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An orchestration learning framework for ultrasound imaging: Prompt-Guided Hyper-Perception and Attention-Matching Downstream Synchronization.

Lin Z, Li S, Wang S, Gao Z, Sun Y, Lam CT, Hu X, Yang X, Ni D, Tan T

pubmed logopapersMay 27 2025
Ultrasound imaging is pivotal in clinical diagnostics due to its affordability, portability, safety, real-time capability, and non-invasive nature. It is widely utilized for examining various organs, such as the breast, thyroid, ovary, cardiac, and more. However, the manual interpretation and annotation of ultrasound images are time-consuming and prone to variability among physicians. While single-task artificial intelligence (AI) solutions have been explored, they are not ideal for scaling AI applications in medical imaging. Foundation models, although a trending solution, often struggle with real-world medical datasets due to factors such as noise, variability, and the incapability of flexibly aligning prior knowledge with task adaptation. To address these limitations, we propose an orchestration learning framework named PerceptGuide for general-purpose ultrasound classification and segmentation. Our framework incorporates a novel orchestration mechanism based on prompted hyper-perception, which adapts to the diverse inductive biases required by different ultrasound datasets. Unlike self-supervised pre-trained models, which require extensive fine-tuning, our approach leverages supervised pre-training to directly capture task-relevant features, providing a stronger foundation for multi-task and multi-organ ultrasound imaging. To support this research, we compiled a large-scale Multi-task, Multi-organ public ultrasound dataset (M<sup>2</sup>-US), featuring images from 9 organs and 16 datasets, encompassing both classification and segmentation tasks. Our approach employs four specific prompts-Object, Task, Input, and Position-to guide the model, ensuring task-specific adaptability. Additionally, a downstream synchronization training stage is introduced to fine-tune the model for new data, significantly improving generalization capabilities and enabling real-world applications. Experimental results demonstrate the robustness and versatility of our framework in handling multi-task and multi-organ ultrasound image processing, outperforming both specialist models and existing general AI solutions. Compared to specialist models, our method improves segmentation from 82.26% to 86.45%, classification from 71.30% to 79.08%, while also significantly reducing model parameters.

Fetal origins of adult disease: transforming prenatal care by integrating Barker's Hypothesis with AI-driven 4D ultrasound.

Andonotopo W, Bachnas MA, Akbar MIA, Aziz MA, Dewantiningrum J, Pramono MBA, Sulistyowati S, Stanojevic M, Kurjak A

pubmed logopapersMay 26 2025
The fetal origins of adult disease, widely known as Barker's Hypothesis, suggest that adverse fetal environments significantly impact the risk of developing chronic diseases, such as diabetes and cardiovascular conditions, in adulthood. Recent advancements in 4D ultrasound (4D US) and artificial intelligence (AI) technologies offer a promising avenue for improving prenatal diagnostics and validating this hypothesis. These innovations provide detailed insights into fetal behavior and neurodevelopment, linking early developmental markers to long-term health outcomes. This study synthesizes contemporary developments in AI-enhanced 4D US, focusing on their roles in detecting fetal anomalies, assessing neurodevelopmental markers, and evaluating congenital heart defects. The integration of AI with 4D US allows for real-time, high-resolution visualization of fetal anatomy and behavior, surpassing the diagnostic precision of traditional methods. Despite these advancements, challenges such as algorithmic bias, data diversity, and real-world validation persist and require further exploration. Findings demonstrate that AI-driven 4D US improves diagnostic sensitivity and accuracy, enabling earlier detection of fetal abnormalities and optimization of clinical workflows. By providing a more comprehensive understanding of fetal programming, these technologies substantiate the links between early-life conditions and adult health outcomes, as proposed by Barker's Hypothesis. The integration of AI and 4D US has the potential to revolutionize prenatal care, paving the way for personalized maternal-fetal healthcare. Future research should focus on addressing current limitations, including ethical concerns and accessibility challenges, to promote equitable implementation. Such advancements could significantly reduce the global burden of chronic diseases and foster healthier generations.

ScanAhead: Simplifying standard plane acquisition of fetal head ultrasound.

