Artificial intelligence (AI) models are effective for analyzing high-quality slit-lamp images but often face challenges in real-world clinical settings due to image variability. This study aims to develop and evaluate a hybrid AI-based image quality control system to classify slit-lamp images, improving diagnostic accuracy and efficiency, particularly in telemedicine applications. Cross-sectional study. Our Zhejiang Eye Hospital dataset comprised 2982 slit-lamp images as the internal dataset. Two external datasets were included: 13,554 images from the Aier Guangming Eye Hospital (AGEH) and 9853 images from the First People's Hospital of Aksu District in Xinjiang (FPH of Aksu). We developed a Hybrid Prior-Net (HP-Net), a novel network that combines a ResNet-based classification branch with a prior knowledge branch leveraging Hough circle transform and frequency domain blur detection. The two branches' features are channel-wise concatenated at the fully connected layer, enhancing representational power and improving the network's ability to classify eligible, misaligned, blurred, and underexposed corneal images. Model performance was evaluated using metrics such as accuracy, precision, recall, specificity, and F1-score, and compared against the performance of other deep learning models. The HP-Net outperformed all other models, achieving an accuracy of 99.03 %, precision of 98.21 %, recall of 95.18 %, specificity of 99.36 %, and an F1-score of 96.54 % in image classification. The results demonstrated that HP-Net was also highly effective in filtering slit-lamp images from the other two datasets, AGEH and FPH of Aksu with accuracies of 97.23 % and 96.97 %, respectively. These results underscore the superior feature extraction and classification capabilities of HP-Net across all evaluated metrics. Our AI-based image quality control system offers a robust and efficient solution for classifying corneal images, with significant implications for telemedicine applications. By incorporating slightly blurred but diagnostically usable images into training datasets, the system enhances the reliability and adaptability of AI tools for medical imaging quality control, paving the way for more accurate and efficient diagnostic workflows.

Deep learning-based medical image segmentation and surface mesh generation typically involve a sequential pipeline from image to segmentation to meshes, often requiring large training datasets while making limited use of prior geometric knowledge. This may lead to topological inconsistencies and suboptimal performance in low-data regimes. To address these challenges, we propose a data-efficient deep learning method for direct 3D anatomical object surface meshing using geometric priors. Our approach employs a multi-resolution graph neural network that operates on a prior geometric template which is deformed to fit object boundaries of interest. We show how different templates may be used for the different surface meshing targets, and introduce a novel masked autoencoder pretraining strategy for 3D spherical data. The proposed method outperforms nnUNet in a one-shot setting for segmentation of the pericardium, left ventricle (LV) cavity and the LV myocardium. Similarly, the method outperforms other lumen segmentation operating on multi-planar reformatted images. Results further indicate that mesh quality is on par with or improves upon marching cubes post-processing of voxel mask predictions, while remaining flexible in the choice of mesh triangulation prior, thus paving the way for more accurate and topologically consistent 3D medical object surface meshing.

To compare clinical ratings and signal-to-noise ratio (SNR) measures of a commercially available Deep Learning-based MRI reconstruction method (T2_(DR)) against conventional T2- turbo spin echo brain MRI (T2_(CN)). 100 consecutive patients with various neurological conditions underwent both T2_(DR) and T2_(CN) on a Siemens Vida 3 T scanner with a 64-channel head coil in the same examination. Acquisition times were 3.33 min for T2_(CN) and 1.04 min for T2_(DR). Four neuroradiologists evaluated overall image quality (OIQ), diagnostic safety (DS), and image artifacts (IA), blinded to the acquisition mode. SNR and SNR_eff (adjusted for acquisition time) were calculated for air, grey- and white matter, and cerebrospinal fluid. The mean patient age was 43.6 years (SD 20.3), with 54 females. The distribution of non-diagnostic ratings did not differ significantly between T2_(CN) and T2_(DR) (IA p = 0.108; OIQ: p = 0.700 and DS: p = 0.652). However, when considering the full spectrum of ratings, significant differences favouring T2_(CN) emerged in OIQ (p = 0.003) and IA (p < 0.001). T2_(CN) had higher SNR (157.9, SD 123.4) than T2_(DR) (112.8, SD 82.7), p < 0.001, but T2_(DR) demonstrated superior SNR_eff (14.1, SD 10.3) compared to T2_(CN) (10.8, SD 8.5), p < 0.001. Our results suggest that while T2_(DR) may be clinically applicable for a diagnostic setting, it does not fully match the quality of high-standard conventional T2_(CN), MRI acquisitions.

