Aiming to evaluate the effects of the smart metal artifact reduction (MAR) algorithm and combinations of various scanning parameters, including radiation dose levels, tube voltage, and reconstruction algorithms, on metal artifact reduction and overall image quality, to identify the optimal protocol for clinical application. A phantom with a pacemaker was examined using standard dose (effective dose (ED): 3 mSv) and low dose (ED: 0.5 mSv), with three scan voltages (70, 100, and 120 kVp) selected for each dose. Raw data were reconstructed using 50% adaptive statistical iterative reconstruction-V (ASIR-V), ASIR-V with MAR, high-strength deep learning image reconstruction (DLIR-H), and DLIR-H with MAR. Quantitative analyses (artifact index (AI), noise, signal-to-noise ratio (SNR) of artifact-impaired pulmonary nodules (PNs), and noise power spectrum (NPS) of artifact-free regions) and qualitative evaluation were performed. Quantitatively, the deep learning image recognition (DLIR) algorithm or high tube voltages exhibited lower noise compared to the ASIR-V or low tube voltages (<i>p</i> < 0.001). AI of images with MAR or high tube voltages was significantly lower than that of images without MAR or low tube voltages (<i>p</i> < 0.001). No significant difference was observed in AI between low-dose images with 120 kVp DLIR-H MAR and standard-dose images with 70 kVp ASIR-V MAR (<i>p</i> = 0.143). Only the 70 kVp 3 mSv protocol demonstrated statistically significant differences in SNR for artifact-impaired PNs (<i>p</i> = 0.041). The f_peak and f_avg values were similar across various scenarios, indicating that the MAR algorithm did not alter the image texture in artifact-free regions. The qualitative results of the extent of metal artifacts, the confidence in diagnosing artifact-impaired PNs, and the overall image quality were generally consistent with the quantitative results. The MAR algorithm combined with DLIR-H can reduce metal artifacts and enhance the overall image quality, particularly at high kVp tube voltages.

Volumetric atlases are an invaluable tool in neuroscience and otolaryngology, greatly aiding experiment planning and surgical interventions, as well as the interpretation of experimental and clinical data. The rat is a major animal model for hearing and balance studies, and a detailed volumetric atlas for the rat central auditory system (Waxholm) is available. However, the Waxholm rat atlas only contains a low-resolution inner ear featuring five structures. In the present work, we segmented and annotated 34 structures in the rat inner ear, yielding a detailed volumetric inner ear atlas which can be integrated with the Waxholm rat brain atlas. We performed iodine-enhanced microCT and iDISCO+-based clearing and fluorescence lightsheet microscopy imaging on a sample of rat temporal bones. Image stacks were segmented in a semiautomated way, and 34 inner ear volumes were reconstructed from five samples. Using geometrical morphometry, high-resolution segmentations obtained from lightsheet and microCT stacks were registered into the coordinate system of the Waxholm rat atlas. Cleared sample autofluorescence was used for the reconstruction of most inner ear structures, including fluid-filled compartments, nerves and sensory epithelia, blood vessels, and connective tissue structures. Image resolution allowed reconstruction of thin ducts (reuniting, saccular and endolymphatic), and the utriculoendolymphatic valve. The vestibulocochlear artery coursing through bone was found to be associated to the reuniting duct, and to be visible both in cleared and microCT samples, thus allowing to infer duct location from microCT scans. Cleared labyrinths showed minimal shape distortions, as shown by alignment with microCT and Waxholm labyrinths. However, membranous labyrinths could display variable collapse of the superior division, especially the roof of canal ampullae, whereas the inferior division (saccule and cochlea) was well preserved, with the exception of Reissner's membrane that could display ruptures in the second cochlear turn. As an example of atlas use, the volumes reconstructed from segmentations were used to separate macrophage populations from the spiral ganglion, auditory neuron dendrites, and Organ of Corti. We have reconstructed 34 structures from the rat temporal bone, which are available as both image stacks and printable 3D objects in a shared repository for download. These can be used for teaching, localizing cells or other features within the ear, modeling auditory and vestibular sensory physiology and training of automated segmentation machine learning tools.

