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Developing deep learning-based cerebral ventricle auto-segmentation system and clinical application for the evaluation of ventriculomegaly.

Nam SM, Hwang JH, Kim JM, Lee DI, Kim YH, Park SJ, Park CK, Dho YS, Kim MS

pubmed logopapersJul 23 2025
Current methods for evaluating ventriculomegaly, particularly Evans' Index (EI), fail to accurately assess three-dimensional ventricular changes. We developed and validated an automated multi-class segmentation system for precise volumetric assessment, simultaneously segmenting five anatomical classes (ventricles, parenchyma, skull, skin, and hemorrhage) to support future augmented reality (AR)-guided external ventricular drainage (EVD) systems. Using the nnUNet architecture, we trained our model on 288 brain CT scans with diverse pathological conditions and validated it using internal (n=10),external (n=43) and public (n=192) datasets. Clinical validation involved 227 patients who underwent CSF drainage procedures. We compared automated volumetric measurements against traditional EI measurements and actual CSF drainage volumes in surgical cases. The model achieved exceptional performance with a mean Dice similarity coefficient of 93.0% across all five classes, demonstrating consistent performance across institutional and public datasets, with particularly robust ventricle segmentation (92.5%). Clinical validation revealed EI was the strongest single predictor of ventricular volume (adjusted R<sup>2</sup> = 0.430, p < 0.001), though influenced by age, sex, and diagnosis type. Most significantly, in EVD cases, automated volume differences showed remarkable correlation with actual CSF drainage amounts (β = 0.956, adjusted R<sup>2</sup> = 0.936, p < 0.001), validating the system's accuracy in measuring real CSF volume changes. Our comprehensive multi-class segmentation system offers a superior alternative to traditional measurements with potential for non-invasive CSF dynamics monitoring and AR-guided EVD placement.

Kissing Spine and Other Imaging Predictors of Postoperative Cement Displacement Following Percutaneous Kyphoplasty: A Machine Learning Approach.

Zhao Y, Bo L, Qian L, Chen X, Wang Y, Cui L, Xin Y, Liu L

pubmed logopapersJul 23 2025
To investigate the risk factors associated with postoperative cement displacement following percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fractures (OVCF) and to develop predictive models for clinical risk assessment. This retrospective study included 198 patients with OVCF who underwent PKP. Imaging and clinical variables were collected. Multiple machine learning models, including logistic regression, L1- and L2-regularized logistic regression, support vector machine (SVM), decision tree, gradient boosting, and random forest, were developed to predict cement displacement. L1- and L2-regularized logistic regression models identified four key risk factors: kissing spine (L1: 1.11; L2: 0.91), incomplete anterior cortex (L1: -1.60; L2: -1.62), low vertebral body CT value (L1: -2.38; L2: -1.71), and large Cobb change (L1: 0.89; L2: 0.87). The support vector machine (SVM) model achieved the best performance (accuracy: 0.983, precision: 0.875, recall: 1.000, F1-score: 0.933, specificity: 0.981, AUC: 0.997). Other models, including logistic regression, decision tree, gradient boosting, and random forest, also showed high performance but were slightly inferior to SVM. Key predictors of cement displacement were identified, and machine learning models were developed for risk assessment. These findings can assist clinicians in identifying high-risk patients, optimizing treatment strategies, and improving patient outcomes.

Interpretable Deep Learning Approaches for Reliable GI Image Classification: A Study with the HyperKvasir Dataset

Wahid, S. B., Rothy, Z. T., News, R. K., Rieyan, S. A.

medrxiv logopreprintJul 23 2025
Deep learning has emerged as a promising tool for automating gastrointestinal (GI) disease diagnosis. However, multi-class GI disease classification remains underexplored. This study addresses this gap by presenting a framework that uses advanced models like InceptionNetV3 and ResNet50, combined with boosting algorithms (XGB, LGBM), to classify lower GI abnormalities. InceptionNetV3 with XGB achieved the best recall of 0.81 and an F1 score of 0.90. To assist clinicians in understanding model decisions, the Grad-CAM technique, a form of explainable AI, was employed to highlight the critical regions influencing predictions, fostering trust in these systems. This approach significantly improves both the accuracy and reliability of GI disease diagnosis.

Semantic Segmentation for Preoperative Planning in Transcatheter Aortic Valve Replacement

Cedric Zöllner, Simon Reiß, Alexander Jaus, Amroalalaa Sholi, Ralf Sodian, Rainer Stiefelhagen

arxiv logopreprintJul 22 2025
When preoperative planning for surgeries is conducted on the basis of medical images, artificial intelligence methods can support medical doctors during assessment. In this work, we consider medical guidelines for preoperative planning of the transcatheter aortic valve replacement (TAVR) and identify tasks, that may be supported via semantic segmentation models by making relevant anatomical structures measurable in computed tomography scans. We first derive fine-grained TAVR-relevant pseudo-labels from coarse-grained anatomical information, in order to train segmentation models and quantify how well they are able to find these structures in the scans. Furthermore, we propose an adaptation to the loss function in training these segmentation models and through this achieve a +1.27% Dice increase in performance. Our fine-grained TAVR-relevant pseudo-labels and the computed tomography scans we build upon are available at https://doi.org/10.5281/zenodo.16274176.

