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Clinical interventional hemodynamic studies quantify the ventricular function from two-dimensional (2-D) X-ray projection images without having enough information of the actual three-dimensional (3-D) shape of this cardiac cavity. This paper reports a left ventricle 3-D reconstruction method from two orthogonal angiographic projections. This investigation is motivated by the lack of information about the actual 3-D shape of the cardiac cavity. The proposed algorithm works in 3-D space and considers the oblique projection geometry associated with the biplane image acquisition equipment. The reconstruction process starts by performing an approximate reconstruction based on the Cylindrical Closure Operation and the Dempster--Shafer theory. This approximate reconstruction is appropriately deformed in order to match the given projections. The deformation procedure is carried out by an iterative process that, by means of the Dempster--Shafer and the fuzzy integral theory, combines the information provided by the projection error and the connectivity between voxels. The performance of the proposed reconstruction method is evaluated by considering first the reconstruction of two 3-D binary databases from two orthogonal synthetized projections, obtaining errors as low as 6.48%. The method is then tested on real data, where two orthogonal preprocessed angiographic images are used for reconstruction. The performance of the technique, in this case, is assessed by means of the projection error, whose average for both views is 7.5%. The reconstruction method is also tested by performing the 3-D reconstruction of a ventriculographic sequence throughout an entire cardiac cycle. [ABSTRACT FROM AUTHOR]

In this short paper, accelerated three-dimensional computer simulations of vascular trees development, preserving physiological and haemodynamic features, are reported. The new computation schemes deal: (i) with the geometrical optimization of each newly created bifurcation; and (ii) with the recalculation of blood pressures and radii of vessels in the whole tree. A significant decrease of the computation time is obtained by replacing the global optimization by the fast updating algorithm allowing more complex structure to be simulated. A comparison between the new algorithms and the previous one is illustrated through the hepatic arterial tree. [Copyright &y& Elsevier]

In this paper, a model-based approach to medical image analysis is presented. It is aimed at understanding the influence of the physiological (related to tissue) and physical (related to image modality) processes underlying the image content. This methodology is exemplified by modeling first, the liver and its vascular network, and second, the standard computed tomography (CT) scan acquisition. After a brief survey on vascular modeling literature, a new method, aimed at the generation of growing three-dimensional vascular structures perfusing the tissue, is described. A solution is proposed in order to avoid intersections among vessels belonging to arterial and/or venous trees, which are physiologically connected. Then it is shown how the propagation of contrast material leads to simulate time-dependent sequences of enhanced liver CT slices. [ABSTRACT FROM AUTHOR]

Focuses on creation of animated models to improve the understanding of the complex changes that occur during normal heart development. Development of a three-dimensional model capable of rendering the dynamics of the various stages of normal heart development; Availability of a videotape of a full-length animation. INSET: Development of Cardiac Outflow Tracts..

Automatic detection of arrhythmia through an electrocardiogram (ECG) is of great significance for the prevention and treatment of cardiovascular diseases. In Convolutional neural network, the ECG signal is converted into multiple feature channels with equal weights through the convolution operation. Multiple feature channels can provide richer and more comprehensive information, but also contain redundant information, which will affect the diagnosis of arrhythmia, so feature channels that contain arrhythmia information should be paid attention to and given larger weight. In this paper, we introduced the Squeeze-and-Excitation (SE) block for the first time for the automatic detection of multiple types of arrhythmias with ECG. Our algorithm combines the residual convolutional module and the SE block to extract features from the original ECG signal. The SE block adaptively enhances the discriminative features and suppresses noise by explicitly modeling the interdependence between the channels, which can adaptively integrate information from different feature channels of ECG. The one-dimensional convolution operation over the time dimension is used to extract temporal information and the shortcut connection of the Se-Residual convolutional module in the proposed model makes the network easier to optimize. Thanks to the powerful feature extraction capabilities of the network, which can effectively extract discriminative arrhythmia features in multiple feature channels, so that no extra data preprocessing including denoising in other methods are need for our framework. It thus improves the working efficiency and keeps the collected biological information without loss. Experiments conducted with the 12-lead ECG dataset of the China Physiological Signal Challenge (CPSC) 2018 and the dataset of PhysioNet/Computing in Cardiology (CinC) Challenge 2017. The experiment results show that our model gains great performance and has great potential in clinical. [ABSTRACT FROM AUTHOR]

