Recent advances in foundation models have revolutionized model development in digital pathology, reducing dependence on extensive manual annotations required by traditional methods. The ability of foundation models to generalize well with few-shot learning addresses critical barriers in adapting models to diverse medical imaging tasks. This work presents the Granular Box Prompt Segment Anything Model (GB-SAM), an improved version of the Segment Anything Model (SAM) fine-tuned using granular box prompts with limited training data. The GB-SAM aims to reduce the dependency on expert pathologist annotators by enhancing the efficiency of the automated annotation process. Granular box prompts are small box regions derived from ground truth masks, conceived to replace the conventional approach of using a single large box covering the entire H&E-stained image patch. This method allows a localized and detailed analysis of gland morphology, enhancing the segmentation accuracy of individual glands and reducing the ambiguity that larger boxes might introduce in morphologically complex regions. We compared the performance of our GB-SAM model against U-Net trained on different sizes of the CRAG dataset. We evaluated the models across histopathological datasets, including CRAG, GlaS, and Camelyon16. GB-SAM consistently outperformed U-Net, with reduced training data, showing less segmentation performance degradation. Specifically, on the CRAG dataset, GB-SAM achieved a Dice coefficient of 0.885 compared to U-Net\'s 0.857 when trained on 25% of the data. Additionally, GB-SAM demonstrated segmentation stability on the CRAG testing dataset and superior generalization across unseen datasets, including challenging lymph node segmentation in Camelyon16, which achieved a Dice coefficient of 0.740 versus U-Net\'s 0.491. Furthermore, compared to SAM-Path and Med-SAM, GB-SAM showed competitive performance. GB-SAM achieved a Dice score of 0.900 on the CRAG dataset, while SAM-Path achieved 0.884. On the GlaS dataset, Med-SAM reported a Dice score of 0.956, whereas GB-SAM achieved 0.885 with significantly less training data. These results highlight GB-SAM\'s advanced segmentation capabilities and reduced dependency on large datasets, indicating its potential for practical deployment in digital pathology, particularly in settings with limited annotated datasets.

BACKGROUND: Bladder cancer (BC) segmentation on MRI images is the first step to determining the presence of muscular invasion. This study aimed to assess the tumor segmentation performance of three deep learning (DL) models on multi-parametric MRI (mp-MRI) images.
METHODS: We studied 53 patients with bladder cancer. Bladder tumors were segmented on each slice of T2-weighted (T2WI), diffusion-weighted imaging/apparent diffusion coefficient (DWI/ADC), and T1-weighted contrast-enhanced (T1WI) images acquired at a 3Tesla MRI scanner. We trained Unet, MAnet, and PSPnet using three loss functions: cross-entropy (CE), dice similarity coefficient loss (DSC), and focal loss (FL). We evaluated the model performances using DSC, Hausdorff distance (HD), and expected calibration error (ECE).
RESULTS: The MAnet algorithm with the CE+DSC loss function gave the highest DSC values on the ADC, T2WI, and T1WI images. PSPnet with CE+DSC obtained the smallest HDs on the ADC, T2WI, and T1WI images. The segmentation accuracy overall was better on the ADC and T1WI than on the T2WI. The ECEs were the smallest for PSPnet with FL on the ADC images, while they were the smallest for MAnet with CE+DSC on the T2WI and T1WI.
CONCLUSIONS: Compared to Unet, MAnet and PSPnet with a hybrid CE+DSC loss function displayed better performances in BC segmentation depending on the choice of the evaluation metric.

Gastric cancer (GC) is a significant healthcare concern, and the identification of high-risk patients is crucial. Indeed, gastric precancerous conditions present significant diagnostic challenges, particularly early intestinal metaplasia (IM) detection. This study developed a deep learning system to assist in IM detection using image patches from gastric corpus examined using virtual chromoendoscopy in a Western country. Utilizing a retrospective dataset of endoscopic images from Sant\'Andrea University Hospital of Rome, collected between January 2020 and December 2023, the system extracted 200 × 200 pixel patches, classifying them with a voting scheme. The specificity and sensitivity on the patch test set were 76% and 72%, respectively. The optimization of a learnable voting scheme on a validation set achieved a specificity of 70% and sensitivity of 100% for entire images. Despite data limitations and the absence of pre-trained models, the system shows promising results for preliminary screening in gastric precancerous condition diagnostics, providing an explainable and robust Artificial Intelligence approach.