To review the current risk and prognostic stratification systems in localised prostate cancer. To explore some of the most promising adjuncts to clinical models and what the evidence has shown regarding their value. There are many new biomarker-based models seeking to improve, optimise or replace clinical models. There are promising data on the value of MRI, radiomics, genomic classifiers and most recently artificial intelligence tools in refining stratification. Despite the extensive literature however, there remains uncertainty on where in pathways they can provide the most benefit and whether a biomarker is most useful for prognosis or predictive use. Comparisons studies have also often overlooked the fact that clinical models have themselves evolved and the context of the baseline used in biomarker studies that have shown superiority have to be considered. For new biomarkers to be included in stratification models, well designed prospective clinical trials are needed. Until then, there needs to be caution in interpretation of their use for day-to-day decision making. It is critical that users balance any purported incremental value against the performance of the latest clinical classification and multivariate models especially as the latter are cost free and widely available.

Pathologic complete response (pCR) following neoadjuvant chemotherapy (NACT) is a critical prognostic marker for patients with breast cancer, potentially allowing surgery omission. However, noninvasive and accurate pCR diagnosis remains a significant challenge due to the limitations of current imaging techniques, particularly in cases where tumors completely disappear post-NACT. We developed a novel framework incorporating Dimensional Accumulation for Layered Images (DALI) and an Attention-Box annotation tool to address the unique challenge of analyzing imaging data where target lesions are absent. These methods transform three-dimensional magnetic resonance imaging into two-dimensional representations and ensure consistent target tracking across time-points. Preprocessing techniques, including tissue-region normalization and subtraction imaging, were used to enhance model performance. Imaging features were extracted using radiomics and pretrained deep-learning models, and machine-learning algorithms were integrated into a stacked ensemble model. The approach was developed using the I-SPY 2 dataset and validated with an independent Tangshan People's Hospital cohort. The stacked ensemble model achieved superior diagnostic performance, with an area under the receiver operating characteristic curve of 0.831 (95 % confidence interval, 0.769-0.887) on the test set, outperforming individual models. Tissue-region normalization and subtraction imaging significantly enhanced diagnostic accuracy. SHAP analysis identified variables that contributed to the model predictions, ensuring model interpretability. This innovative framework addresses challenges of noninvasive pCR diagnosis. Integrating advanced preprocessing techniques improves feature quality and model performance, supporting clinicians in identifying patients who can safely omit surgery. This innovation reduces unnecessary treatments and improves quality of life for patients with breast cancer.

Revision total hip arthroplasty (rTHA) involving large acetabular defects is associated with high early failure rates, primarily due to cup loosening. Most acetabular defect classification systems used in surgical planning are based on planar radiographs and do not encapsulate three-dimensional geometry and morphology of the acetabular defect. This study aimed to develop an automated computational modeling pipeline for rapid generation of three-dimensional acetabular bone defect geometry. The framework employed artificial neural network segmentation of preoperative pelvic computed tomography (CT) images and statistical shape model generation for defect reconstruction in 60 rTHA patients. Regional acetabular absolute defect volumes (ADV), relative defect volumes (RDV) and defect depths (DD) were calculated and stratified within Paprosky classifications. Defect geometries from the automated modeling pipeline were validated against manually reconstructed models and were found to have a mean dice coefficient of 0.827 and a mean relative volume error of 16.4%. The mean ADV, RDV and DD of classification groups generally increased with defect severity. Except for superior RDV and ADV between 3A and 2A defects, and anterior RDV and DD between 3B and 3A defects, statistically significant differences in ADV, RDV or DD were only found between 3B and 2B-2C defects (p < 0.05). Poor correlations observed between ADV, RDV, and DD within Paprosky classifications suggest that quantitative measures are not unique to each Paprosky grade. The automated modeling tools developed may be useful in surgical planning and computational modeling of rTHA.

