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Application of Artificial Intelligence in rheumatic disease classification: an example of ankylosing spondylitis severity inspection model.

Chen CW, Tsai HH, Yeh CY, Yang CK, Tsou HK, Leong PY, Wei JC

pubmed logopapersDec 1 2025
The development of the Artificial Intelligence (AI)-based severity inspection model for ankylosing spondylitis (AS) could support health professionals to rapidly assess the severity of the disease, enhance proficiency, and reduce the demands of human resources. This paper aims to develop an AI-based severity inspection model for AS using patients' X-ray images and modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The numerical simulation with AI is developed following the progress of data preprocessing, building and testing the model, and then the model. The training data is preprocessed by inviting three experts to check the X-ray images of 222 patients following the Gold Standard. The model is then developed through two stages, including keypoint detection and mSASSS evaluation. The two-stage AI-based severity inspection model for AS was developed to automatically detect spine points and evaluate mSASSS scores. At last, the data obtained from the developed model was compared with those from experts' assessment to analyse the accuracy of the model. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. The spine point detection at the first stage achieved 1.57 micrometres in mean error distance with the ground truth, and the second stage of the classification network can reach 0.81 in mean accuracy. The model can correctly identify 97.4% patches belonging to mSASSS score 3, while those belonging to score 0 can still be classified into scores 1 or 2. The automatic severity inspection model for AS developed in this paper is accurate and can support health professionals in rapidly assessing the severity of AS, enhancing assessment proficiency, and reducing the demands of human resources.

SurgPointTransformer: transformer-based vertebra shape completion using RGB-D imaging.

Massalimova A, Liebmann F, Jecklin S, Carrillo F, Farshad M, Fürnstahl P

pubmed logopapersDec 1 2025
State-of-the-art computer- and robot-assisted surgery systems rely on intraoperative imaging technologies such as computed tomography and fluoroscopy to provide detailed 3D visualizations of patient anatomy. However, these methods expose both patients and clinicians to ionizing radiation. This study introduces a radiation-free approach for 3D spine reconstruction using RGB-D data. Inspired by the "mental map" surgeons form during procedures, we present SurgPointTransformer, a shape completion method that reconstructs unexposed spinal regions from sparse surface observations. The method begins with a vertebra segmentation step that extracts vertebra-level point clouds for subsequent shape completion. SurgPointTransformer then uses an attention mechanism to learn the relationship between visible surface features and the complete spine structure. The approach is evaluated on an <i>ex vivo</i> dataset comprising nine samples, with CT-derived data used as ground truth. SurgPointTransformer significantly outperforms state-of-the-art baselines, achieving a Chamfer distance of 5.39 mm, an F-score of 0.85, an Earth mover's distance of 11.00 and a signal-to-noise ratio of 22.90 dB. These results demonstrate the potential of our method to reconstruct 3D vertebral shapes without exposing patients to ionizing radiation. This work contributes to the advancement of computer-aided and robot-assisted surgery by enhancing system perception and intelligence.

MLP-UNet: an algorithm for segmenting lesions in breast and thyroid ultrasound images.

Dong TF, Zhou CJ, Huang ZY, Zhao H, Wang XL, Yan SJ

pubmed logopapersDec 1 2025
Breast and thyroid cancers are among the most prevalent and fastest growing malignancies worldwide with ultrasound imaging serving as the primary modality for screening and surgical navigation of these lesions. Accurate and real-time lesion segmentation in ultrasound images is crucial for guiding precise needle placement during biopsies and surgeries. To address this clinical need, we propose <b>MLP-UNet</b>, a deep learning model for automatic segmentation of breast tumors and thyroid nodules in ultrasound images. MLP-UNet adopts an encoder-decoder architecture with a U-shaped structure and integrates a MLP-based module(MAP) module within the encoder stage. Attention module is a lightweight employed during the skip connections to enhance feature representation. Using only using 33.75 M parameters, MLP-UNet achieves state-of-the-art segmentation performance. On the BUSI, it attains Dice, IoU, and Recall of 80.61%, 67.93%, and 80.48%, respectively. And on the DDTI, it attains Dice, IoU, and Recall of 81.67% for Dice, 71.72%. These results outperform several classical and state-of-the-art segmentation networks while maintaining low computational complexity, highlighting its significant potential for clinical application in ultrasound-guided surgical navigation systems.

Aortic atherosclerosis evaluation using deep learning based on non-contrast CT: A retrospective multi-center study.

