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4D cone-beam computed tomography (CBCT) plays a critical role in adaptive radiation therapy for lung cancer. However, extremely sparse sampling projection data will cause severe streak artifacts in 4D CBCT images. Existing deep learning (DL) methods heavily rely on large labeled training datasets which are difficult to obtain in practical scenarios. Restricted by this dilemma, DL models often struggle with simultaneously retaining dynamic motions, removing streak degradations, and recovering fine details. To address the above challenging problem, we introduce a Deep Prior Image Constrained Motion Compensation framework (DPI-MoCo) that decouples the 4D CBCT reconstruction into two sub-tasks including coarse image restoration and structural detail fine-tuning. In the first stage, the proposed DPI-MoCo combines the prior image guidance, generative adversarial network, and contrastive learning to globally suppress the artifacts while maintaining the respiratory movements. After that, to further enhance the local anatomical structures, the motion estimation and compensation technique is adopted. Notably, our framework is performed without the need for paired datasets, ensuring practicality in clinical cases. In the Monte Carlo simulation dataset, the DPI-MoCo achieves competitive quantitative performance compared to the state-of-the-art (SOTA) methods. Furthermore, we test DPI-MoCo in clinical lung cancer datasets, and experiments validate that DPI-MoCo not only restores small anatomical structures and lesions but also preserves motion information.

Quantitative infarct estimation is crucial for diagnosis, treatment and prognosis in acute ischemic stroke (AIS) patients. As the early changes of ischemic tissue are subtle and easily confounded by normal brain tissue, it remains a very challenging task. However, existing methods often ignore or confuse the contribution of different types of anatomical asymmetry caused by intrinsic and pathological changes to segmentation. Further, inefficient domain knowledge utilization leads to mis-segmentation for AIS infarcts. Inspired by this idea, we propose a pathological asymmetry-guided progressive learning (PAPL) method for AIS infarct segmentation. PAPL mimics the step-by-step learning patterns observed in humans, including three progressive stages: knowledge preparation stage, formal learning stage, and examination improvement stage. First, knowledge preparation stage accumulates the preparatory domain knowledge of the infarct segmentation task, helping to learn domain-specific knowledge representations to enhance the discriminative ability for pathological asymmetries by constructed contrastive learning task. Then, formal learning stage efficiently performs end-to-end training guided by learned knowledge representations, in which the designed feature compensation module (FCM) can leverage the anatomy similarity between adjacent slices from the volumetric medical image to help aggregate rich anatomical context information. Finally, examination improvement stage encourages improving the infarct prediction from the previous stage, where the proposed perception refinement strategy (RPRS) further exploits the bilateral difference comparison to correct the mis-segmentation infarct regions by adaptively regional shrink and expansion. Extensive experiments on public and in-house NCCT datasets demonstrated the superiority of the proposed PAPL, which is promising to help better stroke evaluation and treatment.

Internet of Medical Things (IoMT) and telemedicine technologies utilize computers, communications, and medical devices to facilitate off-site exchanges between specialists and patients, specialists, and medical staff. If the information communicated in IoMT is illegally steganography, tampered or leaked during transmission and storage, it will directly impact patient privacy or the consultation results with possible serious medical incidents. Steganalysis is of great significance for the identification of medical images transmitted illegally in IoMT and telemedicine. In this article, we propose a Residual and Enhanced Discriminative Network (RED-Net) for image steganalysis in the internet of medical things and telemedicine. RED-Net consists of a steganographic information enhancement module, a deep residual network, and steganographic information discriminative mechanism. Specifically, a steganographic information enhancement module is adopted by the RED-Net to boost the illegal steganographic signal in texturally complex high-dimensional medical image features. A deep residual network is utilized for steganographic feature extraction and compression. A steganographic information discriminative mechanism is employed by the deep residual network to enable it to recalibrate the steganographic features and drop high-frequency features that are mistaken for steganographic information. Experiments conducted on public and private datasets with data hiding payloads ranging from 0.1bpp/bpnzac-0.5bpp/bpnzac in the spatial and JPEG domain led to RED-Net's steganalysis error P E in the range of 0.0732-0.0010 and 0.231-0.026, respectively. In general, qualitative and quantitative results on public and private datasets demonstrate that the RED-Net outperforms 8 state-of-art steganography detectors.

