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FreqU-FNet: Frequency-Aware U-Net for Imbalanced Medical Image Segmentation

Ruiqi Xing

arxiv logopreprintMay 23 2025
Medical image segmentation faces persistent challenges due to severe class imbalance and the frequency-specific distribution of anatomical structures. Most conventional CNN-based methods operate in the spatial domain and struggle to capture minority class signals, often affected by frequency aliasing and limited spectral selectivity. Transformer-based models, while powerful in modeling global dependencies, tend to overlook critical local details necessary for fine-grained segmentation. To overcome these limitations, we propose FreqU-FNet, a novel U-shaped segmentation architecture operating in the frequency domain. Our framework incorporates a Frequency Encoder that leverages Low-Pass Frequency Convolution and Daubechies wavelet-based downsampling to extract multi-scale spectral features. To reconstruct fine spatial details, we introduce a Spatial Learnable Decoder (SLD) equipped with an adaptive multi-branch upsampling strategy. Furthermore, we design a frequency-aware loss (FAL) function to enhance minority class learning. Extensive experiments on multiple medical segmentation benchmarks demonstrate that FreqU-FNet consistently outperforms both CNN and Transformer baselines, particularly in handling under-represented classes, by effectively exploiting discriminative frequency bands.

Anatomy-Guided Multitask Learning for MRI-Based Classification of Placenta Accreta Spectrum and its Subtypes

Hai Jiang, Qiongting Liu, Yuanpin Zhou, Jiawei Pan, Ting Song, Yao Lu

arxiv logopreprintMay 23 2025
Placenta Accreta Spectrum Disorders (PAS) pose significant risks during pregnancy, frequently leading to postpartum hemorrhage during cesarean deliveries and other severe clinical complications, with bleeding severity correlating to the degree of placental invasion. Consequently, accurate prenatal diagnosis of PAS and its subtypes-placenta accreta (PA), placenta increta (PI), and placenta percreta (PP)-is crucial. However, existing guidelines and methodologies predominantly focus on the presence of PAS, with limited research addressing subtype recognition. Additionally, previous multi-class diagnostic efforts have primarily relied on inefficient two-stage cascaded binary classification tasks. In this study, we propose a novel convolutional neural network (CNN) architecture designed for efficient one-stage multiclass diagnosis of PAS and its subtypes, based on 4,140 magnetic resonance imaging (MRI) slices. Our model features two branches: the main classification branch utilizes a residual block architecture comprising multiple residual blocks, while the second branch integrates anatomical features of the uteroplacental area and the adjacent uterine serous layer to enhance the model's attention during classification. Furthermore, we implement a multitask learning strategy to leverage both branches effectively. Experiments conducted on a real clinical dataset demonstrate that our model achieves state-of-the-art performance.

Dual Attention Residual U-Net for Accurate Brain Ultrasound Segmentation in IVH Detection

Dan Yuan, Yi Feng, Ziyun Tang

arxiv logopreprintMay 23 2025
Intraventricular hemorrhage (IVH) is a severe neurological complication among premature infants, necessitating early and accurate detection from brain ultrasound (US) images to improve clinical outcomes. While recent deep learning methods offer promise for computer-aided diagnosis, challenges remain in capturing both local spatial details and global contextual dependencies critical for segmenting brain anatomies. In this work, we propose an enhanced Residual U-Net architecture incorporating two complementary attention mechanisms: the Convolutional Block Attention Module (CBAM) and a Sparse Attention Layer (SAL). The CBAM improves the model's ability to refine spatial and channel-wise features, while the SAL introduces a dual-branch design, sparse attention filters out low-confidence query-key pairs to suppress noise, and dense attention ensures comprehensive information propagation. Extensive experiments on the Brain US dataset demonstrate that our method achieves state-of-the-art segmentation performance, with a Dice score of 89.04% and IoU of 81.84% for ventricle region segmentation. These results highlight the effectiveness of integrating spatial refinement and attention sparsity for robust brain anatomy detection. Code is available at: https://github.com/DanYuan001/BrainImgSegment.

A Unified Multi-Scale Attention-Based Network for Automatic 3D Segmentation of Lung Parenchyma & Nodules In Thoracic CT Images

