-19 are highly diverse and robust, ranging from invisible to severe respiratory failure. Current detection methods for the disease are time-consuming and expensive with low accuracy and precision. To address such situations, we have designed a framework for COVID-19 and Pneumonia detection using multiple deep learning algorithms further accompanied by a deployment scheme. In this study, we have utilized four prominent deep learning models, which are VGG-19, ResNet-50, Inception V3 and Xception, on two separate datasets of CT scan and X-ray images (COVID/Non-COVID) to identify the best models for the detection of COVID-19. We achieved accuracies ranging from 86% to 99% depending on the model and dataset. To further validate our findings, we have applied the four distinct models on two more supplementary datasets of X-ray images of bacterial pneumonia and viral pneumonia. Additionally, we have implemented a flask app to visualize the outcome of our framework to show the identified COVID and Non-COVID images. The findings of this study will be helpful to develop an AI-driven automated tool for the cost effective and faster detection and better management of COVID-19 patients. [ABSTRACT FROM AUTHOR]

Organ segmentation has become a preliminary task for computer-aided intervention, diagnosis, radiation therapy, and critical robotic surgery. Automatic organ segmentation from medical images is a challenging task due to the inconsistent shape and size of different organs. Besides this, low contrast at the edges of organs due to similar types of tissue confuses the network's ability to segment the contour of organs properly. In this paper, we propose a novel convolution neural network based uncertainty-driven boundary-refined segmentation network (UDBRNet) that segments the organs from CT images. The CT images are segmented first and produce multiple segmentation masks from multi-line segmentation decoder. Uncertain regions are identified from multiple masks and the boundaries of the organs are refined based on uncertainty data. Our method achieves remarkable performance, boasting dice accuracies of 0.80, 0.95, 0.92, and 0.94 for Esophagus, Heart, Trachea, and Aorta respectively on the SegThor dataset, and 0.71, 0.89, 0.85, 0.97, and 0.97 for Esophagus, Spinal Cord, Heart, Left-Lung, and Right-Lung respectively on the LCTSC dataset. These results demonstrate the superiority of our uncertainty-driven boundary refinement technique over state-of-the-art segmentation networks such as UNet, Attention UNet, FC-denseNet, BASNet, UNet++, R2UNet, TransUNet, and DS-TransUNet. UDBRNet presents a promising network for more precise organ segmentation, particularly in challenging, uncertain conditions. The source code of our proposed method will be available at https://github.com/riadhassan/UDBRNet. [ABSTRACT FROM AUTHOR]

Low-Dose computer tomography (LDCT) is an ideal alternative to reduce radiation risk in clinical applications. Although supervised-deep-learning-based reconstruction methods have demonstrated superior performance compared to conventional model-driven reconstruction algorithms, they require collecting massive pairs of low-dose and norm-dose CT images for neural network training, which limits their practical application in LDCT imaging. In this paper, we propose an unsupervised and training data-free learning reconstruction method for LDCT imaging that avoids the requirement for training data. The proposed method is a post-processing technique that aims to enhance the initial low-quality reconstruction results, and it reconstructs the high-quality images by neural work training that minimizes the ℓ1-norm distance between the CT measurements and their corresponding simulated sinogram data, as well as the total variation (TV) value of the reconstructed image. Moreover, the proposed method does not require to set the weights for both the data fidelity term and the plenty term. Experimental results on the AAPM challenge data and LoDoPab-CT data demonstrate that the proposed method is able to effectively suppress the noise and preserve the tiny structures. Also, these results demonstrate the rapid convergence and low computational cost of the proposed method. The source code is available at https://github.com/linfengyu77/IRLDCT. [ABSTRACT FROM AUTHOR]

Diagnosing lung diseases accurately and promptly is essential for effectively managing this significant public health challenge on a global scale. This paper introduces a new framework called Modified Segnet-based Lung Disease Segmentation and Severity Classification (MSLDSSC). The MSLDSSC model comprises four phases: "preprocessing, segmentation, feature extraction, and classification." Initially, the input image undergoes preprocessing using an improved Wiener filter technique. This technique estimates the power spectral density of the noisy and original images and computes the SNR assisted by PSNR to evaluate image quality. Next, the preprocessed image undergoes Segmentation to identify and separate the RoI from the background objects in the lung image. We employ a Modified Segnet mechanism that utilizes a proposed hard tanh-Softplus activation function for effective Segmentation. Following Segmentation, features such as MLDN, entropy with MRELBP, shape features, and deep features are extracted. Following the feature extraction phase, the retrieved feature set is input into a hybrid severity classification model. This hybrid model comprises two classifiers: SDPA-Squeezenet and DCNN. These classifiers train on the retrieved feature set and effectively classify the severity level of lung diseases. [ABSTRACT FROM AUTHOR]

Lung cancer is one of the leading causes of cancer-related deaths worldwide. To reduce the mortality rate, early detection and proper treatment should be ensured. Computer-aided diagnosis methods analyze different modalities of medical images to increase diagnostic precision. In this paper, we propose an ensemble model, called the Mitscherlich function-based Ensemble Network (MENet), which combines the prediction probabilities obtained from three deep learning models, namely Xception, InceptionResNetV2, and MobileNetV2, to improve the accuracy of a lung cancer prediction model. The ensemble approach is based on the Mitscherlich function, which produces a fuzzy rank to combine the outputs of the said base classifiers. The proposed method is trained and tested on the two publicly available lung cancer datasets, namely Iraq-Oncology Teaching Hospital/National Center for Cancer Diseases (IQ-OTH/NCCD) and LIDC-IDRI, both of these are computed tomography (CT) scan datasets. The obtained results in terms of some standard metrics show that the proposed method performs better than state-of-the-art methods. The codes for the proposed work are available at https://github.com/SuryaMajumder/MENet. [ABSTRACT FROM AUTHOR]

Background: Reversible cerebral vasoconstriction syndrome (RCVS) is a syndrome of recurrent thunderclap headaches and reversible vasoconstriction of the cerebral arteries on neuroimaging within 3 months of onset. Initial non-contrast computed tomography (CT) can reveal abnormalities such as ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage (SAH) can be present in patients with RCVS and may delay diagnosis. Aims: We conducted a systematic review and meta-analysis in accordance with the PRISMA guidelines. We aimed to estimate the prevalence of imaging abnormalities on initial non-contrast CT head in adult patients with RCVS. Data sources & eligibility criteria: We searched electronic databases including MEDLINE, EMBASE, and the Cochrane Register of Clinical Trials from inception to August 2, 2022. Eligible studies included articles reporting the prevalence of non-contrast CT abnormalities on initial neuroimaging in patients with RCVS, aged 18 and older. Case series, observational studies and clinical trials were included. Data was extracted directly from included papers using a standardized data charting form. Results: The search yielded 722 titles with duplicates removed. Twenty studies that included 379 patients with RCVS met inclusion criteria. We classified non-contrast CT abnormalities as either ischemic stroke, ICH, or SAH. We pooled prevalence data using a random effects model with the inverse-variance weighted method. The most common imaging finding was SAH with a pooled prevalence of 24% (95% CI:17%-33%), followed by ICH at 14% (95% CI:8%-22%), and ischemic stroke at 10% (95% CI:7%-14%). The pooled prevalence of any of these imaging abnormalities on initial non-contrast CT was 31% (95% CI:23%-40%). Risk of bias was moderate to very-high-risk for case-series and low-risk for observational studies. Conclusion: Our review demonstrates that one-third of patients with RCVS will have an abnormality on initial non-contrast CT head, including either an ischemic stroke, ICH, or SAH. These findings highlight the diagnostic challenges of RCVS imaging and contribute to our understanding of this disease. [ABSTRACT FROM AUTHOR]

