Hausdorff Distance Research Articles

Radiomics-guided generative adversarial network for automatic primary target volume segmentation for nasopharyngeal carcinoma using computed tomography images.

Automatic primary gross tumor volume (GTVp) segmentation for nasopharyngeal carcinoma (NPC) is a quite challenging task because of the existence of similar visual characteristics between tumors and their surroundings, especially on computed tomography (CT) images with severe low contrast resolution. Therefore, most recently proposed methods based on radiomics or deep learning (DL) is difficult to achieve good results on CT datasets. A peritumoral radiomics-guided generative adversarial network (PRG-GAN) was proposed to address this challenge. A total of 157 NPC patients with CT images was collected and divided into training, validation, and testing cohorts of 108, 9, and 30 patients, respectively. The proposed model was based on a standard GAN consisting of a generator network and a discriminator network. Morphological dilation on the initial segmentation results from GAN was first conducted to delineate annular peritumoral region, in which radiomics features were extracted as priori guide knowledge. Then, radiomics features were fused with semantic features by the discriminator's fully connected layer to achieve the voxel-level classification and segmentation. The dice similarity coefficient (DSC), 95% Hausdorff distance (HD95), and average symmetric surface distance (ASSD) were used to evaluate the segmentation performance using a paired samples t-test with Bonferroni correction and Cohen's d (d) effect sizes. A two-sided p-value of less than 0.05 was considered statistically significant. The model-generated predictions had a high overlap ratio with the ground truth. The average DSC, HD95, and ASSD were significantly improved from 0.80±0.12, 4.65±4.71mm, and 1.35±1.15mm of GAN to 0.85±0.18 (p=0.001, d=0.71), 4.15±7.56mm (p=0.002, d=0.67), and 1.11±1.65mm (p<0.001, d=0.46) of PRG-GAN, respectively. Integrating radiomics features into GAN is promising to solve unclear border limitations and increase the delineation accuracy of GTVp for patients with NPC.

TIA-UNet: transformer-enhanced deep learning for adolescent idiopathic scoliosis spinal x-ray image segmentation

Abstract Adolescent Idiopathic Scoliosis (AIS) is a common spinal deformity where precise diagnosis is crucial for developing effective treatment strategies. Traditional manual x-ray image analysis is time-consuming and highly dependent on the operator’s expertise, thus constraining diagnostic efficiency and accuracy. This study aimed to develop an automated thoracolumbar spine segmentation method utilizing deep learning to enhance the efficiency and accuracy of AIS diagnosis. We introduced TIA-UNet, an innovative network architecture that combines Convolutional Neural Networks (CNN) with Transformer models. By integrating the IR Block and DA Block, TIA-UNet was optimized for feature extraction and multi-scale information fusion. The model underwent training and validation using our established Adolescent Scoliosis Medical Dataset (ASMD). TIA-UNet attained a Dice similarity coefficient of 90. 02%, a Mean Intersection over Union (MIoU) of 81. 96%, and a Hausdorff Distance (HD) of 4. 09, significantly surpassing current state-of-the-art methods such as UNet and TransUNet. Moreover, TIA-UNet exhibited superior computational efficiency regarding parameter count, inference time, and floating-point operations (FLOPs). As an automated medical image segmentation algorithm, TIA-UNet enhanced segmentation accuracy while maintaining high computational efficiency, demonstrating significant potential for clinical diagnostic applications. This study provides compelling evidence supporting the utilization of deep learning techniques in medical image analysis.

A triplanar 2D convolutional network ensemble for infra-alveolar nerve segmentation

AbstractCone Beam Computed Tomography scan segmentation is a key step in the digital dentistry workflow. This technology is considered the gold standard for imaging in implant dentistry as well as maxillofacial and oral surgery, where extracting volumetric information is essential. However, manual segmentation is a tedious process that requires significant time and expertise. Therefore, to circumvent these issues, we have developed and present in this study a novel tool for automated nerve segmentation based on deep learning. Specifically, we build on nnU-Net’s self-configuring framework by constructing an ensemble of three 2D convolutional models that leverage information extracted from the three orthogonal planes: axial, coronal and sagittal. We tested our method by participating in the Challenge from the $$26^{th}$$ 26 th edition of the International Conference on Medical Image Computing and Computer Assisted Interventions, held in 2023, where we achieved a Dice Similarity Coefficient of 0.66 and a $$95^{th}$$ 95 th percentile Hausdorff distance of 8.63.

