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PolyPose: Localizing Deformable Anatomy in 3D from Sparse 2D X-ray Images using Polyrigid Transforms

Vivek Gopalakrishnan, Neel Dey, Polina Golland

arxiv logopreprintMay 25 2025
Determining the 3D pose of a patient from a limited set of 2D X-ray images is a critical task in interventional settings. While preoperative volumetric imaging (e.g., CT and MRI) provides precise 3D localization and visualization of anatomical targets, these modalities cannot be acquired during procedures, where fast 2D imaging (X-ray) is used instead. To integrate volumetric guidance into intraoperative procedures, we present PolyPose, a simple and robust method for deformable 2D/3D registration. PolyPose parameterizes complex 3D deformation fields as a composition of rigid transforms, leveraging the biological constraint that individual bones do not bend in typical motion. Unlike existing methods that either assume no inter-joint movement or fail outright in this under-determined setting, our polyrigid formulation enforces anatomically plausible priors that respect the piecewise rigid nature of human movement. This approach eliminates the need for expensive deformation regularizers that require patient- and procedure-specific hyperparameter optimization. Across extensive experiments on diverse datasets from orthopedic surgery and radiotherapy, we show that this strong inductive bias enables PolyPose to successfully align the patient's preoperative volume to as few as two X-ray images, thereby providing crucial 3D guidance in challenging sparse-view and limited-angle settings where current registration methods fail.

Evaluation of synthetic training data for 3D intraoral reconstruction of cleft patients from single images.

Lingens L, Lill Y, Nalabothu P, Benitez BK, Mueller AA, Gross M, Solenthaler B

pubmed logopapersMay 24 2025
This study investigates the effectiveness of synthetic training data in predicting 2D landmarks for 3D intraoral reconstruction in cleft lip and palate patients. We take inspiration from existing landmark prediction and 3D reconstruction techniques for faces and demonstrate their potential in medical applications. We generated both real and synthetic datasets from intraoral scans and videos. A convolutional neural network was trained using a negative-Gaussian log-likelihood loss function to predict 2D landmarks and their corresponding confidence scores. The predicted landmarks were then used to fit a statistical shape model to generate 3D reconstructions from individual images. We analyzed the model's performance on real patient data and explored the dataset size required to overcome the domain gap between synthetic and real images. Our approach generates satisfying results on synthetic data and shows promise when tested on real data. The method achieves rapid 3D reconstruction from single images and can therefore provide significant value in day-to-day medical work. Our results demonstrate that synthetic training data are viable for training models to predict 2D landmarks and reconstruct 3D meshes in patients with cleft lip and palate. This approach offers an accessible, low-cost alternative to traditional methods, using smartphone technology for noninvasive, rapid, and accurate 3D reconstructions in clinical settings.

Classifying athletes and non-athletes by differences in spontaneous brain activity: a machine learning and fMRI study.

Peng L, Xu L, Zhang Z, Wang Z, Zhong X, Wang L, Peng Z, Xu R, Shao Y

pubmed logopapersMay 24 2025
Different types of sports training can induce distinct changes in brain activity and function; however, it remains unclear if there are commonalities across various sports disciplines. Moreover, the relationship between these brain activity alterations and the duration of sports training requires further investigation. This study employed resting-state functional magnetic resonance imaging (rs-fMRI) techniques to analyze spontaneous brain activity using the amplitude of low-frequency fluctuations (ALFF) and fractional amplitude of low-frequency fluctuations (fALFF) in 86 highly trained athletes compared to 74 age- and gender-matched non-athletes. Our findings revealed significantly higher ALFF values in the Insula_R (Right Insula), OFCpost_R (Right Posterior orbital gyrus), and OFClat_R (Right Lateral orbital gyrus) in athletes compared to controls, whereas fALFF in the Postcentral_R (Right Postcentral) was notably higher in controls. Additionally, we identified a significant negative correlation between fALFF values in the Postcentral_R of athletes and their years of professional training. Utilizing machine learning algorithms, we achieved accurate classification of brain activity patterns distinguishing athletes from non-athletes with over 96.97% accuracy. These results suggest that the functional reorganization observed in athletes' brains may signify an adaptation to prolonged training, potentially reflecting enhanced processing efficiency. This study emphasizes the importance of examining the impact of long-term sports training on brain function, which could influence cognitive and sensory systems crucial for optimal athletic performance. Furthermore, machine learning methods could be used in the future to select athletes based on differences in brain activity.