• An algorithm for dissected aorta segmentation based on 3-D and 2-D convolutional neural networks. • A 3-D CNN model identifies the proximal and distal regions of the dissected aorta data. • A 2-D CNN model for aorta segmentation which incorporates boundary information. Aortic dissection is a severe cardiovascular pathology in which an injury of the intimal layer of the aorta allows blood flowing into the aortic wall, forcing the wall layers apart. Such situation presents a high mortality rate and requires an in-depth understanding of the 3-D morphology of the dissected aorta to plan the right treatment. An accurate automatic segmentation algorithm is therefore needed. In this paper, we propose a deep-learning-based algorithm to segment dissected aorta on computed tomography angiography (CTA) images. The algorithm consists of two steps. Firstly, a 3-D convolutional neural network (CNN) is applied to divide the 3-D volume into two anatomical portions. Secondly, two 2-D CNNs based on pyramid scene parsing network (PSPnet) segment each specific portion separately. An edge extraction branch was added to the 2-D model to get higher segmentation accuracy on intimal flap area. The experiments conducted and the comparisons made show that the proposed solution performs well with an average dice index over 92%. The combination of 3-D and 2-D models improves the aorta segmentation accuracy compared to 3-D only models and the segmentation robustness compared to 2-D only models. The edge extraction branch improves the DICE index near aorta boundaries from 73.41% to 81.39%. The proposed algorithm has satisfying performance for capturing the aorta structure while avoiding false positives on the intimal flaps. [ABSTRACT FROM AUTHOR]

• We propose a novel image-level meta-learning framework, the meta greyscale adaptive network (MGANet), for 3D integrated renal structures segmentation task for the first time. • We propose a novel hyper-parameter optimization strategy, the grayscale interest search (GIS), to adaptively focus the segmentation networks on the task-dependent grayscale distribution in CTA images. • We propose a novel image-level meta-learning strategy, the meta grayscale adaptation (MGA) learning, to adapt the grayscale distribution variation. • We proof of the effectiveness of our proposed framework and analyze the role of different parts in grayscale distribution optimization. [Display omitted] Three-dimensional (3D) integrated renal structures (IRS) segmentation targets segmenting the kidneys, renal tumors, arteries, and veins in one inference. Clinicians will benefit from the 3D IRS visual model for accurate preoperative planning and intraoperative guidance of laparoscopic partial nephrectomy (LPN). However, no success has been reported in 3D IRS segmentation due to the inherent challenges in grayscale distribution: low contrast caused by the narrow task-dependent distribution range of regions of interest (ROIs), and the networks representation preferences caused by the distribution variation inter-images. In this paper, we propose the Meta Greyscale Adaptive Network (MGANet), the first deep learning framework to simultaneously segment the kidney, renal tumors, arteries and veins on CTA images in one inference. It makes innovations in two collaborate aspects: 1) The Grayscale Interest Search (GIS) adaptively focuses segmentation networks on task-dependent grayscale distributions via scaling the window width and center with two cross-correlated coefficients for the first time, thus learning the fine-grained representation for fine segmentation. 2) The Meta Grayscale Adaptive (MGA) learning makes an image-level meta-learning strategy. It represents diverse robust features from multiple distributions, perceives the distribution characteristic, and generates the model parameters to fuse features dynamically according to image's distribution, thus adapting the grayscale distribution variation. This study enrolls 123 patients and the average Dice coefficients of the renal structures are up to 87.9%. Fine selection of the task-dependent grayscale distribution ranges and personalized fusion of multiple representations on different distributions will lead to better 3D IRS segmentation quality. Extensive experiments with promising results on renal structures reveal powerful segmentation accuracy and great clinical significance in renal cancer treatment. [ABSTRACT FROM AUTHOR]

Presents information on the development of a time-frequency scaling method, based on the matching pursuit (MP) method, for use in phonocardiography. Examination of the MP method; Assessment of three types of transformations; Analysis of statistical data compiled in this research; Details on the time-scaling of phonocardiograms.

