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In the field of medical image analysis, image registration is a crucial technique. Despite the numerous registration models that have been proposed, existing methods still fall short in terms of accuracy and interpretability. In this paper, we present MsMorph, a deep learning-based image registration framework aimed at mimicking the manual process of registering image pairs to achieve more similar deformations, where the registered image pairs exhibit consistency or similarity in features. By extracting the feature differences between image pairs across various as-pects using gradients, the framework decodes semantic information at different scales and continuously compen-sates for the predicted deformation field, driving the optimization of parameters to significantly improve registration accuracy. The proposed method simulates the manual approach to registration, focusing on different regions of the image pairs and their neighborhoods to predict the deformation field between the two images, which provides strong interpretability. We compared several existing registration methods on two public brain MRI datasets, including LPBA and Mindboggle. The experimental results show that our method consistently outperforms state of the art in terms of metrics such as Dice score, Hausdorff distance, average symmetric surface distance, and non-Jacobian. The source code is publicly available at https://github.com/GaodengFan/MsMorph, Comment: 18 pages, 10 figures

Alzheimer's disease (AD) is a chronic neurodegenerative disorder and the leading cause of dementia, significantly impacting cost, mortality, and burden worldwide. The advent of high-throughput omics technologies, such as genomics, transcriptomics, proteomics, and epigenomics, has revolutionized the molecular understanding of AD. Conventional AI approaches typically require the completion of all omics data at the outset to achieve optimal AD diagnosis, which are inefficient and may be unnecessary. To reduce the clinical cost and improve the accuracy of AD diagnosis using multi-omics data, we propose a novel staged graph convolutional network with uncertainty quantification (SGUQ). SGUQ begins with mRNA and progressively incorporates DNA methylation and miRNA data only when necessary, reducing overall costs and exposure to harmful tests. Experimental results indicate that 46.23% of the samples can be reliably predicted using only single-modal omics data (mRNA), while an additional 16.04% of the samples can achieve reliable predictions when combining two omics data types (mRNA + DNA methylation). In addition, the proposed staged SGUQ achieved an accuracy of 0.858 on ROSMAP dataset, which outperformed existing methods significantly. The proposed SGUQ can not only be applied to AD diagnosis using multi-omics data but also has the potential for clinical decision-making using multi-viewed data. Our implementation is publicly available at https://github.com/chenzhao2023/multiomicsuncertainty., Comment: 20 pages, 2 figures

As electric power systems evolve towards decarbonization, the transition to inverter-based resources (IBRs) presents challenges to grid stability, necessitating innovative control solutions. Virtual synchronous generator (VSG) emerges as a prominent solution. However, conventional VSGs are prone to instability in strong grids, slow voltage regulation, and coupled power-voltage response. To address these issues, this paper introduces an advanced VSG control strategy. A novel analysis of the VSG control dynamics is presented through a second-order closed-loop complex single-input single-output system, employing a vectorized geometrical pole analysis technique for enhanced voltage stability and dynamics. The proposed comprehensive controller design mitigates issues related to control interacted subsynchronous resonance and $dq \leftrightarrow 3\phi$ transformation-induced voltage-coupled power transients, achieving improved system robustness and simplified control tuning. Key contributions include a two-fold design: optimized voltage transition characteristics through direct pole placement and transient power overshoot correction via a compensator. Validated by simulation and experiments, the findings offer a pragmatic solution for integrating VSG technology into decarbonizing power systems, ensuring reliability and efficiency., Comment: 13 pages, 26 figures. Preparing for journal submission