WGAN-based multi-structure segmentation of vertebral cross-section MRI using ResU-Net and clustered transformer

The vertebral foramen, lamina, and vertebral body are three critical components of the spine structure, essential for maintaining spinal connectivity and stability. Accurately segmenting lumbar structures such as the vertebral body, vertebral foramen, and lamina in MRI cross-sections helps doctors better understand and diagnose the pathological causes of spine-related diseases. This study presents a multi-structure semantic segmentation method for vertebral transverse section MRI slices using WGAN with a residual U-Net and clustered Transformer. The generator network was replaced with a combination of a residual U-Net and a clustered Transformer-based segmentation network. The enhanced U-Net encoder, utilizing dilated convolutions and residual structures, improved multi-scale feature extraction capabilities. Meanwhile, the clustered Transformer structure, with reduced progressive linear complexity, ensured the extraction of global positional information. The results of multiple experiments show that the Dice coefficient for vertebral body segmentation increased by 3.1%, the Hausdorff distance decreased by 0.6 mm, mIOU improved by 4.1–96.2%, and PPV increased by 2.0–98.8% compared to mainstream segmentation models. These improvements are statistically significant (p < 0.05).Ablation experiments further validated the effectiveness of the proposed enhanced modules in improving segmentation accuracy for the three target structures.

Automatic segmentation and visualization of cortical and marrow bone in mandibular condyle on CBCT: a preliminary exploration of clinical application.

To develop a deep learning-based automatic segmentation method for cortex and marrow in mandibular condyle on cone-beam computed tomography (CBCT) images and explore its clinical application. 825 condyles of 490 CBCT images from 3 centers of Stomatology hospitalaffliated to Zhejiang University School of Medicinewere collected. A deep learning model was developed for simultaneous segmentation of cortex and marrow in mandibular condyle. It included a region of interest extraction network and a segmentation network based on 3D U-net, with modifications made to improve the segmentation boundaries. To evaluate its clinical potential, the model's segmentation efficiency and accuracy were compared with those of both junior and senior oral and maxillofacial radiologists. Additionally, the model's ability to assist junior radiologists in diagnosis through visualization and quantitative analysis of the generated 3D model was also assessed. The Dice similarity coefficient of the deep learning model was 0.901 (cortex), 0.969 (marrow), and 0.982 (entire condyle). Hausdorff distance was 0.755mm (cortex), 0.826mm (marrow), and 0.760mm (entire condyle). The model outperformed radiologists across all segmentation metrics, completing the task in merely 15.06s. With the assistance of visualization and quantitative analysis generated from the model's segmentation, the diagnostic accuracy of junior radiologists significantly improved. The proposed deep learning-based model achieved accurate and efficient segmentation for mandibular condylar cortex and marrow. It possessed capability to generate precise 3D models, facilitating visual quantitative measurement and aiding in the diagnosis of condylar bony changes. This model holds potential for clinical applications in orthognathic surgery, orthodontic treatment, and other TMJ-related interventions.

Automatic delineation of cervical cancer target volumes in small samples based on multi-decoder and semi-supervised learning and clinical application

Radiotherapy has been demonstrated to be one of the most significant treatments for cervical cancer, during which accurate and efficient delineation of target volumes is critical. To alleviate the data demand of deep learning and promote the establishment and promotion of auto-segmentation models in small and medium-sized oncology departments and single centres, we proposed an auto-segmentation algorithm to determine the cervical cancer target volume in small samples based on multi-decoder and semi-supervised learning (MDSSL), and we evaluated the accuracy via an independent test cohort. In this study, we retrospectively collected computed tomography (CT) datasets from 71 pelvic cervical cancer patients, and a 3:4 ratio was used for the training and testing sets. The clinical target volumes (CTVs) of the primary tumour area (CTV1) and pelvic lymph drainage area (CTV2) were delineated. For definitive radiotherapy (dRT), the primary gross target volume (GTVp) was simultaneously delineated. According to the data characteristics for small samples, the MDSSL network structure based on 3D U-Net was established to train the model by combining clinical anatomical information, which was compared with other segmentation methods, including supervised learning (SL) and transfer learning (TL). The dice similarity coefficient (DSC), 95% Hausdorff distance (HD95) and average surface distance (ASD) were used to evaluate the segmentation performance. The ability of the segmentation algorithm to improve the efficiency of online adaptive radiation therapy (ART) was assessed via geometric indicators and a subjective evaluation of radiation oncologists (ROs) in prospective clinical applications. Compared with the SL model and TL model, the proposed MDSSL model displayed the best DSC, HD95 and ASD overall, especially for the GTVp of dRT. We calculated the above geometric indicators in the range of the ground truth (head-foot direction). In the test set, the DSC, HD95 and ASD of the MDSSL model were 0.80/5.85 mm/0.95 mm for CTV1 of post-operative radiotherapy (pRT), 0.84/ 4.88 mm/0.73 mm for CTV2 of pRT, 0.84/6.58 mm/0.89 mm for GTVp of dRT, 0.85/5.36 mm/1.35 mm for CTV1 of dRT, and 0.84/4.09 mm/0.73 mm for CTV2 of dRT, respectively. In a prospective clinical study of online ART, the target volume modification time (MTime) was 3–5 min for dRT and 2–4 min for pRT, and the main duration of CTV1 modification was approximately 2 min. The introduction of the MDSSL method successfully improved the accuracy of auto-segmentation for the cervical cancer target volume in small samples, showed good consistency with RO delineation and satisfied clinical requirements. In this prospective online ART study, the application of the segmentation model was demonstrated to be useful for reducing the target volume delineation time and improving the efficiency of the online ART workflow, which can contribute to the development and promotion of cervical cancer online ART.

