UNASSIGNED: Tuberculosis (TB) remains a significant global infectious disease, posing a considerable health threat, particularly in resource-constrained regions. Due to diverse datasets, radiologists face challenges in accurately diagnosing TB using X-ray images. This study aims to propose an innovative approach leveraging image processing techniques to enhance TB diagnostic accuracy within the automatic segmentation and classification (AuSC) framework for healthcare.
UNASSIGNED: The AuSC of detection of TB (AuSC-DTB) framework comprises several steps: image preprocessing involving resizing and median filtering, segmentation using the random walker algorithm, and feature extraction utilizing local binary pattern and histogram of gradient descriptors. The extracted features are then classified using the support vector machine classifier to distinguish between healthy and infected chest X-ray images. The effectiveness of the proposed technique was evaluated using four distinct datasets, such as Japanese Society of Radiological Technology (JSRT), Montgomery, National Library of Medicine (NLM), and Shenzhen.
UNASSIGNED: Experimental results demonstrate promising outcomes, with accuracy rates of 94%, 95%, 95%, and 93% achieved for JSRT, Montgomery, NLM, and Shenzhen datasets, respectively. Comparative analysis against recent studies indicates superior performance of the proposed hybrid approach.
UNASSIGNED: The presented hybrid approach within the AuSC framework showcases improved diagnostic accuracy for TB detection from diverse X-ray image datasets. Furthermore, this methodology holds promise for generalizing other diseases diagnosed through X-ray imaging. It can be adapted with computed tomography scans and magnetic resonance imaging images, extending its applicability in healthcare diagnostics.

UNASSIGNED: Medical imaging datasets frequently encounter a data imbalance issue, where the majority of pixels correspond to healthy regions, and the minority belong to affected regions. This uneven distribution of pixels exacerbates the challenges associated with computer-aided diagnosis. The networks trained with imbalanced data tends to exhibit bias toward majority classes, often demonstrate high precision but low sensitivity.
UNASSIGNED: We have designed a new network based on adversarial learning namely conditional contrastive generative adversarial network (CCGAN) to tackle the problem of class imbalancing in a highly imbalancing MRI dataset. The proposed model has three new components: (1) class-specific attention, (2) region rebalancing module (RRM) and supervised contrastive-based learning network (SCoLN). The class-specific attention focuses on more discriminative areas of the input representation, capturing more relevant features. The RRM promotes a more balanced distribution of features across various regions of the input representation, ensuring a more equitable segmentation process. The generator of the CCGAN learns pixel-level segmentation by receiving feedback from the SCoLN based on the true negative and true positive maps. This process ensures that final semantic segmentation not only addresses imbalanced data issues but also enhances classification accuracy.
UNASSIGNED: The proposed model has shown state-of-art-performance on five highly imbalance medical image segmentation datasets. Therefore, the suggested model holds significant potential for application in medical diagnosis, in cases characterized by highly imbalanced data distributions. The CCGAN achieved the highest scores in terms of dice similarity coefficient (DSC) on various datasets: 0.965 ± 0.012 for BUS2017, 0.896 ± 0.091 for DDTI, 0.786 ± 0.046 for LiTS MICCAI 2017, 0.712 ± 1.5 for the ATLAS dataset, and 0.877 ± 1.2 for the BRATS 2015 dataset. DeepLab-V3 follows closely, securing the second-best position with DSC scores of 0.948 ± 0.010 for BUS2017, 0.895 ± 0.014 for DDTI, 0.763 ± 0.044 for LiTS MICCAI 2017, 0.696 ± 1.1 for the ATLAS dataset, and 0.846 ± 1.4 for the BRATS 2015 dataset.