Despite advancements in medical care, hip fractures impose a significant burden on individuals and healthcare systems. This paper focuses on the prediction of hip fracture risk in older and middle-aged adults, where falls and compromised bone quality are predominant factors. We propose a novel staged model that combines advanced imaging and clinical data to improve predictive performance. By using CNNs to extract features from hip DXA images, along with clinical variables, shape measurements, and texture features, our method provides a comprehensive framework for assessing fracture risk. A staged machine learning-based model was developed using two ensemble models: Ensemble 1 (clinical variables only) and Ensemble 2 (clinical variables and DXA imaging features). This staged approach used uncertainty quantification from Ensemble 1 to decide if DXA features are necessary for further prediction. Ensemble 2 exhibited the highest performance, achieving an AUC of 0.9541, an accuracy of 0.9195, a sensitivity of 0.8078, and a specificity of 0.9427. The staged model also performed well, with an AUC of 0.8486, an accuracy of 0.8611, a sensitivity of 0.5578, and a specificity of 0.9249, outperforming Ensemble 1, which had an AUC of 0.5549, an accuracy of 0.7239, a sensitivity of 0.1956, and a specificity of 0.8343. Furthermore, the staged model suggested that 54.49% of patients did not require DXA scanning. It effectively balanced accuracy and specificity, offering a robust solution when DXA data acquisition is not always feasible. Statistical tests confirmed significant differences between the models, highlighting the advantages of the advanced modeling strategies. Our staged approach could identify individuals at risk with a high accuracy but reduce the unnecessary DXA scanning. It has great promise to guide interventions to prevent hip fractures with reduced cost and radiation., Comment: 29 pages, 5 figures, 6 tables

Purpose of Review Recently, machine learning has developed rapidly in the field of medicine, playing an important role in disease diagnosis. Our aim of this paper is to provide an overview of the advancements in machine learning techniques applied to invasive coronary angiography (ICA) for segmentation of coronary arteries and quantitative evaluation like fractional flow reserve (FFR) and stenosis assessment. Recent Findings ICA are used extensively along with machine learning techniques for the segmentation of arteries and quantitative evaluation of stenosis, coronary artery disease and measurement of fractional flow reserve, representing a trend towards using computational methods for enhanced diagnostic precision in cardiovascular medicine. Summary Various research studies have been conducted in this field, each using different algorithms and datasets. The performance of these studies largely depends on the algorithms employed and the datasets used for training and evaluation. However, despite the progress made, there remains a need for machine learning (ML) algorithms that can be easily integrated into clinical practice.

Coronary artery disease (CAD) stands as the leading cause of death worldwide, and invasive coronary angiography (ICA) remains the gold standard for assessing vascular anatomical information. However, deep learning-based methods encounter challenges in generating semantic labels for arterial segments, primarily due to the morphological similarity between arterial branches and varying anatomy of arterial system between different projection view angles and patients. To address this challenge, we model the vascular tree as a graph and propose a multi-graph graph matching (MGM) algorithm for coronary artery semantic labeling. The MGM algorithm assesses the similarity between arterials in multiple vascular tree graphs, considering the cycle consistency between each pair of graphs. As a result, the unannotated arterial segments are appropriately labeled by matching them with annotated segments. Through the incorporation of anatomical graph structure, radiomics features, and semantic mapping, the proposed MGM model achieves an impressive accuracy of 0.9471 for coronary artery semantic labeling using our multi-site dataset with 718 ICAs. With the semantic labeled arteries, an overall accuracy of 0.9155 was achieved for stenosis detection. The proposed MGM presents a novel tool for coronary artery analysis using multiple ICA-derived graphs, offering valuable insights into vascular health and pathology.

A method was proposed for the point cloud-based registration and image fusion between cardiac single photon emission computed tomography (SPECT) myocardial perfusion images (MPI) and cardiac computed tomography angiograms (CTA). Firstly, the left ventricle (LV) epicardial regions (LVERs) in SPECT and CTA images were segmented by using different U-Net neural networks trained to generate the point clouds of the LV epicardial contours (LVECs). Secondly, according to the characteristics of cardiac anatomy, the special points of anterior and posterior interventricular grooves (APIGs) were manually marked in both SPECT and CTA image volumes. Thirdly, we developed an in-house program for coarsely registering the special points of APIGs to ensure a correct cardiac orientation alignment between SPECT and CTA images. Fourthly, we employed ICP, SICP or CPD algorithm to achieve a fine registration for the point clouds (together with the special points of APIGs) of the LV epicardial surfaces (LVERs) in SPECT and CTA images. Finally, the image fusion between SPECT and CTA was realized after the fine registration. The experimental results showed that the cardiac orientation was aligned well and the mean distance error of the optimal registration method (CPD with affine transform) was consistently less than 3 mm. The proposed method could effectively fuse the structures from cardiac CTA and SPECT functional images, and demonstrated a potential in assisting in accurate diagnosis of cardiac diseases by combining complementary advantages of the two imaging modalities.