MAN-GAN: a mask-adaptive normalization based generative adversarial networks for liver multi-phase CT image generation.

Zhao W, Chen W, Fan L, Shang Y, Wang Y, Situ W, Li W, Liu T, Yuan Y, Liu J

pubmed logopapersJul 22 2025
Liver multiphase enhanced computed tomography (MPECT) is vital in clinical practice, but its utility is limited by various factors. We aimed to develop a deep learning network capable of automatically generating MPECT images from standard non-contrast CT scans. Dataset 1 included 374 patients and was divided into three parts: a training set, a validation set and a test set. Dataset 2 included 144 patients with one specific liver disease and was used as an internal test dataset. We further collected another dataset comprising 83 patients for external validation. Then, we propose a Mask-Adaptive Normalization-based Generative Adversarial Network with Cycle-Consistency Loss (MAN-GAN) to achieve non-contrast CT to MPECT translation. To assess the efficiency of MAN-GAN, we conducted a comparative analysis with state-of-the-art methods commonly employed in diverse medical image synthesis tasks. Moreover, two subjective radiologist evaluation studies were performed to verify the clinical usefulness of the generated images. MAN-GAN outperformed the baseline network and other state-of-the-art methods in all generations of the three phases. These results were verified in internal and external datasets. According to radiological evaluation, the image quality of generated three phase images are all above average. Moreover, the similarities between real images and generated images in all three phases are satisfactory. MAN-GAN demonstrates the feasibility of liver MPECT image translation based on non-contrast images and achieves state-of-the-art performance via the subtraction strategy. It has great potential for solving the dilemma of liver CT contrast canning and aiding further liver interaction clinical scenarios.

A Biomimetic Titanium Scaffold with and Without Magnesium Filled for Adjustable Patient-Specific Elastic Modulus.

Jana S, Sarkar R, Rana M, Das S, Chakraborty A, Das A, Roy Chowdhury A, Pal B, Dutta Majumdar J, Dhara S

pubmed logopapersJul 22 2025
This study focuses on determining the effective young modulus (stiffness) of various lattice structures for titanium scaffolds filled with magnesium and without magnesium. For specific patient success of the implant is depends on adequate elastic modulus which helps proper osteointegration. The Mg filled portion in the Ti scaffold is expected to dissolve with time as the bone growth through the Ti scaffold porous cavity is started. The proposed method is based on a general numerical homogenization scheme to determine the effective elastic properties of the lattice scaffold at the macroscopic scale. A large numerical campaign has been conducted on 18 geometries. The 3D scaffold is conceived based on the model generated from the Micro CT data of the prepared sample. The effect of the scaffold local features, e.g., the distribution of porosity, presence of scaffold's surface area to the adjacent bone location, strut diameter of implant, on the effective elastic properties is investigated. Results show that both the relative density and the geometrical features of the scaffold strongly affect the equivalent macroscopic elastic behaviour of the lattice. 6 samples are made (three each Mg filled and three without Mg) The compression test was carried out for each type of samples and the displacement obtained from the test results were in close match with the simulated results from finite element analysis. To predict the unknown required stiffness what would be the ratio between Ti scaffold and filled up Mg have been calculated using the data driven AI model.

LA-Seg: Disentangled sinogram pattern-guided transformer for lesion segmentation in limited-angle computed tomography.

Yoon JH, Lee YJ, Yoo SB

pubmed logopapersJul 21 2025
Limited-angle computed tomography (LACT) offers patient-friendly benefits, such as rapid scanning and reduced radiation exposure. However, the incompleteness of data in LACT often causes notable artifacts, posing challenges for precise medical interpretation. Although numerous approaches have been introduced to reconstruct LACT images into complete computed tomography (CT) scans, they focus on improving image quality and operate separately from lesion segmentation models, often overlooking essential lesion-specific information. This is because reconstruction models are primarily optimized to satisfy overall image quality rather than local lesion-specific regions, in a non-end-to-end setup where each component is optimized independently and may not contribute to reaching the global minimum of the overall objective function. To address this problem, we propose LA-Seg, a transformer-based segmentation model using the sinogram domain of LACT data. The LA-Seg method uses an auxiliary reconstruction task to estimates incomplete sinogram regions to enhance segmentation robustness. Applying transformers adapted from video prediction models captures the spatial structure and sequential patterns in sinograms and reconstructs features in incomplete regions using a disentangled representation guided by distinctive patterns. We propose contrastive abnormal feature loss to distinguish between normal and abnormal regions better. The experimental results demonstrate that LA-Seg consistently surpasses existing medical segmentation approaches in diverse LACT conditions. The source code is provided at https://github.com/jhyoon964/LA-Seg.

Artificial intelligence in radiology: diagnostic sensitivity of ChatGPT for detecting hemorrhages in cranial computed tomography scans.