Advancements in medical imaging technology have facilitated the acquisition of high-quality brain images through computed tomography (CT) or magnetic resonance imaging (MRI), enabling professional brain specialists to diagnose brain tumors more effectively. However, manual diagnosis is time-consuming, which has led to the growing importance of automatic detection and classification through brain imaging. Conventional object detection models for brain tumor detection face limitations in brain tumor detection owing to the significant differences between medical images and natural scene images, as well as challenges such as complex backgrounds, noise interference, and blurred boundaries between cancerous and normal tissues. This study investigates the application of deep learning to brain tumor detection, analyzing the effect of three factors, the number of model parameters, input data batch size, and the use of anchor boxes, on detection performance. Experimental results reveal that an excessive number of model parameters or the use of anchor boxes may reduce detection accuracy. However, increasing the number of brain tumor samples improves detection performance. This study, introduces a backbone network built using RepConv and RepC3, along with FGConcat feature map splicing module to optimize the brain tumor detection model. The experimental results show that the proposed RepConv-RepC3-FGConcat Network (RRFNet) can learn underlying semantic information about brain tumors during training stage, while maintaining a low number of parameters during inference, which improves the speed of brain tumor detection. Compared with YOLOv8, RRFNet achieved a higher accuracy in brain tumor detection, with a mAP value of 79.2%. This optimized approach enhances both accuracy and efficiency, which is essential in clinical settings where time and precision are critical.

Optimizing resource allocation for Parkinson's disease (PD) motor rehabilitation necessitates identifying biomarkers of responsiveness and dynamic neuroplasticity signatures underlying efficacy. A cohort study of 52 early-stage PD patients undergoing 2-week multidisciplinary intensive rehabilitation therapy (MIRT) was conducted, which stratified participants into responders and nonresponders. A multimodal analysis of resting-state electroencephalography (EEG) microstates and functional magnetic resonance imaging (fMRI) coactivation patterns was performed to characterize MIRT-induced spatiotemporal network reorganization. Responders demonstrated clinically meaningful improvement in motor symptoms, exceeding the minimal clinically important difference threshold of 3.25 on the Unified PD Rating Scale part III, alongside significant reductions in bradykinesia and a significant enhancement in quality-of-life scores at the 3-month follow-up. Resting-state EEG in responders showed a significant attenuation in microstate C and a significant enhancement in microstate D occurrences, along with significantly increased transitions from microstate A/B to D, which significantly correlated with motor function, especially in bradykinesia gains. Concurrently, fMRI analyses identified a prolonged dwell time of the dorsal attention network coactivation/ventral attention network deactivation pattern, which was significantly inversely associated with microstate C occurrence and significantly linked to motor improvement. The identified brain spatiotemporal neural markers were validated using machine learning models to assess the efficacy of MIRT in motor rehabilitation for PD patients, achieving an average accuracy rate of 86%. These findings suggest that MIRT may facilitate a shift in neural networks from sensory processing to higher-order cognitive control, with the dynamic reallocation of attentional resources. This preliminary study validates the necessity of integrating cognitive-motor strategies for the motor rehabilitation of PD and identifies novel neural markers for assessing treatment efficacy.

To investigate the efficacy of CT measurement parameters combined with AI-assisted 3D planning for personalized femoral prosthesis selection in total hip arthroplasty (THA). A retrospective analysis was conducted on clinical data from 247 patients with unilateral hip or knee joint disorders treated at Renmin Hospital of Hubei University of Medicine between April 2021 and February 2024. All patients underwent preoperative full-pelvis and bilateral full-length femoral CT scans. The raw CT data were imported into Mimics 19.0 software to reconstruct a three-dimensional (3D) model of the healthy femur. Using 3-matic Research 11.0 software, the femoral head rotation center was located, and parameters including femoral head diameter (FHD), femoral neck length (FNL), femoral neck-shaft angle (FNSA), femoral offset (FO), femoral neck anteversion angle (FNAA), tip-apex distance (TAD), and tip-apex angle (TAA) were measured. AI-assisted THA 3D planning system AIJOINT V1.0.0.0 software was used for preoperative planning and design, enabling personalized selection of femoral prostheses with varying neck-shaft angles and surgical simulation. Groups were compared by gender, age, and parameters. ROC curves evaluated prediction efficacy. Females exhibited smaller FHD, FNL, FO, TAD, TAA but larger FNSA/FNAA vs males (P<0.05). Patients >65 years had higher FO, TAD, TAA (P<0.05). TAD-TAA correlation was strong (r=0.954), while FNSA negatively correlated with TAD/TAA (r=-0.773/-0.701). ROC analysis demonstrated high predictive accuracy: TAD (AUC=0.891, sensitivity=91.7%, specificity=87.6%) and TAA (AUC=0.882, sensitivity=100%, specificity=88.8%). CT parameters (TAA, TAD, FNSA, FO) are interrelated and effective predictors for femoral prosthesis selection. Integration with AI-assisted planning optimizes personalized THA, reducing biomechanical mismatch risks.

