Attention-based deep learning framework for automatic fundus image processing to aid in diabetic retinopathy grading.

BACKGROUND AND OBJECTIVE: Early detection and grading of Diabetic Retinopathy (DR) is essential to determine an adequate treatment and prevent severe vision loss. However, the manual analysis of fundus images is time consuming and DR screening programs are challenged by the availability of human graders. Current automatic approaches for DR grading attempt the joint detection of all signs at the same time. However, the classification can be optimized if red lesions and bright lesions are independently processed since the task gets divided and simplified. Furthermore, clinicians would greatly benefit from explainable artificial intelligence (XAI) to support the automatic model predictions, especially when the type of lesion is specified. As a novelty, we propose an end-to-end deep learning framework for automatic DR grading (5 severity degrees) based on separating the attention of the dark structures from the bright structures of the retina. As the main contribution, this approach allowed us to generate independent interpretable attention maps for red lesions, such as microaneurysms and hemorrhages, and bright lesions, such as hard exudates, while using image-level labels only. METHODS: Our approach is based on a novel attention mechanism which focuses separately on the dark and the bright structures of the retina by performing a previous image decomposition. This mechanism can be seen as a XAI approach which generates independent attention maps for red lesions and bright lesions. The framework includes an image quality assessment stage and deep learning-related techniques, such as data augmentation, transfer learning and fine-tuning. We used the architecture Xception as a feature extractor and the focal loss function to deal with data imbalance. RESULTS: The Kaggle DR detection dataset was used for method development and validation. The proposed approach achieved 83.7 % accuracy and a Quadratic Weighted Kappa of 0.78 to classify DR among 5 severity degrees, which outperforms several state-of-the-art approaches. Nevertheless, the main result of this work is the generated attention maps, which reveal the pathological regions on the image distinguishing the red lesions and the bright lesions. These maps provide explainability to the model predictions. CONCLUSIONS: Our results suggest that our framework is effective to automatically grade DR. The separate attention approach has proven useful for optimizing the classification. On top of that, the obtained attention maps facilitate visual interpretation for clinicians. Therefore, the proposed method could be a diagnostic aid for the early detection and grading of DR.

Vessel Wall Characterization Using Quantitative MR Imaging.

MR imaging's exceptional capabilities in vascular imaging stem from its ability to visualize and quantify vessel wall features, such as plaque burden, composition, and biomechanical properties. The application of advanced MR imaging techniques, including two-dimensional and three-dimensional black-blood MR imaging, T1 and T2 relaxometry, diffusion-weighted imaging, and dynamic contrast-enhanced MR imaging, wall shear stress, and arterial stiffness, empowers clinicians and researchers to explore the intricacies of vascular diseases. This array of techniques provides comprehensive insights into the development and progression of vascular pathologies, facilitating earlier diagnosis, targeted treatment, and improved patient outcomes in the management of vascular health.

Dual path parallel hierarchical diagnosis model for intracranial tumors based on multi-feature entropy weight.

The grading diagnosis of intracranial tumors is a key step in formulating clinical treatment plans and surgical guidelines. To effectively grade the diagnosis of intracranial tumors, this paper proposes a dual path parallel hierarchical model that can automatically grade the diagnosis of intracranial tumors with high accuracy. In this model, prior features of solid tumor mass and intratumoral necrosis are extracted. Then the optimal division of the data set is achieved through multi-feature entropy weight. The multi-modal input is realized by the dual path structure. Multiple features are superimposed and fused to achieve the image grading. The model has been tested on the actual clinical medical images provided by the Second Affiliated Hospital of Dalian Medical University. The experiment shows that the proposed model has good generalization ability, with an accuracy of 0.990. The proposed model can be applied to clinical diagnosis and has practical application prospects.

An interpretable dual attention network for diabetic retinopathy grading: IDANet.

