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A CVAE-based generative model for generalized B<sub>1</sub> inhomogeneity corrected chemical exchange saturation transfer MRI at 5 T.

Zhang R, Zhang Q, Wu Y

pubmed logopapersMay 15 2025
Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) has emerged as a powerful tool to image endogenous or exogenous macromolecules. CEST contrast highly depends on radiofrequency irradiation B<sub>1</sub> level. Spatial inhomogeneity of B<sub>1</sub> field would bias CEST measurement. Conventional interpolation-based B<sub>1</sub> correction method required CEST dataset acquisition under multiple B<sub>1</sub> levels, substantially prolonging scan time. The recently proposed supervised deep learning approach reconstructed B<sub>1</sub> inhomogeneity corrected CEST effect at the identical B<sub>1</sub> as of the training data, hindering its generalization to other B<sub>1</sub> levels. In this study, we proposed a Conditional Variational Autoencoder (CVAE)-based generative model to generate B<sub>1</sub> inhomogeneity corrected Z spectra from single CEST acquisition. The model was trained from pixel-wise source-target paired Z spectra under multiple B<sub>1</sub> with target B<sub>1</sub> as a conditional variable. Numerical simulation and healthy human brain imaging at 5 T were respectively performed to evaluate the performance of proposed model in B<sub>1</sub> inhomogeneity corrected CEST MRI. Results showed that the generated B<sub>1</sub>-corrected Z spectra agreed well with the reference averaged from regions with subtle B<sub>1</sub> inhomogeneity. Moreover, the performance of the proposed model in correcting B<sub>1</sub> inhomogeneity in APT CEST effect, as measured by both MTR<sub>asym</sub> and [Formula: see text] at 3.5 ppm, were superior over conventional Z/contrast-B<sub>1</sub>-interpolation and other deep learning methods, especially when target B<sub>1</sub> were not included in sampling or training dataset. In summary, the proposed model allows generalized B<sub>1</sub> inhomogeneity correction, benefiting quantitative CEST MRI in clinical routines.

2.5D Multi-view Averaging Diffusion Model for 3D Medical Image Translation: Application to Low-count PET Reconstruction with CT-less Attenuation Correction.

Chen T, Hou J, Zhou Y, Xie H, Chen X, Liu Q, Guo X, Xia M, Duncan JS, Liu C, Zhou B

pubmed logopapersMay 15 2025
Positron Emission Tomography (PET) is an important clinical imaging tool but inevitably introduces radiation exposure to patients and healthcare providers. Reducing the tracer injection dose and eliminating the CT acquisition for attenuation correction can reduce the overall radiation dose, but often results in PET with high noise and bias. Thus, it is desirable to develop 3D methods to translate the non-attenuation-corrected low-dose PET (NAC-LDPET) into attenuation-corrected standard-dose PET (AC-SDPET). Recently, diffusion models have emerged as a new state-of-the-art deep learning method for image-to-image translation, better than traditional CNN-based methods. However, due to the high computation cost and memory burden, it is largely limited to 2D applications. To address these challenges, we developed a novel 2.5D Multi-view Averaging Diffusion Model (MADM) for 3D image-to-image translation with application on NAC-LDPET to AC-SDPET translation. Specifically, MADM employs separate diffusion models for axial, coronal, and sagittal views, whose outputs are averaged in each sampling step to ensure the 3D generation quality from multiple views. To accelerate the 3D sampling process, we also proposed a strategy to use the CNN-based 3D generation as a prior for the diffusion model. Our experimental results on human patient studies suggested that MADM can generate high-quality 3D translation images, outperforming previous CNN-based and Diffusion-based baseline methods. The code is available at https://github.com/tianqic/MADM.

[Orthodontics in the CBCT era: 25 years later, what are the guidelines?].