Muhammad Abdullah, Furqan Shaukat

arxiv logopreprintMay 23 2025
Lung cancer has been one of the major threats across the world with the highest mortalities. Computer-aided detection (CAD) can help in early detection and thus can help increase the survival rate. Accurate lung parenchyma segmentation (to include the juxta-pleural nodules) and lung nodule segmentation, the primary symptom of lung cancer, play a crucial role in the overall accuracy of the Lung CAD pipeline. Lung nodule segmentation is quite challenging because of the diverse nodule types and other inhibit structures present within the lung lobes. Traditional machine/deep learning methods suffer from generalization and robustness. Recent Vision Language Models/Foundation Models perform well on the anatomical level, but they suffer on fine-grained segmentation tasks, and their semi-automatic nature limits their effectiveness in real-time clinical scenarios. In this paper, we propose a novel method for accurate 3D segmentation of lung parenchyma and lung nodules. The proposed architecture is an attention-based network with residual blocks at each encoder-decoder state. Max pooling is replaced by strided convolutions at the encoder, and trilinear interpolation is replaced by transposed convolutions at the decoder to maximize the number of learnable parameters. Dilated convolutions at each encoder-decoder stage allow the model to capture the larger context without increasing computational costs. The proposed method has been evaluated extensively on one of the largest publicly available datasets, namely LUNA16, and is compared with recent notable work in the domain using standard performance metrics like Dice score, IOU, etc. It can be seen from the results that the proposed method achieves better performance than state-of-the-art methods. The source code, datasets, and pre-processed data can be accessed using the link: https://github.com/EMeRALDsNRPU/Attention-Based-3D-ResUNet.

SUFFICIENT: A scan-specific unsupervised deep learning framework for high-resolution 3D isotropic fetal brain MRI reconstruction

Jiangjie Wu, Lixuan Chen, Zhenghao Li, Xin Li, Saban Ozturk, Lihui Wang, Rongpin Wang, Hongjiang Wei, Yuyao Zhang

arxiv logopreprintMay 23 2025
High-quality 3D fetal brain MRI reconstruction from motion-corrupted 2D slices is crucial for clinical diagnosis. Reliable slice-to-volume registration (SVR)-based motion correction and super-resolution reconstruction (SRR) methods are essential. Deep learning (DL) has demonstrated potential in enhancing SVR and SRR when compared to conventional methods. However, it requires large-scale external training datasets, which are difficult to obtain for clinical fetal MRI. To address this issue, we propose an unsupervised iterative SVR-SRR framework for isotropic HR volume reconstruction. Specifically, SVR is formulated as a function mapping a 2D slice and a 3D target volume to a rigid transformation matrix, which aligns the slice to the underlying location in the target volume. The function is parameterized by a convolutional neural network, which is trained by minimizing the difference between the volume slicing at the predicted position and the input slice. In SRR, a decoding network embedded within a deep image prior framework is incorporated with a comprehensive image degradation model to produce the high-resolution (HR) volume. The deep image prior framework offers a local consistency prior to guide the reconstruction of HR volumes. By performing a forward degradation model, the HR volume is optimized by minimizing loss between predicted slices and the observed slices. Comprehensive experiments conducted on large-magnitude motion-corrupted simulation data and clinical data demonstrate the superior performance of the proposed framework over state-of-the-art fetal brain reconstruction frameworks.

Graph Mamba for Efficient Whole Slide Image Understanding

Jiaxuan Lu, Junyan Shi, Yuhui Lin, Fang Yan, Yue Gao, Shaoting Zhang, Xiaosong Wang

arxiv logopreprintMay 23 2025
Whole Slide Images (WSIs) in histopathology present a significant challenge for large-scale medical image analysis due to their high resolution, large size, and complex tile relationships. Existing Multiple Instance Learning (MIL) methods, such as Graph Neural Networks (GNNs) and Transformer-based models, face limitations in scalability and computational cost. To bridge this gap, we propose the WSI-GMamba framework, which synergistically combines the relational modeling strengths of GNNs with the efficiency of Mamba, the State Space Model designed for sequence learning. The proposed GMamba block integrates Message Passing, Graph Scanning & Flattening, and feature aggregation via a Bidirectional State Space Model (Bi-SSM), achieving Transformer-level performance with 7* fewer FLOPs. By leveraging the complementary strengths of lightweight GNNs and Mamba, the WSI-GMamba framework delivers a scalable solution for large-scale WSI analysis, offering both high accuracy and computational efficiency for slide-level classification.

Novel Deep Learning Framework for Simultaneous Assessment of Left Ventricular Mass and Longitudinal Strain: Clinical Feasibility and Validation in Patients with Hypertrophic Cardiomyopathy

Park, J., Yoon, Y. E., Jang, Y., Jung, T., Jeon, J., Lee, S.-A., Choi, H.-M., Hwang, I.-C., Chun, E. J., Cho, G.-Y., Chang, H.-J.