Men Q, Zhao H, Drukker L, Papageorghiou AT, Noble JA

pubmed logopapersMay 26 2025
The fetal standard plane acquisition task aims to detect an Ultrasound (US) image characterized by specified anatomical landmarks and appearance for assessing fetal growth. However, in practice, due to variability in human operator skill and possible fetal motion, it can be challenging for a human operator to acquire a satisfactory standard plane. To support a human operator with this task, this paper first describes an approach to automatically predict the fetal head standard plane from a video segment approaching the standard plane. A transformer-based image predictor is proposed to produce a high-quality standard plane by understanding diverse scales of head anatomy within the US video frame. Because of the visual gap between the video frames and standard plane image, the predictor is equipped with an offset adaptor that performs domain adaption to translate the off-plane structures to the anatomies that would usually appear in a standard plane view. To enhance the anatomical details of the predicted US image, the approach is extended by utilizing a second modality, US probe movement, that provides 3D location information. Quantitative and qualitative studies conducted on two different head biometry planes demonstrate that the proposed US image predictor produces clinically plausible standard planes with superior performance to comparative published methods. The results of dual-modality solution show an improved visualization with enhanced anatomical details of the predicted US image. Clinical evaluations are also conducted to demonstrate the consistency between the predicted echo textures and the expected echo patterns seen in a typical real standard plane, which indicates its clinical feasibility for improving the standard plane acquisition process.

Deep learning model for malignancy prediction of TI-RADS 4 thyroid nodules with high-risk characteristics using multimodal ultrasound: A multicentre study.

Chu X, Wang T, Chen M, Li J, Wang L, Wang C, Wang H, Wong ST, Chen Y, Li H

pubmed logopapersMay 26 2025
The automatic screening of thyroid nodules using computer-aided diagnosis holds great promise in reducing missed and misdiagnosed cases in clinical practice. However, most current research focuses on single-modal images and does not fully leverage the comprehensive information from multimodal medical images, limiting model performance. To enhance screening accuracy, this study uses a deep learning framework that integrates high-dimensional convolutions of B-mode ultrasound (BMUS) and strain elastography (SE) images to predict the malignancy of TI-RADS 4 thyroid nodules with high-risk features. First, we extract nodule regions from the images and expand the boundary areas. Then, adaptive particle swarm optimization (APSO) and contrast limited adaptive histogram equalization (CLAHE) algorithms are applied to enhance ultrasound image contrast. Finally, deep learning techniques are used to extract and fuse high-dimensional features from both ultrasound modalities to classify benign and malignant thyroid nodules. The proposed model achieved an AUC of 0.937 (95 % CI 0.917-0.949) and 0.927 (95 % CI 0.907-0.948) in the test and external validation sets, respectively, demonstrating strong generalization ability. When compared with the diagnostic performance of three groups of radiologists, the model outperformed them significantly. Meanwhile, with the model's assistance, all three radiologist groups showed improved diagnostic performance. Furthermore, heatmaps generated by the model show a high alignment with radiologists' expertise, further confirming its credibility. The results indicate that our model can assist in clinical thyroid nodule diagnosis, reducing the risk of missed and misdiagnosed diagnoses, particularly for high-risk populations, and holds significant clinical value.

Detecting microcephaly and macrocephaly from ultrasound images using artificial intelligence.