Diabetic retinopathy (DR) is the most prevalent cause of visual impairment in adults worldwide. Typically, patients with DR do not show symptoms until later stages, by which time it may be too late to receive effective treatment. DR Grading is challenging because of the small size and variation in lesion patterns. The key to fine-grained DR grading is to discover more discriminating elements such as cotton wool, hard exudates, hemorrhages, microaneurysms etc. Although deep learning models like convolutional neural networks (CNN) seem ideal for the automated detection of abnormalities in advanced clinical imaging, small-size lesions are very hard to distinguish by using traditional networks. This work proposes a bi-directional spatial and channel-wise parallel attention based network to learn discriminative features for diabetic retinopathy grading. The proposed attention block plugged with a backbone network helps to extract features specific to fine-grained DR-grading. This scheme boosts classification performance along with the detection of small-sized lesion parts. Extensive experiments are performed on four widely used benchmark datasets for DR grading, and performance is evaluated on different quality metrics. Also, for model interpretability, activation maps are generated using the LIME method to visualize the predicted lesion parts. In comparison with state-of-the-art methods, the proposed IDANet exhibits better performance for DR grading and lesion detection.

High-resolution free-breathing hepatobiliary phase MRI of the liver using XD-GRASP.

PURPOSE: To evaluate the performance of high-resolution free-breathing (FB) hepatobiliary phase imaging of the liver using the eXtra-Dimension Golden-angle RAdial Sparse Parallel (XD-GRASP) MRI technique. METHODS: Fifty-eight clinical patients (41 males, mean age = 52.9 ± 12.9) with liver lesions who underwent dynamic contrast-enhanced MRI with a liver-specific contrast agent were prospectively recruited for this study. Both breath-hold volumetric interpolated examination (BH-VIBE) imaging and FB imaging were performed during the hepatobiliary phase. FB images were acquired using a stack-of-stars golden-angle radial sequence and were reconstructed using the XD-GRASP method. Two experienced radiologists blinded to acquisition schemes independently scored the overall image quality, liver edge sharpness, hepatic vessel clarity, conspicuity of lesion, and overall artifact level of each image. The non-parametric paired two-tailed Wilcoxon signed-rank test was used for statistical analysis. RESULTS: Compared to BH-VIBE images, XD-GRASP images received significantly higher scores (P < 0.05) for the liver edge sharpness (4.83 ± 0.45 vs 4.29 ± 0.46), the hepatic vessel clarity (4.64 ± 0.67 vs 4.15 ± 0.56) and the conspicuity of lesion (4.75 ± 0.53 vs 4.31 ± 0.50). There were no significant differences (P > 0.05) between BH-VIBE and XD-GRASP images for the overall image quality (4.61 ± 0.50 vs 4.74 ± 0.47) and the overall artifact level (4.13 ± 0.44 vs 4.05 ± 0.61). CONCLUSION: Compared to conventional BH-VIBE MRI, FB radial acquisition combined with XD-GRASP reconstruction facilitates higher spatial resolution imaging of the liver during the hepatobiliary phase. This enhancement can significantly improve the visualization and evaluation of the liver.

A reliable diabetic retinopathy grading via transfer learning and ensemble learning with quadratic weighted kappa metric.

The most common eye infection in people with diabetes is diabetic retinopathy (DR). It might cause blurred vision or even total blindness. Therefore, it is essential to promote early detection to prevent or alleviate the impact of DR. However, due to the possibility that symptoms may not be noticeable in the early stages of DR, it is difficult for doctors to identify them. Therefore, numerous predictive models based on machine learning (ML) and deep learning (DL) have been developed to determine all stages of DR. However, existing DR classification models cannot classify every DR stage or use a computationally heavy approach. Common metrics such as accuracy, F1 score, precision, recall, and AUC-ROC score are not reliable for assessing DR grading. This is because they do not account for two key factors: the severity of the discrepancy between the assigned and predicted grades and the ordered nature of the DR grading scale. This research proposes computationally efficient ensemble methods for the classification of DR. These methods leverage pre-trained model weights, reducing training time and resource requirements. In addition, data augmentation techniques are used to address data limitations, improve features, and improve generalization. This combination offers a promising approach for accurate and robust DR grading. In particular, we take advantage of transfer learning using models trained on DR data and employ CLAHE for image enhancement and Gaussian blur for noise reduction. We propose a three-layer classifier that incorporates dropout and ReLU activation. This design aims to minimize overfitting while effectively extracting features and assigning DR grades. We prioritize the Quadratic Weighted Kappa (QWK) metric due to its sensitivity to label discrepancies, which is crucial for an accurate diagnosis of DR. This combined approach achieves state-of-the-art QWK scores (0.901, 0.967 and 0.944) in the Eyepacs, Aptos, and Messidor datasets.

