Journal Of Digital Imaging[JOURNAL]
Sun
200 papers
Bayesian Convolutional Neural Networks in Medical Imaging Classification: A Promising Solution for Deep Learning Limits in Data Scarcity Scenarios.
Bargagna F, De Santi LA, Martini N … +7 more , Genovesi D, Favilli B, Vergaro G, Emdin M, Giorgetti A, Positano V, Santarelli MF
J Digit Imaging · 2023 Dec · PMID 37787869 · Full text
Deep neural networks (DNNs) have already impacted the field of medicine in data analysis, classification, and image processing. Unfortunately, their performance is drastically reduced when datasets are scarce in nature (...
Deep neural networks (DNNs) have already impacted the field of medicine in data analysis, classification, and image processing. Unfortunately, their performance is drastically reduced when datasets are scarce in nature (e.g., rare diseases or early-research data). In such scenarios, DNNs display poor capacity for generalization and often lead to highly biased estimates and silent failures. Moreover, deterministic systems cannot provide epistemic uncertainty, a key component to asserting the model's reliability. In this work, we developed a probabilistic system for classification as a framework for addressing the aforementioned criticalities. Specifically, we implemented a Bayesian convolutional neural network (BCNN) for the classification of cardiac amyloidosis (CA) subtypes. We prepared four different CNNs: base-deterministic, dropout-deterministic, dropout-Bayesian, and Bayesian. We then trained them on a dataset of 1107 PET images from 47 CA and control patients (data scarcity scenario). The Bayesian model achieved performances (78.28 (1.99) % test accuracy) comparable to the base-deterministic, dropout-deterministic, and dropout-Bayesian ones, while showing strongly increased "Out of Distribution" input detection (validation-test accuracy mismatch reduction). Additionally, both the dropout-Bayesian and the Bayesian models enriched the classification through confidence estimates, while reducing the criticalities of the dropout-deterministic and base-deterministic approaches. This in turn increased the model's reliability, also providing much needed insights into the network's estimates. The obtained results suggest that a Bayesian CNN can be a promising solution for addressing the challenges posed by data scarcity in medical imaging classification tasks.
Detecting and Characterizing Inferior Vena Cava Filters on Abdominal Computed Tomography with Data-Driven Computational Frameworks.
Candemir S, Moranville R, Wong KA … +4 more , Campbell W, Bigelow MT, Prevedello LM, Makary MS
J Digit Imaging · 2023 Dec · PMID 37770730 · Full text
Two data-driven algorithms were developed for detecting and characterizing Inferior Vena Cava (IVC) filters on abdominal computed tomography to assist healthcare providers with the appropriate management of these devices...
Two data-driven algorithms were developed for detecting and characterizing Inferior Vena Cava (IVC) filters on abdominal computed tomography to assist healthcare providers with the appropriate management of these devices to decrease complications: one based on 2-dimensional data and transfer learning (2D + TL) and an augmented version of the same algorithm which accounts for the 3-dimensional information leveraging recurrent convolutional neural networks (3D + RCNN). The study contains 2048 abdominal computed tomography studies obtained from 439 patients who underwent IVC filter placement during the 10-year period from January 1st, 2009, to January 1st, 2019. Among these, 399 patients had retrievable filters, and 40 had non-retrievable filter types. The reference annotations for the filter location were obtained through a custom-developed interface. The ground truth annotations for the filter types were determined based on the electronic medical record and physician review of imaging. The initial stage of the framework returns a list of locations containing metallic objects based on the density of the structure. The second stage processes the candidate locations and determines which one contains an IVC filter. The final stage of the pipeline classifies the filter types as retrievable vs. non-retrievable. The computational models are trained using Tensorflow Keras API on an Nvidia Quadro GV100 system. We utilized a fine-tuning supervised training strategy to conduct our experiments. We find that the system achieves high sensitivity on detecting the filter locations with a high confidence value. The 2D + TL model achieved a sensitivity of 0.911 and a precision of 0.804, and the 3D + RCNN model achieved a sensitivity of 0.923 and a precision of 0.853 for filter detection. The system confidence for the IVC location predictions is high: 0.993 for 2D + TL and 0.996 for 3D + RCNN. The filter type prediction component of the system achieved 0.945 sensitivity, 0.882 specificity, and 0.97 AUC score with 2D + TL and 0. 940 sensitivity, 0.927 specificity, and 0.975 AUC score with 3D + RCNN. With the intent to create tools to improve patient outcomes, this study describes the initial phase of a computational framework to support healthcare providers in detecting patients with retained IVC filters, so an individualized decision can be made to remove these devices when appropriate, to decrease complications. To our knowledge, this is the first study that curates abdominal computed tomography (CT) scans and presents an algorithm for automated detection and characterization of IVC filters.