• A novel 3D semi-supervised segmentation framework for fine renal artery segmentation task for the first time. • A dense biased connection method and a dense biased network (DenseBiasNet) are proposed for renal artery's large intra-scale changes problem and training process optimization. • A semi-supervised learning strategy (DPA) which embeds deep priori anatomy features in network to handle the large inter-anatomy variation problem and the limitation of labeled dataset. • A hard region adaptation (HRA) loss function for category imbalanced problem. • Proof of the effectiveness of the proposed framework and analyze the role of different parts. Fine renal artery segmentation on abdominal CT angiography (CTA) image is one of the most important tasks for kidney disease diagnosis and pre-operative planning. It will help clinicians locate each interlobar artery's blood-feeding region via providing the complete 3D renal artery tree masks. However, it is still a task of great challenges due to the large intra-scale changes, large inter-anatomy variation, thin structures, small volume ratio and small labeled dataset of the fine renal artery. In this paper, we propose the first semi-supervised 3D fine renal artery segmentation framework, DPA-DenseBiasNet, which combines deep prior anatomy (DPA), dense biased network (DenseBiasNet) and hard region adaptation loss (HRA): 1) Based on our proposed dense biased connection, the DenseBiasNet fuses multi-receptive field and multi-resolution feature maps for large intra-scale changes. This dense biased connection also obtains a dense information flow and dense gradient flow so that the training is accelerated and the accuracy is enhanced. 2) DPA features extracted from an autoencoder (AE) are embedded in DenseBiasNet to cope with the challenge of large inter-anatomy variation and thin structures. The AE is pre-trained (unsupervised) by numerous unlabeled data to achieve the representation ability of anatomy features and these features are embedded in DenseBiasNet. This process will not introduce incorrect labels as optimization targets and thus contributes to a stable semi-supervised training strategy that is suitable for sensitive thin structures. 3) The HRA selects the loss value calculation region dynamically according to the segmentation quality so the network will pay attention to the hard regions in the training process and keep the class balanced. Experiments demonstrated that DPA-DenseBiasNet had high predictive accuracy and generalization with the Dice coefficient of 0.884 which increased by 0.083 compared with 3D U-Net (Çiçek et al., 2016). This revealed our framework with great potential for the 3D fine renal artery segmentation in clinical practice. [ABSTRACT FROM AUTHOR]

Minimal path method has been widely recognized as an efficient tool for extracting vascular structures in medical imaging. In a previous paper, a method termed minimal path propagation with backtracking (MPP-BT) was derived to deal with curve-like structures such as vessel centerlines. A robust approach termed CMPP (constrained minimal path propagation) is here proposed to extend this work. The proposed method utilizes another minimal path propagation procedure to extract the complete vessel lumen after the centerlines have been found. Moreover, a process named local MPP-BT is applied to handle structure missing caused by the so-called close loop problems. This approach is fast and unsupervised with only one roughly set start point required in the whole process to get the entire vascular structure. A variety of datasets, including 2D cardiac angiography, 2D retinal images and 3D kidney CT angiography, are used for validation. A quantitative evaluation, together with a comparison to recently reported methods, is performed on retinal images for which a ground truth is available. The proposed method leads to specificity (Sp) and sensitivity (Se) values equal to 0.9750 and 0.6591. This evaluation is also extended to 3D synthetic vascular datasets and shows that the specificity (Sp) and sensitivity (Se) values are higher than 0.99. Parameter setting and computation cost are analyzed in this paper. [ABSTRACT FROM AUTHOR]

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.