Background: Accurate segmentation of diffuse large B-cell lymphoma (DLBCL) lesions is challenging due to their complex patterns in medical imaging. Objective: This study aims to develop a precise segmentation method for DLBCL using 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) and computed tomography (CT) images. Methods: We propose a 3D dual-branch encoder segmentation method using shifted window transformers and a Multi-Scale Information Fusion (MSIF) module. To enhance feature integration, the MSIF module performs multi-scale feature fusion using cross-attention mechanisms with a shifted window framework. A gated neural network within the MSIF module dynamically balances the contributions from each modality. The model was optimized using the Dice Similarity Coefficient (DSC) loss function. Additionally, we computed the total metabolic tumor volume (TMTV) and performed statistical analyses. Results: The model was trained and validated on a dataset of 165 DLBCL patients using 5-fold cross-validation, achieving a DSC of 0.7512. Statistical analysis showed a significant improvement over comparative methods (p < 0.05). Additionally, a Pearson correlation coefficient of 0.91 and an R^2 of 0.89 were observed when comparing manual annotations to segmentation results for TMTV measurement. Conclusion: This study presents an effective automatic segmentation method for DLBCL that leverages the complementary strengths of PET and CT imaging. Our method has the potential to improve diagnostic interpretations and assist in treatment planning for DLBCL patients., Comment: 19 pages, 7 figures; reference added

Objectives To develop and validate a deep learning-based diagnostic model incorporating uncertainty estimation so as to facilitate radiologists in the preoperative differentiation of the pathological subtypes of renal cell carcinoma (RCC) based on CT images. Methods Data from 668 consecutive patients, pathologically proven RCC, were retrospectively collected from Center 1. By using five-fold cross-validation, a deep learning model incorporating uncertainty estimation was developed to classify RCC subtypes into clear cell RCC (ccRCC), papillary RCC (pRCC), and chromophobe RCC (chRCC). An external validation set of 78 patients from Center 2 further evaluated the model's performance. Results In the five-fold cross-validation, the model's area under the receiver operating characteristic curve (AUC) for the classification of ccRCC, pRCC, and chRCC was 0.868 (95% CI: 0.826-0.923), 0.846 (95% CI: 0.812-0.886), and 0.839 (95% CI: 0.802-0.88), respectively. In the external validation set, the AUCs were 0.856 (95% CI: 0.838-0.882), 0.787 (95% CI: 0.757-0.818), and 0.793 (95% CI: 0.758-0.831) for ccRCC, pRCC, and chRCC, respectively. Conclusions The developed deep learning model demonstrated robust performance in predicting the pathological subtypes of RCC, while the incorporated uncertainty emphasized the importance of understanding model confidence, which is crucial for assisting clinical decision-making for patients with renal tumors. Clinical relevance statement Our deep learning approach, integrated with uncertainty estimation, offers clinicians a dual advantage: accurate RCC subtype predictions complemented by diagnostic confidence references, promoting informed decision-making for patients with RCC., Comment: 16 pages, 6 figures

Background: Missing data is a common challenge in mass spectrometry-based metabolomics, which can lead to biased and incomplete analyses. The integration of whole-genome sequencing (WGS) data with metabolomics data has emerged as a promising approach to enhance the accuracy of data imputation in metabolomics studies. Method: In this study, we propose a novel method that leverages the information from WGS data and reference metabolites to impute unknown metabolites. Our approach utilizes a multi-view variational autoencoder to jointly model the burden score, polygenetic risk score (PGS), and linkage disequilibrium (LD) pruned single nucleotide polymorphisms (SNPs) for feature extraction and missing metabolomics data imputation. By learning the latent representations of both omics data, our method can effectively impute missing metabolomics values based on genomic information. Results: We evaluate the performance of our method on empirical metabolomics datasets with missing values and demonstrate its superiority compared to conventional imputation techniques. Using 35 template metabolites derived burden scores, PGS and LD-pruned SNPs, the proposed methods achieved R^2-scores > 0.01 for 71.55% of metabolites. Conclusion: The integration of WGS data in metabolomics imputation not only improves data completeness but also enhances downstream analyses, paving the way for more comprehensive and accurate investigations of metabolic pathways and disease associations. Our findings offer valuable insights into the potential benefits of utilizing WGS data for metabolomics data imputation and underscore the importance of leveraging multi-modal data integration in precision medicine research., Comment: 19 pages, 3 figures