High-resolution CT images are essential in clinical practice to accurately replicate patient anatomy for 3D virtual surgical planning and designing patient-specific surgical guides. These technologies are commonly used in corrective osteotomy of the distal radius. This study evaluated how the virtual radius models and the surgical guides' surface that is in contact with the bone vary between experienced raters. Further, the discrepancies from the reference radius of surgical guides and radius models created from CT images with slice thicknesses larger than the reference standard of 0.625mm were assessed. Maximum overlap with radius model was measured for guides, and absolute average distance error was measured for radius models. The agreement between the lower-resolution guides surface and the raters' guide surface was evaluated. The average inter-rater guide surface overlap was -0.11mm [95% CI: -0.13–0.09]. The surface of surgical guides designed on CT images with a 1mm slice thickness deviated from the reference radius within the inter-rater range (0.03mm). For slice thicknesses of 1.25mm and 1.5mm, the average guide surface overlap was 0.12mm and 0.15mm, respectively. The average inter-rater radius surface variability was 0.03mm [95% CI: 0.025–0.035]. The discrepancy from the reference of all radius models created from CT images with a slice thickness larger than the reference slice thickness was notably larger than the inter-rater variability but, excluding one case, did not exceed 0.2mm. The results suggest that 1mm CT images are suitable for surgical guide design. While 1.25mm slices are commonly used for virtual planning in hand and forearm surgery, slices larger than 1mm may approach the limit of clinical acceptability. Discrepancies in radius models were below 1mm, likely below clinical relevance. [ABSTRACT FROM AUTHOR]

The field of radiology imaging has experienced a remarkable increase in using of deep learning (DL) algorithms to support diagnostic and treatment decisions. This rise has led to the development of Explainable AI (XAI) system to improve the transparency and trust of complex DL methods. However, XAI systems face challenges in gaining acceptance within the healthcare sector, mainly due to technical hurdles in utilizing these systems in practice and the lack of human-centered evaluation/validation. In this study, we focus on visual XAI systems applied to DL-enabled diagnostic system in chest radiography. In particular, we conduct a user study to evaluate two prominent visual XAI techniques from the human perspective. To this end, we created two clinical scenarios for diagnosing pneumonia and COVID-19 using DL techniques applied to chest X-ray and CT scans. The achieved accuracy rates were 90% for pneumonia and 98% for COVID-19. Subsequently, we employed two well-known XAI methods, Grad-CAM (Gradient-weighted Class Activation Mapping) and LIME (Local Interpretable Model-agnostic Explanations), to generate visual explanations elucidating the AI decision-making process. The visual explainability results were shared through a user study, undergoing evaluation by medical professionals in terms of clinical relevance, coherency, and user trust. In general, participants expressed a positive perception of the use of XAI systems in chest radiography. However, there was a noticeable lack of awareness regarding their value and practical aspects. Regarding preferences, Grad-CAM showed superior performance over LIME in terms of coherency and trust, although concerns were raised about its clinical usability. Our findings highlight key user-driven explainability requirements, emphasizing the importance of multi-modal explainability and the necessity to increase awareness of XAI systems among medical practitioners. Inclusive design was also identified as a crucial need to ensure better alignment of these systems with user needs. [ABSTRACT FROM AUTHOR]

To improve the prognosis of patients suffering from pulmonary diseases, such as lung cancer, early diagnosis and treatment are crucial. The analysis of CT images is invaluable for diagnosis, whereas high quality segmentation of the airway tree are required for intervention planning and live guidance during bronchoscopy. Recently, the Multi-domain Airway Tree Modeling (ATM'22) challenge released a large dataset, both enabling training of deep-learning based models and bringing substantial improvement of the state-of-the-art for the airway segmentation task. The ATM'22 dataset includes a large group of COVID'19 patients and a range of other lung diseases, however, relatively few patients with severe pathologies affecting the airway tree anatomy was found. In this study, we introduce a new public benchmark dataset (AeroPath), consisting of 27 CT images from patients with pathologies ranging from emphysema to large tumors, with corresponding trachea and bronchi annotations. Second, we present a multiscale fusion design for automatic airway segmentation. Models were trained on the ATM'22 dataset, tested on the AeroPath dataset, and further evaluated against competitive open-source methods. The same performance metrics as used in the ATM'22 challenge were used to benchmark the different considered approaches. Lastly, an open web application is developed, to easily test the proposed model on new data. The results demonstrated that our proposed architecture predicted topologically correct segmentations for all the patients included in the AeroPath dataset. The proposed method is robust and able to handle various anomalies, down to at least the fifth airway generation. In addition, the AeroPath dataset, featuring patients with challenging pathologies, will contribute to development of new state-of-the-art methods. The AeroPath dataset and the web application are made openly available. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to explore the auxiliary diagnostic value of volumetric CT value in quantifying the activity of a pulmonary tuberculoma. Methods: Chest CT image data of 112 patients with pulmonary tuberculomas who were diagnosed clinically between October 16, 2013 and March 21, 2023 were selected. With the shortest diameter axis>5 mm on the mediastinal window serving as the inclusion criterion, 108 active tuberculomas and 64 non-active tuberculomas were selected. The focused image was manually segmented using ITK-SNAP software, the volumetric CT value of the focus was calculated, and the ROC curve was analyzed. Using the final clinical diagnosis as the reference standard, the auxiliary diagnostic efficacy and consistency of the conventional CT film reading method and volumetric CT value in determining the activity of a pulmonary tuberculoma were compared. Results: The volumetric CT value of 108 active pulmonary tuberculoma lesions (33.39 [28.17,36.23] HU) was significantly less than 64 inactive pulmonary tuberculoma lesions (78.91 [57.81,120.31] HU); the difference was statistically significant (Z = −10.888. P < 0.001). ROC curve analysis showed that at a maximum Yoden index value of 0.963, the optimal volumetric CT threshold value was 45.32 HU, the sensitivity and specificity of the volumetric CT value in determining the activity of a pulmonary tuberculoma were 97.2% and 100.0%, respectively, and the maximum area under the ROC curve was 0.998. Taking the final clinical diagnosis as the reference standard, the sensitivity, specificity, consistency, and kappa value of the conventional CT film reading method for determining the activity of a pulmonary tuberculoma were 72.2% (78/108), 70.3% (45/64), 71.5% (123/172), and 0.413, respectively, while the corresponding volumetric CT values were 97.2% (105/108), 100.0% (64/64), 98.3% (168/172), and 0.951, respectively. Conclusion: Accurately quantifying the volumetric CT value of a pulmonary tuberculoma focus determines the activity of a pulmonary tuberculoma, which has very important auxiliary diagnostic value. [ABSTRACT FROM AUTHOR]