Low-dose computed tomography (LDCT) imaging faces great challenges. Although supervised learning has revealed great potential, it requires sufficient and high-quality references for network training. Therefore, existing deep learning methods have been sparingly applied in clinical practice. To this end, this paper presents a novel Unsharp Structure Guided Filtering (USGF) method, which can reconstruct high-quality CT images directly from low-dose projections without clean references. Specifically, we first employ low-pass filters to estimate the structure priors from the input LDCT images. Then, inspired by classical structure transfer techniques, deep convolutional networks are adopted to implement our imaging method which combines guided filtering and structure transfer. Finally, the structure priors serve as the guidance images to alleviate over-smoothing, as they can transfer specific structural characteristics to the generated images. Furthermore, we incorporate traditional FBP algorithms into self-supervised training to enable the transformation of projection domain data to the image domain. Extensive comparisons and analyses on three datasets demonstrate that the proposed USGF has achieved superior performance in terms of noise suppression and edge preservation, and could have a significant impact on LDCT imaging in the future.

The deep learning-based automatic recognition of the scanning or exposing region in medical imaging automation is a promising new technique, which can decrease the heavy workload of the radiographers, optimize imaging workflow and improve image quality. However, there is little related research and practice in X-ray imaging. In this paper, we focus on two key problems in X-ray imaging automation: automatic recognition of the exposure moment and the exposure region. Consequently, we propose an automatic video analysis framework based on the hybrid model, approaching real-time performance. The framework consists of three interdependent components: Body Structure Detection, Motion State Tracing, and Body Modeling. Body Structure Detection disassembles the patient to obtain the corresponding body keypoints and body Bboxes. Combining and analyzing the two different types of body structure representations is to obtain rich spatial location information about the patient body structure. Motion State Tracing focuses on the motion state analysis of the exposure region to recognize the appropriate exposure moment. The exposure region is calculated by Body Modeling when the exposure moment appears. A large-scale dataset for X-ray examination scene is built to validate the performance of the proposed method. Extensive experiments demonstrate the superiority of the proposed method in automatically recognizing the exposure moment and exposure region. This paradigm provides the first method that can enable automatically and accurately recognize the exposure region in X-ray imaging without the help of the radiographer.

X-ray computed tomography (CT) is of great clinical significance in medical practice because it can provide anatomical information about the human body without invasion, while its radiation risk has continued to attract public concerns. Reducing the radiation dose may induce noise and artifacts to the reconstructed images, which will interfere with the judgments of radiologists. Previous studies have confirmed that deep learning (DL) is promising for improving low-dose CT imaging. However, almost all the DL-based methods suffer from subtle structure degeneration and blurring effect after aggressive denoising, which has become the general challenging issue. This paper develops the Comprehensive Learning Enabled Adversarial Reconstruction (CLEAR) method to tackle the above problems. CLEAR achieves subtle structure enhanced low-dose CT imaging through a progressive improvement strategy. First, the generator established on the comprehensive domain can extract more features than the one built on degraded CT images and directly map raw projections to high-quality CT images, which is significantly different from the routine GAN practice. Second, a multi-level loss is assigned to the generator to push all the network components to be updated towards high-quality reconstruction, preserving the consistency between generated images and gold-standard images. Finally, following the WGAN-GP modality, CLEAR can migrate the real statistical properties to the generated images to alleviate over-smoothing. Qualitative and quantitative analyses have demonstrated the competitive performance of CLEAR in terms of noise suppression, structural fidelity and visual perception improvement.