Ovarian cysts pose significant health risks including torsion, infertility, and cancer, necessitating rapid and accurate diagnosis. Ultrasonography is commonly employed for screening, yet its effectiveness is hindered by challenges like weak contrast, speckle noise, and hazy boundaries in images. This study proposes an adaptive deep learning-based segmentation technique using a database of ovarian ultrasound cyst images. A Guided Trilateral Filter (GTF) is applied for noise reduction in pre-processing. Segmentation utilizes an Adaptive Convolutional Neural Network (AdaResU-net) for precise cyst size identification and benign/malignant classification, optimized via the Wild Horse Optimization (WHO) algorithm. Objective functions Dice Loss Coefficient and Weighted Cross-Entropy are optimized to enhance segmentation accuracy. Classification of cyst types is performed using a Pyramidal Dilated Convolutional (PDC) network. The method achieves a segmentation accuracy of 98.87%, surpassing existing techniques, thereby promising improved diagnostic accuracy and patient care outcomes.

OBJECTIVE: This study aimed to train a 3D U-Net convolutional neural network (CNN) for mandible and lower dentition segmentation from cone-beam computed tomography (CBCT) scans.
METHODS: In an ambispective cross-sectional design, CBCT scans from two hospitals (2009-2019 and 2021-2022) constituted an internal dataset and external validation set, respectively. Manual segmentation informed CNN training, and evaluations employed Dice similarity coefficient (DSC) for volumetric accuracy. A blinded oral maxillofacial surgeon performed qualitative grading of CBCT scans and object meshes. Statistical analyses included independent t-tests and ANOVA tests to compare DSC across patient subgroups of gender, race, body mass index (BMI), test dataset used, age, and degree of metal artifact. Tests were powered for a minimum detectable difference in DSC of 0.025, with alpha of 0.05 and power level of 0.8.
RESULTS: 648 CBCT scans from 490 patients were included in the study. The CNN achieved high accuracy (average DSC: 0.945 internal, 0.940 external). No DSC differences were observed between test set used, gender, BMI, and race. Significant differences in DSC were identified based on age group and the degree of metal artifact. The majority (80%) of object meshes produced by both manual and automatic segmentation were rated as acceptable or higher quality.
CONCLUSIONS: We developed a model for automatic mandible and lower dentition segmentation from CBCT scans in a demographically diverse cohort including a high degree of metal artifacts. The model demonstrated good accuracy on internal and external test sets, with majority acceptable quality from a clinical grader.

Segmentation of infarcts is clinically important in ischemic stroke management and prognostication. It is unclear what role the combination of DWI, ADC, and FLAIR MRI sequences provide for deep learning in infarct segmentation. Recent technologies in model self-configuration have promised greater performance and generalizability through automated optimization. We assessed the utility of DWI, ADC, and FLAIR sequences on ischemic stroke segmentation, compared self-configuring nnU-Net models to conventional U-Net models without manual optimization, and evaluated the generalizability of results on an external clinical dataset. 3D self-configuring nnU-Net models and standard 3D U-Net models with MONAI were trained on 200 infarcts using DWI, ADC, and FLAIR sequences separately and in all combinations. Segmentation results were compared between models using paired t-test comparison on a hold-out test set of 50 cases. The highest performing model was externally validated on a clinical dataset of 50 MRIs. nnU-Net with DWI sequences attained a Dice score of 0.810 ± 0.155. There was no statistically significant difference when DWI sequences were supplemented with ADC and FLAIR images (Dice score of 0.813 ± 0.150; p = 0.15). nnU-Net models significantly outperformed standard U-Net models for all sequence combinations (p < 0.001). On the external dataset, Dice scores measured 0.704 ± 0.199 for positive cases with false positives with intracranial hemorrhage. Highly optimized neural networks such as nnU-Net provide excellent stroke segmentation even when only provided DWI images, without significant improvement from other sequences. This differs from-and significantly outperforms-standard U-Net architectures. Results translated well to the external clinical environment and provide the groundwork for optimized acute stroke segmentation on MRI.