This work aims to promote early and accurate diagnosis of Temporal Lobe Epilepsy (TLE) by developing state-of-the-art deep learning techniques, with the goal of minimizing the consequences of epilepsy on individuals and society. Current approaches for TLE detection have drawbacks, including applicability to particular MRI sequences, moderate ability to determine the side of the onset zones, and weak cross-validation with different patient groups, which hampers their practical use. To overcome these difficulties, a new Hybrid Attention-Enhanced Transformer Network (HAETN) is introduced for early TLE diagnosis. This approach uses newly developed Fuzzy-AAL Segmentation Framework (FASF) which is a combination of Fuzzy Possibilistic C-Means (FPCM) algorithm for segmentation of tissue and AAL labelling for labelling of tissues. Furthermore, an effective feature selection method is proposed using the Dipper- grey wolf optimization (DGWO) algorithm to improve the performance of the proposed model. The performance of the proposed method is thoroughly assessed by accuracy, sensitivity, and F1-score. The performance of the suggested approach is evaluated on the Temporal Lobe Epilepsy-UNAM MRI Dataset, where it attains an accuracy of 98.61%, a sensitivity of 99.83%, and F1-score of 99.82%, indicating its efficiency and applicability in clinical practice.

Increasing evidence suggests that non-operative management (NOM) with antibiotics could serve as a safe alternative to surgery for the treatment of uncomplicated acute appendicitis (AA). However, accurately differentiating between uncomplicated and complicated AA remains challenging. Our aim was to develop and validate machine-learning-based diagnostic models to differentiate uncomplicated from complicated AA. This was a multicenter cohort trial conducted from January 2021 and December 2022 across five tertiary hospitals. Three distinct diagnostic models were created, namely, the clinical-parameter-based model, the CT-radiomics-based model, and the clinical-radiomics-fused model. These models were developed using a comprehensive set of eight machine-learning algorithms, which included logistic regression (LR), support vector machine (SVM), random forest (RF), decision tree (DT), gradient boosting (GB), K-nearest neighbors (KNN), Gaussian Naïve Bayes (GNB), and multi-layer perceptron (MLP). The performance and accuracy of these diverse models were compared. All models exhibited excellent diagnostic performance in the training cohort, achieving a maximal AUC of 1.00. For the clinical-parameter model, the GB classifier yielded the optimal AUC of 0.77 (95% confidence interval [CI]: 0.64-0.90) in the testing cohort, while the LR classifier yielded the optimal AUC of 0.76 (95% CI: 0.66-0.86) in the validation cohort. For the CT-radiomics-based model, GB classifier achieved the best AUC of 0.74 (95% CI: 0.60-0.88) in the testing cohort, and SVM yielded an optimal AUC of 0.63 (95% CI: 0.51-0.75) in the validation cohort. For the clinical-radiomics-fused model, RF classifier yielded an optimal AUC of 0.84 (95% CI: 0.74-0.95) in the testing cohort and 0.76 (95% CI: 0.67-0.86) in the validation cohort. An open-access, user-friendly online tool was developed for clinical application. This multicenter study suggests that the clinical-radiomics-fused model, constructed using RF algorithm, effectively differentiated between complicated and uncomplicated AA.

The use of artificial intelligence (AI) in medicine has shown promise to improve the quality of healthcare decisions. However, AI can be biased in a manner that produces unfair predictions for certain demographic subgroups. In MIMIC-CXR, a publicly available dataset of over 300,000 chest X-ray images, diagnostic AI has been shown to have a higher false negative rate for racial minorities. We evaluated the capacity of synthetic data augmentation, oversampling, and demographic-based corrections to enhance the fairness of AI predictions. We show that adjusting unfair predictions for demographic attributes, such as race, is ineffective at improving fairness or predictive performance. However, using oversampling and synthetic data augmentation to modify disease prevalence reduced such disparities by 74.7% and 10.6%, respectively. Moreover, such fairness gains were accomplished without reduction in performance (95% CI AUC: [0.816, 0.820] versus [0.810, 0.819] versus [0.817, 0.821] for baseline, oversampling, and augmentation, respectively).