In low dose computed tomography (LDCT) imaging, the data inconsistency of measured noisy projections can significantly deteriorate reconstruction images. To deal with this problem, we propose here a new sinogram restoration approach, the sinogram- discriminative feature representation (S-DFR) method. Different from other sinogram restoration methods, the proposed method works through a 3-D representation-based feature decomposition of the projected attenuation component and the noise component using a well-designed composite dictionary containing atoms with discriminative features. This method can be easily implemented with good robustness in parameter setting. Its comparison to other competing methods through experiments on simulated and real data demonstrated that the S-DFR method offers a sound alternative in LDCT.

In this paper, we focus on the "blind" identification of the computed tomography (CT) scanner that has produced a CT image. To do so, we propose a set of noise features derived from the image chain acquisition and which can be used as CT-scanner footprint. Basically, we propose two approaches. The first one aims at identifying a CT scanner based on an original sensor pattern noise (OSPN) that is intrinsic to the X-ray detectors. The second one identifies an acquisition system based on the way this noise is modified by its three-dimensional (3-D) image reconstruction algorithm. As these reconstruction algorithms are manufacturer dependent and kept secret, our features are used as input to train a support vector machine (SVM) based classifier to discriminate acquisition systems. Experiments conducted on images issued from 15 different CT-scanner models of 4 distinct manufacturers demonstrate that our system identifies the origin of one CT image with a detection rate of at least 94% and that it achieves better performance than sensor pattern noise (SPN) based strategy proposed for general public camera devices.

This paper describes a computer-aided detection and diagnosis system for breast cancer, the most common form of cancer among women, using mammography. The system relies on the Multiple-Instance Learning (MIL) paradigm, which has proven useful for medical decision support in previous works from our team. In the proposed framework, breasts are first partitioned adaptively into regions. Then, features derived from the detection of lesions (masses and microcalcifications) as well as textural features, are extracted from each region and combined in order to classify mammography examinations as "normal" or "abnormal". Whenever an abnormal examination record is detected, the regions that induced that automated diagnosis can be highlighted. Two strategies are evaluated to define this anomaly detector. In a first scenario, manual segmentations of lesions are used to train an SVM that assigns an anomaly index to each region; local anomaly indices are then combined into a global anomaly index. In a second scenario, the local and global anomaly detectors are trained simultaneously, without manual segmentations, using various MIL algorithms (DD, APR, mi-SVM, MI-SVM and MILBoost). Experiments on the DDSM dataset show that the second approach, which is only weakly-supervised, surprisingly outperforms the first approach, even though it is strongly-supervised. This suggests that anomaly detectors can be advantageously trained on large medical image archives, without the need for manual segmentation.

In this paper, we present a medical image integrity verification system to detect and approximate local malevolent image alterations (e.g., removal or addition of lesions) as well as identifying the nature of a global processing an image may have undergone (e.g., lossy compression, filtering, etc.). The proposed integrity analysis process is based on nonsignificant region watermarking with signatures extracted from different pixel blocks of interest, which are compared with the recomputed ones at the verification stage. A set of three signatures is proposed. The first two devoted to detection and modification location are cryptographic hashes and checksums, while the last one is issued from the image moment theory. In this paper, we first show how geometric moments can be used to approximate any local modification by its nearest generalized 2-D Gaussian. We then demonstrate how ratios between original and recomputed geometric moments can be used as image features in a classifier-based strategy in order to determine the nature of a global image processing. Experimental results considering both local and global modifications in MRI and retina images illustrate the overall performances of our approach. With a pixel block signature of about 200 bit long, it is possible to detect, to roughly localize, and to get an idea about the image tamper.