Quantitative modeling of lenticulostriate arteries on 7-T TOF-MRA for cerebral small vessel disease.

We developed a framework for segmenting and modeling lenticulostriate arteries (LSAs) on 7-T time-of-flight magnetic resonance angiography and tested its performance on cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) patients and controls. We prospectively included 29 CADASIL patients and 21 controls. The framework includes a small-patch convolutional neural network (SP-CNN) for fine segmentation, a random forest for modeling LSAs, and a screening model for removing wrong branches. The segmentation performance of our SP-CNN was compared to competitive networks. External validation with different resolution was performed on ten patients with aneurysms. Dice similarity coefficient (DSC) and Hausdorff distance (HD) between each network and manual segmentation were calculated. The modeling results of the centerlines, diameters, and lengths of LSAs were compared against manual labeling by four neurologists. The SP-CNN achieved higher DSC (92.741 ± 2.789, mean ± standard deviation) and lower HD (0.610 ± 0.141 mm) in the segmentation of LSAs. It also outperformed competitive networks in the external validation (DSC 82.6 ± 5.5, HD 0.829 ± 0.143 mm). The framework versus manual difference was lower than the manual inter-observer difference for the vessel length of primary branches (median -0.040 mm, interquartile range -0.209 to 0.059 mm) and secondary branches (0.202 mm, 0.016-0.537 mm), as well as for the offset of centerlines of primary branches (0.071 mm, 0.065-0.078 mm) and secondary branches (0.072, 0.064-0.080 mm), with p < 0.001 for all comparisons. Our framework for LSAs modeling/quantification demonstrated high reliability and accuracy when compared to manual labeling. NCT05902039 ( https://clinicaltrials.gov/study/NCT05902039?cond=NCT05902039 ). The proposed automatic segmentation and modeling framework offers precise quantification of the morphological parameters of lenticulostriate arteries. This innovative technology streamlines diagnosis and research of cerebral small vessel disease, eliminating the burden of manual labeling, facilitating cohort studies and clinical diagnosis. The morphology of LSAs is important in the diagnosis of CSVD but difficult to quantify. The proposed algorithm achieved the performance equivalent to manual labeling by neurologists. Our method can provide standardized quantitative results, reducing radiologists' workload in cohort studies.

Multi-objective optimization based robotic path planning for interpolation reconstruction model of CT data

Robotic path planning plays a pivotal role in computer-aided liver tumor thermal ablation surgery. However, traditional methods face challenges in terms of low reconstruction efficiency and planning safety. To address these issues, we propose a method for robotic path planning of liver tumor thermal ablation surgery. Firstly, an interlayer interpolation algorithm based on optical flow estimation is utilized to compensate for large interlayer spacing in computed tomography (CT) images by inserting predicted images between sequence images. Secondly, the voxel traversal strategy and patch intersection calculation strategy in the standard marching cube (MC) algorithm is optimized to improve the efficiency of abdominal tissues reconstruction. Finally, comprehensive clinical constraints are summarized to ensure the surgery safety and the strength pareto evolutionary algorithm II (SPEA-II) is leveraged to optimize surgery path, which can obtain even distribution of solutions in high-dimension optimization problems. Extensive experiments conducted on the 3Dircadb and SLIVER07 datasets revealed that our proposed method reduces reconstruction time by 21.5% compared to the standard MC algorithm, while achieving an average overlap rate of 88.25% and an average Hausdorff distance of 15.25 mm between Pareto front points and surgeon's recommended puncture points.