Diagnosis of Alzheimer's disease via optimized lightweight convolution-attention and structural MRI.

Alzheimer's disease (AD) poses a substantial public health challenge, demanding accurate screening and diagnosis. Identifying AD in its early stages, including mild cognitive impairment (MCI) and healthy control (HC), is crucial given the global aging population. Structural magnetic resonance imaging (sMRI) is essential for understanding the brain's structural changes due to atrophy. While current deep learning networks overlook voxel long-term dependencies, vision transformers (ViT) excel at recognizing such dependencies in images, making them valuable in AD diagnosis. Our proposed method integrates convolution-attention mechanisms in transformer-based classifiers for AD brain datasets, enhancing performance without excessive computing resources. Replacing multi-head attention with lightweight multi-head self-attention (LMHSA), employing inverted residual (IRU) blocks, and introducing local feed-forward networks (LFFN) yields exceptional results. Training on AD datasets with a gradient-centralized optimizer and Adam achieves an impressive accuracy rate of 94.31% for multi-class classification, rising to 95.37% for binary classification (AD vs. HC) and 92.15% for HC vs. MCI. These outcomes surpass existing AD diagnosis approaches, showcasing the model's efficacy. Identifying key brain regions aids future clinical solutions for AD and neurodegenerative diseases. However, this study focused exclusively on the AD Neuroimaging Initiative (ADNI) cohort, emphasizing the need for a more robust, generalizable approach incorporating diverse databases beyond ADNI in future research.

Ultrashort VIBE-Dixon versus Cine and late gadolinium enhancement MRI sequences for cardiac thrombus detection.

PURPOSE: To determine the diagnostic accuracy of volumetric interpolated breath-hold examination sequences with fat suppression in Dixon technique (VIBE-Dixon) for cardiac thrombus detection. METHOD: From our clinical database, we retrospectively identified consecutive patients between 2014 and 2022 who had definite diagnosis or exclusion of cardiac thrombus confirmed by an independent adjudication committee, serving as the reference standard. All patients received 2D-Cine plus 2D-Late-Gadolinium-Enhancement (Cine + LGE) and VIBE-Dixon sequences. Two blinded readers assessed all images for the presence of cardiac thrombus. The diagnostic accuracy of Cine + LGE and VIBE-Dixon was determined and compared. RESULTS: Among 141 MRI studies (116 male, mean age: 61 years) mean image examination time was 28.8 ± 3.1 s for VIBE-Dixon and 23.3 ± 2.5 min for Cine + LGE. Cardiac thrombus was present in 49 patients (prevalence: 35 %). For both readers sensitivity for thrombus detection was significantly higher in VIBE-Dixon compared with Cine + LGE (Reader 1: 96 % vs.73 %, Reader 2: 96 % vs. 78 %, p < 0.01 for both readers), whereas specificity did not differ significantly (Reader 1: 96 % vs. 98 %, Reader 2: 92 % vs. 93 %, p > 0.1). Overall diagnostic accuracy of VIBE-Dixon was higher than for Cine + LGE (95 % vs. 89 %, p = 0.02) and was non-inferior to the reference standard (Delta ≤ 5 % with probability > 95 %). CONCLUSIONS: Biplanar VIBE-Dixon sequences, acquired within a few seconds, provided a very high diagnostic accuracy for cardiac thrombus detection. They could be used as stand-alone sequences to rapidly screen for cardiac thrombus in patients not amenable to lengthy acquisition times.