In this work, we address the task of few-shot medical image segmentation (MIS) with a novel proposed framework based on the learning registration to learn segmentation (LRLS) paradigm. To cope with the limitations of lack of authenticity, diversity, and robustness in the existing LRLS frameworks, we propose the better registration better segmentation (BRBS) framework with three main contributions that are experimentally shown to have substantial practical merit. First, we improve the authenticity in the registration-based generation program and propose the knowledge consistency constraint strategy that constrains the registration network to learn according to the domain knowledge. It brings the semantic-aligned and topology-preserved registration, thus allowing the generation program to output new data with great space and style authenticity. Second, we deeply studied the diversity of the generation process and propose the space-style sampling program, which introduces the modeling of the transformation path of style and space change between few atlases and numerous unlabeled images into the generation program. Therefore, the sampling on the transformation paths provides much more diverse space and style features to the generated data effectively improving the diversity. Third, we first highlight the robustness in the learning of segmentation in the LRLS paradigm and propose the mix misalignment regularization, which simulates the misalignment distortion and constrains the network to reduce the fitting degree of misaligned regions. Therefore, it builds regularization for these regions improving the robustness of segmentation learning. Without any bells and whistles, our approach achieves a new state-of-the-art performance in few-shot MIS on two challenging tasks that outperform the existing LRLS-based few-shot methods. We believe that this novel and effective framework will provide a powerful few-shot benchmark for the field of medical image and efficiently reduce the costs of medical image research. All of our code will be made publicly available online.

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.

Accurate and robust anatomical landmark localization is a mandatory and crucial step in deformation diagnosis and treatment planning for patients with craniomaxillofacial (CMF) malformations. In this paper, we propose a trainable end-to-end cephalometric landmark localization framework on Cone-beam computed tomography (CBCT) scans, referred to as CMF-Net, which combines the appearance with transformers, geometric constraint, and adaptive wing (AWing) loss. More precisely: (1) we decompose the localization task into two branches: the appearance branch integrates transformers for identifying the exact positions of candidates, while the geometric constraint branch at low resolution allows the implicit spatial relationships to be effectively learned on the reduced training data. (2) We use the AWing loss to leverage the difference between the pixel values of the target heatmaps and the automatic prediction heatmaps. We verify our CMF-Net by identifying the 24 most relevant clinical landmarks on 150 dental CBCT scans with complicated scenarios collected from real-world clinics. Comprehensive experiments show that it performs better than the state-of-the-art deep learning methods, with an average localization error of 1.108 mm (the clinically acceptable precision range being 1.5 mm) and a correct landmark detection rate equal to 79.28%. Our CMF-Net is time-efficient and able to locate skull landmarks with high accuracy and significant robustness. This approach could be applied in 3D cephalometric measurement, analysis, and surgical planning., (© 2023 Institute of Physics and Engineering in Medicine.)

Pulmonary arterial hypertension (PAH) prognosis prediction on 3D non-contrast CT images is one of the most important tasks for PAH treatment. It will help clinicians stratify patients into different groups for early diagnosis and timely intervention via automatically extracting the potential biomarkers of PAH to predict mortality. However, it is still a task of great challenges due to the large volume and low-contrast regions of interest in 3D chest CT images. In this paper, we propose the first multi-task learning-based PAH prognosis prediction framework, P 2 -Net, which effectively optimizes the model and powerfully represents task-dependent features via our Memory Drift (MD) and Prior Prompt Learning (PPL) strategies. 1) Our MD maintains a large memory bank to provide a dense sampling of the deep biomarkers' distribution. Therefore, although the batch size is very small caused by our large volume, a reliable (negative log partial) likelihood loss is still able to be calculated on a representative probability distribution for robust optimization. 2) Our PPL simultaneously learns an additional manual biomarkers prediction task to embed clinical prior knowledge into our deep prognosis prediction task in hidden and explicit ways. Therefore, it will prompt the prediction of deep biomarkers and improve the perception of task-dependent features in our low-contrast regions. Our P 2 -Net achieves a high prognostic correlation of the prediction and great generalization with the highest 70.19% C-index and 2.14 HR. Extensive experiments with promising results on our PAH prognosis prediction reveal powerful prognosis performance and great clinical significance in PAH treatment. All of our code will be made publicly available online Opened source: https://github.com/YutingHe-list/P2-Net.