Yang M, Lyu J, Xiong Y, Mei A, Hu J, Zhang Y, Wang X, Bian X, Huang J, Li R, Xing X, Su S, Gao J, Lou X

pubmed logopapersAug 15 2025
Non-contrast CT (NCCT) is widely used in clinical practice and holds potential for large-scale atherosclerosis screening, yet its application in detecting and grading aortic atherosclerosis remains limited. To address this, we propose Aortic-AAE, an automated segmentation system based on a cascaded attention mechanism within the nnU-Net framework. The cascaded attention module enhances feature learning across complex anatomical structures, outperforming existing attention modules. Integrated preprocessing and post-processing ensure anatomical consistency and robustness across multi-center data. Trained on 435 labeled NCCT scans from three centers and validated on 388 independent cases, Aortic-AAE achieved 81.12% accuracy in aortic stenosis classification and 92.37% in Agatston scoring of calcified plaques, surpassing five state-of-the-art models. This study demonstrates the feasibility of using deep learning for accurate detection and grading of aortic atherosclerosis from NCCT, supporting improved diagnostic decisions and enhanced clinical workflows.

Deep Learning-Based Instance-Level Segmentation of Kidney and Liver Cysts in CT Images of Patients Affected by Polycystic Kidney Disease.

Gregory AV, Khalifa M, Im J, Ramanathan S, Elbarougy DE, Cruz C, Yang H, Denic A, Rule AD, Chebib FT, Dahl NK, Hogan MC, Harris PC, Torres VE, Erickson BJ, Potretzke TA, Kline TL

pubmed logopapersAug 14 2025
Total kidney and liver volumes are key image-based biomarkers to predict the severity of kidney and liver phenotype in autosomal dominant polycystic kidney disease (ADPKD). However, MRI-based advanced biomarkers like total cyst number (TCN) and cyst parenchyma surface area (CPSA) have been shown to more accurately assess cyst burden and improve the prediction of disease progression. The main aim of this study is to extend the calculation of advanced biomarkers to other imaging modalities; thus, we propose a fully automated model to segment kidney and liver cysts in CT images. Abdominal CTs of ADPKD patients were gathered retrospectively between 2001-2018. A 3D deep-learning method using the nnU-Net architecture was trained to learn cyst edges-cores and the non-cystic kidney/liver parenchyma. Separate segmentation models were trained for kidney cysts in contrast-enhanced CTs and liver cysts in non-contrast CTs using an active learning approach. Two experienced research fellows manually generated the reference standard segmentation, which were reviewed by an expert radiologist for accuracy. Two-hundred CT scans from 148 patients (mean age, 51.2 ± 14.1 years; 48% male) were utilized for model training (80%) and testing (20%). In the test set, both models showed good agreement with the reference standard segmentations, similar to the agreement between two independent human readers (model vs reader: TCNkidney/liver r=0.96/0.97 and CPSAkidney r=0.98), inter-reader: TCNkidney/liver r=0.96/0.98 and CPSAkidney r=0.99). Our study demonstrates that automated models can segment kidney and liver cysts accurately in CT scans of patients with ADPKD.

ES-UNet: efficient 3D medical image segmentation with enhanced skip connections in 3D UNet.

Park M, Oh S, Park J, Jeong T, Yu S

pubmed logopapersAug 13 2025
Deep learning has significantly advanced medical image analysis, particularly in semantic segmentation, which is essential for clinical decisions. However, existing 3D segmentation models, like the traditional 3D UNet, face challenges in balancing computational efficiency and accuracy when processing volumetric medical data. This study aims to develop an improved architecture for 3D medical image segmentation with enhanced learning strategies to improve accuracy and address challenges related to limited training data. We propose ES-UNet, a 3D segmentation architecture that achieves superior segmentation performance while offering competitive efficiency across multiple computational metrics, including memory usage, inference time, and parameter count. The model builds upon the full-scale skip connection design of UNet3+ by integrating channel attention modules into each encoder-to-decoder path and incorporating full-scale deep supervision to enhance multi-resolution feature learning. We further introduce Region Specific Scaling (RSS), a data augmentation method that adaptively applies geometric transformations to annotated regions, and a Dynamically Weighted Dice (DWD) loss to improve the balance between precision and recall. The model was evaluated on the MICCAI HECKTOR dataset, and additional validation was conducted on selected tasks from the Medical Segmentation Decathlon (MSD). On the HECKTOR dataset, ES-UNet achieved a Dice Similarity Coefficient (DSC) of 76.87%, outperforming baseline models including 3D UNet, 3D UNet 3+, nnUNet, and Swin UNETR. Ablation studies showed that RSS and DWD contributed up to 1.22% and 1.06% improvement in DSC, respectively. A sensitivity analysis demonstrated that the chosen scaling range in RSS offered a favorable trade-off between deformation and anatomical plausibility. Cross-dataset evaluation on MSD Heart and Spleen tasks also indicated strong generalization. Computational analysis revealed that ES-UNet achieves superior segmentation performance with moderate computational demands. Specifically, the enhanced skip connection design with lightweight channel attention modules integrated throughout the network architecture enables this favorable balance between high segmentation accuracy and computational efficiency. ES-UNet integrates architectural and algorithmic improvements to achieve robust 3D medical image segmentation. While the framework incorporates established components, its core contributions lie in the optimized skip connection strategy and supporting techniques like RSS and DWD. Future work will explore adaptive scaling strategies and broader validation across diverse imaging modalities.

