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Optical coherence tomography (OCT) has been widely adopted in research on coronary atherosclerosis and adopted clinically to optimize percutaneous coronary intervention. In this Review, Jang and colleagues summarize this rapidly progressing field, with the aim of standardizing the use of OCT in coronary atherosclerosis.Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing with the rapid progression of atherosclerosis. Accurate detection by OCT of sequelae from percutaneous coronary interventions that might be missed by angiography could improve clinical outcomes. In addition, OCT has become an essential diagnostic modality for myocardial infarction with non-obstructive coronary arteries. Insight into neoatherosclerosis from OCT could improve our understanding of the mechanisms of very late stent thrombosis. The appropriate use of OCT depends on accurate interpretation and understanding of the clinical significance of OCT findings. In this Review, we summarize the state of the art in cardiac OCT and facilitate the uniform use of this modality in coronary atherosclerosis. Contributions have been made by clinicians and investigators worldwide with extensive experience in OCT, with the aim that this document will serve as a standard reference for future research and clinical application.

Healed coronary plaques, morphologically characterized by a layered phenotype, are signs of previous plaque destabilization and healing. Recent optical coherence tomography (OCT) studies demonstrated that layered plaque is associated with higher levels of local and systemic inflammation and rapid plaque progression. However, the diagnosis of layered plaque needs expertise in OCT image analysis and is susceptible to inter-observer variability. We developed a deep learning (DL) model for an accurate diagnosis of layered plaque. A Visual Transformer (ViT)-based DL model that integrates information from adjacent frames emulating the cardiologists who review consecutive OCT frames to make a diagnosis was developed and compared with the standard convolutional neural network (CNN) model. A total of 237,021 cross-sectional OCT images from 581 patients collected from 8 sites were used for training and internal validation, and 65,394 images from 292 patients collected from another site were used for external validation. In the five-fold cross-validation, the ViT-based model provided better performance (area under the curve [AUC]: 0.860; 95% confidence interval [CI]: 0.855–0.866) than the standard CNN-based model (AUC: 0.799; 95% CI: 0.792–0.805). The ViT-based model (AUC: 0.845; 95% CI: 0.837–0.853) also surpassed the standard CNN-based model (AUC: 0.791; 95% CI: 0.782–0.800) in the external validation. The ViT-based DL model can accurately diagnose a layered plaque, which could help risk stratification for cardiac events.

Although deep learning-based computer-aided diagnosis systems have recently achieved expert-level performance, developing a robust model requires large, high-quality data with annotations that are expensive to obtain. This situation poses a conundrum that annually-collected chest x-rays cannot be utilized due to the absence of labels, especially in deprived areas. In this study, we present a framework named distillation for self-supervision and self-train learning (DISTL) inspired by the learning process of the radiologists, which can improve the performance of vision transformer simultaneously with self-supervision and self-training through knowledge distillation. In external validation from three hospitals for diagnosis of tuberculosis, pneumothorax, and COVID-19, DISTL offers gradually improved performance as the amount of unlabeled data increase, even better than the fully supervised model with the same amount of labeled data. We additionally show that the model obtained with DISTL is robust to various real-world nuisances, offering better applicability in clinical setting.

(1) To compare low-contrast detectability of a deep learning–based denoising algorithm (DLA) with ADMIRE and FBP, and (2) to compare image quality parameters of DLA with those of reconstruction methods from two different CT vendors (ADMIRE, IMR, and FBP). Using abdominal CT images of 100 patients reconstructed via ADMIRE and FBP, we trained DLA by feeding FBP images as input and ADMIRE images as the ground truth. To measure the low-contrast detectability, the randomized repeat scans of Catphan® phantom were performed under various conditions of radiation exposures. Twelve radiologists evaluated the presence/absence of a target on a five-point confidence scale. The multi-reader multi-case area under the receiver operating characteristic curve (AUC) was calculated, and non-inferiority tests were performed. Using American College of Radiology CT accreditation phantom, contrast-to-noise ratio, target transfer function, noise magnitude, and detectability index (d’) of DLA, ADMIRE, IMR, and FBPs were computed. The AUC of DLA in low-contrast detectability was non-inferior to that of ADMIRE (p < .001) and superior to that of FBP (p < .001). DLA improved the image quality in terms of all physical measurements compared to FBPs from both CT vendors and showed profiles of physical measurements similar to those of ADMIRE. The low-contrast detectability of the proposed deep learning–based denoising algorithm was non-inferior to that of ADMIRE and superior to that of FBP. The DLA could successfully improve image quality compared with FBP while showing the similar physical profiles of ADMIRE. • Low-contrast detectability in the images denoised using the deep learning algorithm was non-inferior to that in the images reconstructed using standard algorithms. • The proposed deep learning algorithm showed similar profiles of physical measurements to advanced iterative reconstruction algorithm (ADMIRE).

