There has been increasing interest in the generation of high-quality, realistic synthetic medical images in recent years. Such synthetic datasets can mitigate the scarcity of public datasets for artificial intelligence research, and can also be used for educational purposes. In this paper, we propose a combination of diffusion-based generation (PanoDiff) and Super-Resolution (SR) for generating synthetic dental panoramic radiographs (PRs). The former generates a low-resolution (LR) seed of a PR (256 X 128) which is then processed by the SR model to yield a high-resolution (HR) PR of size 1024 X 512. For SR, we propose a state-of-the-art transformer that learns local-global relationships, resulting in sharper edges and textures. Experimental results demonstrate a Frechet inception distance score of 40.69 between 7243 real and synthetic images (in HR). Inception scores were 2.55, 2.30, 2.90 and 2.98 for real HR, synthetic HR, real LR and synthetic LR images, respectively. Among a diverse group of six clinical experts, all evaluating a mixture of 100 synthetic and 100 real PRs in a time-limited observation, the average accuracy in distinguishing real from synthetic images was 68.5% (with 50% corresponding to random guessing).

Craniofacial reconstruction in forensic science is crucial for the identification of the victims of crimes and disasters. The objective is to map a given skull to its corresponding face in a corpus of faces with known identities using recent advancements in computer vision, such as deep learning. In this paper, we presented a framework for the identification of a person given the X-ray image of a skull using convolutional Siamese networks for cross-domain identity representation. Siamese networks are twin networks that share the same architecture and can be trained to discover a feature space where nearby observations that are similar are grouped and dissimilar observations are moved apart. To do this, the network is exposed to two sets of comparable and different data. The Euclidean distance is then minimized between similar pairs and maximized between dissimilar ones. Since getting pairs of skull and face images are difficult, we prepared our own dataset of 40 volunteers whose front and side skull X-ray images and optical face images were collected. Experiments were conducted on the collected cross-domain dataset to train and validate the Siamese networks. The experimental results provide satisfactory results on the identification of a person from the given skull.

Pneumonia detection in chest X-rays (CXR) increasingly relies on AI-driven diagnostic systems. However, their "black-box" nature often lacks transparency, underscoring the need for interpretability to improve patient outcomes. This study presents the first application of the Deformable Prototypical Part Network (D-ProtoPNet), an ante-hoc interpretable deep learning (DL) model, for pneumonia classification in pediatric patients' CXR images. Clinical insights were integrated through expert radiologist evaluation of the model's learned prototypes and activated image patches, ensuring that explanations aligned with medically meaningful features. The model was developed and tested on a retrospective dataset of 5,856 CXR images of pediatric patients, ages 1-5 years. The images were originally acquired at a tertiary academic medical center as part of routine clinical care and were publicly hosted on a Kaggle platform. This dataset comprised anterior-posterior images labeled normal, viral, and bacterial. It was divided into 80 % training and 20 % validation splits, and utilised in a supervised five-fold cross-validation. Performance metrics were compared with the original ProtoPNet, utilising ResNet50 as the base model. An experienced radiologist assessed the clinical relevance of the learned prototypes, patch activations, and model explanations. The D-ProtoPNet achieved an accuracy of 86 %, precision of 86 %, recall of 85 %, and AUC of 93 %, marking a 3 % improvement over the original ProtoPNet. While further optimisation is required before clinical use, the radiologist praised D-ProtoPNet's intuitive explanations, highlighting its interpretability and potential to aid clinical decision-making. Prototypical part learning offers a balance between classification performance and explanation quality, but requires improvements to match the accuracy of black-box models. This study underscores the importance of integrating domain expertise during model evaluation to ensure the interpretability of XAI models is grounded in clinically valid insights.

The rapid and accurate detection of COVID-19 (coronavirus disease 2019) from normal and pneumonia chest x-ray images is essential for timely diagnosis and treatment. The overlapping features in radiology images make it challenging for radiologists to distinguish COVID-19 cases. This research study investigates the effectiveness of combining local binary pattern (LBP) and histogram of oriented gradients (HOG) features with machine learning algorithms to differentiate COVID-19 from normal and pneumonia cases using chest x-rays. The proposed hybrid fusion model "RadientFusion-XR" utilizes LBP and HOG features with shallow learning algorithms. The proposed hybrid HOG-LBP fusion model, RadientFusion-XR, detects COVID-19 cases from normal and pneumonia classes. This fusion model provides a comprehensive representation, enabling more precise differentiation among the three classes. This methodology presents a promising and efficient tool for early COVID-19 and pneumonia diagnosis in clinical settings, with potential integration into automated diagnostic systems. The findings highlight the potential of this hybrid feature extraction and a shallow learning approach to improve diagnostic accuracy in chest x-ray analysis significantly. The hybrid model using LBP and HOG features with an ensemble model achieved an exceptional accuracy of 99% for binary class (COVID-19, normal) and 97% for multi-class (COVID-19, normal, pneumonia), respectively. These results demonstrate the efficacy of our hybrid approach in enhancing feature representation and achieving superior classification accuracy. The proposed RadientFusion-XR model with hybrid feature extraction and shallow learning approach significantly increases the accuracy of COVID-19 and pneumonia diagnoses from chest x-rays. The interpretable nature of RadientFusion-XR, alongside its effectiveness and explainability, makes it a valuable tool for clinical applications, fostering trust and enabling informed decision-making by healthcare professionals.