MTFN: multi-temporal feature fusing network with co-attention for DCE-MRI synthesis.

BACKGROUND: Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) plays an important role in the diagnosis and treatment of breast cancer. However, obtaining complete eight temporal images of DCE-MRI requires a long scanning time, which causes patients' discomfort in the scanning process. Therefore, to reduce the time, the multi temporal feature fusing neural network with Co-attention (MTFN) is proposed to generate the eighth temporal images of DCE-MRI, which enables the acquisition of DCE-MRI images without scanning. In order to reduce the time, multi-temporal feature fusion cooperative attention mechanism neural network (MTFN) is proposed to generate the eighth temporal images of DCE-MRI, which enables DCE-MRI image acquisition without scanning. METHODS: In this paper, we propose multi temporal feature fusing neural network with Co-attention (MTFN) for DCE-MRI Synthesis, in which the Co-attention module can fully fuse the features of the first and third temporal image to obtain the hybrid features. The Co-attention explore long-range dependencies, not just relationships between pixels. Therefore, the hybrid features are more helpful to generate the eighth temporal images. RESULTS: We conduct experiments on the private breast DCE-MRI dataset from hospitals and the multi modal Brain Tumor Segmentation Challenge2018 dataset (BraTs2018). Compared with existing methods, the experimental results of our method show the improvement and our method can generate more realistic images. In the meanwhile, we also use synthetic images to classify the molecular typing of breast cancer that the accuracy on the original eighth time-series images and the generated images are 89.53% and 92.46%, which have been improved by about 3%, and the classification results verify the practicability of the synthetic images. CONCLUSIONS: The results of subjective evaluation and objective image quality evaluation indicators show the effectiveness of our method, which can obtain comprehensive and useful information. The improvement of classification accuracy proves that the images generated by our method are practical.

Resilient back-propagation machine learning-based classification on fundus images for retinal microaneurysm detection.

BACKGROUND: The timely diagnosis of medical conditions, particularly diabetic retinopathy, relies on the identification of retinal microaneurysms. However, the commonly used retinography method poses a challenge due to the diminutive dimensions and limited differentiation of microaneurysms in images. PROBLEM STATEMENT: Automated identification of microaneurysms becomes crucial, necessitating the use of comprehensive ad-hoc processing techniques. Although fluorescein angiography enhances detectability, its invasiveness limits its suitability for routine preventative screening. OBJECTIVE: This study proposes a novel approach for detecting retinal microaneurysms using a fundus scan, leveraging circular reference-based shape features (CR-SF) and radial gradient-based texture features (RG-TF). METHODOLOGY: The proposed technique involves extracting CR-SF and RG-TF for each candidate microaneurysm, employing a robust back-propagation machine learning method for training. During testing, extracted features from test images are compared with training features to categorize microaneurysm presence. RESULTS: The experimental assessment utilized four datasets (MESSIDOR, Diaretdb1, e-ophtha-MA, and ROC), employing various measures. The proposed approach demonstrated high accuracy (98.01%), sensitivity (98.74%), specificity (97.12%), and area under the curve (91.72%). CONCLUSION: The presented approach showcases a successful method for detecting retinal microaneurysms using a fundus scan, providing promising accuracy and sensitivity. This non-invasive technique holds potential for effective screening in diabetic retinopathy and other related medical conditions.

DctViT: Discrete Cosine Transform meet vision transformers.