4D cone-beam computed tomography (CBCT) is an important imaging modality in image-guided radiation therapy to address the motion-induced artifacts caused by organ movements during the respiratory process. However, due to the extremely sparse projection data for each temporal phase, 4D CBCT reconstructions will suffer from severe streaking artifacts. Therefore, to tackle the streak artifacts and provide high-quality images, we proposed a framework termed Prior-Regularized Iterative Optimization Reconstruction (PRIOR) for 4D CBCT. The PRIOR framework combines the physics-based model and data-driven method simultaneously, with powerful feature extracting capacity, significantly promoting the image quality compared to single model-based or deep learning-based methods. Besides, we designed a specialized deep learning model named PRIOR-Net, which can effectively excavate the static information in the prior image reconstructed from the fully-sampled projections at the encoding stage to improve the reconstruction performance for individual phase-resolved images. Both the simulated and clinical 4D CBCT datasets were performed to evaluate the performance of the PRIOR-Net and the PRIOR framework. Compared with the advanced 4D CBCT reconstruction methods, the proposed methods achieve promising results quantitatively and qualitatively in streak artifact suppression, soft tissue restoration, and tiny detail preservation.

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.

Accurate and robust cephalometric image analysis plays an essential role in orthodontic diagnosis, treatment assessment and surgical planning. This paper proposes a novel landmark localization method for cephalometric analysis using multiscale image patch-based graph convolutional networks. In detail, image patches with the same size are hierarchically sampled from the Gaussian pyramid to well preserve multiscale context information. We combine local appearance and shape information into spatialized features with an attention module to enrich node representations in graph. The spatial relationships of landmarks are built with the incorporation of three-layer graph convolutional networks, and multiple landmarks are simultaneously updated and moved toward the targets in a cascaded coarse-to-fine process. Quantitative results obtained on publicly available cephalometric X-ray images have exhibited superior performance compared with other state-of-the-art methods in terms of mean radial error and successful detection rate within various precision ranges. Our approach performs significantly better especially in the clinically accepted range of 2 mm and this makes it suitable in cephalometric analysis and orthognathic surgery.

Purpose: Clinical rib fracture diagnosis via computed tomography (CT) screening has attracted much attention in recent years. However, automated and accurate segmentation solutions remain a challenging task due to the large sets of 3D CT data to deal with. Down-sampling is often required to face computer constraints, but the performance of the segmentation may decrease in this case., Methods: A new multi-angle projection network (MAPNet) method is proposed for accurately segmenting rib fractures by means of a deep learning approach. The proposed method incorporates multi-angle projection images to complementarily and comprehensively extract the rib characteristics using a rib extraction (RE) module and the fracture features using a fracture segmentation (FS) module. A multi-angle projection fusion (MPF) module is designed for fusing multi-angle spatial features. RESULTS: It is shown that MAPNet can capture more detailed rib fracture features than some commonly used segmentation networks. Our method achieves a better performance in accuracy (88.06 ± 6.97%), sensitivity (89.26 ± 5.69%), specificity (87.58% ± 7.66%) and in terms of classical criteria like dice (85.41 ± 3.35%), intersection over union (IoU, 80.37 ± 4.63%), and Hausdorff distance (HD, 4.34 ± 3.1)., Conclusion: We propose a rib fracture segmentation technique to deal with the problem of automatic fracture diagnosis. The proposed method avoids the down-sampling of 3D CT data through a projection technique. Experimental results show that it has excellent potential for clinical applications., (© 2022. CARS.)