Optimization tasks in diagnostic radiological imaging require objective quantitative metrics that correlate with the subjective perception of observers. However, although one such metric, the structural similarity index (SSIM), is popular, it has limitations across various aspects in its application to medical images. In this study, we introduce a novel image quality evaluation approach based on keypoints and their associated unique image feature values, focusing on developing a framework to address the need for robustness and interpretability that are lacking in conventional methodologies. The proposed index quantifies and visualizes the distance between feature vectors associated with keypoints, which varies depending on changes in the image quality. This metric was validated on images with varying noise levels and resolution characteristics, and its applicability and effectiveness were examined by evaluating images subjected to various affine transformations. In the verification of X-ray computed tomography imaging using a head phantom, the distances between feature descriptors for each keypoint increased as the image quality degraded, exhibiting a strong correlation with the changes in the SSIM. Notably, the proposed index outperformed conventional full-reference metrics in terms of robustness to various transformations which are without changes in the image quality. Overall, the results suggested that image analysis performed using the proposed framework could effectively visualize the corresponding feature points, potentially harnessing lost feature information owing to changes in the image quality. These findings demonstrate the feasibility of applying the novel index to analyze changes in the image quality. This method may overcome limitations inherent in conventional evaluation methodologies and contribute to medical image analysis in the broader domain. [ABSTRACT FROM AUTHOR]

Medical image segmentation is a critical application that plays a significant role in clinical research. Despite the fact that many deep neural networks have achieved quite high accuracy in the field of medical image segmentation, there is still a scarcity of annotated labels, making it difficult to train a robust and generalized model. Few-shot learning has the potential to predict new classes that are unseen in training with a few annotations. In this study, a novel few-shot semantic segmentation framework named prototype-based generative adversarial network (PG-Net) is proposed for medical image segmentation without annotations. The proposed PG-Net consists of two subnetworks: the prototype-based segmentation network (P-Net) and the guided evaluation network (G-Net). On one hand, the P-Net as a generator focuses on extracting multi-scale features and local spatial information in order to produce refined predictions with discriminative context between foreground and background. On the other hand, the G-Net as a discriminator, which employs an attention mechanism, further distills the relation knowledge between support and query, and contributes to P-Net producing segmentation masks of query with more similar distributions as support. Hence, the PG-Net can enhance segmentation quality by an adversarial training strategy. Compared to the state-of-the-art (SOTA) few-shot segmentation methods, comparative experiments demonstrate that the proposed PG-Net provides noticeably more robust and prominent generalization ability on different medical image modality datasets, including an abdominal Computed Tomography (CT) dataset and an abdominal Magnetic Resonance Imaging (MRI) dataset. [ABSTRACT FROM AUTHOR]

In this paper, we propose a framework for CT image segmentation of oil rock core. According to the characteristics of CT image of oil rock core, the existing level set segmentation algorithm is improved. Firstly, an algorithm of Chan-Vese (C-V) model is carried out to segment rock core from image background. Secondly the gray level of image background region is replaced by the average gray level of rock core, so that image background does not affect the binary segmentation. Next, median filtering processing is carried out. Finally, an algorithm of local binary fitting (LBF) model is executed to obtain the crack region. The proposed algorithm has been applied to oil rock core CT images with promising results. [ABSTRACT FROM AUTHOR]

A non-contrast cranial computer tomography (ncCT) is often employed for the diagnosis of the early stage of the ischemic stroke. However, the number of false negatives is high. More accurate results are obtained by an MRI. However, the MRI is not available in every hospital. Moreover, even if it is available in the clinic for the routine tests, emergency often does not have it. Therefore, this paper proposes an end-to-end framework for detection and segmentation of the brain infarct on the ncCT. The computer tomography perfusion (CTp) is used as the ground truth. The proposed ensemble model employs three deep convolution neural networks (CNNs) to process three end-to-end feature maps and a hand-craft features characterized by specific contra-lateral features. To improve the accuracy of the detected infarct area, the spatial dependencies between neighboring slices are employed at the postprocessing step. The numerical experiments have been performed on 18 ncCT-CTp paired stroke cases (804 image-pairs). The leave-one-out approach is applied for evaluating the proposed method. The model achieves 91.16% accuracy, 65.15% precision, 77.44% recall, 69.97% F1 score, and 0.4536 IoU. [ABSTRACT FROM AUTHOR]

Lung cancer is a serious threat to human health, with millions dying because of its late diagnosis. The computerized tomography (CT) scan of the chest is an efficient method for early detection and classification of lung nodules. The requirement for high accuracy in analyzing CT scan images is a significant challenge in detecting and classifying lung cancer. In this paper, a new deep fusion structure based on the long short-term memory (LSTM) has been introduced, which is applied to the texture features computed from lung nodules through new volumetric grey-level-co-occurrence-matrices (GLCMs), classifying the nodules into benign, malignant, and ambiguous. Also, an improved Otsu segmentation method combined with the water strider optimization algorithm (WSA) is proposed to detect the lung nodules. WSA-Otsu thresholding can overcome the fixed thresholds and time requirement restrictions in previous thresholding methods. Extended experiments are used to assess this fusion structure by considering 2D-GLCM based on 2D-slices and approximating the proposed 3D-GLCM computations based on volumetric 2.5D-GLCMs. The proposed methods are trained and assessed through the LIDC-IDRI dataset. The accuracy, sensitivity, and specificity obtained for 2D-GLCM fusion are 94.4%, 91.6%, and 95.8%, respectively. For 2.5D-GLCM fusion, the accuracy, sensitivity, and specificity are 97.33%, 96%, and 98%, respectively. For 3D-GLCM, the accuracy, sensitivity, and specificity of the proposed fusion structure reached 98.7%, 98%, and 99%, respectively, outperforming most state-of-the-art counterparts. The results and analysis also indicate that the WSA-Otsu method requires a shorter execution time and yields a more accurate thresholding process. [ABSTRACT FROM AUTHOR]

Identification of 3D cephalometric landmarks that serve as proxy to the shape of human skull is the fundamental step in cephalometric analysis. Since manual landmarking from 3D computed tomography (CT) images is a cumbersome task even for the trained experts, automatic 3D landmark detection system is in a great need. Recently, automatic landmarking of 2D cephalograms using deep learning (DL) has achieved great success, but 3D landmarking for more than 80 landmarks has not yet reached a satisfactory level, because of the factors hindering machine learning such as the high dimensionality of the input data and limited amount of training data due to the ethical restrictions on the use of medical data. This paper presents a semi-supervised DL method for 3D landmarking that takes advantage of anonymized landmark dataset with paired CT data being removed. The proposed method first detects a small number of easy-to-find reference landmarks, then uses them to provide a rough estimation of the all landmarks by utilizing the low dimensional representation learned by variational autoencoder (VAE). The anonymized landmark dataset is used for training the VAE. Finally, coarse-to-fine detection is applied to the small bounding box provided by rough estimation, using separate strategies suitable for the mandible and the cranium. For mandibular landmarks, patch-based 3D CNN is applied to the segmented image of the mandible (separated from the maxilla), in order to capture 3D morphological features of mandible associated with the landmarks. We detect 6 landmarks around the condyle all at once rather than one by one, because they are closely related to each other. For cranial landmarks, we again use the VAE-based latent representation for more accurate annotation. In our experiment, the proposed method achieved a mean detection error of 2.88 mm for 90 landmarks using only 15 paired training data. [ABSTRACT FROM AUTHOR]