DMCA-GAN: Dual Multilevel Constrained Attention GAN for MRI-Based Hippocampus Segmentation.
Chen X, Peng Y, Li D … +1 more , Sun J
J Digit Imaging · 2023 Dec · PMID 37735310 · Full text
Precise segmentation of the hippocampus is essential for various human brain activity and neurological disorder studies. To overcome the small size of the hippocampus and the low contrast of MR images, a dual multilevel...
Precise segmentation of the hippocampus is essential for various human brain activity and neurological disorder studies. To overcome the small size of the hippocampus and the low contrast of MR images, a dual multilevel constrained attention GAN for MRI-based hippocampus segmentation is proposed in this paper, which is used to provide a relatively effective balance between suppressing noise interference and enhancing feature learning. First, we design the dual-GAN backbone to effectively compensate for the spatial information damage caused by multiple pooling operations in the feature generation stage. Specifically, dual-GAN performs joint adversarial learning on the multiscale feature maps at the end of the generator, which yields an average Dice coefficient (DSC) gain of 5.95% over the baseline. Next, to suppress MRI high-frequency noise interference, a multilayer information constraint unit is introduced before feature decoding, which improves the sensitivity of the decoder to forecast features by 5.39% and effectively alleviates the network overfitting problem. Then, to refine the boundary segmentation effects, we construct a multiscale feature attention restraint mechanism, which forces the network to concentrate more on effective multiscale details, thus improving the robustness. Furthermore, the dual discriminators D1 and D2 also effectively prevent the negative migration phenomenon. The proposed DMCA-GAN obtained a DSC of 90.53% on the Medical Segmentation Decathlon (MSD) dataset with tenfold cross-validation, which is superior to the backbone by 3.78%.
Left Ventricular Myocardial Dysfunction Evaluation in Thalassemia Patients Using Echocardiographic Radiomic Features and Machine Learning Algorithms.
Taleie H, Hajianfar G, Sabouri M … +5 more , Parsaee M, Houshmand G, Bitarafan-Rajabi A, Zaidi H, Shiri I
J Digit Imaging · 2023 Dec · PMID 37735309 · Full text
Heart failure caused by iron deposits in the myocardium is the primary cause of mortality in beta-thalassemia major patients. Cardiac magnetic resonance imaging (CMRI) T2* is the primary screening technique used to detec...
Heart failure caused by iron deposits in the myocardium is the primary cause of mortality in beta-thalassemia major patients. Cardiac magnetic resonance imaging (CMRI) T2* is the primary screening technique used to detect myocardial iron overload, but inherently bears some limitations. In this study, we aimed to differentiate beta-thalassemia major patients with myocardial iron overload from those without myocardial iron overload (detected by T2*CMRI) based on radiomic features extracted from echocardiography images and machine learning (ML) in patients with normal left ventricular ejection fraction (LVEF > 55%) in echocardiography. Out of 91 cases, 44 patients with thalassemia major with normal LVEF (> 55%) and T2* ≤ 20 ms and 47 people with LVEF > 55% and T2* > 20 ms as the control group were included in the study. Radiomic features were extracted for each end-systolic (ES) and end-diastolic (ED) image. Then, three feature selection (FS) methods and six different classifiers were used. The models were evaluated using various metrics, including the area under the ROC curve (AUC), accuracy (ACC), sensitivity (SEN), and specificity (SPE). Maximum relevance-minimum redundancy-eXtreme gradient boosting (MRMR-XGB) (AUC = 0.73, ACC = 0.73, SPE = 0.73, SEN = 0.73), ANOVA-MLP (AUC = 0.69, ACC = 0.69, SPE = 0.56, SEN = 0.83), and recursive feature elimination-K-nearest neighbors (RFE-KNN) (AUC = 0.65, ACC = 0.65, SPE = 0.64, SEN = 0.65) were the best models in ED, ES, and ED&ES datasets. Using radiomic features extracted from echocardiographic images and ML, it is feasible to predict cardiac problems caused by iron overload.
Public Imaging Datasets of Gastrointestinal Endoscopy for Artificial Intelligence: a Review.
Zhu S, Gao J, Liu L … +5 more , Yin M, Lin J, Xu C, Xu C, Zhu J
J Digit Imaging · 2023 Dec · PMID 37735308 · Full text
With the advances in endoscopic technologies and artificial intelligence, a large number of endoscopic imaging datasets have been made public to researchers around the world. This study aims to review and introduce these...