OBJECTIVE: To determine the performance of volumetric dual energy low kV and iodine radiomic features for the differentiation of intrathoracic lymph node histopathology, and influence of contrast protocol.
METHODS: Intrathoracic lymph nodes with histopathologic correlation (neoplastic, granulomatous sarcoid, benign) within 90 days of DECT chest imaging were volumetrically segmented. 1691 volumetric radiomic features were extracted from iodine maps and low-kV images, totaling 3382 features. Univariate analysis was performed using 2-sample t-test and filtered for false discoveries. Multivariable analysis was used to compute AUCs for lymph node classification tasks.
RESULTS: 129 lymph nodes from 72 individuals (mean age 61 ± 15 years) were included, 52 neoplastic, 51 benign, and 26 granulomatous-sarcoid. Among all contrast enhanced DECT protocol exams (routine, PE and CTA), univariable analysis demonstrated no significant differences in iodine and low kV features between neoplastic and non-neoplastic lymph nodes; in the subset of neoplastic versus benign lymph nodes with routine DECT protocol, 199 features differed (p = .01- < 0.05). Multivariable analysis using both iodine and low kV features yielded AUCs >0.8 for differentiating neoplastic from non-neoplastic lymph nodes (AUC 0.86), including subsets of neoplastic from granulomatous (AUC 0.86) and neoplastic from benign (AUC 0.9) lymph nodes, among all contrast protocols.
CONCLUSIONS: Volumetric DECT radiomic features demonstrate strong collective performance in differentiation of neoplastic from non-neoplastic intrathoracic lymph nodes, and are influenced by contrast protocol.

With increasing numbers of magnetic resonance imaging (MRI) datasets becoming publicly available, researchers and clinicians alike have turned to automated methods of segmentation to enable population-level analyses of these data. Although prior research has evaluated the extent to which automated methods recapitulate \"gold standard\" manual segmentation methods in the human brain, such an evaluation has not yet been carried out for segmentation of MRIs of the macaque brain. Macaques offer the important opportunity to bridge gaps between microanatomical studies using invasive methods like tract tracing, neural recordings, and high-resolution histology and non-invasive macroanatomical studies using methods like MRI. As such, it is important to evaluate whether automated tools derive data of sufficient quality from macaque MRIs to bridge these gaps. We tested the relationship between automated registration-based segmentation using an open source and actively maintained NHP imaging analysis pipeline (AFNI) and gold standard manual segmentation of 4 structures (2 cortical: anterior cingulate cortex and insula; 2 subcortical: amygdala and caudate) across 37 rhesus macaques (Macaca mulatta). We identified some variability in the strength of correlation between automated and manual segmentations across neural regions and differences in relationships with demographic variables like age and sex between the two techniques.

To study plant organs, it is necessary to investigate the three-dimensional (3D) structures of plants. In recent years, non-destructive measurements through computed tomography (CT) have been used to understand the 3D structures of plants. In this study, we use the Chrysanthemum seticuspe capitulum inflorescence as an example and focus on contact points between the receptacles and florets within the 3D capitulum inflorescence bud structure to investigate the 3D arrangement of the florets on the receptacle. To determine the 3D order of the contact points, we constructed slice images from the CT volume data and detected the receptacles and florets in the image. However, because each CT sample comprises hundreds of slice images to be processed and each C. seticuspe capitulum inflorescence comprises several florets, manually detecting the receptacles and florets is labor-intensive. Therefore, we propose an automatic contact point detection method based on CT slice images using image recognition techniques. The proposed method improves the accuracy of contact point detection using prior knowledge that contact points exist only around the receptacle. In addition, the integration of the detection results enables the estimation of the 3D position of the contact points. According to the experimental results, we confirmed that the proposed method can detect contacts on slice images with high accuracy and estimate their 3D positions through clustering. Additionally, the sample-independent experiments showed that the proposed method achieved the same detection accuracy as sample-dependent experiments.

