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3D-MRI brain glioma intelligent segmentation based on improved 3D U-net network.

Wang T, Wu T, Yang D, Xu Y, Lv D, Jiang T, Wang H, Chen Q, Xu S, Yan Y, Lin B

pubmed logopapersJan 1 2025
To enhance glioma segmentation, a 3D-MRI intelligent glioma segmentation method based on deep learning is introduced. This method offers significant guidance for medical diagnosis, grading, and treatment strategy selection. Glioma case data were sourced from the BraTS2023 public dataset. Firstly, we preprocess the dataset, including 3D clipping, resampling, artifact elimination and normalization. Secondly, in order to enhance the perception ability of the network to different scale features, we introduce the space pyramid pool module. Then, by making the model focus on glioma details and suppressing irrelevant background information, we propose a multi-scale fusion attention mechanism; And finally, to address class imbalance and enhance learning of misclassified voxels, a combination of Dice and Focal loss functions was employed, creating a loss function, this method not only maintains the accuracy of segmentation, It also improves the recognition of challenge samples, thus improving the accuracy and generalization of the model in glioma segmentation. Experimental findings reveal that the enhanced 3D U-Net network model stabilizes training loss at 0.1 after 150 training iterations. The refined model demonstrates superior performance with the highest DSC, Recall, and Precision values of 0.7512, 0.7064, and 0.77451, respectively. In Whole Tumor (WT) segmentation, the Dice Similarity Coefficient (DSC), Recall, and Precision scores are 0.9168, 0.9426, and 0.9375, respectively. For Core Tumor (TC) segmentation, these scores are 0.8954, 0.9014, and 0.9369, respectively. In Enhanced Tumor (ET) segmentation, the method achieves DSC, Recall, and Precision values of 0.8674, 0.9045, and 0.9011, respectively. The DSC, Recall, and Precision indices in the WT, TC, and ET segments using this method are the highest recorded, significantly enhancing glioma segmentation. This improvement bolsters the accuracy and reliability of diagnoses, ultimately providing a scientific foundation for clinical diagnosis and treatment.

Same-model and cross-model variability in knee cartilage thickness measurements using 3D MRI systems.

Katano H, Kaneko H, Sasaki E, Hashiguchi N, Nagai K, Ishijima M, Ishibashi Y, Adachi N, Kuroda R, Tomita M, Masumoto J, Sekiya I

pubmed logopapersJan 1 2025
Magnetic Resonance Imaging (MRI) based three-dimensional analysis of knee cartilage has evolved to become fully automatic. However, when implementing these measurements across multiple clinical centers, scanner variability becomes a critical consideration. Our purposes were to quantify and compare same-model variability (between repeated scans on the same MRI system) and cross-model variability (across different MRI systems) in knee cartilage thickness measurements using MRI scanners from five manufacturers, as analyzed with a specific 3D volume analysis software. Ten healthy volunteers (eight males and two females, aged 22-60 years) underwent two scans of their right knee on 3T MRI systems from five manufacturers (Canon, Fujifilm, GE, Philips, and Siemens). The imaging protocol included fat-suppressed spoiled gradient echo and proton density weighted sequences. Cartilage regions were automatically segmented into 7 subregions using a specific deep learning-based 3D volume analysis software. This resulted in 350 measurements for same-model variability and 2,800 measurements for cross-model variability. For same-model variability, 82% of measurements showed variability ≤0.10 mm, and 98% showed variability ≤0.20 mm. For cross-model variability, 51% showed variability ≤0.10 mm, and 84% showed variability ≤0.20 mm. The mean same-model variability (0.06 ± 0.05 mm) was significantly lower than cross-model variability (0.11 ± 0.09 mm) (p < 0.001). This study demonstrates that knee cartilage thickness measurements exhibit significantly higher variability across different MRI systems compared to repeated measurements on the same system, when analyzed using this specific software. This finding has important implications for multi-center studies and longitudinal assessments using different MRI systems and highlights the software-dependent nature of such variability assessments.

RRFNet: A free-anchor brain tumor detection and classification network based on reparameterization technology.