Centerline-guided reinforcement learning model for pancreatic duct identifications.

Pancreatic ductal adenocarcinoma is forecast to become the second most significant cause of cancer mortality as the number of patients with cancer in the main duct of the pancreas grows, and measurement of the pancreatic duct diameter from medical images has been identified as relevant for its early diagnosis. We propose an automated pancreatic duct centerline tracing method from computed tomography (CT) images that is based on deep reinforcement learning, which employs an artificial agent to interact with the environment and calculates rewards by combining the distances from the target and the centerline. A deep neural network is implemented to forecast step-wise values for each potential action. With the help of this mechanism, the agent can probe along the pancreatic duct centerline using the best possible navigational path. To enhance the tracing accuracy, we employ landmark-based registration, which enables the generation of a probability map of the pancreatic duct. Subsequently, we utilize a gradient-based method on the registered data to extract a probability map specifically indicating the centerline of the pancreatic duct. Three datasets with a total of 115 CT images were used to evaluate the proposed method. Using image hold-out from the first two datasets, the method performance was 2.0, 4.0, and 2.1mm measured in terms of the mean detection error, Hausdorff distance (HD), and root mean squared error (RMSE), respectively. Using the first two datasets for training and the third one for testing, the method accuracy was 2.2, 4.9, and 2.6mm measured in terms of the mean detection error, HD, and RMSE, respectively. We present an algorithm for automated pancreatic duct centerline tracing using deep reinforcement learning. We observe that validation on an external dataset confirms the potential for practical utilization of the presented method.

Validation of different automated segmentation models for target volume contouring in postoperative radiotherapy for breast cancer and regional nodal irradiation

IntroductionTarget volume delineation is routinely performed in postoperative radiotherapy (RT) for breast cancer patients, but it is a time-consuming process. The aim of the present study was to validate the quality, clinical usability and institutional-specific implementation of different auto-segmentation tools into clinical routine. MethodsThree different commercially available, artificial intelligence-, ESTRO-guideline-based segmentation models (M1-3) were applied to fifty consecutive reference patients who received postoperative local RT including regional nodal irradiation for breast cancer for the delineation of clinical target volumes: the residual breast, implant or chestwall, axilla levels 1 and 2, the infra- and supraclavicular regions, the interpectoral and internal mammary nodes. Objective evaluation metrics of the created structures were conducted with the Dice similarity index (DICE) and the Hausdorff distance, and a manual evaluation of usability. ResultsThe resulting geometries of the segmentation models were compared to the reference volumes for each patient and required no or only minor corrections in 72 % (M1), 64 % (M2) and 78 % (M3) of the cases. The median DICE and Hausdorff values for the resulting planning target volumes were 0.87–0.88 and 2.96–3.55, respectively. Clinical usability was significantly correlated with the DICE index, with calculated cut-off values used to define no or minor adjustments of 0.82–0.86. Right or left sided target and breathing method (deep inspiration breath hold vs. free breathing) did not impact the quality of the resulting structures. ConclusionArtificial intelligence-based auto-segmentation programs showed high-quality accuracy and provided standardization and efficient support for guideline-based target volume contouring as a precondition for fully automated workflows in radiotherapy treatment planning.

Impact of Artificial Intelligence-Based Autosegmentation of Organs at Risk in Low- and Middle-Income Countries

Radiation therapy (RT) processes require significant human resources and expertise, creating a barrier to rapid RT deployment in low- and middle-income countries (LMICs). Accurate segmentation of tumor targets and organs at risk (OARs) is crucial for optimal RT. This study assessed the impact of artificial intelligence (AI)-based autosegmentation of OARs in 2 LMICs. Ten patients, comprising 5 head and neck (HN) cancer patients and 5 prostate cancer patients, were randomly selected. Planning computed tomography images were subjected to autosegmentation using an Food and Drug Administration-approved AI software tool and manual segmentation by experienced radiation oncologists from 2 LMIC RT clinics. The control data, obtained from a large academic institution in the United States, consisted of contours obtained by an experienced radiation oncologist. The segmentation time, DICE similarity coefficient (DSC), Hausdorff distance, and mean surface distance were evaluated. AI significantly reduced segmentation time, averaging 2 minutes per patient, compared with 57 to 84 minutes for manual contouring in LMICs. Compared with the control data, the AI pelvic contours provided better agreement than did the LMIC manual contours (mean DSC of 0.834 vs 0.807 in LMIC1 and 0.844 vs 0.801 in LMIC2). For HN contours, AI provided better agreement for the majority of OAR contours than manual contours in LMIC1 (mean DSC: 0.823 vs 0.821) or LMIC2 (mean DSC: 0.792 vs 0.748). Neither the AI nor LMIC manual contours had good agreement with the control data (DSC < 0.600) for the optic nerves, chiasm, and cochlea. AI-based autosegmentation generates OAR contours of comparable quality to manual segmentation for both pelvic and HN cancer patients in LMICs, with substantial time savings.