Bayar-Kapıcı O, Altunışık E, Musabeyoğlu F, Dev Ş, Kaya Ö

pubmed logopapersJul 21 2025
Chat Generative Pre-trained Transformer (ChatGPT)-4V, a large language model developed by OpenAI, has been explored for its potential application in radiology. This study assesses ChatGPT-4V's diagnostic performance in identifying various types of intracranial hemorrhages in non-contrast cranial computed tomography (CT) images. Intracranial hemorrhages were presented to ChatGPT using the clearest 2D imaging slices. The first question, "Q1: Which imaging technique is used in this image?" was asked to determine the imaging modality. ChatGPT was then prompted with the second question, "Q2: What do you see in this image and what is the final diagnosis?" to assess whether the CT scan was normal or showed pathology. For CT scans containing hemorrhage that ChatGPT did not interpret correctly, a follow-up question-"Q3: There is bleeding in this image. Which type of bleeding do you see?"-was used to evaluate whether this guidance influenced its response. ChatGPT accurately identified the imaging technique (Q1) in all cases but demonstrated difficulty diagnosing epidural hematoma (EDH), subdural hematoma (SDH), and subarachnoid hemorrhage (SAH) when no clues were provided (Q2). When a hemorrhage clue was introduced (Q3), ChatGPT correctly identified EDH in 16.7% of cases, SDH in 60%, and SAH in 15.6%, and achieved 100% diagnostic accuracy for hemorrhagic cerebrovascular disease. Its sensitivity, specificity, and accuracy for Q2 were 23.6%, 92.5%, and 57.4%, respectively. These values improved substantially with the clue in Q3, with sensitivity rising to 50.9% and accuracy to 71.3%. ChatGPT also demonstrated higher diagnostic accuracy in larger hemorrhages in EDH and SDH images. Although the model performs well in recognizing imaging modalities, its diagnostic accuracy substantially improves when guided by additional contextual information. These findings suggest that ChatGPT's diagnostic performance improves with guided prompts, highlighting its potential as a supportive tool in clinical radiology.

Lightweight Network Enhancing High-Resolution Feature Representation for Efficient Low Dose CT Denoising.

Li J, Li Y, Qi F, Wang S, Zhang Z, Huang Z, Yu Z

pubmed logopapersJul 21 2025
Low-dose computed tomography plays a crucial role in reducing radiation exposure in clinical imaging, however, the resultant noise significantly impacts image quality and diagnostic precision. Recent transformer-based models have demonstrated strong denoising capabilities but are often constrained by high computational complexity. To overcome these limitations, we propose AMFA-Net, an adaptive multi-order feature aggregation network that provides a lightweight architecture for enhancing highresolution feature representation in low-dose CT imaging. AMFA-Net effectively integrates local and global contexts within high-resolution feature maps while learning discriminative representations through multi-order context aggregation. We introduce an agent-based self-attention crossshaped window transformer block that efficiently captures global context in high-resolution feature maps, which is subsequently fused with backbone features to preserve critical structural information. Our approach employs multiorder gated aggregation to adaptively guide the network in capturing expressive interactions that may be overlooked in fused features, thereby producing robust representations for denoised image reconstruction. Experiments on two challenging public datasets with 25% and 10% full-dose CT image quality demonstrate that our method surpasses state-of-the-art approaches in denoising performance with low computational cost, highlighting its potential for realtime medical applications.

MedSR-Impact: Transformer-Based Super-Resolution for Lung CT Segmentation, Radiomics, Classification, and Prognosis

Marc Boubnovski Martell, Kristofer Linton-Reid, Mitchell Chen, Sumeet Hindocha, Benjamin Hunter, Marco A. Calzado, Richard Lee, Joram M. Posma, Eric O. Aboagye

arxiv logopreprintJul 21 2025
High-resolution volumetric computed tomography (CT) is essential for accurate diagnosis and treatment planning in thoracic diseases; however, it is limited by radiation dose and hardware costs. We present the Transformer Volumetric Super-Resolution Network (\textbf{TVSRN-V2}), a transformer-based super-resolution (SR) framework designed for practical deployment in clinical lung CT analysis. Built from scalable components, including Through-Plane Attention Blocks (TAB) and Swin Transformer V2 -- our model effectively reconstructs fine anatomical details in low-dose CT volumes and integrates seamlessly with downstream analysis pipelines. We evaluate its effectiveness on three critical lung cancer tasks -- lobe segmentation, radiomics, and prognosis -- across multiple clinical cohorts. To enhance robustness across variable acquisition protocols, we introduce pseudo-low-resolution augmentation, simulating scanner diversity without requiring private data. TVSRN-V2 demonstrates a significant improvement in segmentation accuracy (+4\% Dice), higher radiomic feature reproducibility, and enhanced predictive performance (+0.06 C-index and AUC). These results indicate that SR-driven recovery of structural detail significantly enhances clinical decision support, positioning TVSRN-V2 as a well-engineered, clinically viable system for dose-efficient imaging and quantitative analysis in real-world CT workflows.
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