With the advances in endoscopic technologies and artificial intelligence, a large number of endoscopic imaging datasets have been made public to researchers around the world. This study aims to review and introduce these datasets. An extensive literature search was conducted to identify appropriate datasets in PubMed, and other targeted searches were conducted in GitHub, Kaggle, and Simula to identify datasets directly. We provided a brief introduction to each dataset and evaluated the characteristics of the datasets included. Moreover, two national datasets in progress were discussed. A total of 40 datasets of endoscopic images were included, of which 34 were accessible for use. Basic and detailed information on each dataset was reported. Of all the datasets, 16 focus on polyps, and 6 focus on small bowel lesions. Most datasets (n = 16) were constructed by colonoscopy only, followed by normal gastrointestinal endoscopy and capsule endoscopy (n = 9). This review may facilitate the usage of public dataset resources in endoscopic research.
External Validation of Robust Radiomic Signature to Predict 2-Year Overall Survival in Non-Small-Cell Lung Cancer.
Jha AK, Sherkhane UB, Mthun S … +6 more , Jaiswar V, Purandare N, Prabhash K, Wee L, Rangarajan V, Dekker A
J Digit Imaging · 2023 Dec · PMID 37735307 · Full text
Lung cancer is the second most fatal disease worldwide. In the last few years, radiomics is being explored to develop prediction models for various clinical endpoints in lung cancer. However, the robustness of radiomic f...
Lung cancer is the second most fatal disease worldwide. In the last few years, radiomics is being explored to develop prediction models for various clinical endpoints in lung cancer. However, the robustness of radiomic features is under question and has been identified as one of the roadblocks in the implementation of a radiomic-based prediction model in the clinic. Many past studies have suggested identifying the robust radiomic feature to develop a prediction model. In our earlier study, we identified robust radiomic features for prediction model development. The objective of this study was to develop and validate the robust radiomic signatures for predicting 2-year overall survival in non-small cell lung cancer (NSCLC). This retrospective study included a cohort of 300 stage I-IV NSCLC patients. Institutional 200 patients' data were included for training and internal validation and 100 patients' data from The Cancer Image Archive (TCIA) open-source image repository for external validation. Radiomic features were extracted from the CT images of both cohorts. The feature selection was performed using hierarchical clustering, a Chi-squared test, and recursive feature elimination (RFE). In total, six prediction models were developed using random forest (RF-Model-O, RF-Model-B), gradient boosting (GB-Model-O, GB-Model-B), and support vector(SV-Model-O, SV-Model-B) classifiers to predict 2-year overall survival (OS) on original data as well as balanced data. Model validation was performed using 10-fold cross-validation, internal validation, and external validation. Using a multistep feature selection method, the overall top 10 features were chosen. On internal validation, the two random forest models (RF-Model-O, RF-Model-B) displayed the highest accuracy; their scores on the original and balanced datasets were 0.81 and 0.77 respectively. During external validation, both the random forest models' accuracy was 0.68. In our study, robust radiomic features showed promising predictive performance to predict 2-year overall survival in NSCLC.
Correction to: The FIND Program: Improving Follow-up of Incidental Imaging Findings.
Zaki-Metias KM, MacLean JJ, Satei AM … +4 more , Medvedev S, Wang H, Zarour CC, Arpasi PJ
J Digit Imaging · 2023 Dec · PMID 37714970 · Full text
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MF-Net: Automated Muscle Fiber Segmentation From Immunofluorescence Images Using a Local-Global Feature Fusion Network.
Du G, Zhang P, Guo J … +6 more , Pang X, Kan G, Zeng B, Chen X, Liang J, Zhan Y
J Digit Imaging · 2023 Dec · PMID 37714969 · Full text
Histological assessment of skeletal muscle slices is very important for the accurate evaluation of weightless muscle atrophy. The accurate identification and segmentation of muscle fiber boundary is an important prerequi...
Histological assessment of skeletal muscle slices is very important for the accurate evaluation of weightless muscle atrophy. The accurate identification and segmentation of muscle fiber boundary is an important prerequisite for the evaluation of skeletal muscle fiber atrophy. However, there are many challenges to segment muscle fiber from immunofluorescence images, including the presence of low contrast in fiber boundaries in immunofluorescence images and the influence of background noise. Due to the limitations of traditional convolutional neural network-based segmentation methods in capturing global information, they cannot achieve ideal segmentation results. In this paper, we propose a muscle fiber segmentation network (MF-Net) method for effective segmentation of macaque muscle fibers in immunofluorescence images. The network adopts a dual encoder branch composed of convolutional neural networks and transformer to effectively capture local and global feature information in the immunofluorescence image, highlight foreground features, and suppress irrelevant background noise. In addition, a low-level feature decoder module is proposed to capture more global context information by combining different image scales to supplement the missing detail pixels. In this study, a comprehensive experiment was carried out on the immunofluorescence datasets of six macaques' weightlessness models and compared with the state-of-the-art deep learning model. It is proved from five segmentation indices that the proposed automatic segmentation method can be accurately and effectively applied to muscle fiber segmentation in shank immunofluorescence images.
