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1.
Clin Breast Cancer ; 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38494415

RESUMO

OBJECTIVES: To develop predictive nomograms based on clinical and ultrasound features and to improve the clinical strategy for US BI-RADS 4A lesions. METHODS: Patients with US BI-RADS 4A lesions from 3 hospitals between January 2016 and June 2020 were retrospectively included. Clinical and ultrasound features were extracted to establish nomograms CE (based on clinical experience) and DL (based on deep-learning algorithm). The performances of nomograms were evaluated by receiver operator characteristic curves, calibration curves and decision curves. Diagnostic performances with DL of radiologists were analyzed. RESULTS: 1616 patients from 2 hospitals were randomly divided into training and internal validation cohorts at a ratio of 7:3. Hundred patients from another hospital made up external validation cohort. DL achieved more optimized AUCs than CE (internal validation: 0.916 vs. 0.863, P < .01; external validation: 0.884 vs. 0.776, P = .05). The sensitivities of DL were higher than CE (internal validation: 81.03% vs. 72.41%, P = .044; external validation: 93.75% vs. 81.25%, P = .4795) without losing specificity (internal validation: 84.91% vs. 86.47%, P = .353; external validation: 69.14% vs. 71.60%, P = .789). Decision curves indicated DL adds more clinical net benefit. With DL's assistance, both radiologists achieved higher AUCs (0.712 vs. 0.801; 0.547 vs. 0.800), improved specificities (70.93% vs. 74.42%, P < .001; 59.3% vs. 81.4%, P = .004), and decreased unnecessary biopsy rates by 6.7% and 24%. CONCLUSION: DL was developed to discriminate US BI-RADS 4A lesions with a higher diagnostic power and more clinical net benefit than CE. Using DL may guide clinicians to make precise clinical decisions and avoid overtreatment of benign lesions.

2.
Comput Biol Med ; 171: 108137, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38447499

RESUMO

Lesion segmentation in ultrasound images is an essential yet challenging step for early evaluation and diagnosis of cancers. In recent years, many automatic CNN-based methods have been proposed to assist this task. However, most modern approaches often lack capturing long-range dependencies and prior information making it difficult to identify the lesions with unfixed shapes, sizes, locations, and textures. To address this, we present a novel lesion segmentation framework that guides the model to learn the global information about lesion characteristics and invariant features (e.g., morphological features) of lesions to improve the segmentation in ultrasound images. Specifically, the segmentation model is guided to learn the characteristics of lesions from the global maps using an adversarial learning scheme with a self-attention-based discriminator. We argue that under such a lesion characteristics-based guidance mechanism, the segmentation model gets more clues about the boundaries, shapes, sizes, and positions of lesions and can produce reliable predictions. In addition, as ultrasound lesions have different textures, we embed this prior knowledge into a novel region-invariant loss to constrain the model to focus on invariant features for robust segmentation. We demonstrate our method on one in-house breast ultrasound (BUS) dataset and two public datasets (i.e., breast lesion (BUS B) and thyroid nodule from TNSCUI2020). Experimental results show that our method is specifically suitable for lesion segmentation in ultrasound images and can outperform the state-of-the-art approaches with Dice of 0.931, 0.906, and 0.876, respectively. The proposed method demonstrates that it can provide more important information about the characteristics of lesions for lesion segmentation in ultrasound images, especially for lesions with irregular shapes and small sizes. It can assist the current lesion segmentation models to better suit clinical needs.


Assuntos
Processamento de Imagem Assistida por Computador , Nódulo da Glândula Tireoide , Humanos , Processamento de Imagem Assistida por Computador/métodos , Ultrassonografia , Mama
3.
ACS Appl Mater Interfaces ; 16(6): 7790-7805, 2024 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-38301153

RESUMO

Adhesive hydrogels, playing an essential role in stretchable electronics, soft robotics, tissue engineering, and so forth, upon functioning often need to adhere to various substrates in wet conditions and simultaneously exhibit antibacterial/antioxidant properties while possessing the intrinsic stretchability and elasticity of the hydrogel network intact. Therefore, simple approaches to conveniently access adhesive hydrogels with multifunctional surfaces are being pursued. Herein, a facile strategy has been proposed to construct multifunctional adhesive hydrogels via surface engineering of a multifunctional carbon dot (CD)-decorated polymeric thin layer by dynamic bond exchange. By this strategy, a double cross-linked network hydrogel of polyacrylamide (PAM) and oxidized dextran (ODA) was engineered with a unique dense layer over the Schiff base hydrogel matrix by aqueous solution immersion of PA-120, versatile CDs derived from tannic acid (TA) and ε-polylysine (PL). Without any additional agents, the PA-120 CDs with residual polyphenolic/catechol and amine moieties were incorporated into the surface structure of the hydrogel network by the combined action of the Schiff base and hydrogen bonds to form a dense surface layer that can exhibit high wet adhesive performance via the amine-polyphenol/catechol pair. The armor-like dense architecture also endowed hydrogels with considerably enhanced tensile/compression properties and excellent antioxidant/antibacterial abilities. Besides, the single-sided modified Janus hydrogel and completely surface-modified hydrogel can be flexibly developed through this approach. This strategy will provide new insights into the preparation and application of surface-modified hydrogels featuring multiple functions and tunable interfacial properties.