Background: A computer tomography image (CI) sequence can be regarded as a time-series data that is composed of a great deal of nearby and similar CIs. Since the computational and I/O costs of similarity measure, encryption, and decryption calculation during a similarity retrieval of the large CI sequences (CIS) are extremely high, deploying all retrieval tasks in the cloud, however, will lead to excessive computing load on the cloud, which will greatly and negatively affect the retrieval performance. Methodologies: To tackle the above challenges, the paper proposes a progressive privacy-preserving Batch Retrieval scheme for the lung CISs based on edge-cloud collaborative computation called the BRS method. There are four supporting techniques to enable the BRS method, such as: 1) batch similarity measure for CISs, 2) CIB-based privacy preserving scheme, 3) uniform edge-cloud index framework, and 4) edge buffering. Results: The experimental results reveal that our method outperforms the state-of-the-art approaches in terms of efficiency and scalability, drastically reducing response time by lowering network communication costs while enhancing retrieval safety and accuracy. [ABSTRACT FROM AUTHOR]

Objectives: This paper aimed to identify the technology frontiers of artificial intelligence-assisted pathology based on patent citation network. Methods: Patents related to artificial intelligence-assisted pathology were searched and collected from the Derwent Innovation Index (DII), which were imported into Derwent Data Analyzer (DDA, Clarivate Derwent, New York, NY, USA) for authority control, and imported into the freely available computer program Ucinet 6 for drawing the patent citation network. The patent citation network according to the citation relationship could describe the technology development context in the field of artificial intelligence-assisted pathology. The patent citations were extracted from the collected patent data, selected highly cited patents to form a co-occurrence matrix, and built a patent citation network based on the co-occurrence matrix in each period. Text clustering is an unsupervised learning method, an important method in text mining, where similar documents are grouped into clusters. The similarity between documents are determined by calculating the distance between them, and the two documents with the closest distance are combined. The method of text clustering was used to identify the technology frontiers based on the patent citation network, which was according to co-word analysis of the title and abstract of the patents in this field. Results: 1704 patents were obtained in the field of artificial intelligence-assisted pathology, which had been currently undergoing three stages, namely the budding period (1992–2000), the development period (2001–2015), and the rapid growth period (2016–2021). There were two technology frontiers in the budding period (1992–2000), namely systems and methods for image data processing in computerized tomography (CT), and immunohistochemistry (IHC), five technology frontiers in the development period (2001–2015), namely spectral analysis methods of biomacromolecules, pathological information system, diagnostic biomarkers, molecular pathology diagnosis, and pathological diagnosis antibody, and six technology frontiers in the rapid growth period (2016–2021), namely digital pathology (DP), deep learning (DL) algorithms—convolutional neural networks (CNN), disease prediction models, computational pathology, pathological image analysis method, and intelligent pathological system. Conclusions: Artificial intelligence-assisted pathology was currently in a rapid development period, and computational pathology, DL and other technologies in this period all involved the study of algorithms. Future research hotspots in this field would focus on algorithm improvement and intelligent diagnosis in order to realize the precise diagnosis. The results of this study presented an overview of the characteristics of research status and development trends in the field of artificial intelligence-assisted pathology, which could help readers broaden innovative ideas and discover new technological opportunities, and also served as important indicators for government policymaking. [ABSTRACT FROM AUTHOR]

Ring artifact elimination is one of the popular problems in computed tomography (CT). It appears in the reconstructed image in the form of bright or dark patterns of concentric circles. In this paper, based on the compressed sensing theory, we propose a method for eliminating the ring artifact during the image reconstruction. The proposed method is based on representing the projection data by a sum of two components. The first component contains ideal correct values, while the latter contains imperfect error values causing the ring artifact. We propose to minimize some sparsity-induced norms corresponding to the imperfect error components to effectively eliminate the ring artifact. In particular, we investigate the effect of using different sparse models, i.e. different sparsity-induced norms, on the accuracy of the ring artifact correction. The proposed cost function is optimized using an iterative algorithm derived from the alternative direction method of multipliers. Moreover, we propose improved versions of the proposed algorithms by incorporating a smoothing penalty function into the cost function. We also introduce angular constrained forms of the proposed algorithms by considering a special case as follows. The imperfect error values are constant over all the projection angles, as in the case where the source of ring artifact is the non-uniform sensitivity of the detector. Real data and simulation studies were performed to evaluate the proposed algorithms. Results demonstrate that the proposed algorithms with incorporating smoothing penalty and their angular constrained forms are effective in ring artifact elimination. [ABSTRACT FROM AUTHOR]

Purpose: Cancer is among the leading causes of death in the developed world, and lung cancer is the most lethal type. Early detection is crucial for better prognosis, but can be resource intensive to achieve. 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. Our model trained on a small number of semantically labeled data achieved a mean dice similarity coefficient of 71.0 on the MSD Lung dataset. 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. [ABSTRACT FROM AUTHOR]

Background: Detection of pulmonary nodules is an important aspect of an automatic detection system. Incomputer-aided diagnosis (CAD) systems, the ability to detect pulmonary nodules is highly important, which plays an important role in the diagnosis and early treatment of lung cancer. Currently, the detection of pulmonary nodules depends mainly on doctor experience, which varies. This paper aims to address the challenge of pulmonary nodule detection more effectively. Methods: A method for detecting pulmonary nodules based on an improved neural network is presented in this paper. Nodules are clusters of tissue with a diameter of 3 mm to 30 mm in the pulmonary parenchyma. Because pulmonary nodules are similar to other lung structures and have a low density, false positive nodules often occur. Thus, our team proposed an improved convolutional neural network (CNN) framework to detect nodules. First, a nonsharpening mask is used to enhance the nodules in computed tomography (CT) images; then, CT images of 512×512 pixels are segmented into smaller images of 96×96 pixels. Second, in the 96×96 pixel images which contain or exclude pulmonary nodules, the plaques corresponding to positive and negative samples are segmented. Third, CT images segmented into 96×96 pixels are down-sampled to 64×64 and 32×32 size respectively. Fourth, an improved fusion neural network structure is constructed that consists of three three-dimensional convolutional neural networks, designated as CNN-1, CNN-2, and CNN-3, to detect false positive pulmonary nodules. The networks’ input sizes are 32×32×32, 64×64×64, and 96×96×96 and include 5, 7, and 9 layers, respectively. Finally, we use the AdaBoost classifier to fuse the results of CNN-1, CNN-2, and CNN-3. We call this new neural network framework the Amalgamated-Convolutional Neural Network (A-CNN) and use it to detect pulmonary nodules. Findings: Our team trained A-CNN using the LUNA16 and Ali Tianchi datasets and evaluated its performance using the LUNA16 dataset. We discarded nodules less than 5mm in diameter. When the average number of false positives per scan was 0.125 and 0.25, the sensitivity of A-CNN reached as high as 81.7% and 85.1%, respectively. [ABSTRACT FROM AUTHOR]