Pulmonary Surface Irregularity Score as a New Quantitative CT Marker for Idiopathic Pulmonary Fibrosis-a Pilot Study.
Elkassem AMA, Mresh R, Farag A … +4 more , Rothenberg S, Lirette ST, Smith AD, Kulkarni T
J Digit Imaging · 2023 Dec · PMID 37670182 · Full text
The purpose of this study is to evaluate the accuracy and inter-observer agreement of a quantitative pulmonary surface irregularity (PSI) score on high-resolution chest CT (HRCT) for predicting transplant-free survival i...
The purpose of this study is to evaluate the accuracy and inter-observer agreement of a quantitative pulmonary surface irregularity (PSI) score on high-resolution chest CT (HRCT) for predicting transplant-free survival in patients with IPF. For this IRB-approved HIPAA-compliant retrospective single-center study, adult patients with IPF and HRCT imaging (N = 50) and an age- and gender-matched negative control group with normal HRCT imaging (N = 50) were identified. Four independent readers measured the PSI score in the midlungs on HRCT images using dedicated software while blinded to clinical data. A t-test was used to compare the PSI scores between negative control and IPF cohorts. In the IPF cohort, multivariate cox regression analysis was used to associate PSI score and clinical parameters with transplant-free survival. Inter-observer agreement for the PSI score was assessed by intraclass correlation coefficient (ICC). The technical failure rate of the midlung PSI score was 0% (0/100). The mean PSI score of 5.38 in the IPF cohort was significantly higher than 3.14 in the negative control cohort (p < .001). In the IPF cohort, patients with a high PSI score (≥ median) were 8 times more likely to die than patients with a low PSI score (HR: 8.36; 95%CI: 2.91-24.03; p < .001). In a multivariate model including age, gender, FVC, DLCO, and PSI score, only the PSI score was associated with transplant-free survival (HR:2.11 per unit increase; 95%CI: 0.26-3.51; p = .004). Inter-observer agreement for the PSI score among 4 readers was good (ICC: 0.88; 95%CI: 0.84-0.91). The PSI score had high accuracy and good inter-observer agreement on HRCT for predicting transplant-free survival in patients with IPF.
Deep Transfer Learning-Based Approach for Glucose Transporter-1 (GLUT1) Expression Assessment.
Al Zorgani MM, Ugail H, Pors K … +1 more , Dauda AM
J Digit Imaging · 2023 Dec · PMID 37670181 · Full text
Glucose transporter-1 (GLUT-1) expression level is a biomarker of tumour hypoxia condition in immunohistochemistry (IHC)-stained images. Thus, the GLUT-1 scoring is a routine procedure currently employed for predicting t...
Glucose transporter-1 (GLUT-1) expression level is a biomarker of tumour hypoxia condition in immunohistochemistry (IHC)-stained images. Thus, the GLUT-1 scoring is a routine procedure currently employed for predicting tumour hypoxia markers in clinical practice. However, visual assessment of GLUT-1 scores is subjective and consequently prone to inter-pathologist variability. Therefore, this study proposes an automated method for assessing GLUT-1 scores in IHC colorectal carcinoma images. For this purpose, we leverage deep transfer learning methodologies for evaluating the performance of six different pre-trained convolutional neural network (CNN) architectures: AlexNet, VGG16, GoogleNet, ResNet50, DenseNet-201 and ShuffleNet. The target CNNs are fine-tuned as classifiers or adapted as feature extractors with support vector machine (SVM) to classify GLUT-1 scores in IHC images. Our experimental results show that the winning model is the trained SVM classifier on the extracted deep features fusion Feat-Concat from DenseNet201, ResNet50 and GoogLeNet extractors. It yields the highest prediction accuracy of 98.86%, thus outperforming the other classifiers on our dataset. We also conclude, from comparing the methodologies, that the off-the-shelf feature extraction is better than the fine-tuning model in terms of time and resources required for training.
Enhancing Caries Detection in Bitewing Radiographs Using YOLOv7.
Panyarak W, Wantanajittikul K, Charuakkra A … +2 more , Prapayasatok S, Suttapak W
J Digit Imaging · 2023 Dec · PMID 37640971 · Full text
The study aimed to evaluate the impact of image size, area of detection (IoU) thresholds and confidence thresholds on the performance of the YOLO models in the detection of dental caries in bitewing radiographs. A total...