medrxiv logopreprintMay 23 2025
BackgroundThis study aims to present the Segmentation-based Myocardial Advanced Refinement Tracking (SMART) system, a novel artificial intelligence (AI)-based framework for transthoracic echocardiography (TTE) that incorporates motion tracking and left ventricular (LV) myocardial segmentation for automated LV mass (LVM) and global longitudinal strain (LVGLS) assessment. MethodsThe SMART system demonstrates LV speckle tracking based on motion vector estimation, refined by structural information using endocardial and epicardial segmentation throughout the cardiac cycle. This approach enables automated measurement of LVMSMART and LVGLSSMART. The feasibility of SMART is validated in 111 hypertrophic cardiomyopathy (HCM) patients (median age: 58 years, 69% male) who underwent TTE and cardiac magnetic resonance imaging (CMR). ResultsLVGLSSMART showed a strong correlation with conventional manual LVGLS measurements (Pearsons correlation coefficient [PCC] 0.851; mean difference 0 [-2-0]). When compared to CMR as the reference standard for LVM, the conventional dimension-based TTE method overestimated LVM (PCC 0.652; mean difference: 106 [90-123]), whereas LVMSMART demonstrated excellent agreement with CMR (PCC 0.843; mean difference: 1 [-11-13]). For predicting extensive myocardial fibrosis, LVGLSSMART and LVMSMART exhibited performance comparable to conventional LVGLS and CMR (AUC: 0.72 and 0.66, respectively). Patients identified as high-risk for extensive fibrosis by LVGLSSMART and LVMSMART had significantly higher rates of adverse outcomes, including heart failure hospitalization, new-onset atrial fibrillation, and defibrillator implantation. ConclusionsThe SMART technique provides a comparable LVGLS evaluation and a more accurate LVM assessment than conventional TTE, with predictive values for myocardial fibrosis and adverse outcomes. These findings support its utility in HCM management.

High-Fidelity Functional Ultrasound Reconstruction via A Visual Auto-Regressive Framework

Xuhang Chen, Zhuo Li, Yanyan Shen, Mufti Mahmud, Hieu Pham, Chi-Man Pun, Shuqiang Wang

arxiv logopreprintMay 23 2025
Functional ultrasound (fUS) imaging provides exceptional spatiotemporal resolution for neurovascular mapping, yet its practical application is significantly hampered by critical challenges. Foremost among these are data scarcity, arising from ethical considerations and signal degradation through the cranium, which collectively limit dataset diversity and compromise the fairness of downstream machine learning models.

PDS-UKAN: Subdivision hopping connected to the U-KAN network for medical image segmentation.

Deng L, Wang W, Chen S, Yang X, Huang S, Wang J

pubmed logopapersMay 23 2025
Accurate and efficient segmentation of medical images plays a vital role in clinical tasks, such as diagnostic procedures and planning treatments. Traditional U-shaped encoder-decoder architectures, built on convolutional and transformer-based networks, have shown strong performance in medical image processing. However, the simple skip connections commonly used in these networks face limitations, such as insufficient nonlinear modeling capacity, weak global multiscale context modeling, and limited interpretability. To address these challenges, this study proposes the PDS-UKAN network, an innovative subdivision-based U-KAN architecture, designed to improve segmentation accuracy. The PDS-UKAN incorporates a PKAN module-comprising partial convolutions and Kolmogorov - Arnold network layers-into the encoder bottleneck, enhancing the network's nonlinear modeling and interpretability. Additionally, the proposed Dual-Branch Convolutional Boundary Enhancement Module (DBE) focuses on pixel-level boundary refinement, improving edge detail preservation in shallow skip connections. Meanwhile, the Skip Connection Channel Spatial Attention Module (SCCSA) mechanism is applied in the deeper skip connections to strengthen cross-dimensional interactions between channels and spatial features, mitigating the loss of spatial information due to downsampling. Extensive experiments across multiple medical imaging datasets demonstrate that PDS-UKAN consistently achieves superior performance compared to state-of-the-art (SOTA) methods.

How We Won the ISLES'24 Challenge by Preprocessing

Tianyi Ren, Juampablo E. Heras Rivera, Hitender Oswal, Yutong Pan, William Henry, Sophie Walters, Mehmet Kurt

arxiv logopreprintMay 23 2025
Stroke is among the top three causes of death worldwide, and accurate identification of stroke lesion boundaries is critical for diagnosis and treatment. Supervised deep learning methods have emerged as the leading solution for stroke lesion segmentation but require large, diverse, and annotated datasets. The ISLES'24 challenge addresses this need by providing longitudinal stroke imaging data, including CT scans taken on arrival to the hospital and follow-up MRI taken 2-9 days from initial arrival, with annotations derived from follow-up MRI. Importantly, models submitted to the ISLES'24 challenge are evaluated using only CT inputs, requiring prediction of lesion progression that may not be visible in CT scans for segmentation. Our winning solution shows that a carefully designed preprocessing pipeline including deep-learning-based skull stripping and custom intensity windowing is beneficial for accurate segmentation. Combined with a standard large residual nnU-Net architecture for segmentation, this approach achieves a mean test Dice of 28.5 with a standard deviation of 21.27.
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