Vision transformers (ViTs) have become one of the dominant frameworks for vision tasks in recent years because of their ability to efficiently capture long-range dependencies in image recognition tasks using self-attention. In fact, both CNNs and ViTs have advantages and disadvantages in vision tasks, and some studies suggest that the use of both may be an effective way to balance performance and computational cost. In this paper, we propose a new hybrid network based on CNN and transformer, using CNN to extract local features and transformer to capture long-distance dependencies. We also proposed a new feature map resolution reduction based on Discrete Cosine Transform and self-attention, named DCT-Attention Down-sample (DAD). Our DctViT-L achieves 84.8% top-1 accuracy on ImageNet 1K, far outperforming CMT, Next-ViT, SpectFormer and other state-of-the-art models, with lower computational costs. Using DctViT-B as the backbone, RetinaNet can achieve 46.8% mAP on COCO val2017, which improves mAP by 2.5% and 1.1% with less calculation cost compared with CMT-S and SpectFormer as the backbone.

Intra-patient and inter-observer image quality analysis in liver MRI study with gadoxetic acid using two different multi-arterial phase techniques.

PURPOSE: To evaluate intra-patient and interobserver agreement in patients who underwent liver MRI with gadoxetic acid using two different multi-arterial phase (AP) techniques. METHODS: A total of 154 prospectively enrolled patients underwent clinical gadoxetic acid-enhanced liver MRI twice within 12 months, using two different multi-arterial algorithms: CAIPIRINHA-VIBE and TWIST-VIBE. For every patient, breath-holding time, body mass index, sex, age were recorded. The phase without contrast media and the APs were independently evaluated by two radiologists who quantified Gibbs artefacts, noise, respiratory motion artefacts, and general image quality. Presence or absence of Gibbs artefacts and noise was compared by the McNemar's test. Respiratory motion artefacts and image quality scores were compared using Wilcoxon signed rank test. Interobserver agreement was assessed by Cohen kappa statistics. RESULTS: Compared with TWIST-VIBE, CAIPIRINHA-VIBE images had better scores for every parameter except higher noise score. Triple APs were always acquired with TWIST-VIBE but failed in 37% using CAIPIRINHA-VIBE: 11% have only one AP, 26% have two. Breath-holding time was the only parameter that influenced the success of multi-arterial techniques. TWIST-VIBE images had worst score for Gibbs and respiratory motion artefacts but lower noise score. CONCLUSION: CAIPIRINHA-VIBE images were always diagnostic, but with a failure of triple-AP in 37%. TWIST-VIBE was successful in obtaining three APs in all patients. Breath-holding time is the only parameter which can influence the preliminary choice between CAIPIRINHA-VIBE and TWIST-VIBE algorithm. ADVANCES IN KNOWLEDGE: If the patient is expected to perform good breath-holds, TWIST-VIBE is preferable; otherwise, CAIPIRINHA-VIBE is more appropriate.

Sidebands in CEST MR-How to recognize and avoid them.

PURPOSE: Clinical scanners require pulsed CEST sequences to maintain amplifier and specific absorption rate limits. During off-resonant RF irradiation and interpulse delay, the magnetization can accumulate specific relative phases within the pulse train. In this work, we show that these phases are important to consider, as they can lead to unexpected artifacts when no interpulse gradient spoiling is performed during the saturation train. METHODS: We investigated sideband artifacts using a CEST-3D snapshot gradient-echo sequence at 3 T. Initially, Bloch-McConnell simulations were carried out with Pulseq-CEST, while measurements were performed in vitro and in vivo. RESULTS: Sidebands can be hidden in Z-spectra, and their structure becomes clearly visible only at high sampling. Sidebands are further influenced by B0 inhomogeneities and the RF phase cycling within the pulse train. In vivo, sidebands are mostly visible in liquid compartments such as CSF. Multi-pulse sidebands can be suppressed by interpulse gradient spoiling. CONCLUSION: We provide new insights into sidebands occurring in pulsed CEST experiments and show that, similar as in imaging sequences, gradient and RF spoiling play an important role. Gradient spoiling avoids misinterpretations of sidebands as CEST effects especially in liquid environments including pathological tissue or for CEST resonances close to water. It is recommended to simulate pulsed CEST sequences in advance to avoid artifacts.

