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Deep Learning-accelerated MRI in Body and Chest.

Rajamohan N, Bagga B, Bansal B, Ginocchio L, Gupta A, Chandarana H

pubmed logopapersMay 13 2025
Deep learning reconstruction (DLR) provides an elegant solution for MR acceleration while preserving image quality. This advancement is crucial for body imaging, which is frequently marred by the increased likelihood of motion-related artifacts. Multiple vendor-specific models focusing on T2, T1, and diffusion-weighted imaging have been developed for the abdomen, pelvis, and chest, with the liver and prostate being the most well-studied organ systems. Variational networks with supervised DL models, including data consistency layers and regularizers, are the most common DLR methods. The common theme for all single-center studies on this subject has been noninferior or superior image quality metrics and lesion conspicuity to conventional sequences despite significant acquisition time reduction. DLR also provides a potential for denoising, artifact reduction, increased resolution, and increased signal-noise ratio (SNR) and contrast-to-noise ratio (CNR) that can be balanced with acceleration benefits depending on the imaged organ system. Some specific challenges faced by DLR include slightly reduced lesion detection, cardiac motion-related signal loss, regional SNR variations, and variabilities in ADC measurements as reported in different organ systems. Continued investigations with large-scale multicenter prospective clinical validation of DLR to document generalizability and demonstrate noninferior diagnostic accuracy with histopathologic correlation are the need of the hour. The creation of vendor-neutral solutions, open data sharing, and diversifying training data sets are also critical to strengthening model robustness.

Artificial intelligence for chronic total occlusion percutaneous coronary interventions.

Rempakos A, Pilla P, Alexandrou M, Mutlu D, Strepkos D, Carvalho PEP, Ser OS, Bahbah A, Amin A, Prasad A, Azzalini L, Ybarra LF, Mastrodemos OC, Rangan BV, Al-Ogaili A, Jalli S, Burke MN, Sandoval Y, Brilakis ES

pubmed logopapersMay 13 2025
Artificial intelligence (AI) has become pivotal in advancing medical care, particularly in interventional cardiology. Recent AI developments have proven effective in guiding advanced procedures and complex decisions. The authors review the latest AI-based innovations in the diagnosis of chronic total occlusions (CTO) and in determining the probability of success of CTO percutaneous coronary intervention (PCI). Neural networks and deep learning strategies were the most commonly used algorithms, and the models were trained and deployed using a variety of data types, such as clinical parameters and imaging. AI holds great promise in facilitating CTO PCI.

Artificial Intelligence in Sincalide-Stimulated Cholescintigraphy: A Pilot Study.

Nguyen NC, Luo J, Arefan D, Vasireddi AK, Wu S

pubmed logopapersMay 13 2025
Sincalide-stimulated cholescintigraphy (SSC) calculates the gallbladder ejection fraction (GBEF) to diagnose functional gallbladder disorder. Currently, artificial intelligence (AI)-driven workflows that integrate real-time image processing and organ function calculation remain unexplored in nuclear medicine practice. This pilot study explored an AI-based application for gallbladder radioactivity tracking. We retrospectively analyzed 20 SSC exams, categorized into 10 easy and 10 challenging cases. Two human operators (H1 and H2) independently annotated the gallbladder regions of interest manually over the course of the 60-minute SSC. A U-Net-based deep learning model was developed to automatically segment gallbladder masks, and a 10-fold cross-validation was performed for both easy and challenging cases. The AI-generated masks were compared with human-annotated ones, with Dice similarity coefficients (DICE) used to assess agreement. AI achieved an average DICE of 0.746 against H1 and 0.676 against H2, performing better in easy cases (0.781) than in challenging ones (0.641). Visual inspection showed AI was prone to errors with patient motion or low-count activity. This study highlights AI's potential in real-time gallbladder tracking and GBEF calculation during SSC. AI-enabled real-time evaluation of nuclear imaging data holds promise for advancing clinical workflows by providing instantaneous organ function assessments and feedback to technologists. This AI-enabled workflow could enhance diagnostic efficiency, reduce scan duration, and improve patient comfort by alleviating symptoms associated with SSC, such as abdominal discomfort due to sincalide administration.

An automated cascade framework for glioma prognosis via segmentation, multi-feature fusion and classification techniques.