This work presents the first method of digital blind forensics within the medical imaging field with the objective to detect whether an image has been modified by some processing (e.g. filtering, lossy compression and so on). It compares two image features: the Histogram statistics of Reorganized Block-based Discrete cosine transform coefficients (HRBD), originally proposed for steganalysis purposes, and the Histogram statistics of Reorganized Block-based Tchebichef moments (HRBT). Both features serve as input of a set of SVM classifiers built in order to discriminate tampered images from original ones as well as to identify the nature of the global modification one image may have undergone. Performance evaluation, conducted in application to different medical image modalities, shows that these image features can help, independently or jointly, to blindly distinguish image processing or modifications with a detection rate greater than 70%. They also underline the complementarity of these features.

In this paper, we propose a joint encryption/water-marking system for the purpose of protecting medical images. This system is based on an approach which combines a substitutive watermarking algorithm, the quantization index modulation, with an encryption algorithm: a stream cipher algorithm (e.g., the RC4) or a block cipher algorithm (e.g., the AES in cipher block chaining (CBC) mode of operation). Our objective is to give access to the outcomes of the image integrity and of its origin even though the image is stored encrypted. If watermarking and encryption are conducted jointly at the protection stage, watermark extraction and decryption can be applied independently. The security analysis of our scheme and experimental results achieved on 8-bit depth ultrasound images as well as on 16-bit encoded positron emission tomography images demonstrate the capability of our system to securely make available security attributes in both spatial and encrypted domains while minimizing image distortion. Furthermore, by making use of the AES block cipher in CBC mode, the proposed system is compliant with or transparent to the DICOM standard.

Geometric distortions are generally simple and effective attacks for many watermarking methods. They can make detection and extraction of the embedded watermark difficult or even impossible by destroying the synchronization between the watermark reader and the embedded watermark. In this paper, we propose a new watermarking approach which allows watermark detection and extraction under affine transformation attacks. The novelty of our approach stands on a set of affine invariants we derived from Legendre moments. Watermark embedding and detection are directly performed on this set of invariants. We also show how these moments can be exploited for estimating the geometric distortion parameters in order to permit watermark extraction. Experimental results show that the proposed watermarking scheme is robust to a wide range of attacks: geometric distortion, filtering, compression, and additive noise.

The derivation of moment invariants has been extensively investigated in the past decades. In this paper, we construct a set of invariants derived from Zernike moments which is simultaneously invariant to similarity transformation and to convolution with circularly symmetric point spread function (PSF). Two main contributions are provided: the theoretical framework for deriving the Zernike moments of a blurred image and the way to construct the combined geometric-blur invariants. The performance of the proposed descriptors is evaluated with various PSFs and similarity transformations. The comparison of the proposed method with the existing ones is also provided in terms of pattern recognition accuracy, template matching and robustness to noise. Experimental results show that the proposed descriptors perform on the overall better.

Processing blurred images is a key problem in many image applications. Existing methods to obtain blur invariants which are invariant with respect to centrally symmetric blur are based on geometric moments or complex moments. In this paper, we propose a new method to construct a set of blur invariants using the orthogonal Legendre moments. Some important properties of Legendre moments for the blurred image are presented and proved. The performance of the proposed descriptors is evaluated with various point-spread functions and different image noises. The comparison of the present approach with previous methods in terms of pattern recognition accuracy is also provided. The experimental results show that the proposed descriptors are more robust to noise and have better discriminative power than the methods based on geometric or complex moments.

To improve medical image sharing in applications such as e-learning or remote diagnosis aid, we propose to make the image more usable by watermarking it with a digest of its associated knowledge. The aim of such a knowledge digest (KD) is for it to be used for retrieving similar images with either the same findings or differential diagnoses. It summarizes the symbolic descriptions of the image, the symbolic descriptions of the findings semiology, and the similarity rules that contribute to balancing the importance of previous descriptors when comparing images. Instead of modifying the image file format by adding some extra header information, watermarking is used to embed the KD in the pixel gray-level values of the corresponding images. When shared through open networks, watermarking also helps to convey reliability proofs (integrity and authenticity) of an image and its KD. The interest of these new image functionalities is illustrated in the updating of the distributed users' databases within the framework of an e-learning application demonstrator of endoscopic semiology.