Accurate coronary lumen segmentation on coronary-computed tomography angiography (CCTA) images is crucial for quantification of coronary stenosis and the subsequent computation of fractional flow reserve. Many factors including difficulty in labeling coronary lumens, various morphologies in stenotic lesions, thin structures and small volume ratio with respect to the imaging field complicate the task. In this work, we fused the continuity topological information of centerlines which are easily accessible, and proposed a novel weakly supervised model, Examinee-Examiner Network (EE-Net), to overcome the challenges in automatic coronary lumen segmentation. First, the EE-Net was proposed to address the fracture in segmentation caused by stenoses by combining the semantic features of lumens and the geometric constraints of continuous topology obtained from the centerlines. Then, a Centerline Gaussian Mask Module was proposed to deal with the insensitiveness of the network to the centerlines. Subsequently, a weakly supervised learning strategy, Examinee-Examiner Learning, was proposed to handle the weakly supervised situation with few lumen labels by using our EE-Net to guide and constrain the segmentation with customized prior conditions. Finally, a general network layer, Drop Output Layer, was proposed to adapt to the class imbalance by dropping well-segmented regions and weights the classes dynamically. Extensive experiments on two different data sets demonstrated that our EE-Net has good continuity and generalization ability on coronary lumen segmentation task compared with several widely used CNNs such as 3D-UNet. The results revealed our EE-Net with great potential for achieving accurate coronary lumen segmentation in patients with coronary artery disease. Code at http://github.com/qiyaolei/Examinee-Examiner-Network.

The wide applications of X-ray computed tomography (CT) bring low-dose CT (LDCT) into a clinical prerequisite, but reducing the radiation exposure in CT often leads to significantly increased noise and artifacts, which might lower the judgment accuracy of radiologists. In this paper, we put forward a domain progressive 3D residual convolution network (DP-ResNet) for the LDCT imaging procedure that contains three stages: sinogram domain network (SD-net), filtered back projection (FBP), and image domain network (ID-net). Though both are based on the residual network structure, the SD-net and ID-net provide complementary effect on improving the final LDCT quality. The experimental results with both simulated and real projection data show that this domain progressive deep-learning network achieves significantly improved performance by combing the network processing in the two domains.

The image quality in low dose computed tomography (LDCT) can be severely degraded by amplified mottle noise and streak artifacts. Although the iterative reconstruction (IR) algorithms bring sound improvements, their high computation cost remains a major inconvenient. In this work, a deep iterative reconstruction estimation (DIRE) strategy is developed to estimate IR images from LDCT analytic reconstructions images. Within this DIRE strategy, a 3D residual convolutional network (3D ResNet) architecture is proposed. Experiments on several simulated and real datasets as well as comparisons with state-of-the-art methods demonstrate that the proposed approach is effective in providing improved LDCT images.

Minimal path techniques can efficiently extract geometrically curve-like structures by finding the path with minimal accumulated cost between two given endpoints. Though having found wide practical applications (e.g., line identification, crack detection, and vascular centerline extraction), minimal path techniques suffer from some notable problems. The first one is that they require setting two endpoints for each line to be extracted (endpoint problem). The second one is that the connection might fail when the geodesic distance between the two points is much shorter than the desirable minimal path (shortcut problem). In addition, when connecting two distant points, the minimal path connection might become inefficient as the accumulated cost increases over the propagation and results in leakage into some non-feature regions near the starting point (accumulation problem). To address these problems, this paper proposes an approach termed minimal path propagation with backtracking. We found that the information in the process of backtracking from reached points can be well utilized to overcome the above problems and improve the extraction performance. The whole algorithm is robust to parameter setting and allows a coarse setting of the starting point. Extensive experiments with both simulated and realistic data are performed to validate the performance of the proposed method.

This work presents a novel method for the nonrigid registration of medical images based on the Arimoto entropy, a generalization of the Shannon entropy. The proposed method employed the Jensen-Arimoto divergence measure as a similarity metric to measure the statistical dependence between medical images. Free-form deformations were adopted as the transformation model and the Parzen window estimation was applied to compute the probability distributions. A penalty term is incorporated into the objective function to smooth the nonrigid transformation. The goal of registration is to optimize an objective function consisting of a dissimilarity term and a penalty term, which would be minimal when two deformed images are perfectly aligned using the limited memory BFGS optimization method, and thus to get the optimal geometric transformation. To validate the performance of the proposed method, experiments on both simulated 3D brain MR images and real 3D thoracic CT data sets were designed and performed on the open source elastix package. For the simulated experiments, the registration errors of 3D brain MR images with various magnitudes of known deformations and different levels of noise were measured. For the real data tests, four data sets of 4D thoracic CT from four patients were selected to assess the registration performance of the method, including ten 3D CT images for each 4D CT data covering an entire respiration cycle. These results were compared with the normalized cross correlation and the mutual information methods and show a slight but true improvement in registration accuracy.