Understanding the factors influencing acceptability of AI in medical imaging domains among healthcare professionals: A scoping review.

BACKGROUND: Artificial intelligence (AI) technology has the potential to transform medical practice within the medical imaging industry and materially improve productivity and patient outcomes. However, low acceptability of AI as a digital healthcare intervention among medical professionals threatens to undermine user uptake levels, hinder meaningful and optimal value-added engagement, and ultimately prevent these promising benefits from being realised. Understanding the factors underpinning AI acceptability will be vital for medical institutions to pinpoint areas of deficiency and improvement within their AI implementation strategies. This scoping review aims to survey the literature to provide a comprehensive summary of the key factors influencing AI acceptability among healthcare professionals in medical imaging domains and the different approaches which have been taken to investigate them. METHODS: A systematic literature search was performed across five academic databases including Medline, Cochrane Library, Web of Science, Compendex, and Scopus from January 2013 to September 2023. This was done in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Overall, 31 articles were deemed appropriate for inclusion in the scoping review. RESULTS: The literature has converged towards three overarching categories of factors underpinning AI acceptability including: user factors involving trust, system understanding, AI literacy, and technology receptiveness; system usage factors entailing value proposition, self-efficacy, burden, and workflow integration; and socio-organisational-cultural factors encompassing social influence, organisational readiness, ethicality, and perceived threat to professional identity. Yet, numerous studies have overlooked a meaningful subset of these factors that are integral to the use of medical AI systems such as the impact on clinical workflow practices, trust based on perceived risk and safety, and compatibility with the norms of medical professions. This is attributable to reliance on theoretical frameworks or ad-hoc approaches which do not explicitly account for healthcare-specific factors, the novelties of AI as software as a medical device (SaMD), and the nuances of human-AI interaction from the perspective of medical professionals rather than lay consumer or business end users. CONCLUSION: This is the first scoping review to survey the health informatics literature around the key factors influencing the acceptability of AI as a digital healthcare intervention in medical imaging contexts. The factors identified in this review suggest that existing theoretical frameworks used to study AI acceptability need to be modified to better capture the nuances of AI deployment in healthcare contexts where the user is a healthcare professional influenced by expert knowledge and disciplinary norms. Increasing AI acceptability among medical professionals will critically require designing human-centred AI systems which go beyond high algorithmic performance to consider accessibility to users with varying degrees of AI literacy, clinical workflow practices, the institutional and deployment context, and the cultural, ethical, and safety norms of healthcare professions. As investment into AI for healthcare increases, it would be valuable to conduct a systematic review and meta-analysis of the causal contribution of these factors to achieving high levels of AI acceptability among medical professionals.

ECG-free cine MRI with data-driven clustering of cardiac motion for quantification of ventricular function.

BACKGROUND: Despite the widespread use of cine MRI for evaluation of cardiac function, existing real-time methods do not easily enable quantification of ventricular function. Moreover, segmented cine MRI assumes periodicity of cardiac motion. We aim to develop a self-gated, cine MRI acquisition scheme with data-driven cluster-based binning of cardiac motion. METHODS: A Cartesian golden-step balanced steady-state free precession sequence with sorted k-space ordering was designed. Image data were acquired with breath-holding. Principal component analysis and k-means clustering were used for binning of cardiac phases. Cluster compactness in the time dimension was assessed using temporal variability, and dispersion in the spatial dimension was assessed using the Calinski-Harabasz index. The proposed and the reference electrocardiogram (ECG)-gated cine methods were compared using a four-point image quality score, SNR and CNR values, and Bland-Altman analyses of ventricular function. RESULTS: A total of 10 subjects with sinus rhythm and 8 subjects with arrhythmias underwent cardiac MRI at 3.0 T. The temporal variability was 45.6 ms (cluster) versus 24.6 ms (ECG-based) (p < 0.001), and the Calinski-Harabasz index was 59.1 ± 9.1 (cluster) versus 22.0 ± 7.1 (ECG based) (p < 0.001). In subjects with sinus rhythm, 100% of the end-systolic and end-diastolic images from both the cluster and reference approach received the highest image quality score of 4. Relative to the reference cine images, the cluster-based multiphase (cine) image quality consistently received a one-point lower score (p < 0.05), whereas the SNR and CNR values were not significantly different (p = 0.20). In cases with arrhythmias, 97.9% of the end-systolic and end-diastolic images from the cluster approach received an image quality score of 3 or more. The mean bias values for biventricular ejection fraction and volumes derived from the cluster approach versus reference cine were negligible. CONCLUSION: ECG-free cine cardiac MRI with data-driven clustering for binning of cardiac motion is feasible and enables quantification of cardiac function.

