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MInDI-3D: Iterative Deep Learning in 3D for Sparse-view Cone Beam Computed Tomography

Daniel Barco, Marc Stadelmann, Martin Oswald, Ivo Herzig, Lukas Lichtensteiger, Pascal Paysan, Igor Peterlik, Michal Walczak, Bjoern Menze, Frank-Peter Schilling

arxiv logopreprintAug 13 2025
We present MInDI-3D (Medical Inversion by Direct Iteration in 3D), the first 3D conditional diffusion-based model for real-world sparse-view Cone Beam Computed Tomography (CBCT) artefact removal, aiming to reduce imaging radiation exposure. A key contribution is extending the "InDI" concept from 2D to a full 3D volumetric approach for medical images, implementing an iterative denoising process that refines the CBCT volume directly from sparse-view input. A further contribution is the generation of a large pseudo-CBCT dataset (16,182) from chest CT volumes of the CT-RATE public dataset to robustly train MInDI-3D. We performed a comprehensive evaluation, including quantitative metrics, scalability analysis, generalisation tests, and a clinical assessment by 11 clinicians. Our results show MInDI-3D's effectiveness, achieving a 12.96 (6.10) dB PSNR gain over uncorrected scans with only 50 projections on the CT-RATE pseudo-CBCT (independent real-world) test set and enabling an 8x reduction in imaging radiation exposure. We demonstrate its scalability by showing that performance improves with more training data. Importantly, MInDI-3D matches the performance of a 3D U-Net on real-world scans from 16 cancer patients across distortion and task-based metrics. It also generalises to new CBCT scanner geometries. Clinicians rated our model as sufficient for patient positioning across all anatomical sites and found it preserved lung tumour boundaries well.

Multimodal ensemble machine learning predicts neurological outcome within three hours after out of hospital cardiac arrest.

Kawai Y, Yamamoto K, Tsuruta K, Miyazaki K, Asai H, Fukushima H

pubmed logopapersAug 13 2025
This study aimed to determine if an ensemble (stacking) model that integrates three independently developed base models can reliably predict patients' neurological outcomes following out-of-hospital cardiac arrest (OHCA) within 3 h of arrival and outperform each individual model. This retrospective study included patients with OHCA (≥ 18 years) admitted directly to Nara Medical University between April 2015 and March 2024 who remained comatose for ≥ 3 h after arrival and had suitable head computed tomography (CT) images. The area under the receiver operating characteristic curve (AUC) and Briers scores were used to evaluate the performance of four models (resuscitation-related background OHCA score factors, bilateral pupil diameter, single-slice head CT within 3 h of arrival, and an ensemble stacked model combining these three models) in predicting favourable neurological outcomes at hospital discharge or 1 month, as defined by a Cerebral Performance Category scale of 1-2. Among 533 patients, 82 (15%) had favourable outcomes. The OHCA, pupil, and head CT models yielded AUCs of 0.76, 0.65, and 0.68 with Brier scores of 0.11, 0.13, and 0.12, respectively. The ensemble model outperformed the other models (AUC, 0.82; Brier score, 0.10), thereby supporting its application for early clinical decision-making and optimising resource allocation.

In vivo variability of MRI radiomics features in prostate lesions assessed by a test-retest study with repositioning.

Zhang KS, Neelsen CJO, Wennmann M, Hielscher T, Kovacs B, Glemser PA, Görtz M, Stenzinger A, Maier-Hein KH, Huber J, Schlemmer HP, Bonekamp D