Reducing the radiation in computerized tomography is today a major concern in radiology. Low dose computerized tomography (LDCT) offers a sound way to deal with this problem. However, more severe noise in the reconstructed CT images is observed under low dose scan protocols (e.g. lowered tube current or voltage values). In this paper we propose a Gamma regularization based algorithm for LDCT image reconstruction. This solution is flexible and provides a good balance between the regularizations based on l0-norm and l1-norm. We evaluate the proposed approach using the projection data from simulated phantoms and scanned Catphan phantoms. Qualitative and quantitative results show that the Gamma regularization based reconstruction can perform better in both edge-preserving and noise suppression when compared with other norms.

In CT, ionizing radiation exposure from the scan has attracted much concern from patients and doctors. This work is aimed at improving head CT images from low-dose scans by using a fast Dictionary learning (DL) based post-processing. Both Low-dose CT (LDCT) and Standard-dose CT (SDCT) nonenhanced head images were acquired in head examination from a multi-detector row Siemens Somatom Sensation 16 CT scanner. One hundred patients were involved in the experiments. Two groups of LDCT images were acquired with 50 % (LDCT50 %) and 25 % (LDCT25 %) tube current setting in SDCT. To give quantitative evaluation, Signal to noise ratio (SNR) and Contrast to noise ratio (CNR) were computed from the Hounsfield unit (HU) measurements of GM, WM and CSF tissues. A blinded qualitative analysis was also performed to assess the processed LDCT datasets. Fifty and seventy five percent dose reductions are obtained for the two LDCT groups (LDCT50 %, 1.15 ± 0.1 mSv; LDCT25 %, 0.58 ± 0.1 mSv; SDCT, 2.32 ± 0.1 mSv; P < 0.001). Significant SNR increase over the original LDCT images is observed in the processed LDCT images for all the GM, WM and CSF tissues. Significant GM-WM CNR enhancement is noted in the DL processed LDCT images. Higher SNR and CNR than the reference SDCT images can even be achieved in the processed LDCT50 % and LDCT25 % images. Blinded qualitative review validates the perceptual improvements brought by the proposed approach. Compared to the original LDCT images, the application of DL processing in head CT is associated with a significant improvement of image quality.

This survey on medical imaging provides a look into three major components. The first one deals with the full steps through which it must be apprehended: from the sensors to the reconstruction, from the image analysis up to its interpretation. The second aspect describes the physical principles used for imaging (magnetic resonance, acoustic, optics, etc.). The last section shows how imaging is involved in therapeutic procedures and in particular the new physical therapies. All along this paper, the research perspectives are sketched.

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.

Beyond the advances made in computer-assisted interventions and robotic systems, the demand for more efficient and safer therapies remains challenging. Thus, if it is possible to improve the instrument tracking, steering, and target localization, to miniaturize the sensors and actuators, and to conduct preoperatively planned minimally invasive therapies, we still need new resources to achieve permanent destruction of abnormal tissues or suppression of pathological processes. Most of the physics-based (or energy-based) therapeutic principles at our disposal have been established a long time ago, but their actions on basic cellular and molecular mechanisms are not yet fully understood. They all have a wide spectrum of clinical targets in terms of organs and pathologies, modes of application (external, interstitial, intraluminal, etc.) with advantages and side-effect drawbacks, proven indications, and contraindications. Some of them may still face controversies regarding their outcomes. This short article, mainly focused on tumor destruction, briefly reviews in its first part some of these techniques and sketches the next generation under investigation. The former include radio frequency (RF), high-intensity focused ultrasound (HiFU), microwaves, and cryotherapy, of which all are temperature based. Laser-based approaches [e.g., photodynamic therapy (PDT) at large] are also discussed. Radiotherapy and its variants (hadrontherapy, brachytherapy, Gamma Knife, and CyberKnife) remain, of course, as the reference technique in cancer treatment. The next breakthroughs are examined in the second part of the article. They are based on the close association between imaging agents, drugs, and some stimulation techniques. The ongoing research efforts in that direction show that, if they are still far from clinical applications, strong expectations are made. From the point of view of interventional planning and image guidance, all of them share a lot of concerns.