This paper presents the histological characterisation of a selection of worked bone artefacts from Middle Stone Age layers at Sibudu cave, South Africa. Histographic rendering is achieved using high-resolution Computed Tomography, which is non-destructive and facilitates three-dimensional histologic analysis. Excellent congruency in image quality was achieved with previous studies using this method. The results show that most of the artefact fragments contain mostly primary lamellar tissue, which is the bone tissue best adapted to withstand impact stresses. This indicates that bone with greater elastic properties was chosen. Histological characterisation allows the identification of animal taxa. Based on the sample analysed in this paper, Perissodactyla bone was used predominantly in the older layers at the site. Artiodactyla are represented throughout but appear far more frequently in the later (post-Howiesons Poort onwards) layers. Some of the Artiodactyla specimens have high proportions of Haversian tissue, reducing elasticity. The higher percentages of Haversian tissue in the post-Howiesons Poort artefacts relative to Holocene examples from southern Africa suggests that people may have started experimenting with bone from different animal taxa at this time and had not yet learned to eliminate the mechanically weaker secondary tissue. Apart from mechanical considerations, possible cultural constraints governing raw material selection is also explored. [ABSTRACT FROM AUTHOR]

This paper focuses on the application of deep learning (DL) in the diagnosis of coronavirus disease (COVID-19). The novelty of this work is in the introduction of optimized InceptionResNetV2 for COVID-19 (CO-IRv2) method. A part of the CO-IRv2 scheme is derived from the concepts of InceptionNet and ResNet with hyperparameter tuning, while the remaining part is a new architecture consisting of a global average pooling layer, batch normalization, dense layers, and dropout layers. The proposed CO-IRv2 is applied to a new dataset of 2481 computed tomography (CT) images formed by collecting two independent datasets. Data resizing and normalization are performed, and the evaluation is run up to 25 epochs. Various performance metrics, including precision, recall, accuracy, F1-score, area under the receiver operating characteristics (AUC) curve are used as performance metrics. The effectiveness of three optimizers known as Adam, Nadam and RMSProp are evaluated in classifying suspected COVID-19 patients and normal people. Results show that for CO-IRv2 and for CT images, the obtained accuracies of Adam, Nadam and RMSProp optimizers are 94.97%, 96.18% and 96.18%, respectively. Furthermore, it is shown here that for the case of CT images, CO-IRv2 with Nadam optimizer has better performance than existing DL algorithms in the diagnosis of COVID-19 patients. Finally, CO-IRv2 is applied to an X-ray dataset of 1662 images resulting in a classification accuracy of 99.40%. [ABSTRACT FROM AUTHOR]

Today, while many researchers focus on the improvement of the regularization term in IR algorithms, they pay less concern to the improvement of the fidelity term. In this paper, we hypothesize that improving the fidelity term will further improve IR image quality in low-dose scanning, which typically causes more noise. The purpose of this paper is to systematically test and examine the role of high-fidelity system models using raw data in the performance of iterative image reconstruction approach minimizing energy functional. We first isolated the fidelity term and analyzed the importance of using focal spot area modeling, flying focal spot location modeling, and active detector area modeling as opposed to just flying focal spot motion. We then compared images using different permutations of all three factors. Next, we tested the ability of the fidelity terms to retain signals upon application of the regularization term with all three factors. We then compared the differences between images generated by the proposed method and Filtered-Back-Projection. Lastly, we compared images of low-dose in vivo data using Filtered-Back-Projection, Iterative Reconstruction in Image Space, and the proposed method using raw data. The initial comparison of difference maps of images constructed showed that the focal spot area model and the active detector area model also have significant impacts on the quality of images produced. Upon application of the regularization term, images generated using all three factors were able to substantially decrease model mismatch error, artifacts, and noise. When the images generated by the proposed method were tested, conspicuity greatly increased, noise standard deviation decreased by 90% in homogeneous regions, and resolution also greatly improved. In conclusion, the improvement of the fidelity term to model clinical scanners is essential to generating higher quality images in low-dose imaging. [ABSTRACT FROM AUTHOR]

In recent years, the rapid development of deep neural networks has made great progress in automatic organ segmentation from abdominal CT scans. However, automatic segmentation for small organs (e.g., the pancreas) is still a challenging task. As an inconspicuous and small organ in the abdomen, the pancreas has a high degree of anatomical variability and is indistinguishable from the surrounding organs and tissues, which usually leads to a very vague boundary. Therefore, the accuracy of pancreatic segmentation is sometimes below satisfaction. In this paper, we propose a 2.5D U-net with an attention mechanism. The proposed network includes 2D convolutional layers and 3D convolutional layers, which means that it requires less computational resources than 3D segmentation models while it can capture more spatial information along the third dimension than 2D segmentation models. Then We use a cascaded framework to increase the accuracy of segmentation results. We evaluate our network on the NIH pancreas dataset and measure the segmentation accuracy by the Dice similarity coefficient (DSC). Experimental results demonstrate a better performance compared with state-of-the-art methods. [ABSTRACT FROM AUTHOR]

The correspondence of a stack of planar contours in ICT (industrial computed tomography)-based reverse engineering, a key step in surface reconstruction, is difficult when the contours or topology of the object are complex. Given the regularity of industrial parts and similarity of the inter-layer contours, a specialized shape-based inter-layer contours correspondence method for ICT-based reverse engineering was presented to solve the above problem based on the vectorized contours. In this paper, the vectorized contours extracted from the slices consist of three graphical primitives: circles, arcs and segments. First, the correspondence of the inter-layer primitives is conducted based on the characteristics of the primitives. Second, based on the corresponded primitives, the inter-layer contours correspond with each other using the proximity rules and exhaustive search. The proposed method can make full use of the shape information to handle industrial parts with complex structures. The feasibility and superiority of this method have been demonstrated via the related experiments. This method can play an instructive role in practice and provide a reference for the related research. [ABSTRACT FROM AUTHOR]

Purpose: Overweight and underweight conditions are considered relative contraindications to lung transplantation due to their association with excess mortality. Yet, recent work suggests that body mass index (BMI) does not accurately reflect adipose tissue mass in adults with advanced lung diseases. Alternative and more accurate measures of adiposity are needed. Chest fat estimation by routine computed tomography (CT) imaging may therefore be important for identifying high-risk lung transplant candidates. In this paper, an approach to chest fat quantification and quality assessment based on a recently formulated concept of standardized anatomic space (SAS) is presented. The goal of the paper is to seek answers to several key questions related to chest fat quantity and quality assessment based on a single slice CT (whether in the chest, abdomen, or thigh) versus a volumetric CT, which have not been addressed in the literature. Methods: Unenhanced chest CT image data sets from 40 adult lung transplant candidates (age 58 ± 12 yrs and BMI 26.4 ± 4.3 kg/m2), 16 with chronic obstructive pulmonary disease (COPD), 16 with idiopathic pulmonary fibrosis (IPF), and the remainder with other conditions were analyzed together with a single slice acquired for each patient at the L5 vertebral level and mid-thigh level. The thoracic body region and the interface between subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in the chest were consistently defined in all patients and delineated using Live Wire tools. The SAT and VAT components of chest were then segmented guided by this interface. The SAS approach was used to identify the corresponding anatomic slices in each chest CT study, and SAT and VAT areas in each slice as well as their whole volumes were quantified. Similarly, the SAT and VAT components were segmented in the abdomen and thigh slices. Key parameters of the attenuation (Hounsfield unit (HU) distributions) were determined from each chest slice and from the whole chest volume separately for SAT and VAT components. The same parameters were also computed from the single abdominal and thigh slices. The ability of the slice at each anatomic location in the chest (and abdomen and thigh) to act as a marker of the measures derived from the whole chest volume was assessed via Pearson correlation coefficient (PCC) analysis. Results: The SAS approach correctly identified slice locations in different subjects in terms of vertebral levels. PCC between chest fat volume and chest slice fat area was maximal at the T8 level for SAT (0.97) and at the T7 level for VAT (0.86), and was modest between chest fat volume and abdominal slice fat area for SAT and VAT (0.73 and 0.75, respectively). However, correlation was weak for chest fat volume and thigh slice fat area for SAT and VAT (0.52 and 0.37, respectively), and for chest fat volume for SAT and VAT and BMI (0.65 and 0.28, respectively). These same single slice locations with maximal PCC were found for SAT and VAT within both COPD and IPF groups. Most of the attenuation properties derived from the whole chest volume and single best chest slice for VAT (but not for SAT) were significantly different between COPD and IPF groups. Conclusions: This study demonstrates a new way of optimally selecting slices whose measurements may be used as markers of similar measurements made on the whole chest volume. The results suggest that one or two slices imaged at T7 and T8 vertebral levels may be enough to estimate reliably the total SAT and VAT components of chest fat and the quality of chest fat as determined by attenuation distributions in the entire chest volume. [ABSTRACT FROM AUTHOR]