Liu W, Guo X

pubmed logopapersJan 1 2025
Advancements in medical imaging technology have facilitated the acquisition of high-quality brain images through computed tomography (CT) or magnetic resonance imaging (MRI), enabling professional brain specialists to diagnose brain tumors more effectively. However, manual diagnosis is time-consuming, which has led to the growing importance of automatic detection and classification through brain imaging. Conventional object detection models for brain tumor detection face limitations in brain tumor detection owing to the significant differences between medical images and natural scene images, as well as challenges such as complex backgrounds, noise interference, and blurred boundaries between cancerous and normal tissues. This study investigates the application of deep learning to brain tumor detection, analyzing the effect of three factors, the number of model parameters, input data batch size, and the use of anchor boxes, on detection performance. Experimental results reveal that an excessive number of model parameters or the use of anchor boxes may reduce detection accuracy. However, increasing the number of brain tumor samples improves detection performance. This study, introduces a backbone network built using RepConv and RepC3, along with FGConcat feature map splicing module to optimize the brain tumor detection model. The experimental results show that the proposed RepConv-RepC3-FGConcat Network (RRFNet) can learn underlying semantic information about brain tumors during training stage, while maintaining a low number of parameters during inference, which improves the speed of brain tumor detection. Compared with YOLOv8, RRFNet achieved a higher accuracy in brain tumor detection, with a mAP value of 79.2%. This optimized approach enhances both accuracy and efficiency, which is essential in clinical settings where time and precision are critical.

Patients', clinicians' and developers' perspectives and experiences of artificial intelligence in cardiac healthcare: A qualitative study.

Baillie L, Stewart-Lord A, Thomas N, Frings D

pubmed logopapersJan 1 2025
This study investigated perspectives and experiences of artificial intelligence (AI) developers, clinicians and patients about the use of AI-based software in cardiac healthcare. A qualitative study took place at two hospitals in England that had trialled AI-based software use in stress echocardiography, a scan that uses ultrasound to assess heart function. Semi-structured interviews were conducted with: patients (<i>n = </i>9), clinicians (<i>n = </i>16) and AI software developers (<i>n = </i>5). Data were analysed using thematic analysis. Potential benefits identified were increasing consistency and reliability through reducing human error, and greater efficiency. Concerns included over-reliance on the AI technology, and data security. Participants discussed the need for human input and empathy within healthcare, transparency about AI use, and issues around trusting AI. Participants considered AI's role as assisting diagnosis but not replacing clinician involvement. Clinicians and patients emphasised holistic diagnosis that involves more than the scan. Clinicians considered their diagnostic ability as superior and discrepancies were managed in line with clinicians' diagnoses rather than AI reports. The practicalities of using the AI software concerned image acquisition to meet AI processing requirements and workflow integration. There was positivity towards AI use, but the AI software was considered an adjunct to clinicians rather than replacing their input. Clinicians' experiences were that their diagnostic ability remained superior to the AI, and acquiring images acceptable to AI was sometimes problematic. Despite hopes for increased efficiency through AI use, clinicians struggled to identify fit with clinical workflow to bring benefit.

Enhancing Attention Network Spatiotemporal Dynamics for Motor Rehabilitation in Parkinson's Disease.

Pei G, Hu M, Ouyang J, Jin Z, Wang K, Meng D, Wang Y, Chen K, Wang L, Cao LZ, Funahashi S, Yan T, Fang B

pubmed logopapersJan 1 2025
Optimizing resource allocation for Parkinson's disease (PD) motor rehabilitation necessitates identifying biomarkers of responsiveness and dynamic neuroplasticity signatures underlying efficacy. A cohort study of 52 early-stage PD patients undergoing 2-week multidisciplinary intensive rehabilitation therapy (MIRT) was conducted, which stratified participants into responders and nonresponders. A multimodal analysis of resting-state electroencephalography (EEG) microstates and functional magnetic resonance imaging (fMRI) coactivation patterns was performed to characterize MIRT-induced spatiotemporal network reorganization. Responders demonstrated clinically meaningful improvement in motor symptoms, exceeding the minimal clinically important difference threshold of 3.25 on the Unified PD Rating Scale part III, alongside significant reductions in bradykinesia and a significant enhancement in quality-of-life scores at the 3-month follow-up. Resting-state EEG in responders showed a significant attenuation in microstate C and a significant enhancement in microstate D occurrences, along with significantly increased transitions from microstate A/B to D, which significantly correlated with motor function, especially in bradykinesia gains. Concurrently, fMRI analyses identified a prolonged dwell time of the dorsal attention network coactivation/ventral attention network deactivation pattern, which was significantly inversely associated with microstate C occurrence and significantly linked to motor improvement. The identified brain spatiotemporal neural markers were validated using machine learning models to assess the efficacy of MIRT in motor rehabilitation for PD patients, achieving an average accuracy rate of 86%. These findings suggest that MIRT may facilitate a shift in neural networks from sensory processing to higher-order cognitive control, with the dynamic reallocation of attentional resources. This preliminary study validates the necessity of integrating cognitive-motor strategies for the motor rehabilitation of PD and identifies novel neural markers for assessing treatment efficacy.

