Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting up to 2 % of the population. Catheter ablation is a promising treatment for AF, particularly for paroxysmal AF patients, but it often has high recurrence rates. Developing in silico models of patients' atria during the ablation procedure using cardiac MRI data may help reduce these rates. This study aims to develop an effective automated deep learning-based segmentation pipeline by compiling a specialized dataset and employing standardized labeling protocols to improve segmentation accuracy and efficiency. In doing so, we aim to achieve the highest possible accuracy and generalization ability while minimizing the burden on clinicians involved in manual data segmentation. We collected LGE-MRI data from VMRC and the cDEMRIS database. Two specialists manually labeled the data using standardized protocols to reduce subjective errors. Neural network (nnU-Net and smpU-Net++) performance was evaluated using statistical tests, including sensitivity and specificity analysis. A new database of LGE-MRI images, based on manual segmentation, was created (VMRC). Our approach with consistent labeling protocols achieved a Dice coefficient of 92.4 % ± 0.8 % for the cavity and 64.5 % ± 1.9 % for LA walls. Using the pre-trained RIFE model, we attained a Dice score of approximately 89.1 % ± 1.6 % for atrial LGE-MRI imputation, outperforming classical methods. Sensitivity and specificity values demonstrated substantial enhancement in the performance of neural networks trained with the new protocol. Standardized labeling and RIFE applications significantly improved machine learning tool efficiency for constructing 3D LA models. This novel approach supports integrating state-of-the-art machine learning methods into broader in silico pipelines for predicting ablation outcomes in AF patients.

Accurate brain tumor segmentation from MRI images is critical in the medical industry, directly impacts the efficacy of diagnostic and treatment plans. Accurate segmentation of tumor region can be challenging, especially when noise and abnormalities are present. This research provides a systematic review of automatic brain tumor segmentation techniques, with a specific focus on the design of network architectures. The review categorizes existing methods into unsupervised and supervised learning techniques, as well as machine learning and deep learning approaches within supervised techniques. Deep learning techniques are thoroughly reviewed, with a particular focus on CNN-based, U-Net-based, transfer learning-based, transformer-based, and hybrid transformer-based methods. This survey encompasses a broad spectrum of automatic segmentation methodologies, from traditional machine learning approaches to advanced deep learning frameworks. It provides an in-depth comparison of performance metrics, model efficiency, and robustness across multiple datasets, particularly the BraTS dataset. The study further examines multi-modal MRI imaging and its influence on segmentation accuracy, addressing domain adaptation, class imbalance, and generalization challenges. The analysis highlights the current challenges in Computer-aided Diagnostic (CAD) systems, examining how different models and imaging sequences impact performance. Recent advancements in deep learning, especially the widespread use of U-Net architectures, have significantly enhanced medical image segmentation. This review critically evaluates these developments, focusing the iterative improvements in U-Net models that have driven progress in brain tumor segmentation. Furthermore, it explores various techniques for improving U-Net performance for medical applications, focussing on its potential for improving diagnostic and treatment planning procedures. The efficiency of these automated segmentation approaches is rigorously evaluated using the BraTS dataset, a benchmark dataset, part of the annual Multimodal Brain Tumor Segmentation Challenge (MICCAI). This evaluation provides insights into the current state-of-the-art and identifies key areas for future research and development.

Artificial intelligence (AI) may extract prognostic information from MRI for localized prostate cancer. We evaluate whether AI-derived prostate and gross tumor volume (GTV) are associated with toxicity and oncologic outcomes after radiotherapy. We conducted a retrospective study of patients, who underwent radiotherapy between 2010 and 2017. We trained an AI segmentation algorithm to contour the prostate and GTV from patients treated with external-beam RT, and applied the algorithm to those treated with brachytherapy. AI prostate and GTV volumes were calculated from segmentation results. We evaluated whether AI GTV volume was associated with biochemical failure (BF) and metastasis. We evaluated whether AI prostate volume was associated with acute and late grade 2+ genitourinary toxicity, and International Prostate Symptom Score (IPSS) resolution for monotherapy and combination sets, separately. We identified 187 patients who received brachytherapy (monotherapy (N = 154) or combination therapy (N = 33)). AI GTV volume was associated with BF (hazard ratio (HR):1.28[1.14,1.44];p < 0.001) and metastasis (HR:1.34[1.18,1.53;p < 0.001). For the monotherapy subset, AI prostate volume was associated with both acute (adjusted odds ratio:1.16[1.07,1.25];p < 0.001) and late grade 2 + genitourinary toxicity (adjusted HR:1.04[1.01,1.07];p = 0.01), but not IPSS resolution (0.99[0.97,1.00];p = 0.13). For the combination therapy subset, AI prostate volume was not associated with either acute (p = 0.72) or late (p = 0.75) grade 2 + urinary toxicity. However, AI prostate volume was associated with IPSS resolution (0.96[0.93, 0.99];p = 0.01). AI-derived prostate and GTV volumes may be prognostic for toxicity and oncologic outcomes after RT. Such information may aid in treatment decision-making, given differences in outcomes among RT treatment modalities.