Aims. The purpose of this study is to create a multi-stage machine learning model to predict cardiac resynchronization therapy (CRT) response for heart failure (HF) patients. This model exploits uncertainty quantification to recommend additional collection of single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) variables if baseline clinical variables and features from electrocardiogram (ECG) are not sufficient. Methods. 218 patients who underwent rest-gated SPECT MPI were enrolled in this study. CRT response was defined as an increase in left ventricular ejection fraction (LVEF) > 5% at a 6+-1 month follow-up. A multi-stage ML model was created by combining two ensemble models: Ensemble 1 was trained with clinical variables and ECG; Ensemble 2 included Ensemble 1 plus SPECT MPI features. Uncertainty quantification from Ensemble 1 allowed for multi-stage decision-making to determine if the acquisition of SPECT data for a patient is necessary. The performance of the multi-stage model was compared with that of Ensemble models 1 and 2. Results. The response rate for CRT was 55.5% (n = 121) with overall male gender 61.0% (n = 133), an average age of 62.0+-11.8, and LVEF of 27.7+-11.0. The multi-stage model performed similarly to Ensemble 2 (which utilized the additional SPECT data) with AUC of 0.75 vs. 0.77, accuracy of 0.71 vs. 0.69, sensitivity of 0.70 vs. 0.72, and specificity 0.72 vs. 0.65, respectively. However, the multi-stage model only required SPECT MPI data for 52.7% of the patients across all folds. Conclusions. By using rule-based logic stemming from uncertainty quantification, the multi-stage model was able to reduce the need for additional SPECT MPI data acquisition without sacrificing performance., Comment: 30 pages,6 figures. arXiv admin note: text overlap with arXiv:2305.02475

Coronary artery disease (CAD) is one of the primary causes leading to death worldwide. Accurate extraction of individual arterial branches on invasive coronary angiograms (ICA) is important for stenosis detection and CAD diagnosis. However, deep learning-based models face challenges in generating semantic segmentation for coronary arteries due to the morphological similarity among different types of coronary arteries. To address this challenge, we propose an innovative approach using the hyper association graph-matching neural network with uncertainty quantification (HAGMN-UQ) for coronary artery semantic labeling on ICAs. The graph-matching procedure maps the arterial branches between two individual graphs, so that the unlabeled arterial segments are classified by the labeled segments, and the coronary artery semantic labeling is achieved. By incorporating the anatomical structural loss and uncertainty, our model achieved an accuracy of 0.9345 for coronary artery semantic labeling with a fast inference speed, leading to an effective and efficient prediction in real-time clinical decision-making scenarios., Comment: 8 pages, 2 figures

This study aims to develop a new computational pathology approach that automates the identification and quantification of myocardial inflammatory infiltration in digital HE-stained images to provide a quantitative histological diagnosis of myocarditis.898 HE-stained whole slide images (WSIs) of myocardium from 154 heart transplant patients diagnosed with myocarditis or dilated cardiomyopathy (DCM) were included in this study. An automated DL-based computational pathology approach was developed to identify nuclei and detect myocardial inflammatory infiltration, enabling the quantification of the lymphocyte nuclear density (LND) on myocardial WSIs. A cutoff value based on the quantification of LND was proposed to determine if the myocardial inflammatory infiltration was present. The performance of our approach was evaluated with a five-fold cross-validation experiment, tested with an internal test set from the myocarditis group, and confirmed by an external test from a double-blind trial group. An LND of 1.02/mm2 could distinguish WSIs with myocarditis from those without. The accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) in the five-fold cross-validation experiment were 0.899 plus or minus 0.035, 0.971 plus or minus 0.017, 0.728 plus or minus 0.073 and 0.849 plus or minus 0.044, respectively. For the internal test set, the accuracy, sensitivity, specificity, and AUC were 0.887, 0.971, 0.737, and 0.854, respectively. The accuracy, sensitivity, specificity, and AUC for the external test set reached 0.853, 0.846, 0.858, and 0.852, respectively. Our new approach provides accurate and reliable quantification of the LND of myocardial WSIs, facilitating automated quantitative diagnosis of myocarditis with HE-stained images., Comment: 21 pages,5 figures,6 Tables, 25 references

