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Large Scale MRI Collection and Segmentation of Cirrhotic Liver.

Jha D, Susladkar OK, Gorade V, Keles E, Antalek M, Seyithanoglu D, Cebeci T, Aktas HE, Kartal GD, Kaymakoglu S, Erturk SM, Velichko Y, Ladner DP, Borhani AA, Medetalibeyoglu A, Durak G, Bagci U

pubmed logopapersMay 28 2025
Liver cirrhosis represents the end stage of chronic liver disease, characterized by extensive fibrosis and nodular regeneration that significantly increases mortality risk. While magnetic resonance imaging (MRI) offers a non-invasive assessment, accurately segmenting cirrhotic livers presents substantial challenges due to morphological alterations and heterogeneous signal characteristics. Deep learning approaches show promise for automating these tasks, but progress has been limited by the absence of large-scale, annotated datasets. Here, we present CirrMRI600+, the first comprehensive dataset comprising 628 high-resolution abdominal MRI scans (310 T1-weighted and 318 T2-weighted sequences, totaling nearly 40,000 annotated slices) with expert-validated segmentation labels for cirrhotic livers. The dataset includes demographic information, clinical parameters, and histopathological validation where available. Additionally, we provide benchmark results from 11 state-of-the-art deep learning experiments to establish performance standards. CirrMRI600+ enables the development and validation of advanced computational methods for cirrhotic liver analysis, potentially accelerating progress toward automated Cirrhosis visual staging and personalized treatment planning.

C2 pars interarticularis length on the side of high-riding vertebral artery with implications for pars screw insertion.

Klepinowski T, Kałachurska M, Chylewski M, Żyłka N, Taterra D, Łątka K, Pala B, Poncyljusz W, Sagan L

pubmed logopapersMay 28 2025
C2 pars interarticularis length (C2PIL) required for pars screws has not been thoroughly studied in subjects with high-riding vertebral artery (HRVA). We aimed to measure C2PIL specifically on the sides with HRVA, define short pars, optimal pars screw length, and incorporate C2PIL into HRVA clusters using machine learning algorithms. A clinical anatomical study based on cervical CT was conducted with STROBE-compliant case-control design. HRVA was defined as accepted. Interobserver, intraobserver, and inter-software agreement coefficients for HRVA were adopted from our previous study. Sample size was estimated with pwr package and C2PIL was measured. Cut-off value and predictive statistics of C2PIL for HRVA were computed with cutpointr package. Unsupervised machine learning clustering was applied with all three pars parameters. 345 potential screw insertion sites (PSIS) were grouped as HRVA (143 PSIS in 110 subjects) or controls (202 PSIS in 101 subjects). 68% participants were females. The median C2PIL in HRVA group was 13.7 mm with interquartile range (IQR) of 1.7, whereas in controls it was 19.8 mm (IQR = 2.7). The optimal cut-off value of C2PIL discriminating HRVA was 16.06 mm with sensitivity of 96.5% and specificity of 99.3%. Therefore, clinically important short pars was defined as ≤ 16 mm rounding to the nearest screw length. Two clusters were created incorportating three parameters of pars interarticularis. In preoperative planning, the identified C2PIL cut-off of ≤ 16 mm may assist surgeons in early recognition of HRVA. The average screw lengths of 14 mm for bicortical and 12 mm for safer unicortical purchase in HRVA cases may serve as practical intraoperative reference points, particularly in situations requiring rapid decision-making or when navigation systems are unavailable. Moreover, C2PIL complements the classic HRVA parameters within the dichotomized clustering framework.

Deep learning reconstruction enhances tophus detection in a dual-energy CT phantom study.

Schmolke SA, Diekhoff T, Mews J, Khayata K, Kotlyarov M

pubmed logopapersMay 28 2025
This study aimed to compare two deep learning reconstruction (DLR) techniques (AiCE mild; AiCE strong) with two established methods-iterative reconstruction (IR) and filtered back projection (FBP)-for the detection of monosodium urate (MSU) in dual-energy computed tomography (DECT). An ex vivo bio-phantom and a raster phantom were prepared by inserting syringes containing different MSU concentrations and scanned in a 320-rows volume DECT scanner at different tube currents. The scans were reconstructed in a soft tissue kernel using the four reconstruction techniques mentioned above, followed by quantitative assessment of MSU volumes and image quality parameters, i.e., signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Both DLR techniques outperformed conventional IR and FBP in terms of volume detection and image quality. Notably, unlike IR and FBP, the two DLR methods showed no positive correlation of the MSU detection rate with the CT dose index (CTDIvol) in the bio-phantom. Our study highlights the potential of DLR for DECT imaging in gout, where it offers enhanced detection sensitivity, improved image contrast, reduced image noise, and lower radiation exposure. Further research is needed to assess the clinical reliability of this approach.