Global aging raises concerns about cognitive health, metabolic disorders, and sarcopenia. Prevention of reversible decline and diseases in middle-aged individuals is essential for promoting healthy aging. We hypothesize that changes in body composition, specifically muscle mass and visceral fat, and metabolic indices are associated with accelerated brain aging. To explore these relationships, we employed a brain age model to investigate the links between the brain age gap (BAG), body composition, and metabolic markers. Using T1-weighted anatomical brain MRIs, we developed a machine learning model to predict brain age from gray matter features, trained on 2,675 healthy individuals aged 18-92 years. This model was then applied to a separate cohort of 458 Taiwanese adults (57.8 years ± 11.6; 280 men) to assess associations between BAG, body composition quantified by MRI, and metabolic markers. Our model demonstrated reliable generalizability for predicting individual age in the clinical dataset (MAE = 6.11 years, r = 0.900). Key findings included significant correlations between larger BAG and reduced total abdominal muscle area (r = -0.146, p = 0.018), lower BMI-adjusted skeletal muscle indices, (r = -0.134, p = 0.030), increased systemic inflammation, as indicated by high-sensitivity C-reactive protein levels (r = 0.121, p = 0.048), and elevated fasting glucose levels (r = 0.149, p = 0.020). Our findings confirm that muscle mass and metabolic health decline are associated with accelerated brain aging. Interventions to improve muscle health and metabolic control may mitigate adverse effects of brain aging, supporting healthier aging trajectories.

Focal cortical dysplasia (FCD) is a common cause of pharmacoresistant epilepsy. However, it can be challenging to detect FCD using MRI alone. This study aimed to review and analyze studies that used machine learning and artificial neural networks (ANN) methods as an additional tool to enhance MRI findings in FCD patients. A systematic search was conducted in four databases (Embase, PubMed, Scopus, and Web of Science). The quality of the studies was assessed using QUADAS-AI, and a bivariate random-effects model was used for analysis. The main outcome analyzed was the sensitivity and specificity of patient-wise outcomes. Heterogeneity among studies was assessed using I². A total of 41 studies met the inclusion criteria, including 24 ANN-based studies and 17 machine learning studies. Meta-analysis of internal validation datasets showed a pooled sensitivity of 0.81 and specificity of 0.92 for AI-based models in detecting FCD lesions. Meta-analysis of external validation datasets yielded a pooled sensitivity of 0.73 and specificity of 0.66. There was moderate heterogeneity among studies in the external validation dataset, but no significant publication bias was found. Although there is an increasing number of machine learning and ANN-based models for FCD detection, their clinical applicability remains limited. Further refinement and optimization, along with longitudinal studies, are needed to ensure their integration into clinical practice. Addressing the identified limitations and intensifying research efforts will improve their relevance and reliability in real medical scenarios.

Glioblastoma (GBM), primary central nervous system lymphoma (PCNSL), and brain metastases (BM) are common malignant brain tumors with similar radiological features, while the accurate and non-invasive dialgnosis is essential for selecting appropriate treatment plans. This study develops a deep learning model, FoTNet, to improve the automatic diagnosis accuracy of these tumors, particularly for the relatively rare PCNSL tumor. The model integrates a frequency-based channel attention layer and the focal loss to address the class imbalance issue caused by the limited samples of PCNSL. A multi-center MRI dataset was constructed by collecting and integrating data from Sir Run Run Shaw Hospital, along with public datasets from UPENN and TCGA. The dataset includes T1-weighted contrast-enhanced (T1-CE) MRI images from 58 GBM, 82 PCNSL, and 269 BM cases, which were divided into training and testing sets with a 5:2 ratio. FoTNet achieved a classification accuracy of 92.5 % and an average AUC of 0.9754 on the test set, significantly outperforming existing machine learning and deep learning methods in distinguishing among GBM, PCNSL, and BM. Through multiple validations, FoTNet has proven to be an effective and robust tool for accurately classifying these brain tumors, providing strong support for preoperative diagnosis and assisting clinicians in making more informed treatment decisions.