pubmed logopapersAug 13 2025
Despite academic success, radiomics-based machine learning algorithms have not reached clinical practice, partially due to limited repeatability/reproducibility. To address this issue, this work aims to identify a stable subset of radiomics features in prostate MRI for radiomics modelling. A prospective study was conducted in 43 patients who received a clinical MRI examination and a research exam with repetition of T2-weighted and two different diffusion-weighted imaging (DWI) sequences with repositioning in between. Radiomics feature (RF) extraction was performed from MRI segmentations accounting for intra-rater and inter-rater effects, and three different image normalization methods were compared. Stability of RFs was assessed using the concordance correlation coefficient (CCC) for different comparisons: rater effects, inter-scan (before and after repositioning) and inter-sequence (between the two diffusion-weighted sequences) variability. In total, only 64 out of 321 (~ 20%) extracted features demonstrated stability, defined as CCC ≥ 0.75 in all settings (5 high-b value, 7 ADC- and 52 T2-derived features). For DWI, primarily intensity-based features proved stable with no shape feature passing the CCC threshold. T2-weighted images possessed the largest number of stable features with multiple shape (7), intensity-based (7) and texture features (28). Z-score normalization for high-b value images and muscle-normalization for T2-weighted images were identified as suitable.

Comparative evaluation of CAM methods for enhancing explainability in veterinary radiography.

Dusza P, Banzato T, Burti S, Bendazzoli M, Müller H, Wodzinski M

pubmed logopapersAug 13 2025
Explainable Artificial Intelligence (XAI) encompasses a broad spectrum of methods that aim to enhance the transparency of deep learning models, with Class Activation Mapping (CAM) methods widely used for visual interpretability. However, systematic evaluations of these methods in veterinary radiography remain scarce. This study presents a comparative analysis of eleven CAM methods, including GradCAM, XGradCAM, ScoreCAM, and EigenCAM, on a dataset of 7362 canine and feline X-ray images. A ResNet18 model was chosen based on the specificity of the dataset and preliminary results where it outperformed other models. Quantitative and qualitative evaluations were performed to determine how well each CAM method produced interpretable heatmaps relevant to clinical decision-making. Among the techniques evaluated, EigenGradCAM achieved the highest mean score and standard deviation (SD) of 2.571 (SD = 1.256), closely followed by EigenCAM at 2.519 (SD = 1.228) and GradCAM++ at 2.512 (SD = 1.277), with methods such as FullGrad and XGradCAM achieving worst scores of 2.000 (SD = 1.300) and 1.858 (SD = 1.198) respectively. Despite variations in saliency visualization, no single method universally improved veterinarians' diagnostic confidence. While certain CAM methods provide better visual cues for some pathologies, they generally offered limited explainability and didn't substantially improve veterinarians' diagnostic confidence.

A Chain of Diagnosis Framework for Accurate and Explainable Radiology Report Generation

Haibo Jin, Haoxuan Che, Sunan He, Hao Chen

arxiv logopreprintAug 13 2025
Despite the progress of radiology report generation (RRG), existing works face two challenges: 1) The performances in clinical efficacy are unsatisfactory, especially for lesion attributes description; 2) the generated text lacks explainability, making it difficult for radiologists to trust the results. To address the challenges, we focus on a trustworthy RRG model, which not only generates accurate descriptions of abnormalities, but also provides basis of its predictions. To this end, we propose a framework named chain of diagnosis (CoD), which maintains a chain of diagnostic process for clinically accurate and explainable RRG. It first generates question-answer (QA) pairs via diagnostic conversation to extract key findings, then prompts a large language model with QA diagnoses for accurate generation. To enhance explainability, a diagnosis grounding module is designed to match QA diagnoses and generated sentences, where the diagnoses act as a reference. Moreover, a lesion grounding module is designed to locate abnormalities in the image, further improving the working efficiency of radiologists. To facilitate label-efficient training, we propose an omni-supervised learning strategy with clinical consistency to leverage various types of annotations from different datasets. Our efforts lead to 1) an omni-labeled RRG dataset with QA pairs and lesion boxes; 2) a evaluation tool for assessing the accuracy of reports in describing lesion location and severity; 3) extensive experiments to demonstrate the effectiveness of CoD, where it outperforms both specialist and generalist models consistently on two RRG benchmarks and shows promising explainability by accurately grounding generated sentences to QA diagnoses and images.