Foucart JM, Papelard N, Bourriau J

pubmed logopapersMay 15 2025
CBCT has become an essential tool in orthodontics, although its use must remain judicious and evidence-based. This study provides an updated analysis of international recommendations concerning the use of CBCT in orthodontics, with a particular focus on clinical indications, radiation dose reduction, and recent technological advancements. A systematic review of guidelines published between 2015 and 2025 was conducted following the PRISMA methodology. Inclusion criteria comprised official directives from recognized scientific societies and clinical studies evaluating low dose protocols in orthodontics. The analysis of the 19 retained recommendations reveals a consensus regarding the primary indications for CBCT in orthodontics, particularly for impacted teeth, skeletal anomalies, periodontal and upper airways assessment. Dose optimization and the integration of artificial intelligence emerge as major advancements, enabling significant radiation reduction while preserving diagnostic accuracy. The development of low dose protocols and advanced reconstruction algorithms presents promising perspectives for safer and more efficient imaging, increasingly replacing conventional 2D radiographic techniques. However, an international harmonization of recommendations for these new imaging sequences is imperative to standardize clinical practices and enhance patient radioprotection.

Application of deep learning with fractal images to sparse-view CT.

Kawaguchi R, Minagawa T, Hori K, Hashimoto T

pubmed logopapersMay 15 2025
Deep learning has been widely used in research on sparse-view computed tomography (CT) image reconstruction. While sufficient training data can lead to high accuracy, collecting medical images is often challenging due to legal or ethical concerns, making it necessary to develop methods that perform well with limited data. To address this issue, we explored the use of nonmedical images for pre-training. Therefore, in this study, we investigated whether fractal images could improve the quality of sparse-view CT images, even with a reduced number of medical images. Fractal images generated by an iterated function system (IFS) were used for nonmedical images, and medical images were obtained from the CHAOS dataset. Sinograms were then generated using 36 projections in sparse-view and the images were reconstructed by filtered back-projection (FBP). FBPConvNet and WNet (first module: learning fractal images, second module: testing medical images, and third module: learning output) were used as networks. The effectiveness of pre-training was then investigated for each network. The quality of the reconstructed images was evaluated using two indices: structural similarity (SSIM) and peak signal-to-noise ratio (PSNR). The network parameters pre-trained with fractal images showed reduced artifacts compared to the network trained exclusively with medical images, resulting in improved SSIM. WNet outperformed FBPConvNet in terms of PSNR. Pre-training WNet with fractal images produced the best image quality, and the number of medical images required for main-training was reduced from 5000 to 1000 (80% reduction). Using fractal images for network training can reduce the number of medical images required for artifact reduction in sparse-view CT. Therefore, fractal images can improve accuracy even with a limited amount of training data in deep learning.

Metal Suppression Magnetic Resonance Imaging Techniques in Orthopaedic and Spine Surgery.

Ziegeler K, Yoon D, Hoff M, Theologis AA

pubmed logopapersMay 15 2025
Implantation of metallic instrumentation is the mainstay of a variety of orthopaedic and spine surgeries. Postoperatively, imaging of the soft tissues around these implants is commonly required to assess for persistent, recurrent, and/or new pathology (ie, instrumentation loosening, particle disease, infection, neural compression); visualization of these pathologies often requires the superior soft-tissue contrast of magnetic resonance imaging (MRI). As susceptibility artifacts from ferromagnetic implants can result in unacceptable image quality, unique MRI approaches are often necessary to provide accurate imaging. In this text, a comprehensive review is provided on common artifacts encountered in orthopaedic MRI, including comparisons of artifacts from different metallic alloys and common nonpropriety/propriety MR metallic artifact reduction methods. The newest metal-artifact suppression imaging technology and future directions (ie, deep learning/artificial intelligence) in this important field will be considered.

AI-based metal artefact correction algorithm for radiotherapy patients with dental hardware in head and neck CT: Towards precise imaging.