Deep Learning-Based Fully Automated Aortic Valve Leaflets and Root Measurement From Computed Tomography Images - A Feasibility Study.

Yamauchi H, Aoyama G, Tsukihara H, Ino K, Tomii N, Takagi S, Fujimoto K, Sakaguchi T, Sakuma I, Ono M

pubmed logopapersMay 28 2025
The aim of this study was to retrain our existing deep learning-based fully automated aortic valve leaflets/root measurement algorithm, using computed tomography (CT) data for root dilatation (RD), and assess its clinical feasibility. 67 ECG-gated cardiac CT scans were retrospectively collected from 40 patients with RD to retrain the algorithm. An additional 100 patients' CT data with aortic stenosis (AS, n=50) and aortic regurgitation (AR) with/without RD (n=50) were collected to evaluate the algorithm. 45 AR patients had RD. The algorithm provided patient-specific 3-dimensional aortic valve/root visualization. The measurements of 100 cases automatically obtained by the algorithm were compared with an expert's manual measurements. Overall, there was a moderate-to-high correlation, with differences of 6.1-13.4 mm<sup>2</sup>for the virtual basal ring area, 1.1-2.6 mm for sinus diameter, 0.1-0.6 mm for coronary artery height, 0.2-0.5 mm for geometric height, and 0.9 mm for effective height, except for the sinotubular junction of the AR cases (10.3 mm) with an indefinite borderline over the dilated sinuses, compared with 2.1 mm in AS cases. The measurement time (122 s) per case by the algorithm was significantly shorter than those of the experts (618-1,126 s). This fully automated algorithm can assist in evaluating aortic valve/root anatomy for planning surgical and transcatheter treatments while saving time and minimizing workload.

Artificial Intelligence Augmented Cerebral Nuclear Imaging.

Currie GM, Hawk KE

pubmed logopapersMay 28 2025
Artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), has significant potential to advance the capabilities of nuclear neuroimaging. The current and emerging applications of ML and DL in the processing, analysis, enhancement and interpretation of SPECT and PET imaging are explored for brain imaging. Key developments include automated image segmentation, disease classification, and radiomic feature extraction, including lower dimensionality first and second order radiomics, higher dimensionality third order radiomics and more abstract fourth order deep radiomics. DL-based reconstruction, attenuation correction using pseudo-CT generation, and denoising of low-count studies have a role in enhancing image quality. AI has a role in sustainability through applications in radioligand design and preclinical imaging while federated learning addresses data security challenges to improve research and development in nuclear cerebral imaging. There is also potential for generative AI to transform the nuclear cerebral imaging space through solutions to data limitations, image enhancement, patient-centered care, workflow efficiencies and trainee education. Innovations in ML and DL are re-engineering the nuclear neuroimaging ecosystem and reimagining tomorrow's precision medicine landscape.

Incorporating organ deformation in biological modeling and patient outcome study for permanent prostate brachytherapy.

To S, Mavroidis P, Chen RC, Wang A, Royce T, Tan X, Zhu T, Lian J

pubmed logopapersMay 28 2025
Permanent prostate brachytherapy has inherent intraoperative organ deformation due to the inflatable trans-rectal ultrasound probe cover. Since the majority of the dose is delivered postoperatively with no deformation, the dosimetry approved at the time of implant may not accurately represent the dose delivered to the target and organs at risk. We aimed to evaluate the biological effect of the prostate deformation and its correlation with patient-reported outcomes. We prospectively acquired ultrasound images of the prostate pre- and postprobe cover inflation for 27 patients undergoing I-125 seed implant. The coordinates of implanted seeds from approved clinical plan were transferred to deformation-corrected prostate to simulate the actual dosimetry using a machine learning-based deformable image registration. The DVHs of both sets of plans were reduced to biologically effective dose (BED) distribution and subsequently to Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) metrics. The change in fourteen patient-reported rectal and urinary symptoms between pretreatment to 6 months post-op time points were correlated with the TCP and NTCP metrics using the area under the curve (AUC) and odds ratio (OR). Between the clinical and the deformation corrected research plans, the mean TCP decreased by 9.4% (p < 0.01), whereas mean NTCP of rectum decreased by 10.3% and that of urethra increased by 16.3%, respectively (p < 0.01). For the diarrhea symptom, the deformation corrected research plans showed AUC=0.75 and OR = 8.9 (1.3-58.8) for the threshold NTCP>20%, while the clinical plan showed AUC=0.56 and OR = 1.4 (0.2 to 9.0). For the symptom of urinary control, the deformation corrected research plans showed AUC = 0.70, OR = 6.9 (0.6 to 78.0) for the threshold of NTCP>15%, while the clinical plan showed AUC = 0.51 and no positive OR. Taking organ deformation into consideration, clinical brachytherapy plans showed worse tumor coverage, worse urethra sparing but better rectal sparing. The deformation corrected research plans showed a stronger correlation with the patient-reported outcome than the clinical plans for the symptoms of diarrhea and urinary control.