Multi-Contrast Fusion Module: An attention mechanism integrating multi-contrast features for fetal torso plane classification

Shengjun Zhu, Siyu Liu, Runqing Xiong, Liping Zheng, Duo Ma, Rongshang Chen, Jiaxin Cai

arxiv logopreprintAug 13 2025
Purpose: Prenatal ultrasound is a key tool in evaluating fetal structural development and detecting abnormalities, contributing to reduced perinatal complications and improved neonatal survival. Accurate identification of standard fetal torso planes is essential for reliable assessment and personalized prenatal care. However, limitations such as low contrast and unclear texture details in ultrasound imaging pose significant challenges for fine-grained anatomical recognition. Methods: We propose a novel Multi-Contrast Fusion Module (MCFM) to enhance the model's ability to extract detailed information from ultrasound images. MCFM operates exclusively on the lower layers of the neural network, directly processing raw ultrasound data. By assigning attention weights to image representations under different contrast conditions, the module enhances feature modeling while explicitly maintaining minimal parameter overhead. Results: The proposed MCFM was evaluated on a curated dataset of fetal torso plane ultrasound images. Experimental results demonstrate that MCFM substantially improves recognition performance, with a minimal increase in model complexity. The integration of multi-contrast attention enables the model to better capture subtle anatomical structures, contributing to higher classification accuracy and clinical reliability. Conclusions: Our method provides an effective solution for improving fetal torso plane recognition in ultrasound imaging. By enhancing feature representation through multi-contrast fusion, the proposed approach supports clinicians in achieving more accurate and consistent diagnoses, demonstrating strong potential for clinical adoption in prenatal screening. The codes are available at https://github.com/sysll/MCFM.

Automated Segmentation of Coronal Brain Tissue Slabs for 3D Neuropathology

Jonathan Williams Ramirez, Dina Zemlyanker, Lucas Deden-Binder, Rogeny Herisse, Erendira Garcia Pallares, Karthik Gopinath, Harshvardhan Gazula, Christopher Mount, Liana N. Kozanno, Michael S. Marshall, Theresa R. Connors, Matthew P. Frosch, Mark Montine, Derek H. Oakley, Christine L. Mac Donald, C. Dirk Keene, Bradley T. Hyman, Juan Eugenio Iglesias

arxiv logopreprintAug 13 2025
Advances in image registration and machine learning have recently enabled volumetric analysis of \emph{postmortem} brain tissue from conventional photographs of coronal slabs, which are routinely collected in brain banks and neuropathology laboratories worldwide. One caveat of this methodology is the requirement of segmentation of the tissue from photographs, which currently requires costly manual intervention. In this article, we present a deep learning model to automate this process. The automatic segmentation tool relies on a U-Net architecture that was trained with a combination of \textit{(i)}1,414 manually segmented images of both fixed and fresh tissue, from specimens with varying diagnoses, photographed at two different sites; and \textit{(ii)}~2,000 synthetic images with randomized contrast and corresponding masks generated from MRI scans for improved generalizability to unseen photographic setups. Automated model predictions on a subset of photographs not seen in training were analyzed to estimate performance compared to manual labels -- including both inter- and intra-rater variability. Our model achieved a median Dice score over 0.98, mean surface distance under 0.4~mm, and 95\% Hausdorff distance under 1.60~mm, which approaches inter-/intra-rater levels. Our tool is publicly available at surfer.nmr.mgh.harvard.edu/fswiki/PhotoTools.