Auxiliary Diagnosis of Pulmonary Nodules' Benignancy and Malignancy Based on Machine Learning: A Retrospective Study.

Wang W, Yang B, Wu H, Che H, Tong Y, Zhang B, Liu H, Chen Y

pubmed logopapersJan 1 2025
Lung cancer, one of the most lethal malignancies globally, often presents insidiously as pulmonary nodules. Its nonspecific clinical presentation and heterogeneous imaging characteristics hinder accurate differentiation between benign and malignant lesions, while biopsy's invasiveness and procedural constraints underscore the critical need for non-invasive early diagnostic approaches. In this retrospective study, we analyzed outpatient and inpatient records from the First Medical Center of Chinese PLA General Hospital between 2011 and 2021, focusing on pulmonary nodules measuring 5-30mm on CT scans without overt signs of malignancy. Pathological examination served as the reference standard. Comparative experiments evaluated SVM, RF, XGBoost, FNN, and Atten_FNN using five-fold cross-validation to assess AUC, sensitivity, and specificity. The dataset was split 70%/30%, and stratified five-fold cross-validation was applied to the training set. The optimal model was interpreted with SHAP to identify the most influential predictive features. This study enrolled 3355 patients, including 1156 with benign and 2199 with malignant pulmonary nodules. The Atten_FNN model demonstrated superior performance in five-fold cross-validation, achieving an AUC of 0.82, accuracy of 0.75, sensitivity of 0.77, and F1 score of 0.80. SHAP analysis revealed key predictive factors: demographic variables (age, sex, BMI), CT-derived features (maximum nodule diameter, morphology, density, calcification, ground-glass opacity), and laboratory biomarkers (neuroendocrine markers, carcinoembryonic antigen). This study integrates electronic medical records and pathology data to predict pulmonary nodule malignancy using machine/deep learning models. SHAP-based interpretability analysis uncovered key clinical determinants. Acknowledging limitations in cross-center generalizability, we propose the development of a multimodal diagnostic systems that combines CT imaging and radiomics, to be validated in multi-center prospective cohorts to facilitate clinical translation. This framework establishes a novel paradigm for early precision diagnosis of lung cancer.

AI-Assisted 3D Planning of CT Parameters for Personalized Femoral Prosthesis Selection in Total Hip Arthroplasty.

Yang TJ, Qian W

pubmed logopapersJan 1 2025
To investigate the efficacy of CT measurement parameters combined with AI-assisted 3D planning for personalized femoral prosthesis selection in total hip arthroplasty (THA). A retrospective analysis was conducted on clinical data from 247 patients with unilateral hip or knee joint disorders treated at Renmin Hospital of Hubei University of Medicine between April 2021 and February 2024. All patients underwent preoperative full-pelvis and bilateral full-length femoral CT scans. The raw CT data were imported into Mimics 19.0 software to reconstruct a three-dimensional (3D) model of the healthy femur. Using 3-matic Research 11.0 software, the femoral head rotation center was located, and parameters including femoral head diameter (FHD), femoral neck length (FNL), femoral neck-shaft angle (FNSA), femoral offset (FO), femoral neck anteversion angle (FNAA), tip-apex distance (TAD), and tip-apex angle (TAA) were measured. AI-assisted THA 3D planning system AIJOINT V1.0.0.0 software was used for preoperative planning and design, enabling personalized selection of femoral prostheses with varying neck-shaft angles and surgical simulation. Groups were compared by gender, age, and parameters. ROC curves evaluated prediction efficacy. Females exhibited smaller FHD, FNL, FO, TAD, TAA but larger FNSA/FNAA vs males (P<0.05). Patients >65 years had higher FO, TAD, TAA (P<0.05). TAD-TAA correlation was strong (r=0.954), while FNSA negatively correlated with TAD/TAA (r=-0.773/-0.701). ROC analysis demonstrated high predictive accuracy: TAD (AUC=0.891, sensitivity=91.7%, specificity=87.6%) and TAA (AUC=0.882, sensitivity=100%, specificity=88.8%). CT parameters (TAA, TAD, FNSA, FO) are interrelated and effective predictors for femoral prosthesis selection. Integration with AI-assisted planning optimizes personalized THA, reducing biomechanical mismatch risks.

Current application, possibilities, and challenges of artificial intelligence in the management of rheumatoid arthritis, axial spondyloarthritis, and psoriatic arthritis.