Large-scale multi-center CT and MRI segmentation of pancreas with deep learning

Automated volumetric segmentation of the pancreas on cross-sectional imaging is needed for diagnosis and follow-up of pancreatic diseases. While CT-based pancreatic segmentation is more established, MRI-based segmentation methods are understudied, largely due to a lack of publicly available datasets, benchmarking research efforts, and domain-specific deep learning methods. In this retrospective study, we collected a large dataset (767 scans from 499 participants) of T1-weighted (T1 W) and T2-weighted (T2 W) abdominal MRI series from five centers between March 2004 and November 2022. We also collected CT scans of 1,350 patients from publicly available sources for benchmarking purposes. We introduced a new pancreas segmentation method, called PanSegNet, combining the strengths of nnUNet and a Transformer network with a new linear attention module enabling volumetric computation. We tested PanSegNet’s accuracy in cross-modality (a total of 2,117 scans) and cross-center settings with Dice and Hausdorff distance (HD95) evaluation metrics. We used Cohen’s kappa statistics for intra and inter-rater agreement evaluation and paired t-tests for volume and Dice comparisons, respectively. For segmentation accuracy, we achieved Dice coefficients of 88.3% (±7.2%, at case level) with CT, 85.0% (±7.9%) with T1 W MRI, and 86.3% (±6.4%) with T2 W MRI. There was a high correlation for pancreas volume prediction with R2 of 0.91, 0.84, and 0.85 for CT, T1 W, and T2 W, respectively. We found moderate inter-observer (0.624 and 0.638 for T1 W and T2 W MRI, respectively) and high intra-observer agreement scores. All MRI data is made available at https://osf.io/kysnj/. Our source code is available at https://github.com/NUBagciLab/PaNSegNet.

Deformable Mapping of Rectal Cancer Whole-Mount Histology with Restaging MRI at Voxel Scale: A Feasibility Study.

Purpose To develop a radiology-pathology coregistration method for 1:1 automated spatial mapping between preoperative rectal MRI and ex vivo rectal whole-mount histology (WMH). Materials and Methods This retrospective study included consecutive patients with rectal adenocarcinoma who underwent total neoadjuvant therapy followed by total mesorectal excision with preoperative rectal MRI and WMH from January 2019 to January 2022. A gastrointestinal pathologist and a radiologist established three corresponding levels for each patient at rectal MRI and WMH, subsequently delineating external and internal rectal wall contours and the tumor bed at each level and defining eight point-based landmarks. An advanced deformable image coregistration model based on the linearized iterative boundary reconstruction (LIBR) approach was compared with rigid point-based registration (PBR) and state-of-the-art deformable intensity-based multiscale spectral embedding registration (MSERg). Dice similarity coefficient (DSC), modified Hausdorff distance (MHD), and target registration error (TRE) across patients were calculated to assess the coregistration accuracy of each method. Results Eighteen patients (mean age, 54 years ± 13 [SD]; nine female) were included. LIBR demonstrated higher DSC versus PBR for external and internal rectal wall contours and tumor bed (external: 0.95 ± 0.03 vs 0.86 ± 0.04, respectively, P < .001; internal: 0.71 ± 0.21 vs 0.61 ± 0.21, P < .001; tumor bed: 0.61 ± 0.17 vs 0.52 ± 0.17, P = .001) and versus MSERg for internal rectal wall contours (0.71 ± 0.21 vs 0.63 ± 0.18, respectively; P < .001). LIBR demonstrated lower MHD versus PBR for external and internal rectal wall contours and tumor bed (external: 0.56 ± 0.25 vs 1.68 ± 0.56, respectively, P < .001; internal: 1.00 ± 0.35 vs 1.62 ± 0.59, P < .001; tumor bed: 2.45 ± 0.99 vs 2.69 ± 1.05, P = .03) and versus MSERg for internal rectal wall contours (1.00 ± 0.35 vs 1.62 ± 0.59, respectively; P < .001). LIBR demonstrated lower TRE (1.54 ± 0.39) versus PBR (2.35 ± 1.19, P = .003) and MSERg (2.36 ± 1.43, P = .03). Computation time per WMH slice for LIBR was 35.1 seconds ± 12.1. Conclusion This study demonstrates feasibility of accurate MRI-WMH coregistration using the advanced LIBR method. Keywords: MR Imaging, Abdomen/GI, Rectum, Oncology Supplemental material is available for this article. © RSNA, 2024.