Yu X, Zhong S, Zhang G, Du J, Wang G, Hu J

pubmed logopapersMay 14 2025
To investigate the clinical efficiency of an AI-based metal artefact correction algorithm (AI-MAC), for reducing dental metal artefacts in head and neck CT, compared to conventional interpolation-based MAC. We retrospectively collected 41 patients with non-removal dental hardware who underwent non-contrast head and neck CT prior to radiotherapy. All images were reconstructed with standard reconstruction algorithm (SRA), and were additionally processed with both conventional MAC and AI-MAC. The image quality of SRA, MAC and AI-MAC were compared by qualitative scoring on a 5-point scale, with scores ≥ 3 considered interpretable. This was followed by a quantitative evaluation, including signal-to-noise ratio (SNR) and artefact index (Idxartefact). Organ contouring accuracy was quantified via calculating the dice similarity coefficient (DSC) and hausdorff distance (HD) for oral cavity and teeth, using the clinically accepted contouring as reference. Moreover, the treatment planning dose distribution for oral cavity was assessed. AI-MAC yielded superior qualitative image quality as well as quantitative metrics, including SNR and Idxartefact, to SRA and MAC. The image interpretability significantly improved from 41.46% for SRA and 56.10% for MAC to 92.68% for AI-MAC (p < 0.05). Compared to SRA and MAC, the best DSC and HD for both oral cavity and teeth were obtained on AI-MAC (all p < 0.05). No significant differences for dose distribution were found among the three image sets. AI-MAC outperforms conventional MAC in metal artefact reduction, achieving superior image quality with high image interpretability for patients with dental hardware undergoing head and neck CT. Furthermore, the use of AI-MAC improves the accuracy of organ contouring while providing consistent dose calculation against metal artefacts in radiotherapy. AI-MAC is a novel deep learning-based technique for reducing metal artefacts on CT. This in-vivo study first demonstrated its capability of reducing metal artefacts while preserving organ visualization, as compared with conventional MAC.

Fed-ComBat: A Generalized Federated Framework for Batch Effect Harmonization in Collaborative Studies

Silva, S., Lorenzi, M., Altmann, A., Oxtoby, N.

biorxiv logopreprintMay 14 2025
In neuroimaging research, the utilization of multi-centric analyses is crucial for obtaining sufficient sample sizes and representative clinical populations. Data harmonization techniques are typically part of the pipeline in multi-centric studies to address systematic biases and ensure the comparability of the data. However, most multi-centric studies require centralized data, which may result in exposing individual patient information. This poses a significant challenge in data governance, leading to the implementation of regulations such as the GDPR and the CCPA, which attempt to address these concerns but also hinder data access for researchers. Federated learning offers a privacy-preserving alternative approach in machine learning, enabling models to be collaboratively trained on decentralized data without the need for data centralization or sharing. In this paper, we present Fed-ComBat, a federated framework for batch effect harmonization on decentralized data. Fed-ComBat extends existing centralized linear methods, such as ComBat and distributed as d-ComBat, and nonlinear approaches like ComBat-GAM in accounting for potentially nonlinear and multivariate covariate effects. By doing so, Fed-ComBat enables the preservation of nonlinear covariate effects without requiring centralization of data and without prior knowledge of which variables should be considered nonlinear or their interactions, differentiating it from ComBat-GAM. We assessed Fed-ComBat and existing approaches on simulated data and multiple cohorts comprising healthy controls (CN) and subjects with various disorders such as Parkinson's disease (PD), Alzheimer's disease (AD), and autism spectrum disorder (ASD). The results of our study show that Fed-ComBat performs better than centralized ComBat when dealing with nonlinear effects and is on par with centralized methods like ComBat-GAM. Through experiments using synthetic data, Fed-ComBat demonstrates a superior ability to reconstruct the target unbiased function, achieving a 35% improvement (RMSE=0.5952) compared to d-ComBat (RMSE=0.9162) and a 12% improvement compared to our proposal to federate ComBat-GAM, d-ComBat-GAM (RMSE=0.6751). Additionally, Fed-ComBat achieves comparable results to centralized methods like ComBat-GAM for MRI-derived phenotypes without requiring prior knowledge of potential nonlinearities.

An incremental algorithm for non-convex AI-enhanced medical image processing

Elena Morotti

arxiv logopreprintMay 13 2025
Solving non-convex regularized inverse problems is challenging due to their complex optimization landscapes and multiple local minima. However, these models remain widely studied as they often yield high-quality, task-oriented solutions, particularly in medical imaging, where the goal is to enhance clinically relevant features rather than merely minimizing global error. We propose incDG, a hybrid framework that integrates deep learning with incremental model-based optimization to efficiently approximate the $\ell_0$-optimal solution of imaging inverse problems. Built on the Deep Guess strategy, incDG exploits a deep neural network to generate effective initializations for a non-convex variational solver, which refines the reconstruction through regularized incremental iterations. This design combines the efficiency of Artificial Intelligence (AI) tools with the theoretical guarantees of model-based optimization, ensuring robustness and stability. We validate incDG on TpV-regularized optimization tasks, demonstrating its effectiveness in medical image deblurring and tomographic reconstruction across diverse datasets, including synthetic images, brain CT slices, and chest-abdomen scans. Results show that incDG outperforms both conventional iterative solvers and deep learning-based methods, achieving superior accuracy and stability. Moreover, we confirm that training incDG without ground truth does not significantly degrade performance, making it a practical and powerful tool for solving non-convex inverse problems in imaging and beyond.