BACKGROUND: The volume measurement of intracerebral hemorrhage (ICH) and intraventricular hemorrhage (IVH) provides critical information for precise treatment of patients with spontaneous ICH but remains a big challenge, especially for IVH segmentation. However, the previously proposed ICH and IVH segmentation tools lack external validation and segmentation quality assessment.
OBJECTIVE: This study aimed to develop a robust deep learning model for the segmentation of ICH and IVH with external validation, and to provide quality assessment for IVH segmentation.
METHODS: In this study, a Residual Encoding Unet (REUnet) for the segmentation of ICH and IVH was developed using a dataset composed of 977 CT images (all contained ICH, and 338 contained IVH; a five-fold cross-validation procedure was adopted for training and internal validation), and externally tested using an independent dataset consisting of 375 CT images (all contained ICH, and 105 contained IVH). The performance of REUnet was compared with six other advanced deep learning models. Subsequently, three approaches, including Prototype Segmentation (ProtoSeg), Test Time Dropout (TTD), and Test Time Augmentation (TTA), were employed to derive segmentation quality scores in the absence of ground truth to provide a way to assess the segmentation quality in real practice.
RESULTS: For ICH segmentation, the median (lower-quantile-upper quantile) of Dice scores obtained from REUnet were 0.932 (0.898-0.953) for internal validation and 0.888 (0.859-0.916) for external test, both of which were better than those of other models while comparable to that of nnUnet3D in external test. For IVH segmentation, the Dice scores obtained from REUnet were 0.826 (0.757-0.868) for internal validation and 0.777 (0.693-0.827) for external tests, which were better than those of all other models. The concordance correlation coefficients between the volumes estimated from the REUnet-generated segmentations and those from the manual segmentations for both ICH and IVH ranged from 0.944 to 0.987. For IVH segmentation quality assessment, the segmentation quality score derived from ProtoSeg was correlated with the Dice Score (Spearman r = 0.752 for the external test) and performed better than those from TTD (Spearman r = 0.718) and TTA (Spearman r = 0.260) in the external test. By setting a threshold to the segmentation quality score, we were able to identify low-quality IVH segmentation results by ProtoSeg.
CONCLUSIONS: The proposed REUnet offers a promising tool for accurate and automated segmentation of ICH and IVH, and for effective IVH segmentation quality assessment, and thus exhibits the potential to facilitate therapeutic decision-making for patients with spontaneous ICH in clinical practice.

UNASSIGNED: Accurate and automated segmentation of targets and organs-at-risk (OARs) is crucial for the successful clinical application of online adaptive radiotherapy (ART). Current methods for cone-beam computed tomography (CBCT) auto-segmentation face challenges, resulting in segmentations often failing to reach clinical acceptability. Current approaches for CBCT auto-segmentation overlook the wealth of information available from initial planning and prior adaptive fractions that could enhance segmentation precision.
UNASSIGNED: We introduce a novel framework that incorporates data from a patient\'s initial plan and previous adaptive fractions, harnessing this additional temporal context to significantly refine the segmentation accuracy for the current fraction\'s CBCT images. We present LSTM-UNet, an innovative architecture that integrates Long Short-Term Memory (LSTM) units into the skip connections of the traditional U-Net framework to retain information from previous fractions. The models underwent initial pre-training with simulated data followed by fine-tuning on a clinical dataset.
UNASSIGNED: Our proposed model\'s segmentation predictions yield an average Dice similarity coefficient of 79% from 8 Head & Neck organs and targets, compared to 52% from a baseline model without prior knowledge and 78% from a baseline model with prior knowledge but no memory.
UNASSIGNED: Our proposed model excels beyond baseline segmentation frameworks by effectively utilizing information from prior fractions, thus reducing the effort of clinicians to revise the auto-segmentation results. Moreover, it works together with registration-based methods that offer better prior knowledge. Our model holds promise for integration into the online ART workflow, offering precise segmentation capabilities on synthetic CT images.