Prediction of femoral head collapse in osteonecrosis using deep learning segmentation and radiomics texture analysis of MRI

BackgroundFemoral head collapse is a critical pathological change and is regarded as turning point in disease progression in osteonecrosis of the femoral head (ONFH). In this study, we aim to build an automatic femoral head collapse prediction pipeline for ONFH based on magnetic resonance imaging (MRI) radiomics.MethodsIn the segmentation model development dataset, T1-weighted MRI of 222 hips from two hospitals were retrospectively collected and randomly split into training (n = 190) and test (n = 32) sets. In the prognosis prediction model development dataset, 206 hips were also retrospectively collected from two hospitals and divided into training set (n = 155) and external test set (n = 51) according to data source. A deep learning model for automatic lesion segmentation was trained with nnU-Net, from which three-dimensional regions of interest were segmented and a total of 107 radiomics features were extracted. After intra-class correlation coefficients screening, feature correlation coefficient screening and Least Absolute Shrinkage and Selection Operator regression feature selection, a machine learning model for ONFH prognosis prediction was trained with Logistic Regression (LR) and Light Gradient Boosting Machine (LightGBM) algorithm.ResultsThe segmentation model achieved an average dice similarity coefficient of 0.848 and an average 95% Hausdorff distance of 3.794 in the test set, compared to the manual segmentation results. After feature selection, nine radiomics features were included in the prognosis prediction model. External test showed that the LightGBM model exhibited acceptable predictive performance. The area under the curve (AUC) of the prediction model was 0.851 (95% CI: 0.7268–0.9752), with an accuracy of 0.765, sensitivity of 0.833, and specificity of 0.727. Decision curve analysis showed that the LightGBM model exhibited favorable clinical utility.ConclusionThis study presents an automated pipeline for predicting femoral head collapse in ONFH with acceptable performance. Further research is necessary to determine the clinical applicability of this radiomics-based approach and to assess its potential to assist in treatment decision-making for ONFH.

Automated Organ Segmentation for Radiation Therapy: A Comparative Analysis of AI-Based Tools Versus Manual Contouring in Korean Cancer Patients.

Accurate delineation of tumors and organs at risk (OARs) is crucial for intensity-modulated radiation therapy. This study aimed to evaluate the performance of OncoStudio, an AI-based auto-segmentation tool developed for Korean patients, compared with Protégé AI, a globally developed tool that uses data from Korean cancer patients. A retrospective analysis of 1200 Korean cancer patients treated with radiotherapy was conducted. Auto-contours generated via OncoStudio and Protégé AI were compared with manual contours across the head and neck and thoracic, abdominal, and pelvic organs. Accuracy was assessed using the Dice similarity coefficient (DSC), mean surface distance (MSD), and 95% Hausdorff distance (HD). Feedback was obtained from 10 participants, including radiation oncologists, residents, and radiation therapists, via an online survey with a Turing test component. OncoStudio outperformed Protégé AI in 85% of the evaluated OARs (p < 0.001). For head and neck organs, OncoStudio achieved a similar DSC (0.70 vs. 0.70, p = 0.637) but significantly lower MSD and 95% HD values (p < 0.001). In thoracic organs, OncoStudio performed excellently in 90% of cases, with a significantly greater DSC (male: 0.87 vs. 0.82, p < 0.001; female: 0.95 vs. 0.87, p < 0.001). OncoStudio also demonstrated superior accuracy in abdominal (DSC 0.88 vs. 0.81, p < 0.001) and pelvic organs (male: DSC 0.95 vs. 0.85, p < 0.001; female: DSC 0.82 vs. 0.73, p < 0.001). Clinicians favored OncoStudio in 70% of cases, with 90% endorsing its clinical suitability for Korean patients. OncoStudio, which is tailored for Korean patients, demonstrated superior segmentation accuracy across multiple anatomical regions, suggesting its suitability for radiotherapy planning in this population.