Digital pathology for reporting histopathology samples, including cancer screening samples - definitive evidence from a multisite study.

AIMS: To conduct a definitive multicentre comparison of digital pathology (DP) with light microscopy (LM) for reporting histopathology slides including breast and bowel cancer screening samples. METHODS: A total of 2024 cases (608 breast, 607 GI, 609 skin, 200 renal) were studied, including 207 breast and 250 bowel cancer screening samples. Cases were examined by four pathologists (16 study pathologists across the four speciality groups), using both LM and DP, with the order randomly assigned and 6 weeks between viewings. Reports were compared for clinical management concordance (CMC), meaning identical diagnoses plus differences which do not affect patient management. Percentage CMCs were computed using logistic regression models with crossed random-effects terms for case and pathologist. The obtained percentage CMCs were referenced to 98.3% calculated from previous studies. RESULTS: For all cases LM versus DP comparisons showed the CMC rates were 99.95% [95% confidence interval (CI) = 99.90-99.97] and 98.96 (95% CI = 98.42-99.32) for cancer screening samples. In speciality groups CMC for LM versus DP showed: breast 99.40% (99.06-99.62) overall and 96.27% (94.63-97.43) for cancer screening samples; [gastrointestinal (GI) = 99.96% (99.89-99.99)] overall and 99.93% (99.68-99.98) for bowel cancer screening samples; skin 99.99% (99.92-100.0); renal 99.99% (99.57-100.0). Analysis of clinically significant differences revealed discrepancies in areas where interobserver variability is known to be high, in reads performed with both modalities and without apparent trends to either. CONCLUSIONS: Comparing LM and DP CMC, overall rates exceed the reference 98.3%, providing compelling evidence that pathologists provide equivalent results for both routine and cancer screening samples irrespective of the modality used.

Improved Support Vector Machine based on CNN-SVD for vision-threatening diabetic retinopathy detection and classification.

The integration of artificial intelligence (AI) in diagnosing diabetic retinopathy, a major contributor to global vision impairment, is becoming increasingly pronounced. Notably, the detection of vision-threatening diabetic retinopathy (VTDR) has been significantly fortified through automated techniques. Traditionally, the reliance on manual analysis of retinal images, albeit slow and error-prone, constituted the conventional approach. Addressing this, our study introduces a novel methodology that amplifies the robustness and precision of the detection process. This is complemented by the groundbreaking Hierarchical Block Attention (HBA) and HBA-U-Net architecture, which notably propel attention mechanisms in image segmentation. This innovative model refines image processing without imposing excessive computational demands by honing in on individual pixel intricacies, spatial relationships, and channel-specific attention. Building upon this innovation, our proposed method employs a multi-stage strategy encompassing data pre-processing, feature extraction via a hybrid CNN-SVD model, and classification employing an amalgamation of Improved Support Vector Machine-Radial Basis Function (ISVM-RBF), DT, and KNN techniques. Rigorously tested on the IDRiD dataset classified into five severity tiers, the hybrid model yields remarkable performance, achieving a 99.18% accuracy, 98.15% sensitivity, and 100% specificity in VTDR detection, thus surpassing existing methods. These results underscore a more potent avenue for diagnosing and addressing this crucial ocular condition while underscoring AI's transformative potential in medical care, particularly in ophthalmology.