A moment-based approach is proposed for texture analysis of medical images. The neighborhood of texture pixel is calculated by moments for texture feature extraction. After verified on Brodatz textures, the moment-based texture analysis method is applied on CT liver scan classification and prostate ultrasound segmentation. A support vector machine and a multi-channel active contour model are used in our application. The result shows that our method works well but still have some limitations.

The present work describes a Bayesian maximum a posteriori (MAP) method using a statistical multiscale wavelet prior model. Rather than using the orthogonal discrete wavelet transform (DWT), this prior is built on the translation invariant wavelet transform (TIWT). The statistical modeling of wavelet coefficients relies on the generalized Gaussian distribution. Image reconstruction is performed in spatial domain with a fast block sequential iteration algorithm. We study theoretically the TIWT MAP method by analyzing the Hessian of the prior function to provide some insights on noise and resolution properties of image reconstruction. We adapt the key concept of local shift invariance and explore how the TIWT MAP algorithm behaves with different scales. It is also shown that larger support wavelet filters do not offer better performance in contrast recovery studies. These theoretical developments are confirmed through simulation studies. The results show that the proposed method is more attractive than other MAP methods using either the conventional Gibbs prior or the DWT-based wavelet prior.

This paper proposes a new sequential weighted least squares (SWLS) method for positron emission tomography (PET) reconstruction. The SWLS algorithm is noniterative and can be considered as equivalent to the penalized WLS (PWLS) method under certain initial conditions. However, a full implementation of SWLS is computationally intensive. To overcome this problem, we propose a simplified SWLS as a reasonable alternative to the SWLS. The performance of this SWLS method is evaluated in experiments using both simulated and clinical data. The results show that the method can be advantageously compared with the original SWLS both in computation time and reconstruction quality.

Aneurysms are a local dilatation of a vessel wall of at least twice the normal diameter (commonly accepted definition). They are asymptomatic and rupture is often lethal. Thus, prediction of rupture is an important stake. Aiming at a diagnosis tool relying on patient specific data and general physiological values, we created a virtual aneurysm model based on real imaging data. Fluid/structure interaction (FSI) simulations were made to compute the displacement and stress for the wall. For the fluid, the only in vivo measures used were for the inlet velocity. The mandatory output boundary condition has been implemented with the first order Windkessel model equations. Structure has been much more complicated to handle because of the association of a realistic geometry (no symmetry) and a full fluid/structure interaction approach. We used surface elements to stabilize the structure and to model surrounding organs. Validation parameters are the displacement, the Von Mises stress and the pressure profile at the outlet. The main difference with other studies relies on the association of all these elements in order to prepare industrial applications as the main goal of this study was to build an automated tool easy to use by people who are not experts in numerical simulation.

Signal processing offers a wide spectrum of theories, methods, and algorithms for addressing a variety of problems ranging from noise reduction, restoration, detection (of events or changes), spatiotemporal dynamics estimation, source localization, and pattern recognition. However, the classical assumptions (stationarity, linearity, etc.) usually do not apply in real situations. Recent advances, such as time-scale and time-frequency transforms, data fusion, long-range dependence, and higher order moments, do not always provide sufficiently robust solutions. In this article, the basic properties and generic features of biomedical signals are examined using a wide range of examples. Algorithmic results are presented to show not only the potential performance but also the limitations of the processing resources at our disposal. The last section describes and discusses signal matching, scenario recognition, and data fusion.