Volumetric imaging by fluorescence microscopy is often limited by anisotropic spatial resolution, in which the axial resolution is inferior to the lateral resolution. To address this problem, we present a deep-learning-enabled unsupervised super-resolution technique that enhances anisotropic images in volumetric fluorescence microscopy. In contrast to the existing deep learning approaches that require matched high-resolution target images, our method greatly reduces the effort to be put into practice as the training of a network requires only a single 3D image stack, without a priori knowledge of the image formation process, registration of training data, or separate acquisition of target data. This is achieved based on the optimal transport-driven cycle-consistent generative adversarial network that learns from an unpaired matching between high-resolution 2D images in the lateral image plane and low-resolution 2D images in other planes. Using fluorescence confocal microscopy and light-sheet microscopy, we demonstrate that the trained network not only enhances axial resolution but also restores suppressed visual details between the imaging planes and removes imaging artifacts.

Energy-dispersive X-ray spectroscopy (EDX) is often performed simultaneously with high-angle annular dark-field scanning transmission electron microscopy (STEM) for nanoscale physico-chemical analysis. However, high-quality STEM-EDX tomographic imaging is still challenging due to fundamental limitations such as sample degradation with prolonged scan time and the low probability of X-ray generation. To address this, we propose an unsupervised deep learning method for high-quality 3D EDX tomography of core–shell nanocrystals, which can be usually permanently dammaged by prolonged electron beam. The proposed deep learning STEM-EDX tomography method was used to accurately reconstruct Au nanoparticles and InP/ZnSe/ZnS core–shell quantum dots, used in commercial display devices. Furthermore, the shape and thickness uniformity of the reconstructed ZnSe/ZnS shell closely correlates with optical properties of the quantum dots, such as quantum efficiency and chemical stability. Advanced electron microscopy and spectroscopy techniques can reveal useful structural and chemical details at the nanoscale. An unsupervised deep learning approach helps to reconstruct 3D images and observe the relationship between optical and structural properties of semiconductor nanocrystals, of interest in optoelectronic applications.

Deep-learning-based tomographic imaging is an important application of artificial intelligence and a new frontier of machine learning. Deep learning has been widely used in computer vision and image analysis, which deal with existing images, improve these images, and produce features from them. Since 2016, deep learning techniques have been actively researched for tomographic imaging, especially in the context of biomedicine, with impressive results and great potential. Tomographic reconstruction produces images of multi-dimensional structures from externally measured ‘encoded’ data in the form of various tomographic transforms (integrals, harmonics, echoes and so on). In this Review, we provide a general background, highlight representative results with an emphasis on medical imaging, and discuss key issues that need to be addressed in this emerging field. In particular, tomographic imaging is an integral part of modern medicine, and will play a key role in personalized, preventive and precision medicine and make it intelligent, inexpensive and indiscriminate. The popularity of deep learning is leading to new areas in biomedical applications. Wang and colleagues summarize in this Review the recent development and future directions of deep neural networks for superior image quality in the tomographic imaging field.

A unique advantage of magnetic resonance imaging (MRI) is its mechanism for generating various image contrasts depending on tissue-specific parameters, which provides useful clinical information. Unfortunately, a complete set of MR contrasts is often difficult to obtain in a real clinical environment. Recently, there have been claims that generative models such as generative adversarial networks (GANs) can synthesize MR contrasts that are not acquired. However, the poor scalability of existing GAN-based image synthesis poses a fundamental challenge to understanding the nature of MR contrasts: which contrasts matter, and which cannot be synthesized by generative models? Here, we show that these questions can be addressed systematically by learning the joint manifold of multiple MR contrasts using collaborative generative adversarial networks. Our experimental results show that the exogenous contrast provided by contrast agents is not replaceable, but endogenous contrasts such as T1 and T2 can be synthesized from other contrasts. These findings provide important guidance for the acquisition-protocol design of MR in clinical environments. Magnetic resonance scans use different contrast agents to generate different images, each giving specific clinical information. Lee et al. use a collaborative generative model to synthesize some magnetic resonance contrasts from others, providing guidance for how clinical imaging times can be reduced.

Magnetic resonance imaging (MRI) is an inherently slow imaging modality, since it acquires multi-dimensional k-space data through 1-D free induction decay or echo signals. This often limits the use of MRI, especially for high resolution or dynamic imaging. Accordingly, many investigators has developed various acceleration techniques to allow fast MR imaging. For the last two decades, one of the most important breakthroughs in this direction is the introduction of compressed sensing (CS) that allows accurate reconstruction from sparsely sampled k-space data. The recent FDA approval of compressed sensing products for clinical scans clearly reflect the maturity of this technology. Therefore, this paper reviews the basic idea of CS and how this technology have been evolved for various MR imaging problems.

We address an ill-posed inverse problem of image estimation from sparse samples of its Fourier transform. The problem is formulated as joint estimation of the supports of unknown sparse objects in the image, and pixel values on these supports. The domain and the pixel values are alternately estimated using the level-set method and the conjugate gradient method, respectively. Our level-set evolution shows a unique switching behavior, which stabilizes the level-set evolution. Furthermore, the trade-off between the stability and the speed of evolution can be easily controlled by the number of the conjugate gradient steps, thus avoiding the re-initialization steps in conventional level set approaches.