Mengistu AK, Assaye BT, Flatie AB, Mossie Z

pubmed logopapersMay 26 2025
Microcephaly and macrocephaly, which are abnormal congenital markers, are associated with developmental and neurologic deficits. Hence, there is a medically imperative need to conduct ultrasound imaging early on. However, resource-limited countries such as Ethiopia are confronted with inadequacies such that access to trained personnel and diagnostic machines inhibits the exact and continuous diagnosis from being met. This study aims to develop a fetal head abnormality detection model from ultrasound images via deep learning. Data were collected from three Ethiopian healthcare facilities to increase model generalizability. The recruitment period for this study started on November 9, 2024, and ended on November 30, 2024. Several preprocessing techniques have been performed, such as augmentation, noise reduction, and normalization. SegNet, UNet, FCN, MobileNetV2, and EfficientNet-B0 were applied to segment and measure fetal head structures using ultrasound images. The measurements were classified as microcephaly, macrocephaly, or normal using WHO guidelines for gestational age, and then the model performance was compared with that of existing industry experts. The metrics used for evaluation included accuracy, precision, recall, the F1 score, and the Dice coefficient. This study was able to demonstrate the feasibility of using SegNet for automatic segmentation, measurement of abnormalities of the fetal head, and classification of macrocephaly and microcephaly, with an accuracy of 98% and a Dice coefficient of 0.97. Compared with industry experts, the model achieved accuracies of 92.5% and 91.2% for the BPD and HC measurements, respectively. Deep learning models can enhance prenatal diagnosis workflows, especially in resource-constrained settings. Future work needs to be done on optimizing model performance, trying complex models, and expanding datasets to improve generalizability. If these technologies are adopted, they can be used in prenatal care delivery. Not applicable.

Can intraoperative improvement of radial endobronchial ultrasound imaging enhance the diagnostic yield in peripheral pulmonary lesions?

Nishida K, Ito T, Iwano S, Okachi S, Nakamura S, Chrétien B, Chen-Yoshikawa TF, Ishii M

pubmed logopapersMay 26 2025
Data regarding the diagnostic efficacy of radial endobronchial ultrasound (R-EBUS) findings obtained via transbronchial needle aspiration (TBNA)/biopsy (TBB) with endobronchial ultrasonography with a guide sheath (EBUS-GS) for peripheral pulmonary lesions (PPLs) are lacking. We evaluated whether intraoperative probe repositioning improves R-EBUS imaging and affects diagnostic yield and safety of EBUS-guided sampling for PPLs. We retrospectively studied 363 patients with PPLs who underwent TBNA/TBB (83 lesions) or TBB (280 lesions) using EBUS-GS. Based on the R-EBUS findings before and after these procedures, patients were categorized into three groups: the improved R-EBUS image (n = 52), unimproved R-EBUS image (n = 69), and initial within-lesion groups (n = 242). The impact of improved R-EBUS findings on diagnostic yield and complications was assessed using multivariable logistic regression, adjusting for lesion size, lesion location, and the presence of a bronchus leading to the lesion on CT. A separate exploratory random-forest model with SHAP analysis was used to explore factors associated with successful repositioning in lesions not initially "within." The diagnostic yield in the improved R-EBUS group was significantly higher than that in the unimproved R-EBUS group (76.9% vs. 46.4%, p = 0.001). The regression model revealed that the improvement in intraoperative R-EBUS findings was associated with a high diagnostic yield (odds ratio: 3.55, 95% confidence interval, 1.57-8.06, p = 0.002). Machine learning analysis indicated that inner lesion location and radiographic visibility were the most influential predictors of successful repositioning. The complication rates were similar across all groups (total complications: 5.8% vs. 4.3% vs. 6.2%, p = 0.943). Improved R-EBUS findings during TBNA/TBB or TBB with EBUS-GS were associated with a high diagnostic yield without an increase in complications, even when the initial R-EBUS findings were inadequate. This suggests that repeated intraoperative probe repositioning can safely boost outcomes.

MobNas ensembled model for breast cancer prediction.

Shahzad T, Saqib SM, Mazhar T, Iqbal M, Almogren A, Ghadi YY, Saeed MM, Hamam H

pubmed logopapersMay 25 2025
Breast cancer poses a real and immense threat to humankind, thus a need to develop a way of diagnosing this devastating disease early, accurately, and in a simpler manner. Thus, while substantial progress has been made in developing machine learning algorithms, deep learning, and transfer learning models, issues with diagnostic accuracy and minimizing diagnostic errors persist. This paper introduces MobNAS, a model that uses MobileNetV2 and NASNetLarge to sort breast cancer images into benign, malignant, or normal classes. The study employs a multi-class classification design and uses a publicly available dataset comprising 1,578 ultrasound images, including 891 benign, 421 malignant, and 266 normal cases. By deploying MobileNetV2, it is easy to work well on devices with less computational capability than is used by NASNetLarge, which enhances its applicability and effectiveness in other tasks. The performance of the proposed MobNAS model was tested on the breast cancer image dataset, and the accuracy level achieved was 97%, the Mean Absolute Error (MAE) was 0.05, and the Matthews Correlation Coefficient (MCC) was 95%. From the findings of this research, it is evident that MobNAS can enhance diagnostic accuracy and reduce existing shortcomings in breast cancer detection.