The study aimed to evaluate the impact of image size, area of detection (IoU) thresholds and confidence thresholds on the performance of the YOLO models in the detection of dental caries in bitewing radiographs. A total of 2575 bitewing radiographs were annotated with seven classes according to the ICCMS radiographic scoring system. YOLOv3 and YOLOv7 models were employed with different configurations, and their performances were evaluated based on precision, recall, F1-score and mean average precision (mAP). Results showed that YOLOv7 with 640 × 640 pixel images exhibited significantly superior performance compared to YOLOv3 in terms of precision (0.557 vs. 0.268), F1-score (0.555 vs. 0.375) and mAP (0.562 vs. 0.458), while the recall was significantly lower (0.552 vs. 0.697). The following experiment found that the overall mAPs did not significantly differ between 640 × 640 pixel and 1280 × 1280 pixel images, for YOLOv7 with an IoU of 50% and a confidence threshold of 0.001 (p = 0.866). The last experiment revealed that the precision significantly increased from 0.570 to 0.593 for YOLOv7 with an IoU of 75% and a confidence threshold of 0.5, but the mean-recall significantly decreased and led to lower mAPs in both IoUs. In conclusion, YOLOv7 outperformed YOLOv3 in caries detection and increasing the image size did not enhance the model's performance. Elevating the IoU from 50% to 75% and confidence threshold from 0.001 to 0.5 led to a reduction of the model's performance, while simultaneously improving precision and reducing recall (minimizing false positives and negatives) for carious lesion detection in bitewing radiographs.
Improving Image Classification of Knee Radiographs: An Automated Image Labeling Approach.
Zhang J, Santos C, Park C … +2 more , Mazurowski MA, Colglazier R
J Digit Imaging · 2023 Dec · PMID 37620710 · Full text
Large numbers of radiographic images are available in musculoskeletal radiology practices which could be used for training of deep learning models for diagnosis of knee abnormalities. However, those images do not typical...
Large numbers of radiographic images are available in musculoskeletal radiology practices which could be used for training of deep learning models for diagnosis of knee abnormalities. However, those images do not typically contain readily available labels due to limitations of human annotations. The purpose of our study was to develop an automated labeling approach that improves the image classification model to distinguish normal knee images from those with abnormalities or prior arthroplasty. The automated labeler was trained on a small set of labeled data to automatically label a much larger set of unlabeled data, further improving the image classification performance for knee radiographic diagnosis. We used BioBERT and EfficientNet as the feature extraction backbone of the labeler and imaging model, respectively. We developed our approach using 7382 patients and validated it on a separate set of 637 patients. The final image classification model, trained using both manually labeled and pseudo-labeled data, had the higher weighted average AUC (WA-AUC 0.903) value and higher AUC values among all classes (normal AUC 0.894; abnormal AUC 0.896, arthroplasty AUC 0.990) compared to the baseline model (WA-AUC = 0.857; normal AUC 0.842; abnormal AUC 0.848, arthroplasty AUC 0.987), trained using only manually labeled data. Statistical tests show that the improvement is significant on normal (p value < 0.002), abnormal (p value < 0.001), and WA-AUC (p value = 0.001). Our findings demonstrated that the proposed automated labeling approach significantly improves the performance of image classification for radiographic knee diagnosis, allowing for facilitating patient care and curation of large knee datasets.
Assessing Available Open-Source PACS Options.
Ghaderi H, April A
J Digit Imaging · 2023 Dec · PMID 37610466 · Full text
Medical imaging technology is producing a growing number of medical images types as well as patient-related information. The benefits of using modern medical imaging systems in healthcare are undeniable. Picture archivin...
Medical imaging technology is producing a growing number of medical images types as well as patient-related information. The benefits of using modern medical imaging systems in healthcare are undeniable. Picture archiving and communication system (PACS) have revolutionized medical imaging practice. PACS have widely impacted the accessibility of medical images, reduced imaging costs, eliminated the physical storage of films, improved time management of radiologists, and allowed automated decision-making and diagnosis. Many health organizations and manufacturers have invested on developing commercial PACS. However, commercial PACS are not affordable for all hospitals while open-source PACS are increasingly becoming a viable option. Our research project is looking for an open-source PACS for the Donka University hospital of Guinea. Open-source PACS are currently available and are offering varying functionalities, documentation, and technical support from their developer communities. Selecting an open-source PACS is not an easy task and not only depends on the hospital requirements but also requires assessing each open-source PACS to find the best match. In this paper, the most popular open-source PACS are evaluated using a simple comparison approach based on four criteria. The result of this assessment shows that Orthanc, DCM4CHE, DCMTK, and Dicoogle are the most mature open-source PACS according to our criteria and the needs of Donka.
A Deep Learning Image Reconstruction Algorithm for Improving Image Quality and Hepatic Lesion Detectability in Abdominal Dual-Energy Computed Tomography: Preliminary Results.