OBJECTIVE: Segmentation of the femur in Dual-Energy X-ray (DXA) images poses challenges due to reduced contrast, noise, bone shape variations, and inconsistent X-ray beam penetration. In this study, we investigate the relationship between noise and certain deep learning (DL) techniques for semantic segmentation of the femur to enhance segmentation and bone mineral density (BMD) accuracy by incorporating noise reduction methods into DL models.
METHODS: Convolutional neural network (CNN)-based models were employed to segment femurs in DXA images and evaluate the effects of noise reduction filters on segmentation accuracy and their effect on BMD calculation. Various noise reduction techniques were integrated into DL-based models to enhance image quality before training. We assessed the performance of the fully convolutional neural network (FCNN) in comparison to noise reduction algorithms and manual segmentation methods.
RESULTS: Our study demonstrated that the FCNN outperformed noise reduction algorithms in enhancing segmentation accuracy and enabling precise calculation of BMD. The FCNN-based segmentation approach achieved a segmentation accuracy of 98.84% and a correlation coefficient of 0.9928 for BMD measurements, indicating its effectiveness in the clinical diagnosis of osteoporosis.
CONCLUSIONS: In conclusion, integrating noise reduction techniques into DL-based models significantly improves femur segmentation accuracy in DXA images. The FCNN model, in particular, shows promising results in enhancing BMD calculation and clinical diagnosis of osteoporosis. These findings highlight the potential of DL techniques in addressing segmentation challenges and improving diagnostic accuracy in medical imaging.

Acute lymphoblastic leukemia, commonly referred to as ALL, is a type of cancer that can affect both the blood and the bone marrow. The process of diagnosis is a difficult one since it often calls for specialist testing, such as blood tests, bone marrow aspiration, and biopsy, all of which are highly time-consuming and expensive. It is essential to obtain an early diagnosis of ALL in order to start therapy in a timely and suitable manner. In recent medical diagnostics, substantial progress has been achieved through the integration of artificial intelligence (AI) and Internet of Things (IoT) devices. Our proposal introduces a new AI-based Internet of Medical Things (IoMT) framework designed to automatically identify leukemia from peripheral blood smear (PBS) images. In this study, we present a novel deep learning-based fusion model to detect ALL types of leukemia. The system seamlessly delivers the diagnostic reports to the centralized database, inclusive of patient-specific devices. After collecting blood samples from the hospital, the PBS images are transmitted to the cloud server through a WiFi-enabled microscopic device. In the cloud server, a new fusion model that is capable of classifying ALL from PBS images is configured. The fusion model is trained using a dataset including 6512 original and segmented images from 89 individuals. Two input channels are used for the purpose of feature extraction in the fusion model. These channels include both the original and the segmented images. VGG16 is responsible for extracting features from the original images, whereas DenseNet-121 is responsible for extracting features from the segmented images. The two output features are merged together, and dense layers are used for the categorization of leukemia. The fusion model that has been suggested obtains an accuracy of 99.89%, a precision of 99.80%, and a recall of 99.72%, which places it in an excellent position for the categorization of leukemia. The proposed model outperformed several state-of-the-art Convolutional Neural Network (CNN) models in terms of performance. Consequently, this proposed model has the potential to save lives and effort. For a more comprehensive simulation of the entire methodology, a web application (Beta Version) has been developed in this study. This application is designed to determine the presence or absence of leukemia in individuals. The findings of this study hold significant potential for application in biomedical research, particularly in enhancing the accuracy of computer-aided leukemia detection.

This paper presents a novel segmentation algorithm specially developed for applications in 3D point clouds with high variability and noise, particularly suitable for heritage building 3D data. The method can be categorized within the segmentation procedures based on edge detection. In addition, it uses a graph-based topological structure generated from the supervoxelization of the 3D point clouds, which is used to make the closure of the edge points and to define the different segments. The algorithm provides a valuable tool for generating results that can be used in subsequent classification tasks and broader computer applications dealing with 3D point clouds. One of the characteristics of this segmentation method is that it is unsupervised, which makes it particularly advantageous for heritage applications where labelled data is scarce. It is also easily adaptable to different edge point detection and supervoxelization algorithms. Finally, the results show that the 3D data can be segmented into different architectural elements, which is important for further classification or recognition. Extensive testing on real data from historic buildings demonstrated the effectiveness of the method. The results show superior performance compared to three other segmentation methods, both globally and in the segmentation of planar and curved zones of historic buildings.

Brain stroke, or a cerebrovascular accident, is a devastating medical condition that disrupts the blood supply to the brain, depriving it of oxygen and nutrients. Each year, according to the World Health Organization, 15 million people worldwide experience a stroke. This results in approximately 5 million deaths and another 5 million individuals suffering permanent disabilities. The complex interplay of various risk factors highlights the urgent need for sophisticated analytical methods to more accurately predict stroke risks and manage their outcomes. Machine learning and deep learning technologies offer promising solutions by analyzing extensive datasets including patient demographics, health records, and lifestyle choices to uncover patterns and predictors not easily discernible by humans. These technologies enable advanced data processing, analysis, and fusion techniques for a comprehensive health assessment. We conducted a comprehensive review of 25 review papers published between 2020 and 2024 on machine learning and deep learning applications in brain stroke diagnosis, focusing on classification, segmentation, and object detection. Furthermore, all these reviews explore the performance evaluation and validation of advanced sensor systems in these areas, enhancing predictive health monitoring and personalized care recommendations. Moreover, we also provide a collection of the most relevant datasets used in brain stroke analysis. The selection of the papers was conducted according to PRISMA guidelines. Furthermore, this review critically examines each domain, identifies current challenges, and proposes future research directions, emphasizing the potential of AI methods in transforming health monitoring and patient care.