The privacy protection mechanism of federated learning (FL) offers an effective solution for cross-center medical collaboration and data sharing. In multi-site medical image segmentation, each medical site serves as a client of FL, and its data naturally forms a domain. FL supplies the possibility to improve the performance of seen domains model. However, there is a problem of domain generalization (DG) in the actual de-ployment, that is, the performance of the model trained by FL in unseen domains will decrease. Hence, MLA-BIN is proposed to solve the DG of FL in this study. Specifically, the model-level attention module (MLA) and batch-instance style normalization (BIN) block were designed. The MLA represents the unseen domain as a linear combination of seen domain models. The atten-tion mechanism is introduced for the weighting coefficient to obtain the optimal coefficient ac-cording to the similarity of inter-domain data features. MLA enables the global model to gen-eralize to unseen domain. In the BIN block, batch normalization (BN) and instance normalization (IN) are combined to perform the shallow layers of the segmentation network for style normali-zation, solving the influence of inter-domain image style differences on DG. The extensive experimental results of two medical image seg-mentation tasks demonstrate that the proposed MLA-BIN outperforms state-of-the-art methods., Comment: 9 pages, 8 figures, 2 tables

Background: Cardiac resynchronization therapy (CRT) has emerged as an effective treatment for heart failure patients with electrical dyssynchrony. However, accurately predicting which patients will respond to CRT remains a challenge. This study explores the application of deep transfer learning techniques to train a predictive model for CRT response. Methods: In this study, the short-time Fourier transform (STFT) technique was employed to transform ECG signals into two-dimensional images. A transfer learning approach was then applied on the MIT-BIT ECG database to pre-train a convolutional neural network (CNN) model. The model was fine-tuned to extract relevant features from the ECG images, and then tested on our dataset of CRT patients to predict their response. Results: Seventy-one CRT patients were enrolled in this study. The transfer learning model achieved an accuracy of 72% in distinguishing responders from non-responders in the local dataset. Furthermore, the model showed good sensitivity (0.78) and specificity (0.79) in identifying CRT responders. The performance of our model outperformed clinic guidelines and traditional machine learning approaches. Conclusion: The utilization of ECG images as input and leveraging the power of transfer learning allows for improved accuracy in identifying CRT responders. This approach offers potential for enhancing patient selection and improving outcomes of CRT.

Coronary artery disease (CAD) is one of the primary causes leading deaths worldwide. The presence of atherosclerotic lesions in coronary arteries is the underlying pathophysiological basis of CAD, and accurate extraction of individual arterial branches using invasive coronary angiography (ICA) is crucial for stenosis detection and CAD diagnosis. We propose an innovative approach called the Edge Attention Graph Matching Network (EAGMN) for coronary artery semantic labeling. By converting the coronary artery semantic segmentation task into a graph node similarity comparison task, identifying the node-to-node correspondence would assign semantic labels for each arterial branch. More specifically, The EAGMN utilizes the association graph constructed from the two individual graphs as input. Experimental results indicate the EAGMN achieved a weighted accuracy of 0.8653, a weighted precision of 0.8656, a weighted recall of 0.8653 and a weighted F1-score of 0.8643. Furthermore, we employ ZORRO to provide interpretability and explainability of the graph matching for artery semantic labeling. These findings highlight the potential of the EAGMN for accurate and efficient coronary artery semantic labeling using ICAs. By leveraging the inherent characteristics of ICAs and incorporating graph matching techniques, our proposed model provides a promising solution for improving CAD diagnosis and treatment

Background. Clinical parameters measured from gated single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) have value in predicting cardiac resynchronization therapy (CRT) patient outcomes, but still show limitations. The purpose of this study is to combine clinical variables, features from electrocardiogram (ECG), and parameters from assessment of cardiac function with polarmaps from gated SPECT MPI through deep learning (DL) to predict CRT response. Methods. 218 patients who underwent rest gated SPECT MPI were enrolled in this study. CRT response was defined as an increase in left ventricular ejection fraction (LVEF) > 5% at a 6-month follow up. A DL model was constructed by combining a pre-trained VGG16 module and a multilayer perceptron. Two modalities of data were input to the model: polarmap images from SPECT MPI and tabular data from clinical features and ECG parameters. Gradient-weighted Class Activation Mapping (Grad-CAM) was applied to the VGG16 module to provide explainability for the polarmaps. For comparison, four machine learning (ML) models were trained using only the tabular features. Results. Modeling was performed on 218 patients who underwent CRT implantation with a response rate of 55.5% (n = 121). The DL model demonstrated average AUC (0.83), accuracy (0.73), sensitivity (0.76), and specificity (0.69) surpassing the ML models and guideline criteria. Guideline recommendations presented accuracy (0.53), sensitivity (0.75), and specificity (0.26). Conclusions. The DL model outperformed the ML models, showcasing the additional predictive benefit of utilizing SPECT MPI polarmaps. Incorporating additional patient data directly in the form of medical imagery can improve CRT response prediction.