Preoperative risk assessment of invasive endometrial cancer using MRI-based radiomics: a systematic review and meta-analysis.

Gao Y, Liang F, Tian X, Zhang G, Zhang H

pubmed logopapersMay 24 2025
Image-derived machine learning (ML) is a robust and growing field in diagnostic imaging systems for both clinicians and radiologists. Accurate preoperative radiological evaluation of the invasive ability of endometrial cancer (EC) can increase the degree of clinical benefit. The present study aimed to investigate the diagnostic performance of magnetic resonance imaging (MRI)-derived artificial intelligence for accurate preoperative assessment of the invasive risk. The PubMed, Embase, Cochrane Library and Web of Science databases were searched, and pertinent English-language papers were collected. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), and positive and negative likelihood ratios (PLR and NLR, respectively) of all the papers were calculated using Stata software. The results were plotted on a summary receiver operating characteristic (SROC) curve, publication bias and threshold effects were evaluated, and meta-regression and subgroup analyses were conducted to explore the possible causes of intratumoral heterogeneity. MRI-based radiomics revealed pooled sensitivity (SEN) and specificity (SPE) values of 0.85 and 0.82 for the prediction of high-grade EC; 0.80 and 0.85 for deep myometrial invasion (DMI); 0.85 and 0.73 for lymphovascular space invasion (LVSI); 0.79 and 0.85 for microsatellite instability (MSI); and 0.90 and 0.72 for lymph node metastasis (LNM), respectively. For LVSI prediction and high-grade histological analysis, meta-regression revealed that the image segmentation and MRI-based radiomics modeling contributed to heterogeneity (p = 0.003 and 0.04). Through a systematic review and meta-analysis of the reported literature, preoperative MRI-derived ML could help clinicians accurately evaluate EC risk factors, potentially guiding individual treatment thereafter.

A novel multimodal computer-aided diagnostic model for pulmonary embolism based on hybrid transformer-CNN and tabular transformer.

Zhang W, Gu Y, Ma H, Yang L, Zhang B, Wang J, Chen M, Lu X, Li J, Liu X, Yu D, Zhao Y, Tang S, He Q

pubmed logopapersMay 24 2025
Pulmonary embolism (PE) is a life-threatening clinical problem where early diagnosis and prompt treatment are essential to reducing morbidity and mortality. While the combination of CT images and electronic health records (EHR) can help improve computer-aided diagnosis, there are many challenges that need to be addressed. The primary objective of this study is to leverage both 3D CT images and EHR data to improve PE diagnosis. First, for 3D CT images, we propose a network combining Swin Transformers with 3D CNNs, enhanced by a Multi-Scale Feature Fusion (MSFF) module to address fusion challenges between different encoders. Secondly, we introduce a Polarized Self-Attention (PSA) module to enhance the attention mechanism within the 3D CNN. And then, for EHR data, we design the Tabular Transformer for effective feature extraction. Finally, we design and evaluate three multimodal attention fusion modules to integrate CT and EHR features, selecting the most effective one for final fusion. Experimental results on the RadFusion dataset demonstrate that our model significantly outperforms existing state-of-the-art methods, achieving an AUROC of 0.971, an F1 score of 0.926, and an accuracy of 0.920. These results underscore the effectiveness and innovation of our multimodal approach in advancing PE diagnosis.

Noninvasive prediction of failure of the conservative treatment in lateral epicondylitis by clinicoradiological features and elbow MRI radiomics based on interpretable machine learning: a multicenter cohort study.

Cui J, Wang P, Zhang X, Zhang P, Yin Y, Bai R

pubmed logopapersMay 24 2025
To develop and validate an interpretable machine learning model based on clinicoradiological features and radiomic features based on magnetic resonance imaging (MRI) to predict the failure of conservative treatment in lateral epicondylitis (LE). This retrospective study included 420 patients with LE from three hospitals, divided into a training cohort (n = 245), an internal validation cohort (n = 115), and an external validation cohort (n = 60). Patients were categorized into conservative treatment failure (n = 133) and conservative treatment success (n = 287) groups based on the outcome of conservative treatment. We developed two predictive models: one utilizing clinicoradiological features, and another integrating clinicoradiological and radiomic features. Seven machine learning algorithms were evaluated to determine the optimal model for predicting the failure of conservative treatment. Model performance was assessed using ROC, and model interpretability was examined using SHapley Additive exPlanations (SHAP). The LightGBM algorithm was selected as the optimal model because of its superior performance. The combined model demonstrated enhanced predictive accuracy with an area under the ROC curve (AUC) of 0.96 (95% CI: 0.91, 0.99) in the external validation cohort. SHAP analysis identified the radiological feature "CET coronal tear size" and the radiomic feature "AX_log-sigma-1-0-mm-3D_glszm_SmallAreaEmphasis" as key predictors of conservative treatment failure. We developed and validated an interpretable LightGBM machine learning model that integrates clinicoradiological and radiomic features to predict the failure of conservative treatment in LE. The model demonstrates high predictive accuracy and offers valuable insights into key prognostic factors.