To develop an artificial intelligence (AI)-driven model for automatic Lenke classification of adolescent idiopathic scoliosis (AIS) and assess its performance. This retrospective study utilized 860 spinal radiographs from 215 AIS patients with four views, including 161 training sets and 54 testing sets. Additionally, 1220 spinal radiographs from 610 patients with only anterior-posterior (AP) and lateral (LAT) views were collected for training. The model was designed to perform keypoint detection, pedicle segmentation, and AIS classification based on a custom classification strategy. Its performance was evaluated against the gold standard using metrics such as mean absolute difference (MAD), intraclass correlation coefficient (ICC), Bland-Altman plots, Cohen's Kappa, and the confusion matrix. In comparison to the gold standard, the MAD for all predicted angles was 2.29°, with an excellent ICC. Bland-Altman analysis revealed minimal differences between the methods. For Lenke classification, the model exhibited exceptional consistency in curve type, lumbar modifier, and thoracic sagittal profile, with average Kappa values of 0.866, 0.845, and 0.827, respectively, and corresponding accuracy rates of 87.07%, 92.59%, and 92.59%. Subgroup analysis further confirmed the model's high consistency, with Kappa values ranging from 0.635 to 0.930, 0.672 to 0.926, and 0.815 to 0.847, and accuracy rates between 90.7 and 98.1%, 92.6-98.3%, and 92.6-98.1%, respectively. This novel AI system facilitates the rapid and accurate automatic Lenke classification, offering potential assistance to spinal surgeons.

To construct a deep learning-based SCNet model, in order to automatically measure X-ray imaging parameters related to atlantoaxial subluxation (AAS) in cervical open-mouth view radiographs, and the accuracy and reliability of the model were evaluated. A total of 1973 cervical open-mouth view radiographs were collected from picture archiving and communication system (PACS) of two hospitals(Hospitals A and B). Among them, 365 images of Hospital A were randomly selected as the internal test dataset for evaluating the model's performance, and the remaining 1364 images of Hospital A were used as the training dataset and validation dataset for constructing the model and tuning the model hyperparameters, respectively. The 244 images of Hospital B were used as an external test dataset to evaluate the robustness and generalizability of our model. The model identified and marked landmarks in the images for the parameters of the lateral atlanto-dental space (LADS), atlas lateral mass inclination (ALI), lateral mass width (LW), axis spinous process deviation distance (ASDD). The measured results of landmarks on the internal test dataset and external test dataset were compared with the mean values of manual measurement by three radiologists as the reference standard. Percentage of correct key-points (PCK), intra-class correlation coefficient (ICC), mean absolute error (MAE), Pearson correlation coefficient (r), mean square error (MSE), root mean square error (RMSE) and Bland-Altman plot were used to evaluate the performance of the SCNet model. (1) Within the 2 mm distance threshold, the PCK of the SCNet model predicted landmarks in internal test dataset images was 98.6-99.7%, and the PCK in the external test dataset images was 98-100%. (2) In the internal test dataset, for the parameters LADS, ALI, LW, and ASDD, there were strong correlation and consistency between the SCNet model predictions and the manual measurements (ICC = 0.80-0.96, r = 0.86-0.96, MAE = 0.47-2.39 mm/°, MSE = 0.38-8.55 mm²/°², RMSE = 0.62-2.92 mm/°). (3) The same four parameters also showed strong correlation and consistency between SCNet and manual measurements in the external test dataset (ICC = 0.81-0.91, r = 0.82-0.91, MAE = 0.46-2.29 mm/°, MSE = 0.29-8.23mm²/°², RMSE = 0.54-2.87 mm/°). The SCNet model constructed based on deep learning algorithm in this study can accurately identify atlantoaxial vertebral landmarks in cervical open-mouth view radiographs and automatically measure the AAS-related imaging parameters. Furthermore, the independent external test set demonstrates that the model exhibits a certain degree of robustness and generalization capability under meet radiographic standards.