As a powerful imaging tool, X-ray computed tomography (CT) allows us to investigate the inner structures of specimens in a quantitative and nondestructive way. Limited by the implementation conditions, CT with incomplete projections happens quite often. Conventional reconstruction algorithms are not easy to deal with incomplete data. They are usually involved with complicated parameter selection operations, also sensitive to noise and time-consuming. In this paper, we reported a deep learning reconstruction framework for incomplete data CT. It is the tight coupling of the deep learning U-net and CT reconstruction algorithm in the domain of the projection sinograms. The U-net estimated results are not the artifacts caused by the incomplete data, but the complete projection sinograms. After training, this framework is determined and can reconstruct the final high quality CT image from a given incomplete projection sinogram. Taking the sparse-view and limited-angle CT as examples, this framework has been validated and demonstrated with synthetic and experimental data sets. Embedded with CT reconstruction, this framework naturally encapsulates the physical imaging model of CT systems and is easy to be extended to deal with other challenges. This work is helpful to push the application of the state-of-the-art deep learning techniques in the field of CT. [ABSTRACT FROM AUTHOR]

Several biological tissues undergo changes in their geometry and in their bulk material properties by modelling and remodelling processes. Modelling synthesises tissue in some regions and removes tissue in others. Remodelling overwrites old tissue material properties with newly formed, immature tissue properties. As a result, tissues are made up of different “patches”, i.e., adjacent tissue regions of different ages and different material properties, within evolving boundaries. In this paper, generalised equations governing the spatio-temporal evolution of such tissues are developed within the continuum model. These equations take into account nonconservative, discontinuous surface mass balance due to creation and destruction of material at moving interfaces, and bulk balance due to tissue maturation. These equations make it possible to model patchy tissue states and their evolution without explicitly maintaining a record of when/where resorption and formation processes occurred. The time evolution of spatially averaged tissue properties is derived systematically by integration. These spatially-averaged equations cannot be written in closed form as they retain traces that tissue destruction is localised at tissue boundaries. The formalism developed in this paper is applied to bone tissues, which exhibit strong material heterogeneities due to their slow mineralisation and remodelling processes. Evolution equations are proposed in particular for osteocyte density and bone mineral density. Effective average equations for bone mineral density (BMD) and tissue mineral density (TMD) are derived using a mean-field approximation. The error made by this approximation when remodelling patchy tissue is investigated. The specific signatures of the time evolution of BMD or TMD during remodelling events are exhibited. These signatures may provide a way to detect remodelling events at lower, unseen spatial resolutions from microCT scans. [ABSTRACT FROM AUTHOR]

Repeating X-ray computed tomography (CT) measurements over a short period of time allows for obtaining a spatiotemporal four-dimensional (4D) volume image. This study presents an interactive method for segmenting a 4DCT image by fitting a template model to a target organ. The template consists of a three-dimensional (3D) mesh model and free-form-deformation (FFD) cage enclosing the mesh. The user deforms the template by placing multiple curve constraints that specify the boundary shape of the template in 3D space. We also present curve constraints shared over all time frames and interpolated along the time axis to facilitate efficient curve specification. Our method formulates the template deformation using the FFD cage modification, allowing the user to switch between our curve-based method and traditional FFD at any time. To illustrate the feasibility of our method, we show segmentation results in which we could accurately segment three organs from a 4DCT image capturing a swallowing motion. To evaluate the usability of our method, we conducted a user study comparing our curve-based method with the cage-based FFD. We found that the participants finished segmentation in approximately 20% interaction time periods on average with our method. [ABSTRACT FROM AUTHOR]

Purpose: To develop a better radiomic model for the differential diagnosis of benign and lung adenocarcinoma lesions presenting as larger solid nodules and masses based on multiscale computed tomography (CT) radiomics. Materials and methods: This retrospective study enrolled 205 patients with solid nodules and masses from Center 1 between January 2010 and February 2022 and Center 2 between January 2019 and February 2022. After applying the inclusion and exclusion criteria, we retrospectively enrolled 165 patients from two centers and assigned them to the training dataset (n = 115) or the test dataset (n = 50). Radiomics features were extracted from volumes of interest on CT images. A gradient boosting decision tree (GBDT) was used for data dimensionality reduction to perform the final feature selection. Four models were developed using clinical data, conventional imaging features and radiomics features, namely, the clinical and image model (CIM), the plain CT radiomics model (PRM), the enhanced CT radiomics model (ERM) and the combined model (CM). Model performance was evaluated to determine the best model for identifying benign and lung adenocarcinoma presenting as larger solid nodules and masses. Results: In the training dataset, the areas under the curve (AUCs) for the CIM, PRM, ERM, and CM were 0.718, 0.806, 0.819, and 0.917, respectively. The differential diagnostic capability of the ERM was better than that of the PRM and the CIM. The CM was optimal. Intermediate and junior radiologists and respiratory physicians achieved improved obviously diagnostic results with the radiomics model. The senior radiologists showed slight improved diagnostic results after using the radiomics model. Conclusion: Radiomics may have the potential to be used as a noninvasive tool for the differential diagnosis of benign and lung adenocarcinoma lesions presenting as larger solid nodules and masses. [ABSTRACT FROM AUTHOR]