Hamoud M, Chekima NEI, Hima A, Kholladi NH

pubmed logopapersMay 13 2025
Glioma is one of the most lethal types of brain tumors, accounting for approximately 33% of all diagnosed brain tumor cases. Accurate segmentation and classification are crucial for precise glioma characterization, emphasizing early detection of malignancy, effective treatment planning, and prevention of tumor progression. Magnetic Resonance Imaging (MRI) serves as a non-invasive imaging modality that allows detailed examination of gliomas without exposure to ionizing radiation. However, manual analysis of MRI scans is impractical, time-consuming, subjective, and requires specialized expertise from radiologists. To address this, computer-aided diagnosis (CAD) systems have greatly evolved as powerful tools to support neuro-oncologists in the brain cancer screening process. In this work, we present a glioma classification framework based on 3D multi-modal MRI segmentation using the CNN models SegResNet and Swin UNETR which incorporates transformer mechanisms for enhancing segmentation performance. MRI images undergo preprocessing with a Gaussian filter and skull stripping to improve tissue localization. Key textural features are then extracted from segmented tumor regions using Gabor Transform, Discrete Wavelet Transform (DWT), and deep features from ResNet50. These features are fused, normalized, and classified using a Support Vector Machine (SVM) to distinguish between Low-Grade Glioma (LGG) and High-Grade Glioma (HGG). Extensive experiments on benchmark datasets, including BRATS2020 and BRATS2023, demonstrate the effectiveness of the proposed approach. Our model achieved Dice scores of 0.815 for Tumor Core, 0.909 for Whole Tumor, and 0.829 for Enhancing Tumor. Concerning classification, the framework attained 97% accuracy, 94% precision, 96% recall, and a 95% F1-score. These results highlight the potential of the proposed framework to provide reliable support for radiologists in the early detection and classification of gliomas.

Signal-based AI-driven software solution for automated quantification of metastatic bone disease and treatment response assessment using Whole-Body Diffusion-Weighted MRI (WB-DWI) biomarkers in Advanced Prostate Cancer

Antonio Candito, Matthew D Blackledge, Richard Holbrey, Nuria Porta, Ana Ribeiro, Fabio Zugni, Luca D'Erme, Francesca Castagnoli, Alina Dragan, Ricardo Donners, Christina Messiou, Nina Tunariu, Dow-Mu Koh

arxiv logopreprintMay 13 2025
We developed an AI-driven software solution to quantify metastatic bone disease from WB-DWI scans. Core technologies include: (i) a weakly-supervised Residual U-Net model generating a skeleton probability map to isolate bone; (ii) a statistical framework for WB-DWI intensity normalisation, obtaining a signal-normalised b=900s/mm^2 (b900) image; and (iii) a shallow convolutional neural network that processes outputs from (i) and (ii) to generate a mask of suspected bone lesions, characterised by higher b900 signal intensity due to restricted water diffusion. This mask is applied to the gADC map to extract TDV and gADC statistics. We tested the tool using expert-defined metastatic bone disease delineations on 66 datasets, assessed repeatability of imaging biomarkers (N=10), and compared software-based response assessment with a construct reference standard based on clinical, laboratory and imaging assessments (N=118). Dice score between manual and automated delineations was 0.6 for lesions within pelvis and spine, with an average surface distance of 2mm. Relative differences for log-transformed TDV (log-TDV) and median gADC were below 9% and 5%, respectively. Repeatability analysis showed coefficients of variation of 4.57% for log-TDV and 3.54% for median gADC, with intraclass correlation coefficients above 0.9. The software achieved 80.5% accuracy, 84.3% sensitivity, and 85.7% specificity in assessing response to treatment compared to the construct reference standard. Computation time generating a mask averaged 90 seconds per scan. Our software enables reproducible TDV and gADC quantification from WB-DWI scans for monitoring metastatic bone disease response, thus providing potentially useful measurements for clinical decision-making in APC patients.

DEMAC-Net: A Dual-Encoder Multiattention Collaborative Network for Cervical Nerve Pathway and Adjacent Anatomical Structure Segmentation.