Integration of heterogeneous and high-dimensional multi-omics data is becoming increasingly important in understanding genetic data. Each omics technique only provides a limited view of the underlying biological process and integrating heterogeneous omics layers simultaneously would lead to a more comprehensive and detailed understanding of diseases and phenotypes. However, one obstacle faced when performing multi-omics data integration is the existence of unpaired multi-omics data due to instrument sensitivity and cost. Studies may fail if certain aspects of the subjects are missing or incomplete. In this paper, we propose a deep learning method for multi-omics integration with incomplete data by Cross-omics Linked unified embedding with Contrastive Learning and Self Attention (CLCLSA). Utilizing complete multi-omics data as supervision, the model employs cross-omics autoencoders to learn the feature representation across different types of biological data. The multi-omics contrastive learning, which is used to maximize the mutual information between different types of omics, is employed before latent feature concatenation. In addition, the feature-level self-attention and omics-level self-attention are employed to dynamically identify the most informative features for multi-omics data integration. Extensive experiments were conducted on four public multi-omics datasets. The experimental results indicated that the proposed CLCLSA outperformed the state-of-the-art approaches for multi-omics data classification using incomplete multi-omics data., Comment: 21 pages; 5 figures

Epicardial adipose tissue (EAT) is known for its pro-inflammatory properties and association with Coronavirus Disease 2019 (COVID-19) severity. However, current EAT segmentation methods do not consider positional information. Additionally, the detection of COVID-19 severity lacks consideration for EAT radiomics features, which limits interpretability. This study investigates the use of radiomics features from EAT and lungs to detect the severity of COVID-19 infections. A retrospective analysis of 515 patients with COVID-19 (Cohort1: 415, Cohort2: 100) was conducted using a proposed three-stage deep learning approach for EAT extraction. Lung segmentation was achieved using a published method. A hybrid model for detecting the severity of COVID-19 was built in a derivation cohort, and its performance and uncertainty were evaluated in internal (125, Cohort1) and external (100, Cohort2) validation cohorts. For EAT extraction, the Dice similarity coefficients (DSC) of the two centers were 0.972 (+-0.011) and 0.968 (+-0.005), respectively. For severity detection, the hybrid model with radiomics features of both lungs and EAT showed improvements in AUC, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) compared to the model with only lung radiomics features. The hybrid model exhibited an increase of 0.1 (p<0.001), 19.3%, and 18.0% respectively, in the internal validation cohort and an increase of 0.09 (p<0.001), 18.0%, and 18.0%, respectively, in the external validation cohort while outperforming existing detection methods. Uncertainty quantification and radiomics features analysis confirmed the interpretability of case prediction after inclusion of EAT features., Comment: 20 pages, 7 figures

Semantic labeling of coronary arterial segments in invasive coronary angiography (ICA) is important for automated assessment and report generation of coronary artery stenosis in the computer-aided diagnosis of coronary artery disease (CAD). Inspired by the training procedure of interventional cardiologists for interpreting the structure of coronary arteries, we propose an association graph-based graph matching network (AGMN) for coronary arterial semantic labeling. We first extract the vascular tree from invasive coronary angiography (ICA) and convert it into multiple individual graphs. Then, an association graph is constructed from two individual graphs where each vertex represents the relationship between two arterial segments. Using the association graph, the AGMN extracts the vertex features by the embedding module, aggregates the features from adjacent vertices and edges by graph convolution network, and decodes the features to generate the semantic mappings between arteries. By learning the mapping of arterial branches between two individual graphs, the unlabeled arterial segments are classified by the labeled segments to achieve semantic labeling. A dataset containing 263 ICAs was employed to train and validate the proposed model, and a five-fold cross-validation scheme was performed. Our AGMN model achieved an average accuracy of 0.8264, an average precision of 0.8276, an average recall of 0.8264, and an average F1-score of 0.8262, which significantly outperformed existing coronary artery semantic labeling methods. In conclusion, we have developed and validated a new algorithm with high accuracy, interpretability, and robustness for coronary artery semantic labeling on ICAs., Comment: 26 pages, 7 figures