Evaluation of an artificial intelligence noise reduction tool for conventional X-ray imaging - a visual grading study of pediatric chest examinations at different radiation dose levels using anthropomorphic phantoms.

Hultenmo M, Pernbro J, Ahlin J, Bonnier M, Båth M

pubmed logopapersMay 13 2025
Noise reduction tools developed with artificial intelligence (AI) may be implemented to improve image quality and reduce radiation dose, which is of special interest in the more radiosensitive pediatric population. The aim of the present study was to examine the effect of the AI-based intelligent noise reduction (INR) on image quality at different dose levels in pediatric chest radiography. Anteroposterior and lateral images of two anthropomorphic phantoms were acquired with both standard noise reduction and INR at different dose levels. In total, 300 anteroposterior and 420 lateral images were included. Image quality was evaluated by three experienced pediatric radiologists. Gradings were analyzed with visual grading characteristics (VGC) resulting in area under the VGC curve (AUC<sub>VGC</sub>) values and associated confidence intervals (CI). Image quality of different anatomical structures and overall clinical image quality were statistically significantly better in the anteroposterior INR images than in the corresponding standard noise reduced images at each dose level. Compared with reference anteroposterior images at a dose level of 100% with standard noise reduction, the image quality of the anteroposterior INR images was graded as significantly better at dose levels of ≥ 80%. Statistical significance was also achieved at lower dose levels for some structures. The assessments of the lateral images showed similar trends but with fewer significant results. The results of the present study indicate that the AI-based INR may potentially be used to improve image quality at a specific dose level or to reduce dose and maintain the image quality in pediatric chest radiography.

The utility of low-dose pre-operative CT of ovarian tumor with artificial intelligence iterative reconstruction for diagnosing peritoneal invasion, lymph node and hepatic metastasis.

Cai X, Han J, Zhou W, Yang F, Liu J, Wang Q, Li R

pubmed logopapersMay 13 2025
Diagnosis of peritoneal invasion, lymph node metastasis, and hepatic metastasis is crucial in the decision-making process of ovarian tumor treatment. This study aimed to test the feasibility of low-dose abdominopelvic CT with an artificial intelligence iterative reconstruction (AIIR) for diagnosing peritoneal invasion, lymph node metastasis, and hepatic metastasis in pre-operative imaging of ovarian tumor. This study prospectively enrolled 88 patients with pathology-confirmed ovarian tumors, where routine-dose CT at portal venous phase (120 kVp/ref. 200 mAs) with hybrid iterative reconstruction (HIR) was followed by a low-dose scan (120 kVp/ref. 40 mAs) with AIIR. The performance of diagnosing peritoneal invasion and lymph node metastasis was assessed using receiver operating characteristic (ROC) analysis with pathological results serving as the reference. The hepatic parenchymal metastases were diagnosed and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured. The perihepatic structures were also scored on the clarity of porta hepatis, gallbladder fossa and intersegmental fissure. The effective dose of low-dose CT was 79.8% lower than that of routine-dose scan (2.64 ± 0.46 vs. 13.04 ± 2.25 mSv, p < 0.001). The low-dose AIIR showed similar area under the ROC curve (AUC) with routine-dose HIR for diagnosing both peritoneal invasion (0.961 vs. 0.960, p = 0.734) and lymph node metastasis (0.711 vs. 0.715, p = 0.355). The 10 hepatic parenchymal metastases were all accurately diagnosed on the two image sets. The low-dose AIIR exhibited higher SNR and CNR for hepatic parenchymal metastases and superior clarity for perihepatic structures. In low-dose pre-operative CT of ovarian tumor, AIIR delivers similar diagnostic accuracy for peritoneal invasion, lymph node metastasis, and hepatic metastasis, as compared to routine-dose abdominopelvic CT. It is feasible and diagnostically safe to apply up to 80% dose reduction in CT imaging of ovarian tumor by using AIIR.
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