Chu B, Gan L, Shen Y … +4 more , Song J, Liu L, Li J, Liu B
J Digit Imaging · 2023 Dec · PMID 37580484 · Full text
This study aimed to compare the performance of deep learning image reconstruction (DLIR) and adaptive statistical iterative reconstruction-Veo (ASIR-V) in improving image quality and diagnostic performance using virtual...
This study aimed to compare the performance of deep learning image reconstruction (DLIR) and adaptive statistical iterative reconstruction-Veo (ASIR-V) in improving image quality and diagnostic performance using virtual monochromatic spectral images in abdominal dual-energy computed tomography (DECT). Sixty-two patients [mean age ± standard deviation (SD): 56 years ± 13; 30 men] who underwent abdominal DECT were prospectively included in this study. The 70-keV DECT images in the portal phase were reconstructed at 5-mm and 1.25-mm slice thicknesses with 40% ASIR-V (ASIR-V40%) and at 1.25-mm slice with deep learning image reconstruction at medium (DLIR-M) and high (DLIR-H) levels and then compared. Computed tomography (CT) attenuation, SD values, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured in the liver, spleen, erector spinae, and intramuscular fat. The lesions in each reconstruction group at 1.25-mm slice thickness were counted. The image quality and diagnostic confidence were subjectively evaluated by two radiologists using a 5-point scale. For the 1.25-mm images, DLIR-M and DLIR-H had lower SD, higher SNR and CNR, and better subjective image quality compared with ASIR-V40%; DLIR-H performed the best (all P values < 0.001). Furthermore, the 1.25-mm DLIR-H images had similar SD, SNR, and CNR values as the 5-mm ASIR-V40% images (all P > 0.05). Three image groups had similar lesion detection rates, but DLIR groups exhibited higher confidence in diagnosing lesions. Compared with ASIR-V40% at 70 keV, 70-keV DECT with DLIR-H further reduced image noise and improved image quality. Additionally, it improved diagnostic confidence while ensuring a consistent lesion detection rate of liver lesions.
Improving the Efficacy of ACR TI-RADS Through Deep Learning-Based Descriptor Augmentation.
Barinov L, Jairaj A, Middleton WD … +7 more , D M, Beland, Kirsch J, Filice RW, Reverter JL, Arguelles I, Grant EG
J Digit Imaging · 2023 Dec · PMID 37580483 · Full text
Thyroid nodules occur in up to 68% of people, 95% of which are benign. Of the 5% of malignant nodules, many would not result in symptoms or death, yet 600,000 FNAs are still performed annually, with a PPV of 5-7% (up to...
Thyroid nodules occur in up to 68% of people, 95% of which are benign. Of the 5% of malignant nodules, many would not result in symptoms or death, yet 600,000 FNAs are still performed annually, with a PPV of 5-7% (up to 30%). Artificial intelligence (AI) systems have the capacity to improve diagnostic accuracy and workflow efficiency when integrated into clinical decision pathways. Previous studies have evaluated AI systems against physicians, whereas we aim to compare the benefits of incorporating AI into their final diagnostic decision. This work analyzed the potential for artificial intelligence (AI)-based decision support systems to improve physician accuracy, variability, and efficiency. The decision support system (DSS) assessed was Koios DS, which provides automated sonographic nodule descriptor predictions and a direct cancer risk assessment aligned to ACR TI-RADS. The study was conducted retrospectively between (08/2020) and (10/2020). The set of cases used included 650 patients (21% male, 79% female) of age 53 ± 15. Fifteen physicians assessed each of the cases in the set, both unassisted and aided by the DSS. The order of the reading condition was randomized, and reading blocks were separated by a period of 4 weeks. The system's impact on reader accuracy was measured by comparing the area under the ROC curve (AUC), sensitivity, and specificity of readers with and without the DSS with FNA as ground truth. The impact on reader variability was evaluated using Pearson's correlation coefficient. The impact on efficiency was determined by comparing the average time per read. There was a statistically significant increase in average AUC of 0.083 [0.066, 0.099] and an increase in sensitivity and specificity of 8.4% [5.4%, 11.3%] and 14% [12.5%, 15.5%], respectively, when aided by Koios DS. The average time per case decreased by 23.6% (p = 0.00017), and the observed Pearson's correlation coefficient increased from r = 0.622 to r = 0.876 when aided by Koios DS. These results indicate that providing physicians with automated clinical decision support significantly improved diagnostic accuracy, as measured by AUC, sensitivity, and specificity, and reduced inter-reader variability and interpretation times.
Diagnostic Value of MRI Features in Dual-phenotype Hepatocellular Carcinoma: A Preliminary Study.