An optimized multi-task contrastive learning framework for HIFU lesion detection and segmentation.

Zavar M, Ghaffari HR, Tabatabaee H

pubmed logopapersAug 13 2025
Accurate detection and segmentation of lesions induced by High-Intensity Focused Ultrasound (HIFU) in medical imaging remain significant challenges in automated disease diagnosis. Traditional methods heavily rely on labeled data, which is often scarce, expensive, and time-consuming to obtain. Moreover, existing approaches frequently struggle with variations in medical data and the limited availability of annotated datasets, leading to suboptimal performance. To address these challenges, this paper introduces an innovative framework called the Optimized Multi-Task Contrastive Learning Framework (OMCLF), which leverages self-supervised learning (SSL) and genetic algorithms (GA) to enhance HIFU lesion detection and segmentation. OMCLF integrates classification and segmentation into a unified model, utilizing a shared backbone to extract common features. The framework systematically optimizes feature representations, hyperparameters, and data augmentation strategies tailored for medical imaging, ensuring that critical information, such as lesion details, is preserved. By employing a genetic algorithm, OMCLF explores and optimizes augmentation techniques suitable for medical data, avoiding distortions that could compromise diagnostic accuracy. Experimental results demonstrate that OMCLF outperforms single-task methods in both classification and segmentation tasks while significantly reducing dependency on labeled data. Specifically, OMCLF achieves an accuracy of 93.3% in lesion detection and a Dice score of 92.5% in segmentation, surpassing state-of-the-art methods such as SimCLR and MoCo. The proposed approach achieves superior accuracy in identifying and delineating HIFU-induced lesions, marking a substantial advancement in medical image interpretation and automated diagnosis. OMCLF represents a significant step forward in the evolutionary optimization of self-supervised learning, with potential applications across various medical imaging domains.

Pathology-Guided AI System for Accurate Segmentation and Diagnosis of Cervical Spondylosis.

Zhang Q, Chen X, He Z, Wu L, Wang K, Sun J, Shen H

pubmed logopapersAug 13 2025
Cervical spondylosis, a complex and prevalent condition, demands precise and efficient diagnostic techniques for accurate assessment. While MRI offers detailed visualization of cervical spine anatomy, manual interpretation remains labor-intensive and prone to error. To address this, we developed an innovative AI-assisted Expert-based Diagnosis System that automates both segmentation and diagnosis of cervical spondylosis using MRI. Leveraging multi-center datasets of cervical MRI images from patients with cervical spondylosis, our system features a pathology-guided segmentation model capable of accurately segmenting key cervical anatomical structures. The segmentation is followed by an expert-based diagnostic framework that automates the calculation of critical clinical indicators. Our segmentation model achieved an impressive average Dice coefficient exceeding 0.90 across four cervical spinal anatomies and demonstrated enhanced accuracy in herniation areas. Diagnostic evaluation further showcased the system's precision, with the lowest mean average errors (MAE) for the C2-C7 Cobb angle and the Maximum Spinal Cord Compression (MSCC) coefficient. In addition, our method delivered high accuracy, precision, recall, and F1 scores in herniation localization, K-line status assessment, T2 hyperintensity detection, and Kang grading. Comparative analysis and external validation demonstrate that our system outperforms existing methods, establishing a new benchmark for segmentation and diagnostic tasks for cervical spondylosis.

BSA-Net: Boundary-prioritized spatial adaptive network for efficient left atrial segmentation.

Xu F, Tu W, Feng F, Yang J, Gunawardhana M, Gu Y, Huang J, Zhao J

pubmed logopapersAug 13 2025
Atrial fibrillation, a common cardiac arrhythmia with rapid and irregular atrial electrical activity, requires accurate left atrial segmentation for effective treatment planning. Recently, deep learning methods have gained encouraging success in left atrial segmentation. However, current methodologies critically depend on the assumption of consistently complete centered left atrium as input, which neglects the structural incompleteness and boundary discontinuities arising from random-crop operations during inference. In this paper, we propose BSA-Net, which exploits an adaptive adjustment strategy in both feature position and loss optimization to establish long-range feature relationships and strengthen robust intermediate feature representations in boundary regions. Specifically, we propose a Spatial-adaptive Convolution (SConv) that employs a shuffle operation combined with lightweight convolution to directly establish cross-positional relationships within regions of potential relevance. Moreover, we develop the dual Boundary Prioritized loss, which enhances boundary precision by differentially weighting foreground and background boundaries, thus optimizing complex boundary regions. With the above technologies, the proposed method enjoys a better speed-accuracy trade-off compared to current methods. BSA-Net attains Dice scores of 92.55%, 91.42%, and 84.67% on the LA, Utah, and Waikato datasets, respectively, with a mere 2.16 M parameters-approximately 80% fewer than other contemporary state-of-the-art models. Extensive experimental results on three benchmark datasets have demonstrated that BSA-Net, consistently and significantly outperforms existing state-of-the-art methods.

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.
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