A point cloud is a representation of objects or scenes utilising unordered points comprising 3D positions and attributes. The ability of point clouds to mimic natural forms has gained significant attention from diverse applied fields, such as virtual reality and augmented reality. However, the point cloud, especially those representing dynamic scenes or objects in motion, must be compressed efficiently due to its huge data volume. The latest video-based point cloud compression (V-PCC) standard for dynamic point clouds divides the 3D point cloud into many patches using computationally expensive normal estimation, segmentation, and refinement. The patches are projected onto a 2D plane to apply existing video coding techniques. This process often results in losing proximity information and some original points. This loss induces artefacts that adversely affect user perception. The proposed method segments dynamic point clouds based on shape similarity and occlusion before patch generation. This segmentation strategy helps maintain the points\' proximity and retain more original points by exploiting the density and occlusion of the points. The experimental results establish that the proposed method significantly outperforms the V-PCC standard and other relevant methods regarding rate-distortion performance and subjective quality testing for both geometric and texture data of several benchmark video sequences.

UNASSIGNED: Brain tumor segmentation is highly contributive in diagnosing and treatment planning. Manual brain tumor delineation is a time-consuming and tedious task and varies depending on the radiologist\'s skill. Automated brain tumor segmentation is of high importance and does not depend on either inter- or intra-observation. The objective of this study is to automate the delineation of brain tumors from the Fluid-attenuated inversion recovery (FLAIR), T1-weighted (T1W), T2-weighted (T2W), and T1W contrast-enhanced (T1ce) magnetic resonance (MR) sequences through a deep learning approach, with a focus on determining which MR sequence alone or which combination thereof would lead to the highest accuracy therein.
UNASSIGNED: The BraTS-2020 challenge dataset, containing 370 subjects with four MR sequences and manually delineated tumor masks, is applied to train a residual neural network. This network is trained and assessed separately for each one of the MR sequences (single-channel input) and any combination thereof (dual- or multi-channel input).
UNASSIGNED: The quantitative assessment of the single-channel models reveals that the FLAIR sequence would yield higher segmentation accuracy compared to its counterparts with a 0.77 ± 0.10 Dice index. As to considering the dual-channel models, the model with FLAIR and T2W inputs yields a 0.80 ± 0.10 Dice index, exhibiting higher performance. The joint tumor segmentation on the entire four MR sequences yields the highest overall segmentation accuracy with a 0.82 ± 0.09 Dice index.
UNASSIGNED: The FLAIR MR sequence is considered the best choice for tumor segmentation on a single MR sequence, while the joint segmentation on the entire four MR sequences would yield higher tumor delineation accuracy.

BACKGROUND: The non-perfused volume divided by total fibroid load (NPV/TFL) is a predictive outcome parameter for MRI-guided high-intensity focused ultrasound (MR-HIFU) treatments of uterine fibroids, which is related to long-term symptom relief. In current clinical practice, the MR-HIFU outcome parameters are typically determined by visual inspection, so an automated computer-aided method could facilitate objective outcome quantification. The objective of this study was to develop and evaluate a deep learning-based segmentation algorithm for volume measurements of the uterus, uterine fibroids, and NPVs in MRI in order to automatically quantify the NPV/TFL.
METHODS: A segmentation pipeline was developed and evaluated using expert manual segmentations of MRI scans of 115 uterine fibroid patients, screened for and/or undergoing MR-HIFU treatment. The pipeline contained three separate neural networks, one per target structure. The first step in the pipeline was uterus segmentation from contrast-enhanced (CE)-T1w scans. This segmentation was subsequently used to remove non-uterus background tissue for NPV and fibroid segmentation. In the following step, NPVs were segmented from uterus-only CE-T1w scans. Finally, fibroids were segmented from uterus-only T2w scans. The segmentations were used to calculate the volume for each structure. Reliability and agreement between manual and automatic segmentations, volumes, and NPV/TFLs were assessed.
RESULTS: For treatment scans, the Dice similarity coefficients (DSC) between the manually and automatically obtained segmentations were 0.90 (uterus), 0.84 (NPV) and 0.74 (fibroid). Intraclass correlation coefficients (ICC) were 1.00 [0.99, 1.00] (uterus), 0.99 [0.98, 1.00] (NPV) and 0.98 [0.95, 0.99] (fibroid) between manually and automatically derived volumes. For manually and automatically derived NPV/TFLs, the mean difference was 5% [-41%, 51%] (ICC: 0.66 [0.32, 0.85]).
CONCLUSIONS: The algorithm presented in this study automatically calculates uterus volume, fibroid load, and NPVs, which could lead to more objective outcome quantification after MR-HIFU treatments of uterine fibroids in comparison to visual inspection. When robustness has been ascertained in a future study, this tool may eventually be employed in clinical practice to automatically measure the NPV/TFL after MR-HIFU procedures of uterine fibroids.