Gu HX, Huang XS, Xu JX … +3 more , Zhu P, Xu JF, Fan SF
J Digit Imaging · 2023 Dec · PMID 37578576 · Full text
This study aimed to explore the magnetic resonance imaging (MRI) features of dual-phenotype hepatocellular carcinoma (DPHCC) and their diagnostic value.The data of 208 patients with primary liver cancer were retrospectiv...
This study aimed to explore the magnetic resonance imaging (MRI) features of dual-phenotype hepatocellular carcinoma (DPHCC) and their diagnostic value.The data of 208 patients with primary liver cancer were retrospectively analysed between January 2016 and June 2021. Based on the pathological diagnostic criteria, 27 patients were classified into the DPHCC group, 113 patients into the noncholangiocyte-phenotype hepatocellular carcinoma (NCPHCC) group, and 68 patients with intrahepatic cholangiocarcinoma (ICC) were classified into the ICC group. Two abdominal radiologists reviewed the preoperative MRI features by a double-blind method. The MRI features and key laboratory and clinical indicators were compared between the groups. The potentially valuable MRI features and key laboratory and clinical characteristics for predicting DPHCC were identified by univariate and multivariate analyses, and the odds ratios (ORs) were recorded. In multivariate analysis, tumour without capsule (P = 0.046, OR = 9.777), dynamic persistent enhancement (P = 0.006, OR = 46.941), and targetoid appearance on diffusion-weighted imaging (DWI) (P = 0.021, OR = 30.566) were independently significant factors in the detection of DPHCC compared to NCPHCC. Serum alpha-fetoprotein (AFP) > 20 µg/L (P = 0.036, OR = 67.097) and prevalence of hepatitis B virus (HBV) infection (P = 0.020, OR = 153.633) were independent significant factors in predicting DPHCC compared to ICC. The differences in other tumour marker levels and imaging features between the groups were not significant. In MR enhanced and diffusion imaging, tumour without capsule, persistent enhancement and DWI targetoid findings, combined with AFP > 20 µg/L and HBV infection-positive laboratory results, can help to diagnose DPHCC and differentiate it from NCPHCC and ICC. These results suggest that clinical, laboratory and MRI features should be integrated to construct an AI diagnostic model for DPHCC.
Are the Pilots Onboard? Equipping Radiologists for Clinical Implementation of AI.
Shafique U, Chaudhry US, Towbin AJ
J Digit Imaging · 2023 Dec · PMID 37556028 · Full text
The incorporation of artificial intelligence into radiological clinical workflow is on the verge of being realized. To ensure that these tools are effective, measures must be taken to educate radiologists on tool perform...
The incorporation of artificial intelligence into radiological clinical workflow is on the verge of being realized. To ensure that these tools are effective, measures must be taken to educate radiologists on tool performance and failure modes. Additionally, radiology systems should be designed to avoid automation bias and the potential decline in radiologist performance. Designed solutions should cater to every level of expertise so that patient care can be enhanced and risks reduced. Ultimately, the radiology community must provide education so that radiologists can learn about algorithms, their inputs and outputs, and potential ways they may fail. This manuscript will present suggestions on how to train radiologists to use these new digital systems, how to detect AI errors, and how to maintain underlying diagnostic competency when the algorithm fails.
CT-based Radiogenomics Framework for COVID-19 Using ACE2 Imaging Representations.
Xia T, Fu X, Fulham M … +3 more , Wang Y, Feng D, Kim J
J Digit Imaging · 2023 Dec · PMID 37553526 · Full text
Coronavirus disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 which enters the body via the angiotensin-converting enzyme 2 (ACE2) and altering its gene expression. Altered ACE2 plays a...
Coronavirus disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 which enters the body via the angiotensin-converting enzyme 2 (ACE2) and altering its gene expression. Altered ACE2 plays a crucial role in the pathogenesis of COVID-19. Gene expression profiling, however, is invasive and costly, and is not routinely performed. In contrast, medical imaging such as computed tomography (CT) captures imaging features that depict abnormalities, and it is widely available. Computerized quantification of image features has enabled 'radiogenomics', a research discipline that identifies image features that are associated with molecular characteristics. Radiogenomics between ACE2 and COVID-19 has yet to be done primarily due to the lack of ACE2 expression data among COVID-19 patients. Similar to COVID-19, patients with lung adenocarcinoma (LUAD) exhibit altered ACE2 expression and, LUAD data are abundant. We present a radiogenomics framework to derive image features (ACE2-RGF) associated with ACE2 expression data from LUAD. The ACE2-RGF was then used as a surrogate biomarker for ACE2 expression. We adopted conventional feature selection techniques including ElasticNet and LASSO. Our results show that: i) the ACE2-RGF encoded a distinct collection of image features when compared to conventional techniques, ii) the ACE2-RGF can classify COVID-19 from normal subjects with a comparable performance to conventional feature selection techniques with an AUC of 0.92, iii) ACE2-RGF can effectively identify patients with critical illness with an AUC of 0.85. These findings provide unique insights for automated COVID-19 analysis and future research.