Cui H, Duan J, Lin L, Wu Q, Guo W, Zang Q, Zhou M, Fang W, Hu Y, Zou Z

pubmed logopapersMay 13 2025
Currently, cervical anesthesia is performed using three main approaches: superficial cervical plexus block, deep cervical plexus block, and intermediate plexus nerve block. However, each technique carries inherent risks and demands significant clinical expertise. Ultrasound imaging, known for its real-time visualization capabilities and accessibility, is widely used in both diagnostic and interventional procedures. Nevertheless, accurate segmentation of small and irregularly shaped structures such as the cervical and brachial plexuses remains challenging due to image noise, complex anatomical morphology, and limited annotated training data. This study introduces DEMAC-Net-a dual-encoder, multiattention collaborative network-to significantly improve the segmentation accuracy of these neural structures. By precisely identifying the cervical nerve pathway (CNP) and adjacent anatomical tissues, DEMAC-Net aims to assist clinicians, especially those less experienced, in effectively guiding anesthesia procedures and accurately identifying optimal needle insertion points. Consequently, this improvement is expected to enhance clinical safety, reduce procedural risks, and streamline decision-making efficiency during ultrasound-guided regional anesthesia. DEMAC-Net combines a dual-encoder architecture with the Spatial Understanding Convolution Kernel (SUCK) and the Spatial-Channel Attention Module (SCAM) to extract multi-scale features effectively. Additionally, a Global Attention Gate (GAG) and inter-layer fusion modules refine relevant features while suppressing noise. A novel dataset, Neck Ultrasound Dataset (NUSD), was introduced, containing 1,500 annotated ultrasound images across seven anatomical regions. Extensive experiments were conducted on both NUSD and the BUSI public dataset, comparing DEMAC-Net to state-of-the-art models using metrics such as Dice Similarity Coefficient (DSC) and Intersection over Union (IoU). On the NUSD dataset, DEMAC-Net achieved a mean DSC of 93.3%, outperforming existing models. For external validation on the BUSI dataset, it demonstrated superior generalization, achieving a DSC of 87.2% and a mean IoU of 77.4%, surpassing other advanced methods. Notably, DEMAC-Net displayed consistent segmentation stability across all tested structures. The proposed DEMAC-Net significantly improves segmentation accuracy for small nerves and complex anatomical structures in ultrasound images, outperforming existing methods in terms of accuracy and computational efficiency. This framework holds great potential for enhancing ultrasound-guided procedures, such as peripheral nerve blocks, by providing more precise anatomical localization, ultimately improving clinical outcomes.

A Deep Learning-Driven Inhalation Injury Grading Assistant Using Bronchoscopy Images

Yifan Li, Alan W Pang, Jo Woon Chong

arxiv logopreprintMay 13 2025
Inhalation injuries present a challenge in clinical diagnosis and grading due to Conventional grading methods such as the Abbreviated Injury Score (AIS) being subjective and lacking robust correlation with clinical parameters like mechanical ventilation duration and patient mortality. This study introduces a novel deep learning-based diagnosis assistant tool for grading inhalation injuries using bronchoscopy images to overcome subjective variability and enhance consistency in severity assessment. Our approach leverages data augmentation techniques, including graphic transformations, Contrastive Unpaired Translation (CUT), and CycleGAN, to address the scarcity of medical imaging data. We evaluate the classification performance of two deep learning models, GoogLeNet and Vision Transformer (ViT), across a dataset significantly expanded through these augmentation methods. The results demonstrate GoogLeNet combined with CUT as the most effective configuration for grading inhalation injuries through bronchoscopy images and achieves a classification accuracy of 97.8%. The histograms and frequency analysis evaluations reveal variations caused by the augmentation CUT with distribution changes in the histogram and texture details of the frequency spectrum. PCA visualizations underscore the CUT substantially enhances class separability in the feature space. Moreover, Grad-CAM analyses provide insight into the decision-making process; mean intensity for CUT heatmaps is 119.6, which significantly exceeds 98.8 of the original datasets. Our proposed tool leverages mechanical ventilation periods as a novel grading standard, providing comprehensive diagnostic support.

Automatic deep learning segmentation of mandibular periodontal bone topography on cone-beam computed tomography images.