Using machine learning models based on cardiac magnetic resonance parameters to predict the prognostic in children with myocarditis.

Hu D, Cui M, Zhang X, Wu Y, Liu Y, Zhai D, Guo W, Ju S, Fan G, Cai W

pubmed logopapersMay 24 2025
To develop machine learning (ML) models incorporating explanatory cardiac magnetic resonance (CMR) parameters for predicting the prognosis of myocarditis in pediatric patients. 77 patients with pediatric myocarditis diagnosed clinically between January 2020 and December 2023 were enrolled retrospectively. All patients were examined by ultrasound, electrocardiogram (ECG), serum biomarkers on admission, and CMR scan to obtain 16 explanatory CMR parameters. All patients underwent follow-up echocardiography and CMR. Patients were divided into two groups according to the occurrence of adverse cardiac events (ACE) during follow-up: the poor prognosis group (n = 23) and the good prognosis group (n = 54). Four models were established, including logistic regression (LR), random forest (RF), support vector machine classifier (SVC), and extreme gradient boosting (XGBoost) model. The performance of each model was evaluated by the area under the receiver operating characteristic curve (AUC). Model interpretation was generated by Shapley additive interpretation (Shap). Among the four models, the three most important features were late gadolinium enhancement (LGE), left ventricular ejection fraction (LVEF), and SAXPeak Global Circumferential Strain (SAXGCS). In addition, LGE, LVEF, SAXGCS, and LAXPeak Global Longitudinal Strain (LAXGLS) were selected as the key predictors for all four models. Four interpretable CMR parameters were extracted, among which the LR model had the best prediction performance. The AUC, sensitivity, and specificity were 0.893, 0.820, and 0.944, respectively. The findings indicate that the presence of LGE on CMR imaging, along with reductions in LVEF, SAXGCS, and LAXGLS, are predictive of poor prognosis in patients with acute myocarditis. ML models, particularly the LR model, demonstrate the potential to predict the prognosis of children with myocarditis. These findings provide valuable insights for cardiologists, supporting more informed clinical decision-making and potentially enhancing patient outcomes in pediatric myocarditis cases.

Explainable deep learning for age and gender estimation in dental CBCT scans using attention mechanisms and multi task learning.

Pishghadam N, Esmaeilyfard R, Paknahad M

pubmed logopapersMay 24 2025
Accurate and interpretable age estimation and gender classification are essential in forensic and clinical diagnostics, particularly when using high-dimensional medical imaging data such as Cone Beam Computed Tomography (CBCT). Traditional CBCT-based approaches often suffer from high computational costs and limited interpretability, reducing their applicability in forensic investigations. This study aims to develop a multi-task deep learning framework that enhances both accuracy and explainability in CBCT-based age estimation and gender classification using attention mechanisms. We propose a multi-task learning (MTL) model that simultaneously estimates age and classifies gender using panoramic slices extracted from CBCT scans. To improve interpretability, we integrate Convolutional Block Attention Module (CBAM) and Grad-CAM visualization, highlighting relevant craniofacial regions. The dataset includes 2,426 CBCT images from individuals aged 7 to 23 years, and performance is assessed using Mean Absolute Error (MAE) for age estimation and accuracy for gender classification. The proposed model achieves a MAE of 1.08 years for age estimation and 95.3% accuracy in gender classification, significantly outperforming conventional CBCT-based methods. CBAM enhances the model's ability to focus on clinically relevant anatomical features, while Grad-CAM provides visual explanations, improving interpretability. Additionally, using panoramic slices instead of full 3D CBCT volumes reduces computational costs without sacrificing accuracy. Our framework improves both accuracy and interpretability in forensic age estimation and gender classification from CBCT images. By incorporating explainable AI techniques, this model provides a computationally efficient and clinically interpretable tool for forensic and medical applications.