Bilgin E

pubmed logopapersJan 1 2025
This narrative review outlines the current applications and considerations of artificial intelligence (AI) for diagnosis, management, and prognosis in rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), and psoriatic arthritis (PsA). Advances in AI, mainly in machine learning and deep learning, have significantly influenced medical research and clinical practice over the past decades by offering precisions in data understanding and treatment approaches. AI applications have enhanced risk prediction models, early diagnosis, and better management in RA. Predictive models have guided treatment decisions such as-response to methotrexate and biologics-while wearable devices and electronic health records (EHR) improve disease activity monitoring. In addition, AI applications are reported as promising for the early identification of extra-articular involvements, prediction, detection, and assessment of comorbidities. In axSpA, AI-driven models using imaging techniques such as sacroiliac radiography, magnetic resonance imaging, and computed tomography have increased diagnostic accuracy, especially for early inflammatory changes. Predictive algorithms help stratify and predict disease outcomes, while clinical decision support systems integrate clinical and imaging data for optimized management. For PsA, AI has also allowed for early detection among psoriasis patients using genetic markers, immune profiling, and EHR-based natural language processing systems. Overall, AI models may predict diagnosis, disease severity, treatment response, and comorbidities to improve care in patients with RA, axSpA, and PsA. As a rapidly developing and improving area, AI has the potential to change our current perspective of medical practice by offering better diagnostic evaluation and treatments and improved patient follow-up. Multimodal AI, focusing on collaboration, reliability, transparency, and patient-centered innovation, looks like the future of medical practice. However, data quality, model interpretability, and ethical considerations must be addressed to ensure reliable and equitable applications in clinical practice.

Current Strategies to Reducing Interval Breast Cancers: A Systematic Review.

Goh RSJ, Chong B, Yeo S, Neo SY, Ng QX, Goh SSN

pubmed logopapersJan 1 2025
Interval breast cancers (IBCs) are detected between regular mammographic screenings after an initially negative result. Studies have shown that the prognosis of IBCs is similar to that of unscreened symptomatic cancers and is hence a surrogate used to assess the effectiveness of screening programs. This systematic review consolidates the current literature available on strategies to reduce the rates of IBC. Following PRISMA guidelines, three databases were searched from inception till October 29, 2023 to identify papers, which reported IBC rates. Key search terms included "interval breast cancer", "mammogram", "tomosynthesis" and "screening". A total of 32 articles were included. Fourteen studies discussed the use of digital breast tomosynthesis (DBT) as an alternative screening modality to mammograms. Six studies discussed the use of artificial intelligence (AI) on mammograms, five studies discussed the use of supplemental modalities including ultrasonography (US) in addition to mammograms, five studies discussed varying screening intervals and two studies discussed tamoxifen use. The trajectory of IBCs can be altered by early detection when they are more amenable to treatment, through advanced screening techniques, adjusting inter-screening intervals and modifiable risk factors. The goal is to create a screening protocol that is economically effective and accessible to various populations.

Improved swin transformer-based thorax disease classification with optimal feature selection using chest X-ray.

Rana N, Coulibaly Y, Noor A, Noor TH, Alam MI, Khan Z, Tahir A, Khan MZ

pubmed logopapersJan 1 2025
Thoracic diseases, including pneumonia, tuberculosis, lung cancer, and others, pose significant health risks and require timely and accurate diagnosis to ensure proper treatment. Thus, in this research, a model for thorax disease classification using Chest X-rays is proposed by considering deep learning model. The input is pre-processed by resizing, normalizing pixel values, and applying data augmentation to address the issue of imbalanced datasets and improve model generalization. Significant features are extracted from the images using an Enhanced Auto-Encoder (EnAE) model, which combines a stacked auto-encoder architecture with an attention module to enhance feature representation and classification accuracy. To further improve feature selection, we utilize the Chaotic Whale Optimization (ChWO) Algorithm, which optimally selects the most relevant attributes from the extracted features. Finally, the disease classification is performed using the novel Improved Swin Transformer (IMSTrans) model, which is designed to efficiently process high-dimensional medical image data and achieve superior classification performance. The proposed EnAE + ChWO+IMSTrans model for thorax disease classification was evaluated using extensive Chest X-ray datasets and the Lung Disease Dataset. The proposed method demonstrates enhanced Accuracy, Precision, Recall, F-Score, MCC and MAE of 0.964, 0.977, 0.9845, 0.964, 0.9647, and 0.184 respectively indicating the reliable and efficient solution for thorax disease classification.
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