An AI system for continuous knee osteoarthritis severity grading: An anomaly detection inspired approach with few labels.

Belton N, Lawlor A, Curran KM

pubmed logopapersMay 28 2025
The diagnostic accuracy and subjectivity of existing Knee Osteoarthritis (OA) ordinal grading systems has been a subject of on-going debate and concern. Existing automated solutions are trained to emulate these imperfect systems, whilst also being reliant on large annotated databases for fully-supervised training. This work proposes a three stage approach for automated continuous grading of knee OA that is built upon the principles of Anomaly Detection (AD); learning a robust representation of healthy knee X-rays and grading disease severity based on its distance to the centre of normality. In the first stage, SS-FewSOME is proposed, a self-supervised AD technique that learns the 'normal' representation, requiring only examples of healthy subjects and <3% of the labels that existing methods require. In the second stage, this model is used to pseudo label a subset of unlabelled data as 'normal' or 'anomalous', followed by denoising of pseudo labels with CLIP. The final stage involves retraining on labelled and pseudo labelled data using the proposed Dual Centre Representation Learning (DCRL) which learns the centres of two representation spaces; normal and anomalous. Disease severity is then graded based on the distance to the learned centres. The proposed methodology outperforms existing techniques by margins of up to 24% in terms of OA detection and the disease severity scores correlate with the Kellgren-Lawrence grading system at the same level as human expert performance. Code available at https://github.com/niamhbelton/SS-FewSOME_Disease_Severity_Knee_Osteoarthritis.

Artificial Intelligence in Value-Based Health Care.

Shah R, Bozic KJ, Jayakumar P

pubmed logopapersMay 28 2025
Artificial intelligence (AI) presents new opportunities to advance value-based healthcare in orthopedic surgery through 3 potential mechanisms: agency, automation, and augmentation. AI may enhance patient agency through improved health literacy and remote monitoring while reducing costs through triage and reduction in specialist visits. In automation, AI optimizes operating room scheduling and streamlines administrative tasks, with documented cost savings and improved efficiency. For augmentation, AI has been shown to be accurate in diagnostic imaging interpretation and surgical planning, while enabling more precise outcome predictions and personalized treatment approaches. However, implementation faces substantial challenges, including resistance from healthcare professionals, technical barriers to data quality and privacy, and significant financial investments required for infrastructure. Success in healthcare AI integration requires careful attention to regulatory frameworks, data privacy, and clinical validation.

Quantitative computed tomography imaging classification of cement dust-exposed patients-based Kolmogorov-Arnold networks.

Chau NK, Kim WJ, Lee CH, Chae KJ, Jin GY, Choi S

pubmed logopapersMay 27 2025
Occupational health assessment is critical for detecting respiratory issues caused by harmful exposures, such as cement dust. Quantitative computed tomography (QCT) imaging provides detailed insights into lung structure and function, enhancing the diagnosis of lung diseases. However, its high dimensionality poses challenges for traditional machine learning methods. In this study, Kolmogorov-Arnold networks (KANs) were used for the binary classification of QCT imaging data to assess respiratory conditions associated with cement dust exposure. The dataset comprised QCT images from 609 individuals, including 311 subjects exposed to cement dust and 298 healthy controls. We derived 141 QCT-based variables and employed KANs with two hidden layers of 15 and 8 neurons. The network parameters, including grid intervals, polynomial order, learning rate, and penalty strengths, were carefully fine-tuned. The performance of the model was assessed through various metrics, including accuracy, precision, recall, F1 score, specificity, and the Matthews Correlation Coefficient (MCC). A five-fold cross-validation was employed to enhance the robustness of the evaluation. SHAP analysis was applied to interpret the sensitive QCT features. The KAN model demonstrated consistently high performance across all metrics, with an average accuracy of 98.03 %, precision of 97.35 %, recall of 98.70 %, F1 score of 98.01 %, and specificity of 97.40 %. The MCC value further confirmed the robustness of the model in managing imbalanced datasets. The comparative analysis demonstrated that the KAN model outperformed traditional methods and other deep learning approaches, such as TabPFN, ANN, FT-Transformer, VGG19, MobileNets, ResNet101, XGBoost, SVM, random forest, and decision tree. SHAP analysis highlighted structural and functional lung features, such as airway geometry, wall thickness, and lung volume, as key predictors. KANs significantly improved the classification of QCT imaging data, enhancing early detection of cement dust-induced respiratory conditions. SHAP analysis supported model interpretability, enhancing its potential for clinical translation in occupational health assessments.
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