Applicability Evaluation of Full-Reference Image Quality Assessment Methods for Computed Tomography Images.
Ohashi K, Nagatani Y, Yoshigoe M … +6 more , Iwai K, Tsuchiya K, Hino A, Kida Y, Yamazaki A, Ishida T
J Digit Imaging · 2023 Dec · PMID 37550519 · Full text
Image quality assessments (IQA) are an important task for providing appropriate medical care. Full-reference IQA (FR-IQA) methods, such as peak signal-to-noise ratio (PSNR) and structural similarity (SSIM), are often use...
Image quality assessments (IQA) are an important task for providing appropriate medical care. Full-reference IQA (FR-IQA) methods, such as peak signal-to-noise ratio (PSNR) and structural similarity (SSIM), are often used to evaluate imaging conditions, reconstruction conditions, and image processing algorithms, including noise reduction and super-resolution technology. However, these IQA methods may be inapplicable for medical images because they were designed for natural images. Therefore, this study aimed to investigate the correlation between objective assessment by some FR-IQA methods and human subjective assessment for computed tomography (CT) images. For evaluation, 210 distorted images were created from six original images using two types of degradation: noise and blur. We employed nine widely used FR-IQA methods for natural images: PSNR, SSIM, feature similarity (FSIM), information fidelity criterion (IFC), visual information fidelity (VIF), noise quality measure (NQM), visual signal-to-noise ratio (VSNR), multi-scale SSIM (MSSSIM), and information content-weighted SSIM (IWSSIM). Six observers performed subjective assessments using the double stimulus continuous quality scale (DSCQS) method. The performance of IQA methods was quantified using Pearson's linear correlation coefficient (PLCC), Spearman rank order correlation coefficient (SROCC), and root-mean-square error (RMSE). Nine FR-IQA methods developed for natural images were all strongly correlated with the subjective assessment (PLCC and SROCC > 0.8), indicating that these methods can apply to CT images. Particularly, VIF had the best values for all three items, PLCC, SROCC, and RMSE. These results suggest that VIF provides the most accurate alternative measure to subjective assessments for CT images.
PFP-HOG: Pyramid and Fixed-Size Patch-Based HOG Technique for Automated Brain Abnormality Classification with MRI.
Kaplan E, Chan WY, Altinsoy HB … +6 more , Baygin M, Barua PD, Chakraborty S, Dogan S, Tuncer T, Acharya UR
J Digit Imaging · 2023 Dec · PMID 37537514 · Full text
Detecting neurological abnormalities such as brain tumors and Alzheimer's disease (AD) using magnetic resonance imaging (MRI) images is an important research topic in the literature. Numerous machine learning models have...
Detecting neurological abnormalities such as brain tumors and Alzheimer's disease (AD) using magnetic resonance imaging (MRI) images is an important research topic in the literature. Numerous machine learning models have been used to detect brain abnormalities accurately. This study addresses the problem of detecting neurological abnormalities in MRI. The motivation behind this problem lies in the need for accurate and efficient methods to assist neurologists in the diagnosis of these disorders. In addition, many deep learning techniques have been applied to MRI to develop accurate brain abnormality detection models, but these networks have high time complexity. Hence, a novel hand-modeled feature-based learning network is presented to reduce the time complexity and obtain high classification performance. The model proposed in this work uses a new feature generation architecture named pyramid and fixed-size patch (PFP). The main aim of the proposed PFP structure is to attain high classification performance using essential feature extractors with both multilevel and local features. Furthermore, the PFP feature extractor generates low- and high-level features using a handcrafted extractor. To obtain the high discriminative feature extraction ability of the PFP, we have used histogram-oriented gradients (HOG); hence, it is named PFP-HOG. Furthermore, the iterative Chi2 (IChi2) is utilized to choose the clinically significant features. Finally, the k-nearest neighbors (kNN) with tenfold cross-validation is used for automated classification. Four MRI neurological databases (AD dataset, brain tumor dataset 1, brain tumor dataset 2, and merged dataset) have been utilized to develop our model. PFP-HOG and IChi2-based models attained 100%, 94.98%, 98.19%, and 97.80% using the AD dataset, brain tumor dataset1, brain tumor dataset 2, and merged brain MRI dataset, respectively. These findings not only provide an accurate and robust classification of various neurological disorders using MRI but also hold the potential to assist neurologists in validating manual MRI brain abnormality screening.
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