Privacy preserving verifiable federated learning scheme using blockchain and homomorphic encryption

This paper introduces a novel Privacy-Preserving Verifiable Federated Learning (PPVFL) scheme that integrates blockchain technology and homomorphic encryption to address critical challenges in decentralized machine learning. The proposed scheme ensures data privacy, integrity, verifiability, robust security, and efficiency in collaborative learning environments, particularly in sensitive domains such as healthcare. By leveraging blockchain’s decentralized, immutable ledger and homomorphic encryption’s capability to perform computations on encrypted data, the model maintains the confidentiality of sensitive information throughout the learning process. The inclusion of Byzantine fault tolerance and Elliptic Curve Digital Signature Algorithm (ECDSA) further enhances the system’s security against malicious attacks and data tampering, while the optimization of computational processes ensures efficient model training and communication. The novelty of this work lies in the seamless integration of blockchain and homomorphic encryption within a federated learning framework, specifically tailored for post-quantum cryptography, a combination that has not been extensively explored in prior research. This research represents a significant advancement in secure and efficient federated learning, offering a promising solution for industries that prioritize data privacy, security, and trust in collaborative machine learning. The effectiveness, security, and efficiency of the PPVFL scheme were validated using the Glaucoma dataset. The proposed method outperformed baseline federated learning algorithms, achieving a Dice coefficient of 0.918 and a Hausdorff distance of 4.05 on Severe Glaucoma (SG) cases, compared to 0.905 and 5.27, respectively, with traditional FedAvg. Moreover, the integration of blockchain and homomorphic encryption ensured that data privacy was upheld without compromising model performance, while efficient computation and communication processes minimized latency and resource consumption. This study contributes a robust, privacy-preserving, secure, efficient, and verifiable federated learning framework that addresses the pressing need for secure and scalable data management in distributed machine learning environments.

PZS‐Net: Incorporating of Frame Sequence and Multi‐Scale Priors for Prostate Zonal Segmentation in Transrectal Ultrasound

Transrectal ultrasound (TRUS) videos offer valuable histopathologic information about the prostate. Accurate prostate zonal segmentation in TRUS videos is vital for diagnosing prostate cancer and guiding surgery. However, TRUS videos are manually recorded by urologists, resulting in no standardized coordinate system, which limits direct prostate zonal segmentation in these videos. To overcome the limitation, a novel Prostate Zonal Segmentation Network (PZS‐Net), based on U‐Net, which learns critical cross‐frame information and multi‐scale features from sequential frames, is proposed. First, a sequential frame cross‐attention (SFCA) module is designed to capture remote information from sequential frames to enhance the feature representation of the current frame. The SFCA module is embedded at each skip connection layer to extract crucial cross‐frame information. Then, a multi‐scale fusion (MSF) module that utilizes three parallel branches with different atrous convolutions is designed. The MSF module is placed at the bottleneck layer to dynamically fuse multi‐scale context information from high‐level features. Extensive experiments on TRUS image datasets show that the PZS‐Net achieves higher accuracy in both the transitional zone (dice coefficient [Dice]: 68.90% ± 1.73%, mean intersection over union [mIoU]: 59.19% ± 2.09%, 95% Hausdorff distance [HD95]: 5.02 ± 0.83 mm) and the peripheral zone (Dice: 63.99% ± 3.16%, mIoU: 54.60% ± 3.35%, HD95: 5.28 ± 1.12 mm) and demonstrates the effectiveness and competitiveness of its key components via comprehensive ablation studies.

MRS‐Net: Brain tumour segmentation network based on feature fusion and attention mechanism

AbstractAccurate segmentation of brain tumor magnetic resonance imaging (MRI) is crucial for treatment planning. Addressing the challenges of complex tumor structures and inadequate cross‐channel information utilization in Unet‐based segmentation, this paper proposes the multi‐scale residual brain tumor MRI segmentation network (MRS‐Net) incorporating an attention mechanism to enhance segmentation accuracy. First, the double residual feature fusion module is utilized to enhance the fusion of feature information between different levels. Second, the Atrous Spatial Pyramid Pooling is introduced as a bridging module of the network to capture the features at different scales of the image, so as to enhance the extraction capability of the network for detailed features. Finally, the inverted residual coordinate attention module replaces the direct splicing in Unet to fuse the large feature information at each level and scale, thus enhancing the model's ability to recognize the spatial location information of brain tumors. The Dice coefficients, positive predictive values (PPVs), sensitivities (Sensitivity) and Hausdorff distance (HD), which are the four evaluation indexes, reach 84.54%, 87.43%, 88.37% and 2.248, respectively, which are improved by 1.85%, 2.11%, 2.88% and 6.0%, respectively, compared with Unet. The experimental results show that MRS‐Net achieves better brain tumor image segmentation.