Deep learning-based identification of vertebral fracture and osteoporosis in lateral spine radiographs and DXA vertebral fracture assessment to predict incident fracture.

Hong N, Cho SW, Lee YH, Kim CO, Kim HC, Rhee Y, Leslie WD, Cummings SR, Kim KM

pubmed logopapersMay 24 2025
Deep learning (DL) identification of vertebral fractures and osteoporosis in lateral spine radiographs and DXA vertebral fracture assessment (VFA) images may improve fracture risk assessment in older adults. In 26 299 lateral spine radiographs from 9276 individuals attending a tertiary-level institution (60% train set; 20% validation set; 20% test set; VERTE-X cohort), DL models were developed to detect prevalent vertebral fracture (pVF) and osteoporosis. The pre-trained DL models from lateral spine radiographs were then fine-tuned in 30% of a DXA VFA dataset (KURE cohort), with performance evaluated in the remaining 70% test set. The area under the receiver operating characteristics curve (AUROC) for DL models to detect pVF and osteoporosis was 0.926 (95% CI 0.908-0.955) and 0.848 (95% CI 0.827-0.869) from VERTE-X spine radiographs, respectively, and 0.924 (95% CI 0.905-0.942) and 0.867 (95% CI 0.853-0.881) from KURE DXA VFA images, respectively. A total of 13.3% and 13.6% of individuals sustained an incident fracture during a median follow-up of 5.4 years and 6.4 years in the VERTE-X test set (n = 1852) and KURE test set (n = 2456), respectively. Incident fracture risk was significantly greater among individuals with DL-detected vertebral fracture (hazard ratios [HRs] 3.23 [95% CI 2.51-5.17] and 2.11 [95% CI 1.62-2.74] for the VERTE-X and KURE test sets) or DL-detected osteoporosis (HR 2.62 [95% CI 1.90-3.63] and 2.14 [95% CI 1.72-2.66]), which remained significant after adjustment for clinical risk factors and femoral neck bone mineral density. DL scores improved incident fracture discrimination and net benefit when combined with clinical risk factors. In summary, DL-detected pVF and osteoporosis in lateral spine radiographs and DXA VFA images enhanced fracture risk prediction in older adults.

Relational Bi-level aggregation graph convolutional network with dynamic graph learning and puzzle optimization for Alzheimer's classification.

Raajasree K, Jaichandran R

pubmed logopapersMay 24 2025
Alzheimer's disease (AD) is a neurodegenerative disorder characterized by a progressive cognitive decline, necessitating early diagnosis for effective treatment. This study presents the Relational Bi-level Aggregation Graph Convolutional Network with Dynamic Graph Learning and Puzzle Optimization for Alzheimer's Classification (RBAGCN-DGL-PO-AC), using denoised T1-weighted Magnetic Resonance Images (MRIs) collected from Alzheimer's Disease Neuroimaging Initiative (ADNI) repository. Addressing the impact of noise in medical imaging, the method employs advanced denoising techniques includes: the Modified Spline-Kernelled Chirplet Transform (MSKCT), Jump Gain Integral Recurrent Neural Network (JGIRNN), and Newton Time Extracting Wavelet Transform (NTEWT), to enhance the image quality. Key brain regions, crucial for classification such as hippocampal, lateral ventricle and posterior cingulate cortex are segmented using Attention Guided Generalized Intuitionistic Fuzzy C-Means Clustering (AG-GIFCMC). Feature extraction and classification using segmented outputs are performed with RBAGCN-DGL and puzzle optimization, categorize input images into Healthy Controls (HC), Early Mild Cognitive Impairment (EMCI), Late Mild Cognitive Impairment (LMCI), and Alzheimer's Disease (AD). To assess the effectiveness of the proposed method, we systematically examined the structural modifications to the RBAGCN-DGL-PO-AC model through extensive ablation studies. Experimental findings highlight that RBAGCN-DGL-PO-AC state-of-the art performance, with 99.25 % accuracy, outperforming existing methods including MSFFGCN_ADC, CNN_CAD_DBMRI, and FCNN_ADC, while reducing training time by 28.5 % and increasing inference speed by 32.7 %. Hence, the RBAGCN-DGL-PO-AC method enhances AD classification by integrating denoising, segmentation, and dynamic graph-based feature extraction, achieving superior accuracy and making it a valuable tool for clinical applications, ultimately improving patient outcomes and disease management.
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