Radiomics analysis has emerged as a promising approach to aid in cancer diagnosis and treatment. However, radiomics research currently lacks standardization, and radiomics features can be highly dependent on acquisition and pre-processing techniques used. In this study, we aim to investigate the effect of various image normalization techniques on robustness of radiomics features extracted from breast cancer patient MRI scans. MRI scans from the publicly available MAMA-MIA dataset and an internal breast MRI test set depicting triple negative breast cancer (TNBC) were used. We compared the effect of commonly used image normalization techniques on radiomics feature robustnessusing Concordance-Correlation-Coefficient (CCC) between multiple combinations of normalization approaches. We also trained machine learning-based prediction models of pathologic complete response (pCR) on radiomics after different normalization techniques were used and compared their areas under the receiver operating characteristic curve (ROC-AUC). For predicting complete pathological response from pre-treatment breast cancer MRI radiomics, the highest overall ROC-AUC was achieved by using a combination of three different normalization techniques indicating their potentially powerful role when working with heterogeneous imaging data. The effect of normalization was more pronounced with smaller training data and normalization may be less important with increasing abundance of training data. Additionally, we observed considerable differences between MRI data sets and their feature robustness towards normalization. Overall, we were able to demonstrate the importance of selecting and standardizing normalization methods for accurate and reliable radiomics analysis in breast MRI scans especially with small training data sets.

Alzheimer's disease (AD) might impact the complexity of cerebral cortex, and the underlying biological mechanisms responsible for cortical changes in the AD cortex remain unclear. Fifty-eight participants with AD and 67 normal controls underwent high-resolution 3 T structural brain MRI. Using surface-based morphometry (SBM), we created vertex-wise maps for group comparisons in terms of five measures: cortical thickness, fractal dimension, gyrification index, Toro's gyrification index and sulcal depth respectively. Five machine learning (ML) models combining SBM parameters were established to predict AD. In addition, transcription-neuroimaging association analyses, as well as Mendelian randomization of AD and cortical thickness data, were conducted to investigate the genetic mechanisms and biological functions of AD. AD patients exhibited topological changes in cortical complexity, with increased complexity in the frontal and temporal cortex and decreased complexity in the insula cortex, alongside extensive cortical atrophy. Combining different SBM measures could aid disease diagnosis. The genes involved in cell structure support and the immune response were the strongest contributors to cortical anatomical features in AD patients. The identified genes associated with AD cortical morphology were overexpressed or underexpressed in excitatory neurons, oligodendrocytes, and astrocytes. Complexity alterations of the cerebral surface may be associated with a range of biological processes and molecular mechanisms, including immune responses. The present findings may contribute to a more comprehensive understanding of brain morphological patterns in AD patients.

Brain Tumor Segmentation (BraTS) plays a critical role in clinical diagnosis, treatment planning, and monitoring the progression of brain tumors. However, due to the variability in tumor appearance, size, and intensity across different MRI modalities, automated segmentation remains a challenging task. In this study, we propose a novel Transformer-based framework, multiPI-TransBTS, which integrates multi-physical information to enhance segmentation accuracy. The model leverages spatial information, semantic information, and multi-modal imaging data, addressing the inherent heterogeneity in brain tumor characteristics. The multiPI-TransBTS framework consists of an encoder, an Adaptive Feature Fusion (AFF) module, and a multi-source, multi-scale feature decoder. The encoder incorporates a multi-branch architecture to separately extract modality-specific features from different MRI sequences. The AFF module fuses information from multiple sources using channel-wise and element-wise attention, ensuring effective feature recalibration. The decoder combines both common and task-specific features through a Task-Specific Feature Introduction (TSFI) strategy, producing accurate segmentation outputs for Whole Tumor (WT), Tumor Core (TC), and Enhancing Tumor (ET) regions. Comprehensive evaluations on the BraTS2019 and BraTS2020 datasets demonstrate the superiority of multiPI-TransBTS over the state-of-the-art methods. The model consistently achieves better Dice coefficients, Hausdorff distances, and Sensitivity scores, highlighting its effectiveness in addressing the BraTS challenges. Our results also indicate the need for further exploration of the balance between precision and recall in the ET segmentation task. The proposed framework represents a significant advancement in BraTS, with potential implications for improving clinical outcomes for brain tumor patients.

Understanding optic nerve structure and monitoring changes within it can provide insights into neurodegenerative diseases like multiple sclerosis, in which optic nerves are often damaged by inflammatory episodes of optic neuritis. Over the past decades, interest in the optic nerve has increased, particularly with advances in magnetic resonance technology and the advent of deep learning solutions. These advances have significantly improved the visualisation and analysis of optic nerves, making it possible to detect subtle changes that aid the early diagnosis and treatment of optic nerve-related diseases, and for planning radiotherapy interventions. Effective segmentation techniques, therefore, are crucial for enhancing the accuracy of predictive models, planning interventions and treatment strategies. This comprehensive review, which includes 27 peer-reviewed articles published between 2007 and 2024, examines and highlights the evolution of optic nerve magnetic resonance imaging segmentation over the past decade, tracing the development from intensity-based methods to the latest deep learning algorithms, including multi-atlas solutions using single or multiple image modalities.