SW-ViT: A Spatio-Temporal Vision Transformer Network with Post Denoiser for Sequential Multi-Push Ultrasound Shear Wave Elastography

Ahsan Habib Akash, MD Jahin Alam, Md. Kamrul Hasan

arxiv logopreprintMay 24 2025
Objective: Ultrasound Shear Wave Elastography (SWE) demonstrates great potential in assessing soft-tissue pathology by mapping tissue stiffness, which is linked to malignancy. Traditional SWE methods have shown promise in estimating tissue elasticity, yet their susceptibility to noise interference, reliance on limited training data, and inability to generate segmentation masks concurrently present notable challenges to accuracy and reliability. Approach: In this paper, we propose SW-ViT, a novel two-stage deep learning framework for SWE that integrates a CNN-Spatio-Temporal Vision Transformer-based reconstruction network with an efficient Transformer-based post-denoising network. The first stage uses a 3D ResNet encoder with multi-resolution spatio-temporal Transformer blocks that capture spatial and temporal features, followed by a squeeze-and-excitation attention decoder that reconstructs 2D stiffness maps. To address data limitations, a patch-based training strategy is adopted for localized learning and reconstruction. In the second stage, a denoising network with a shared encoder and dual decoders processes inclusion and background regions to produce a refined stiffness map and segmentation mask. A hybrid loss combining regional, smoothness, fusion, and Intersection over Union (IoU) components ensures improvements in both reconstruction and segmentation. Results: On simulated data, our method achieves PSNR of 32.68 dB, CNR of 46.78 dB, and SSIM of 0.995. On phantom data, results include PSNR of 21.11 dB, CNR of 42.14 dB, and SSIM of 0.936. Segmentation IoU values reach 0.949 (simulation) and 0.738 (phantom) with ASSD values being 0.184 and 1.011, respectively. Significance: SW-ViT delivers robust, high-quality elasticity map estimates from noisy SWE data and holds clear promise for clinical application.

Ovarian Cancer Screening: Recommendations and Future Prospects.

Chiu S, Staley H, Jeevananthan P, Mascarenhas S, Fotopoulou C, Rockall A

pubmed logopapersMay 23 2025
Ovarian cancer remains a significant cause of mortality among women, largely due to challenges in early detection. Current screening strategies, including transvaginal ultrasound and CA125 testing, have limited sensitivity and specificity, particularly in asymptomatic women or those with early-stage disease. The European Society of Gynaecological Oncology, the European Society for Medical Oncology, the European Society of Pathology, and other health organizations currently do not recommend routine population-based screening for ovarian cancer due to the high rates of false-positives and the absence of a reliable early detection method.This review examines existing ovarian cancer screening guidelines and explores recent advances in diagnostic technologies including radiomics, artificial intelligence, point-of-care testing, and novel detection methods.Emerging technologies show promise with respect to improving ovarian cancer detection by enhancing sensitivity and specificity compared to traditional methods. Artificial intelligence and radiomics have potential for revolutionizing ovarian cancer screening by identifying subtle diagnostic patterns, while liquid biopsy-based approaches and cell-free DNA profiling enable tumor-specific biomarker detection. Minimally invasive methods, such as intrauterine lavage and salivary diagnostics, provide avenues for population-wide applicability. However, large-scale validation is required to establish these techniques as effective and reliable screening options. · Current ovarian cancer screening methods lack sensitivity and specificity for early-stage detection.. · Emerging technologies like artificial intelligence, radiomics, and liquid biopsy offer improved diagnostic accuracy.. · Large-scale clinical validation is required, particularly for baseline-risk populations.. · Chiu S, Staley H, Jeevananthan P et al. Ovarian Cancer Screening: Recommendations and Future Prospects. Rofo 2025; DOI 10.1055/a-2589-5696.

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.
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