AST-n: A Fast Sampling Approach for Low-Dose CT Reconstruction using Diffusion Models

Tomás de la Sotta, José M. Saavedra, Héctor Henríquez, Violeta Chang, Aline Xavier

arxiv logopreprintAug 13 2025
Low-dose CT (LDCT) protocols reduce radiation exposure but increase image noise, compromising diagnostic confidence. Diffusion-based generative models have shown promise for LDCT denoising by learning image priors and performing iterative refinement. In this work, we introduce AST-n, an accelerated inference framework that initiates reverse diffusion from intermediate noise levels, and integrate high-order ODE solvers within conditioned models to further reduce sampling steps. We evaluate two acceleration paradigms--AST-n sampling and standard scheduling with high-order solvers -- on the Low Dose CT Grand Challenge dataset, covering head, abdominal, and chest scans at 10-25 % of standard dose. Conditioned models using only 25 steps (AST-25) achieve peak signal-to-noise ratio (PSNR) above 38 dB and structural similarity index (SSIM) above 0.95, closely matching standard baselines while cutting inference time from ~16 seg to under 1 seg per slice. Unconditional sampling suffers substantial quality loss, underscoring the necessity of conditioning. We also assess DDIM inversion, which yields marginal PSNR gains at the cost of doubling inference time, limiting its clinical practicality. Our results demonstrate that AST-n with high-order samplers enables rapid LDCT reconstruction without significant loss of image fidelity, advancing the feasibility of diffusion-based methods in clinical workflows.

Analysis of the Compaction Behavior of Textile Reinforcements in Low-Resolution In-Situ CT Scans via Machine-Learning and Descriptor-Based Methods

Christian Düreth, Jan Condé-Wolter, Marek Danczak, Karsten Tittmann, Jörn Jaschinski, Andreas Hornig, Maik Gude

arxiv logopreprintAug 13 2025
A detailed understanding of material structure across multiple scales is essential for predictive modeling of textile-reinforced composites. Nesting -- characterized by the interlocking of adjacent fabric layers through local interpenetration and misalignment of yarns -- plays a critical role in defining mechanical properties such as stiffness, permeability, and damage tolerance. This study presents a framework to quantify nesting behavior in dry textile reinforcements under compaction using low-resolution computed tomography (CT). In-situ compaction experiments were conducted on various stacking configurations, with CT scans acquired at 20.22 $\mu$m per voxel resolution. A tailored 3D{-}UNet enabled semantic segmentation of matrix, weft, and fill phases across compaction stages corresponding to fiber volume contents of 50--60 %. The model achieved a minimum mean Intersection-over-Union of 0.822 and an $F1$ score of 0.902. Spatial structure was subsequently analyzed using the two-point correlation function $S_2$, allowing for probabilistic extraction of average layer thickness and nesting degree. The results show strong agreement with micrograph-based validation. This methodology provides a robust approach for extracting key geometrical features from industrially relevant CT data and establishes a foundation for reverse modeling and descriptor-based structural analysis of composite preforms.

NEURAL: Attention-Guided Pruning for Unified Multimodal Resource-Constrained Clinical Evaluation

Devvrat Joshi, Islem Rekik

arxiv logopreprintAug 13 2025
The rapid growth of multimodal medical imaging data presents significant storage and transmission challenges, particularly in resource-constrained clinical settings. We propose NEURAL, a novel framework that addresses this by using semantics-guided data compression. Our approach repurposes cross-attention scores between the image and its radiological report from a fine-tuned generative vision-language model to structurally prune chest X-rays, preserving only diagnostically critical regions. This process transforms the image into a highly compressed, graph representation. This unified graph-based representation fuses the pruned visual graph with a knowledge graph derived from the clinical report, creating a universal data structure that simplifies downstream modeling. Validated on the MIMIC-CXR and CheXpert Plus dataset for pneumonia detection, NEURAL achieves a 93.4-97.7\% reduction in image data size while maintaining a high diagnostic performance of 0.88-0.95 AUC, outperforming other baseline models that use uncompressed data. By creating a persistent, task-agnostic data asset, NEURAL resolves the trade-off between data size and clinical utility, enabling efficient workflows and teleradiology without sacrificing performance. Our NEURAL code is available at https://github.com/basiralab/NEURAL.
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