Cardiac resynchronization therapy (CRT) has been established as an important therapy for heart failure. Mechanical dyssynchrony has the potential to predict responders to CRT. The aim of this study was to report the development and the validation of machine learning (ML) models which integrates ECG, gated SPECT MPI (GMPS) and clinical variables to predict patients' response to CRT. This analysis included 153 patients who met criteria for CRT from a prospective cohort study. The variables were used to modeling predictive methods for CRT. Patients were classified as responders for an increase of LVEF>=5% at follow-up. In a second analysis, patients were classified super-responders for increase of LVEF>=15%. For ML, variable selection was applied, and Prediction Analysis of Microarrays (PAM) approach was used for response modeling while Naive Bayes (NB) was used for super-response. They were compared to models obtained with guideline variables. PAM had AUC of 0.80 against 0.71 of logistic regression with guideline variables (p = 0.47). The sensitivity (0.86) and specificity (0.75) were better than for guideline alone, sensitivity (0.72) and specificity (0.22). Neural network with guideline variables outperformed NB (AUC = 0.87 vs 0.86; p = 0.88). Its sensitivity and specificity (1.0 and 0.75, respectively) was better than guideline alone (0.40 and 0.06, respectively). Compared to guideline criteria, ML methods trended towards improved CRT response and super-response prediction. GMPS had a central role in the acquisition of most parameters. Further studies are needed to validate the models.

Hip fracture risk assessment is an important but challenging task. Quantitative CT-based patient specific finite element analysis (FEA) computes the force (fracture load) to break the proximal femur in a particular loading condition. It provides different structural information about the proximal femur that can influence a subject overall fracture risk. To obtain a more robust measure of fracture risk, we used principal component analysis (PCA) to develop a global FEA computed fracture risk index that incorporates the FEA-computed yield and ultimate failure loads and energies to failure in four loading conditions (single-limb stance and impact from a fall onto the posterior, posterolateral, and lateral aspects of the greater trochanter) of 110 hip fracture subjects and 235 age and sex matched control subjects from the AGES-Reykjavik study. We found that the first PC (PC1) of the FE parameters was the only significant predictor of hip fracture. Using a logistic regression model, we determined if prediction performance for hip fracture using PC1 differed from that using FE parameters combined by stratified random resampling with respect to hip fracture status. The results showed that the average of the area under the receive operating characteristic curve (AUC) using PC1 was always higher than that using all FE parameters combined in the male subjects. The AUC of PC1 and AUC of the FE parameters combined were not significantly different than that in the female subjects or in all subjects, Comment: 27 pages, 4 figures

The aim of this paper is to design a deep learning-based model to predict proximal femoral strength using multi-view information fusion. Method: We developed new models using multi-view variational autoencoder (MVAE) for feature representation learning and a product of expert (PoE) model for multi-view information fusion. We applied the proposed models to an in-house Louisiana Osteoporosis Study (LOS) cohort with 931 male subjects, including 345 African Americans and 586 Caucasians. With an analytical solution of the product of Gaussian distribution, we adopted variational inference to train the designed MVAE-PoE model to perform common latent feature extraction. We performed genome-wide association studies (GWAS) to select 256 genetic variants with the lowest p-values for each proximal femoral strength and integrated whole genome sequence (WGS) features and DXA-derived imaging features to predict proximal femoral strength. Results: The best prediction model for fall fracture load was acquired by integrating WGS features and DXA-derived imaging features. The designed models achieved the mean absolute percentage error of 18.04%, 6.84% and 7.95% for predicting proximal femoral fracture loads using linear models of fall loading, nonlinear models of fall loading, and nonlinear models of stance loading, respectively. Compared to existing multi-view information fusion methods, the proposed MVAE-PoE achieved the best performance. Conclusion: The proposed models are capable of predicting proximal femoral strength using WGS features and DXA-derived imaging features. Though this tool is not a substitute for FEA using QCT images, it would make improved assessment of hip fracture risk more widely available while avoiding the increased radiation dosage and clinical costs from QCT., Comment: 16 pages, 3 figures