In pediatric orthodontics, accurate estimation of growth potential is essential for developing effective treatment strategies. Our research aims to predict this potential by identifying the growth peak and analyzing cervical vertebra morphology solely through lateral cephalometric radiographs. We accomplish this by comprehensively analyzing cervical vertebral maturation (CVM) features from these radiographs. This methodology provides clinicians with a reliable and efficient tool to determine the optimal timings for orthodontic interventions, ultimately enhancing patient outcomes. A crucial aspect of this approach is the meticulous annotation of keypoints on the cervical vertebrae, a task often challenged by its labor-intensive nature. To mitigate this, we introduce Attend-and-Refine Network (ARNet), a user-interactive, deep learning-based model designed to streamline the annotation process. ARNet features Interaction-guided recalibration network, which adaptively recalibrates image features in response to user feedback, coupled with a morphology-aware loss function that preserves the structural consistency of keypoints. This novel approach substantially reduces manual effort in keypoint identification, thereby enhancing the efficiency and accuracy of the process. Extensively validated across various datasets, ARNet demonstrates remarkable performance and exhibits wide-ranging applicability in medical imaging. In conclusion, our research offers an effective AI-assisted diagnostic tool for assessing growth potential in pediatric orthodontics, marking a significant advancement in the field.

Recent work has revisited the infamous task Name that dataset and established that in non-medical datasets, there is an underlying bias and achieved high Accuracies on the dataset origin task. In this work, we revisit the same task applied to popular open-source chest X-ray datasets. Medical images are naturally more difficult to release for open-source due to their sensitive nature, which has led to certain open-source datasets being extremely popular for research purposes. By performing the same task, we wish to explore whether dataset bias also exists in these datasets. % We deliberately try to increase the difficulty of the task by dataset transformations. We apply simple transformations of the datasets to try to identify bias. Given the importance of AI applications in medical imaging, it's vital to establish whether modern methods are taking shortcuts or are focused on the relevant pathology. We implement a range of different network architectures on the datasets: NIH, CheXpert, MIMIC-CXR and PadChest. We hope this work will encourage more explainable research being performed in medical imaging and the creation of more open-source datasets in the medical domain. The corresponding code will be released upon acceptance.

The labor-intensive nature of medical data annotation presents a significant challenge for respiratory disease diagnosis, resulting in a scarcity of high-quality labeled datasets in resource-constrained settings. Moreover, patient privacy concerns complicate the direct sharing of local medical data across institutions, and existing centralized data-driven approaches, which rely on amounts of available data, often compromise data privacy. This study proposes a federated few-shot learning framework with privacy-preserving mechanisms to address the issues of limited labeled data and privacy protection in diagnosing respiratory diseases. In particular, a meta-stochastic gradient descent algorithm is proposed to mitigate the overfitting problem that arises from insufficient data when employing traditional gradient descent methods for neural network training. Furthermore, to ensure data privacy against gradient leakage, differential privacy noise from a standard Gaussian distribution is integrated into the gradients during the training of private models with local data, thereby preventing the reconstruction of medical images. Given the impracticality of centralizing respiratory disease data dispersed across various medical institutions, a weighted average algorithm is employed to aggregate local diagnostic models from different clients, enhancing the adaptability of a model across diverse scenarios. Experimental results show that the proposed method yields compelling results with the implementation of differential privacy, while effectively diagnosing respiratory diseases using data from different structures, categories, and distributions.

Recent works have revisited the infamous task ``Name That Dataset'', demonstrating that non-medical datasets contain underlying biases and that the dataset origin task can be solved with high accuracy. In this work, we revisit the same task applied to popular open-source chest X-ray datasets. Medical images are naturally more difficult to release for open-source due to their sensitive nature, which has led to certain open-source datasets being extremely popular for research purposes. By performing the same task, we wish to explore whether dataset bias also exists in these datasets. To extend our work, we apply simple transformations to the datasets, repeat the same task, and perform an analysis to identify and explain any detected biases. Given the importance of AI applications in medical imaging, it's vital to establish whether modern methods are taking shortcuts or are focused on the relevant pathology. We implement a range of different network architectures on the datasets: NIH, CheXpert, MIMIC-CXR and PadChest. We hope this work will encourage more explainable research being performed in medical imaging and the creation of more open-source datasets in the medical domain. Our code can be found here: https://github.com/eedack01/x_ray_ds_bias.