Palkovics D, Molnar B, Pinter C, García-Mato D, Diaz-Pinto A, Windisch P, Ramseier CA

pubmed logopapersMay 13 2025
This study evaluated the performance of a multi-stage Segmentation Residual Network (SegResNet)-based deep learning (DL) model for the automatic segmentation of cone-beam computed tomography (CBCT) images of patients with stage III and IV periodontitis. Seventy pre-processed CBCT scans from patients undergoing periodontal rehabilitation were used for training and validation. The model was tested on 10 CBCT scans independent from the training dataset by comparing results with semi-automatic (SA) segmentations. Segmentation accuracy was assessed using the Dice similarity coefficient (DSC), Intersection over Union (IoU), and Hausdorff distance 95<sup>th</sup> percentile (HD95). Linear periodontal measurements were performed on four tooth surfaces to assess the validity of the DL segmentation in the periodontal region. The DL model achieved a mean DSC of 0.9650 ± 0.0097, with an IoU of 0.9340 ± 0.0180 and HD95 of 0.4820 mm ± 0.1269 mm, showing strong agreement with SA segmentation. Linear measurements revealed high statistical correlations between the mesial, distal, and lingual surfaces, with intraclass correlation coefficients (ICC) of 0.9442 (p<0.0001), 0.9232 (p<0.0001), and 0.9598(p<0.0001), respectively, while buccal measurements revealed lower consistency, with an ICC of 0.7481 (p<0.0001). The DL method reduced the segmentation time by 47 times compared to the SA method. Acquired 3D models may enable precise treatment planning in cases where conventional diagnostic modalities are insufficient. However, the robustness of the model must be increased to improve its general reliability and consistency at the buccal aspect of the periodontal region. This study presents a DL model for the CBCT-based segmentation of periodontal defects, demonstrating high accuracy and a 47-fold time reduction compared to SA methods, thus improving the feasibility of 3D diagnostics for advanced periodontitis.

Fast cortical thickness estimation using deep learning-based anatomy segmentation and diffeomorphic registration.

Wu J, Zhou S

pubmed logopapersMay 13 2025
Accurately and efficiently estimating the cortical thickness from magnetic resonance images (MRIs) is crucial for neuroscientific studies and clinical applications with various large-scale datasets. Diffeomorphic registration-based cortical thickness estimation (DiReCT) is a prominent traditional method of calculating such measures directly from original MRIs by applying diffeomorphic registration on segmented tissues. However, it suffers from prolonged computational time and limited reproducibility, impediments to its application in large-scale studies or real-time environments. This paper proposes a framework for cortical thickness estimation using deep learning-based anatomy segmentation and diffeomorphic registration. The framework begins by applying a convolutional neural network (CNN) segmentation model to the original image, generating a segmentation map that accurately delineates the cortical boundaries. Subsequently, a pair of distance maps generated from the segmentation map is injected into an unsupervised learning-based registration network for fast and diffeomorphic registration. A novel algorithm based on diffeomorphisms of different time points is proposed to calculate the final thickness map. We systematically evaluated and compared our method with surface-based measures from FreeSurfer on two distinct datasets. The experimental results demonstrated a superior performance of the proposed method, surpassing the performance of DiReCT and DL+DiReCT in terms of time efficiency and consistency with FreeSurfer. Our code and pre-trained models are publicly available at: https://github.com/wujiong-hub/DL-CTE.git.

Trustworthy AI for stage IV non-small cell lung cancer: Automatic segmentation and uncertainty quantification.

Dedeken S, Conze PH, Damerjian Pieters V, Gallinato O, Faure J, Colin T, Visvikis D

pubmed logopapersMay 13 2025
Accurate segmentation of lung tumors is essential for advancing personalized medicine in non-small cell lung cancer (NSCLC). However, stage IV NSCLC presents significant challenges due to heterogeneous tumor morphology and the presence of associated conditions including infection, atelectasis and pleural effusion. The complexity of multicentric datasets further complicates robust segmentation across diverse clinical settings. In this study, we evaluate deep-learning-based approaches for automated segmentation of advanced-stage lung tumors using 3D architectures on 387 CT scans from the Deep-Lung-IV study. Through comprehensive experiments, we assess the impact of model design, HU windowing, and dataset size on delineation performance, providing practical guidelines for robust implementation. Additionally, we propose a confidence score using deep ensembles to quantify prediction uncertainty and automate the identification of complex cases that require further review. Our results demonstrate the potential of attention-based architectures and specific preprocessing strategies to improve segmentation quality in such a challenging clinical scenario, while emphasizing the importance of uncertainty estimation to build trustworthy AI systems in medical imaging. Code is available at: https://github.com/Sacha-Dedeken/SegStageIVNSCLC.
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