Mapping 18F-FDG PET uptake in the aortic wall and thrombus

Abstract Background Positron Emission Tomography (PET) uptake allows for the assessment of molecular activity, being 18F-FDG uptake indicative of glucose metabolism. PET uptake is commonly quantified manually by drawing regions of interest, which is subjective, poorly-reproducible and may miss relevant information. Purpose To develop and test an image analysis method to quantify and map 18F-FDG uptake on the whole aortic wall and thrombus. Methods PET-MRI was acquired in patients with thoracic or abdominal aortic aneurysms. The aorta was semi-automatically segmented in the MR angiography using 3DSlicer, generating a surface mesh that was expanded by 3 mm inward and outward. PET uptake was interpolated over this volume with a uniform spatial resolution of 1 mm. By means of 9 reference points, the aortic wall was discretized into 52 (thoracic) or 80 (thoraco-abdominal) standardized regions (i.e. wall patches). For each aortic patch and for the whole thrombus volume, the target to background Ratio (TBR) was calculated by dividing the uptake by a reference uptake in the left atrium. Two observers segmented the aorta and thrombus, located the anatomical reference points and quantified TBR. Inter-observer agreement for segmentation and aortic wall discretization was evaluated in terms of the 95% Hausdorff Distance (HD) and Dice Score Coefficient (DSC), while both median and 95% TBR in each region were tested via intra-class correlation coefficient (absolute value, single measure). Results Data from 20 patients with thoracic or abdominal aneurysms were analysed, 10 of them presented thrombus. The reproducibility of the segmentation of the aorta (median HD 3.16 IQR [2.42 - 3.94] mm, DSC 0.90 [0.89 - 0.92]) and of the thrombus (HD 4.87 [3.51 - 8.45] mm, DSC 0.85 [0.80 - 0.87]) were excellent. The inter-observer agreement in the localization of reference points was good (HD 5.10 [3.29 - 8.73] mm), resulting in excellent overlapping of the standardized aortic wall patches (HD 3.80 [2.44 - 5.08] mm). Inter-observer agreement of median and 95% TBR in each aortic patch were excellent (ICC of 0.90 and 0.93, respectively, Figure 1), with minimal bias (Figure 2). Similarly, excellent interobserver reproducibility was observed for median and 95% TBR in the thrombus (ICC of 0.97 and 0.96, respectively, Figure 2). Conclusions A robust and reproducible image analysis method to map PET uptake along the aortic wall was developed, extending the possibilities to study aortic diseases molecular activity and its association with local aortic characteristics.

Temporomandibular joint CBCT image segmentation via multi-view ensemble learning network.

Accurate segmentation of the temporomandibular joint (TMJ) from cone beam CT (CBCT) images holds significant clinical value for diagnosing temporomandibular joint osteoarthrosis (TMJOA) and related conditions. Convolutional neural network-based medical image segmentation methods have achieved state-of-the-art performance in various segmentation tasks. However, 3D medical images segmentation requires substantial global context and rich spatial semantic information, demanding much more GPU memory and computational resources. To address these challenges in 3D medical image segmentation, we propose a novel network- the MVEL-Net (Multi-view Ensemble Learning Network) for TMJ CBCT image segmentation. By resampling images along three dimensions, we generate multiple weak learners with different spatial semantic information. A subsequent strong learning network effectively integrates the outputs from these weak learners to achieve more accurate segmentation results. We evaluated our network model using a clinical dataset comprising 88 subjects with TMJ CBCT images. The average Dice similarity coefficient (DSC) was 0.9817 ± 0.0049, the average surface distance was 0.0540 ± 0.0179mm, and the 95% Hausdorff distance was 0.1743 ± 0.0550mm. Our proposed MVEL-Net demonstrates excellent segmentation performance on TMJ from CBCT images, while using fewer GPU memory resources compared to other 3D networks. The effectiveness of this method in capturing spatial context could be leveraged for tasks like organ segmentation from volumetric scans. This may facilitate wider adoption of AI-based solutions for automated analysis of 3D medical images.