To evaluate the role of multimodal magnetic resonance imaging radiomics features in predicting early recurrence of primary central nervous system lymphoma (PCNSL) and to investigate their correlation with patient prognosis. A retrospective analysis was conducted on 145 patients with PCNSL who were treated with high-dose methotrexate-based chemotherapy. Clinical data and MRI images were collected, with tumor regions segmented using ITK-SNAP software. Radiomics features were extracted via Pyradiomics, and predictive models were developed using various machine learning algorithms. The predictive performance of these models was assessed using receiver operating characteristic (ROC) curves. Additionally, Cox regression analysis was employed to identify risk factors associated with progression-free survival (PFS). In the cohort of 145 PCNSL patients (72 recurrence, 73 non-recurrence), clinical characteristics were comparable between groups except for multiple lesion frequency (61.1% vs. 39.7%, p < 0.05) and not receiving consolidation therapy (44.4% vs. 13.7%, p < 0.05). A total of 2392 radiomics features were extracted from CET1 and T2WI MRI sequence. Combining clinical variables, 10 features were retained after the feature selection process. The logistic regression (LR) model exhibited superior predictive performance in the test set to predict PCNSL early relapse, with an area under the curve (AUC) of 0.887 (95 % confidence interval: 0.785-0.988). Multivariate Cox regression identified the Cli-Rad score as an independent prognostic factor for PFS. Significant difference in PFS was observed between high- and low-risk groups defined by Cli-Rad score (8.24 months vs. 24.17 months, p < 0.001). The LR model based on multimodal MRI radiomics and clinical features, can effectively predict early recurrence of PCNSL, while the Cli-Rad score could independently forecast PFS among PCNSL patients.

Since the outbreak of the COVID-19 pandemic in 2019, medical imaging has emerged as a primary modality for diagnosing COVID-19 pneumonia. In clinical settings, the segmentation of lung infections from computed tomography images enables rapid and accurate quantification and diagnosis of COVID-19. Segmentation of COVID-19 infections in the lungs poses a formidable challenge, primarily due to the indistinct boundaries and limited contrast presented by ground glass opacity manifestations. Moreover, the confounding similarity among infiltrates, lung tissues, and lung walls further complicates this segmentation task. To address these challenges, this paper introduces a novel deep network architecture, called CAD-Unet, for segmenting COVID-19 lung infections. In this architecture, capsule networks are incorporated into the existing Unet framework. Capsule networks represent a novel type of network architecture that differs from traditional convolutional neural networks. They utilize vectors for information transfer among capsules, facilitating the extraction of intricate lesion spatial information. Additionally, we design a capsule encoder path and establish a coupling path between the unet encoder and the capsule encoder. This design maximizes the complementary advantages of both network structures while achieving efficient information fusion. Finally, extensive experiments are conducted on four publicly available datasets, encompassing binary segmentation tasks and multi-class segmentation tasks. The experimental results demonstrate the superior segmentation performance of the proposed model. The code has been released at: https://github.com/AmanoTooko-jie/CAD-Unet.

Artificial intelligence (AI) may provide a solution for improving access to expert, timely, and accurate magnetic resonance imaging (MRI) interpretation. The PARADIGM trial will provide level 1 evidence on the role of AI in the diagnosis of prostate cancer on MRI.

U-Net is a commonly used model for medical image segmentation. However, when applied to chest X-ray images that show pathologies, it often fails to include these critical pathological areas in the generated masks. To address this limitation, in our study, we tackled the challenge of precise segmentation and mask generation by developing a novel approach, using CycleGAN, that encompasses the areas affected by pathologies within the region of interest, allowing the extraction of relevant radiomic features linked to pathologies. Furthermore, we adopted a feature selection approach to focus the analysis on the most significant features. The results of our proposed pipeline are promising, with an average accuracy of 92.05% and an average AUC of 89.48% for the multi-label classification of effusion and infiltration acquired from the ChestX-ray14 dataset, using the XGBoost model. Furthermore, applying our methodology to the classification of the 14 diseases in the ChestX-ray14 dataset resulted in an average AUC of 83.12%, outperforming previous studies. This research highlights the importance of effective pathological mask generation and features selection for accurate classification of chest diseases. The promising results of our approach underscore its potential for broader applications in the classification of chest diseases.