Skeletal muscle index measurement via dual-energy X-ray absorptiometry or bioelectrical impedance analysis is used to evaluate muscle mass when diagnosing sarcopenia. However, inherent challenges exist with these methods. We previously focused on muscle mass evaluation in the quadriceps femoris by using computed tomography (CT). In this observational study, we utilized a new ultrasound device with a wide field of view that can obtain CT-like images and investigated its usefulness. Reproducibility was investigated by calculating the intra- and inter-examiner intraclass correlation coefficient (ICC) by using three examiners and performing five measurements in 12 participants. In 123 participants (48 men, 75 women, mean age 78.2 ± 8.1 years), we investigated the correlation between the quadriceps cross-sectional area measured with supine ultrasound and CT images as well as between supine and sitting ultrasound images. Unadjusted, age-adjusted, and age–sex-adjusted correlations were calculated. Reproducibility was excellent (intra-examiner ICC[1,1]: 0.978, 0.987, and 0.994; inter-examiner ICC[2,1]: 0.993). The unadjusted, age-adjusted, and age–sex-adjusted correlations between the quadriceps cross-sectional area measured using supine ultrasound and CT were 0.949, 0.940, and 0.894, respectively. For sitting ultrasound, the corresponding values were 0.958, 0.953, and 0.912, respectively. Correlations between the supine and sitting ultrasound measurements were also good, with corresponding values of 0.952, 0.945, and 0.904, respectively. The tested ultrasound device showed excellent measurement reproducibility and had good correlations with CT images. Further studies with an increased numbers of clinical cases and additional evaluations should allow the device to become a screening tool for diagnosing sarcopenia. [ABSTRACT FROM AUTHOR]

Background: To address the numerous unmeet clinical needs, in recent years several Machine Learning models applied to medical images and clinical data have been introduced and developed. Even when they achieve encouraging results, they lack evolutionary progression, thus perpetuating their status as autonomous entities. We postulated that different algorithms which have been proposed in the literature to address the same diagnostic task, can be aggregated to enhance classification performance. We suggested a proof of concept to define an ensemble approach useful for integrating different algorithms proposed to solve the same clinical task. Methods: The proposed approach was developed starting from a public database consisting of radiomic features extracted from CT images relating to 535 patients suffering from lung cancer. Seven algorithms were trained independently by participants in the AI4MP working group on Artificial Intelligence of the Italian Association of Physics in Medicine to discriminate metastatic from non-metastatic patients. The classification scores generated by these algorithms are used to train SVM classifier. The Explainable Artificial Intelligence approach is applied to the final model. The ensemble model was validated following an 80–20 hold-out and leave-one-out scheme on the training set. Results: Compared to individual algorithms, a more accurate result was achieved. On the independent test the ensemble model achieved an accuracy of 0.78, a F1-score of 0.57 and a log-loss of 0.49. Shapley values representing the contribution of each algorithm to the final classification result of the ensemble model were calculated. This information represents an added value for the end user useful for evaluating the appropriateness of the classification result on a particular case. It also allows us to evaluate on a global level which methodological approaches of the individual algorithms are likely to have the most impact. Conclusion: Our proposal represents an innovative approach useful for integrating different algorithms that populate the literature and which lays the foundations for future evaluations in broader application scenarios. [ABSTRACT FROM AUTHOR]

Objective: To address the relationship between tissue accumulation of advanced glycation end-products, assessed by skin autofluorescence (SAF), and subclinical atherosclerosis quantified with coronary artery calcium score (CACS) in the general Dutch population. Methods: A total of 3,839 participants of the LifeLines Cohort Study without diabetes or cardiovascular disease were included in this cross-sectional evaluation. They underwent SAF measurement and cardiac computed tomography to measure CACS. Associations between SAF and CACS was assessed using regression models. Participants at elevated risk for cardiovascular disease were selected by either CACS≥100, or SAF value in the top 15%; overlap and cardiovascular risk profile of these participants were compared. Results: In univariate analysis, every 1 arbitrary unit (AU) increase in SAF resulted in an odds ratio of 2.91 (95% confidence interval 2.44–3.48, p<0.001) for coronary calcification. After adjustment for cardiovascular risk factors, there was still 20% higher odds of coronary calcification with 1 AU increase in SAF, but significance was lost. In total, 1025 (27%) participants either had high SAF and/or high CACS, of these 441 (12%) had only high SAF, 450 (12%) had only high CACS and 134 (3%) participants had high SAF and high CACS. Conclusion: In a population-based Dutch cohort, SAF was associated with the degree of coronary calcification. This association was largely explained by classical cardiovascular risk factors. Limited overlap was found in subgroups with high SAF or high CACS, indicating that SAF and CACS may have complementary role in identifying individuals at elevated cardiovascular risk. [ABSTRACT FROM AUTHOR]

Bakground: To evaluate the quantitative and qualitative image quality using deep learning image reconstruction (DLIR) of pediatric cardiac computed tomography (CT) compared with conventional image reconstruction methods. Methods: Between January 2020 and December 2022, 109 pediatric cardiac CT scans were included in this study. The CT scans were reconstructed using an adaptive statistical iterative reconstruction-V (ASiR-V) with a blending factor of 80% and three levels of DLIR with TrueFidelity (low-, medium-, and high-strength settings). Quantitative image quality was measured using signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). The edge rise distance (ERD) and angle between 25% and 75% of the line density profile were drawn to evaluate sharpness. Qualitative image quality was assessed using visual grading analysis scores. Results: A gradual improvement in the SNR and CNR was noted among the strength levels of the DLIR in sequence from low to high. Compared to ASiR-V, high-level DLIR showed significantly improved SNR and CNR (P<0.05). ERD decreased with increasing angle as the level of DLIR increased. Conclusion: High-level DLIR showed improved SNR and CNR compared to ASiR-V, with better sharpness on pediatric cardiac CT scans. [ABSTRACT FROM AUTHOR]

Background/purpose: Distal radius fractures (DRFs) account for approximately 18% of fractures in patients 65 years and older. While plain radiographs are standard, the value of high-resolution computed tomography (CT) for detailed imaging crucial for diagnosis, prognosis, and intervention planning, and increasingly recognized. High-definition 3D reconstructions from CT scans are vital for applications like 3D printing in orthopedics and for the utility of mobile C-arm CT in orthopedic diagnostics. However, concerns over radiation exposure and suboptimal image resolution from some devices necessitate the exploration of advanced computational techniques for refining CT imaging without compromising safety. Therefore, this study aims to utilize conditional Generative Adversarial Networks (cGAN) to improve the resolution of 3 mm CT images (CT enhancement). Methods: Following institutional review board approval, 3 mm-1 mm paired CT data from 11 patients with DRFs were collected. cGAN was used to improve the resolution of 3 mm CT images to match that of 1 mm images (CT enhancement). Two distinct methods were employed for training and generating CT images. In Method 1, a 3 mm CT raw image was used as input with the aim of generating a 1 mm CT raw image. Method 2 was designed to emphasize the difference value between the 3 mm and 1 mm images; using a 3 mm CT raw image as input, it produced the difference in image values between the 3 mm and 1 mm CT scans. Both quantitative metrics, such as peak signal-to-noise ratio (PSNR), mean squared error (MSE), and structural similarity index (SSIM), and qualitative assessments by two orthopedic surgeons were used to evaluate image quality by assessing the grade (1~4, which low number means high quality of resolution). Results: Quantitative evaluations showed that our proposed techniques, particularly emphasizing the difference value in Method 2, consistently outperformed traditional approaches in achieving higher image resolution. In qualitative evaluation by two clinicians, images from method 2 showed better quality of images (grade: method 1, 2.7; method 2, 2.2). And more choice was found in method 2 for similar image with 1 mm slice image (15 vs 7, p = 201). Conclusion: In our study utilizing cGAN for enhancing CT imaging resolution, the authors found that the method, which focuses on the difference value between 3 mm and 1 mm images (Method 2), consistently outperformed. [ABSTRACT FROM AUTHOR]