Apparent diffusion coefficient histogram in the differentiation of benign and malignant testicular tumors.

Purpose: This retrospective study assessed the value of histogram parameters of the apparent diffusion coefficient (ADC) map (HA) in differentiating between benign and malignant testicular tumors. We compared the diagnostic performance of two different volume-of-interest (VOI) placement methods: VOI 1, the entire tumor; VOI 2, the tumor excluding its cystic, calcified, hemorrhagic, and necrotic portions. Materials and methods: We retrospectively evaluated 45 patients with testicular tumors examined with scrotal contrast-enhanced magnetic resonance imaging. These patients underwent surgery with the pathological result of seven benign and 39 malignant tumors. We calculated the HA parameters, including mean, median, maximum, minimum, kurtosis, skewness, entropy, standard deviation (SD), mean of positive pixels, and uniformity of positive pixels by the two different VOI segmentation methods. We compared these parameters using the chi-square test, Mann-Whitney U test, and area under the receiver operating characteristic curve (AUC) to determine their optimal cut-off, sensitivity (Se), and specificity (Sp). Result: This study included 45 patients with 46 testicular lesions (seven benign and 39 malignant tumors), one of which had bilateral testicular seminoma. With the VOI 1 method, benign lesions had significantly lower maximum ADC (p = 0.002), ADC skewness (p = 0.017), and ADC variance (p = 0.000) than malignant lesions. In contrast, their minimum ADC was significantly higher ADC (p = 0.000). With the VOI 2 method, the benign lesions had significantly higher ADC SD (p = 0.048) and maximum ADC (p = 0.015) than malignant lesions. In contrast, their minimum ADC was significantly lower (p = 0.000). With the VOI 1 method, maximum ADC, ADC variance, and ADC skewness performed well in differentiating benign and malignant testicular lesions with cut-offs (Se, Sp, AUC) of 1846.000 (74.4%, 100%, 0.883), 39198.387 (79.5%, 85.7%, 0.868), and 0.893 (48.7%, 100%, 0.758). Conclusion: The HA parameters showed value in differentiating benign and malignant testicular neoplasms. The entire tumor VOI placement method was preferable to the VOI placement method excluding cystic, calcified, hemorrhagic, and necrotic portions in measuring HA parameters. Using this VOI segmentation, maximum ADC performed best in discriminating benign and malignant testicular lesions, followed by ADC variance and skewness.

Space-feature measures on meshes for mapping spatial transcriptomics.

Advances in the development of largely automated microscopy methods such as MERFISH for imaging cellular structures in mouse brains are providing spatial detection of micron resolution gene expression. While there has been tremendous progress made in the field of Computational Anatomy (CA) to perform diffeomorphic mapping technologies at the tissue scales for advanced neuroinformatic studies in common coordinates, integration of molecular- and cellular-scale populations through statistical averaging via common coordinates remains yet unattained. This paper describes the first set of algorithms for calculating geodesics in the space of diffeomorphisms, what we term space-feature-measure LDDMM, extending the family of large deformation diffeomorphic metric mapping (LDDMM) algorithms to accommodate a space-feature action on marked particles which extends consistently to the tissue scales. It leads to the derivation of a cross-modality alignment algorithm of transcriptomic data to common coordinate systems attached to standard atlases. We represent the brain data as geometric measures, termed as space-feature measures supported by a large number of unstructured points, each point representing a small volume in space and carrying a list of densities of features elements of a high-dimensional feature space. The shape of space-feature measure brain spaces is measured by transforming them by diffeomorphisms. The metric between these measures is obtained after embedding these objects in a linear space equipped with the norm, yielding a so-called "chordal metric".