Single photon emission computed tomography (SPECT) myocardial perfusion images (MPI) can be displayed both in traditional short-axis (SA) cardiac planes and polar maps for interpretation and quantification. It is essential to reorient the reconstructed transaxial SPECT MPI into standard SA slices. This study is aimed to develop a deep-learning-based approach for automatic reorientation of MPI. Methods: A total of 254 patients were enrolled, including 228 stress SPECT MPIs and 248 rest SPECT MPIs. Five-fold cross-validation with 180 stress and 201 rest MPIs was used for training and internal validation; the remaining images were used for testing. The rigid transformation parameters (translation and rotation) from manual reorientation were annotated by an experienced operator and used as the ground truth. A convolutional neural network (CNN) was designed to predict the transformation parameters. Then, the derived transform was applied to the grid generator and sampler in spatial transformer network (STN) to generate the reoriented image. A loss function containing mean absolute errors for translation and mean square errors for rotation was employed. A three-stage optimization strategy was adopted for model optimization: 1) optimize the translation parameters while fixing the rotation parameters; 2) optimize rotation parameters while fixing the translation parameters; 3) optimize both translation and rotation parameters together., Comment: 27 pages,7 figures

Accurate extraction of coronary arteries from invasive coronary angiography (ICA) is important in clinical decision-making for the diagnosis and risk stratification of coronary artery disease (CAD). In this study, we develop a method using deep learning to automatically extract the coronary artery lumen. Methods. A deep learning model U-Net 3+, which incorporates the full-scale skip connections and deep supervisions, was proposed for automatic extraction of coronary arteries from ICAs. Transfer learning and a hybrid loss function were employed in this novel coronary artery extraction framework. Results. A data set containing 616 ICAs obtained from 210 patients was used. In the technical evaluation, the U-Net 3+ achieved a Dice score of 0.8942 and a sensitivity of 0.8735, which is higher than U-Net ++ (Dice score: 0.8814, the sensitivity of 0.8331) and U-net (Dice score: 0.8799, the sensitivity of 0.8305). Conclusion. Our study demonstrates that the U-Net 3+ is superior to other segmentation frameworks for the automatic extraction of the coronary arteries from ICAs. This result suggests great promise for clinical use., Comment: 22 pages,5 figures

Background: The assessment of left ventricular (LV) function by myocardial perfusion SPECT (MPS) relies on accurate myocardial segmentation. The purpose of this paper is to develop and validate a new method incorporating deep learning with shape priors to accurately extract the LV myocardium for automatic measurement of LV functional parameters. Methods: A segmentation architecture that integrates a three-dimensional (3D) V-Net with a shape deformation module was developed. Using the shape priors generated by a dynamic programming (DP) algorithm, the model output was then constrained and guided during the model training for quick convergence and improved performance. A stratified 5-fold cross-validation was used to train and validate our models. Results: Results of our proposed method agree well with those from the ground truth. Our proposed model achieved a Dice similarity coefficient (DSC) of 0.9573(0.0244), 0.9821(0.0137), and 0.9903(0.0041), a Hausdorff distances (HD) of 6.7529(2.7334) mm, 7.2507(3.1952) mm, and 7.6121(3.0134) mm in extracting the endocardium, myocardium, and epicardium, respectively. Conclusion: Our proposed method achieved a high accuracy in extracting LV myocardial contours and assessing LV function., Comment: 21 pages, 14 figures

Network pruning and knowledge distillation are two widely-known model compression methods that efficiently reduce computation cost and model size. A common problem in both pruning and distillation is to determine compressed architecture, i.e., the exact number of filters per layer and layer configuration, in order to preserve most of the original model capacity. In spite of the great advances in existing works, the determination of an excellent architecture still requires human interference or tremendous experimentations. In this paper, we propose an architecture slimming method that automates the layer configuration process. We start from the perspective that the capacity of the over-parameterized model can be largely preserved by finding the minimum number of filters preserving the maximum parameter variance per layer, resulting in a thin architecture. We formulate the determination of compressed architecture as a one-step orthogonal linear transformation, and integrate principle component analysis (PCA), where the variances of filters in the first several projections are maximized. We demonstrate the rationality of our analysis and the effectiveness of the proposed method through extensive experiments. In particular, we show that under the same overall compression rate, the compressed architecture determined by our method shows significant performance gain over baselines after pruning and distillation. Surprisingly, we find that the resulting layer-wise compression rates correspond to the layer sensitivities found by existing works through tremendous experimentations.