In this paper, we present a method for automated estimation of a human face given a skull remain. Our proposed method is based on three statistical models. A volumetric (tetrahedral) skull model encoding the variations of different skulls, a surface head model encoding the head variations, and a dense statistic of facial soft tissue thickness (FSTT). All data are automatically derived from computed tomography (CT) head scans and optical face scans. In order to obtain a proper dense FSTT statistic, we register a skull model to each skull extracted from a CT scan and determine the FSTT value for each vertex of the skull model towards the associated extracted skin surface. The FSTT values at predefined landmarks from our statistic are well in agreement with data from the literature. To recover a face from a skull remain, we first fit our skull model to the given skull. Next, we generate spheres with radius of the respective FSTT value obtained from our statistic at each vertex of the registered skull. Finally, we fit a head model to the union of all spheres. The proposed automated method enables a probabilistic face-estimation that facilitates forensic recovery even from incomplete skull remains. The FSTT statistic allows the generation of plausible head variants, which can be adjusted intuitively using principal component analysis. We validate our face recovery process using an anonymized head CT scan. The estimation generated from the given skull visually compares well with the skin surface extracted from the CT scan itself. [ABSTRACT FROM AUTHOR]

We describe in this paper the experimental procedure, the data treatment and the quantification of the black body correction: an experimental approach to compensate for scattering and systematic biases in quantitative neutron imaging based on experimental data. The correction algorithm is based on two steps; estimation of the scattering component and correction using an enhanced normalization formula. The method incorporates correction terms into the image normalization procedure, which usually only includes open beam and dark current images (open beam correction). Our aim is to show its efficiency and reproducibility: we detail the data treatment procedures and quantitatively investigate the effect of the correction. Its implementation is included within the open source CT reconstruction software MuhRec. The performance of the proposed algorithm is demonstrated using simulated and experimental CT datasets acquired at the ICON and NEUTRA beamlines at the Paul Scherrer Institut. [ABSTRACT FROM AUTHOR]

X-ray phase-contrast tomography can significantly increase the contrast-resolution of conventional attenuation-contrast imaging, especially for soft-tissue structures that have very similar attenuation. Just as in attenuation-based tomography, phase contrast tomography requires a linear dependence of aggregate beam direction on the incremental direction alteration caused by individual voxels along the path of the X-ray beam. Dense objects such as calcifications in biological specimens violate this condition. There are extensive beam deflection artefacts in the vicinity of such structures because they result in large distortion of wave front due to the large difference of refractive index; for such large changes in beam direction, the transmittance of the silicon analyzer crystal saturates and is no longer linearly dependent on the angle of refraction. This paper describes a method by which these effects can be overcome and excellent soft-tissue contrast of phase tomography can be preserved in the vicinity of such artefact-producing structures. [ABSTRACT FROM AUTHOR]

Prevention of brain injury in woodpeckers under high deceleration during the pecking process has been an intriguing biomechanical problem for a long time. Several studies have provided different explanations, but the function of the hyoid bone, one of the more interesting skeletal features of a woodpecker, still has not been fully explored. This paper studies the relationship between a woodpecker head’s response to impact and the hyoid bone. Based on micro-CT scanning images, the material point method (MPM) is employed to simulate woodpecker’s pecking process. The maximum shear stress in the brainstem (SSS) is adopted as an indicator of brain injury. The motion and deformation of the first cervical vertebra is found to be the main reason of the shear stress of the brain. Our study found that the existence of the hyoid bone reduces the SSS level, enhances the rigidity of the head, and suppresses the oscillation of the endoskeleton after impact. The mechanism is explained by a brief mechanical analysis while the influence of the material properties of the muscle is also discussed. [ABSTRACT FROM AUTHOR]

Purpose: This paper lays the groundwork for linking Hounsfield unit measurements to the International System of Units (SI), ultimately enabling traceable measurements across X-ray CT (XCT) machines. We do this by characterizing a material basis that may be used in XCT reconstruction giving linear combinations of concentrations of chemical elements (in the SI units of mol/m3) which may be observed at each voxel. By implication, linear combinations not in the set are not observable. Methods and materials: We formulated a model for our material basis with a set of measurements of elemental powders at four tube voltages, 80 kV, 100 kV, 120 kV, and 140 kV, on a medical XCT. The samples included 30 small plastic bottles of powders containing various compounds spanning the atomic numbers up to 20, and a bottle of water and one of air. Using the chemical formulas and measured masses, we formed a matrix giving the number of Hounsfield units per (mole per cubic meter) at each tube voltage for each of 13 chemical elements. We defined a corresponding matrix in units we call molar Hounsfield unit (HU) potency, the difference in HU values that an added mole per cubic meter in a given voxel would add to the measured HU value. We built a matrix of molar potencies for each chemical element and tube voltage and performed a singular value decomposition (SVD) on these to formulate our material basis. We determined that the dimension of this basis is two. We then compared measurements in this material space with theoretical measurements, combining XCOM cross section data with the tungsten anode spectral model using interpolating cubic splines (TASMICS), a one-parameter filter, and a simple detector model, creating a matrix similar to our experimental matrix for the first 20 chemical elements. Finally, we compared the model predictions to Hounsfield unit measurements on three XCT calibration phantoms taken from the literature. Results: We predict the experimental HU potency values derived from our scans of chemical elements with our theoretical model built from XCOM data. The singular values and singular vectors of the model and powder measurements are in substantial agreement. Application of the Bayesian Information Criterion (BIC) shows that exactly two singular values and singular vectors describe the results over four tube voltages. We give a good account of the HU values from the literature, measured for the calibration phantoms at several tube voltages for several commercial instruments, compared with our theoretical model without introducing additional parameters. Conclusions: We have developed a two-dimensional material basis that specifies the degree to which individual elements in compounds effect the HU values in XCT images of samples with elements up to atomic number Z = 20. We show that two dimensions is sufficient given the contrast and noise in our experiment. The linear combination of concentrations of elements that can be observed using a medical XCT have been characterized, providing a material basis for use in dual-energy reconstruction. This approach provides groundwork for improved reconstruction and for the link of Hounsfield units to the SI. [ABSTRACT FROM AUTHOR]

Analytical CT reconstruction is popular in practice because of its computational efficiency, but it suffers from low reconstruction quality when an insufficient number of projections are used. To address this issue, this paper presents a new analytical method of backprojection Wiener deconvolution (BPWD). BPWD executes backprojection first, and then applies a Wiener deconvolution to the whole backprojected image. The Wiener filter is derived from a ramp filter, enabling the proposed approach to perform reconstruction and denoising simultaneously. The use of a filter after backprojection does not differentiate between real sampled projections and interpolated ones, introducing reconstruction errors. Therefore a weighted ramp filter was applied to increase the contribution of real sampled projections in the reconstruction, thus improving reconstruction quality. Experiments on synthetic data and real phase-contrast x-ray images showed that the proposed approach yields better reconstruction quality compared to the classical filtered backprojection (FBP) method, with comparable reconstruction speed. [ABSTRACT FROM AUTHOR]