4.
Ultrasound Med Biol ; 50(2): 304-314, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38044200

RESUMO

OBJECTIVE: Ultrasound (US) examination has unique advantages in diagnosing carpal tunnel syndrome (CTS), although identification of the median nerve (MN) and diagnosis of CTS depend heavily on the expertise of examiners. In the aim of alleviating this problem, we developed a one-stop automated CTS diagnosis system (OSA-CTSD) and evaluated its effectiveness as a computer-aided diagnostic tool. METHODS: We combined real-time MN delineation, accurate biometric measurements and explainable CTS diagnosis into a unified framework, called OSA-CTSD. We then collected a total of 32,301 static images from US videos of 90 normal wrists and 40 CTS wrists for evaluation using a simplified scanning protocol. RESULTS: The proposed model exhibited better segmentation and measurement performance than competing methods, with a Hausdorff distance (95th percentile) score of 7.21 px, average symmetric surface distance score of 2.64 px, Dice score of 85.78% and intersection over union score of 76.00%. In the reader study, it exhibited performance comparable to the average performance of experienced radiologists in classifying CTS and outperformed inexperienced radiologists in terms of classification metrics (e.g., accuracy score 3.59% higher and F1 score 5.85% higher). CONCLUSION: Diagnostic performance of the OSA-CTSD was promising, with the advantages of real-time delineation, automation and clinical interpretability. The application of such a tool not only reduces reliance on the expertise of examiners but also can help to promote future standardization of the CTS diagnostic process, benefiting both patients and radiologists.


Assuntos
Síndrome do Túnel Carpal , Aprendizado Profundo , Humanos , Síndrome do Túnel Carpal/diagnóstico por imagem , Condução Nervosa/fisiologia , Nervo Mediano/diagnóstico por imagem , Ultrassonografia
5.
J Mater Chem B ; 11(4): 734-754, 2023 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-36602120

RESUMO

Due to the increasing bacterial resistance to conventional antibiotics, developing safe and effective approaches to combat infections caused by bacteria and biofilms has become an urgent clinical problem. Recently, carbon dots (CDs) have received great attention as a promising alternative to conventional antimicrobial agents due to their excellent antimicrobial efficacy and biocompatibility. Although CDs have been widely used in the field of antibacterial applications, their antibacterial and antibiofilm mechanisms have not been systematically discussed. This review provides a systematic overview on the complicated mechanisms of antibacterial and antibiofilm CDs based on recent development.


Assuntos
Anti-Infecciosos , Carbono , Antibacterianos/farmacologia , Bactérias , Biofilmes , Carbono/farmacologia
6.
J Ultrasound Med ; 42(6): 1235-1248, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36445006

RESUMO

OBJECTIVES: Ultrasound (US) is important for diagnosing infant developmental dysplasia of the hip (DDH). However, the accuracy of the diagnosis depends heavily on expertise. We aimed to develop a novel automatic system (DDHnet) for accurate, fast, and robust diagnosis of DDH. METHODS: An automatic system, DDHnet, was proposed to diagnose DDH by analyzing static ultrasound images. A five-fold cross-validation experiment was conducted using a dataset containing 881 patients to verify the performance of DDHnet. In addition, a blind test was conducted on 209 patients (158 normal and 51 abnormal cases). The feasibility and performance of DDHnet were investigated by embedding it into ultrasound machines at low computational cost. RESULTS: DDHnet obtained reliable measurements and accurate diagnosis predictions. It reported an intra-class correlation coefficient (ICC) on α angle of 0.96 (95% CI: 0.93-0.97), ß angle of 0.97 (95% CI: 0.95-0.98), FHC of 0.98 (95% CI: 0.96-0.99) and PFD of 0.94 (95% CI: 0.90-0.96) in abnormal cases. DDHnet achieved a sensitivity of 90.56%, specificity of 100%, accuracy of 98.64%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 98.44% for the diagnosis of DDH. For the measurement task on the US device, DDHnet took only 1.1 seconds to operate and complete, whereas the experienced senior expert required an average 41.4 seconds. CONCLUSIONS: The proposed DDHnet demonstrate state-of-the-art performance for all four indicators of DDH diagnosis. Fast and highly accurate DDH diagnosis is achievable through DDHnet, and is accessible under constrained computational resources.


Assuntos
Displasia do Desenvolvimento do Quadril , Luxação Congênita de Quadril , Lactente , Humanos , Inteligência Artificial , Luxação Congênita de Quadril/diagnóstico por imagem , Ultrassonografia/métodos , Valor Preditivo dos Testes
7.
Artigo em Inglês | MEDLINE | ID: mdl-35820014

RESUMO

Ultrasound (US) is the primary imaging technique for the diagnosis of thyroid cancer. However, accurate identification of nodule malignancy is a challenging task that can elude less-experienced clinicians. Recently, many computer-aided diagnosis (CAD) systems have been proposed to assist this process. However, most of them do not provide the reasoning of their classification process, which may jeopardize their credibility in practical use. To overcome this, we propose a novel deep learning (DL) framework called multi-attribute attention network (MAA-Net) that is designed to mimic the clinical diagnosis process. The proposed model learns to predict nodular attributes and infer their malignancy based on these clinically-relevant features. A multi-attention scheme is adopted to generate customized attention to improve each task and malignancy diagnosis. Furthermore, MAA-Net utilizes nodule delineations as nodules spatial prior guidance for the training rather than cropping the nodules with additional models or human interventions to prevent losing the context information. Validation experiments were performed on a large and challenging dataset containing 4554 patients. Results show that the proposed method outperformed other state-of-the-art methods and provides interpretable predictions that may better suit clinical needs.


Assuntos
Nódulo da Glândula Tireoide , Diagnóstico por Computador , Humanos , Tomografia Computadorizada por Raios X , Ultrassonografia
8.
Med Image Anal ; 80: 102478, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35691144

RESUMO

Breast Ultrasound (BUS) has proven to be an effective tool for the early detection of cancer in the breast. A lesion segmentation provides identification of the boundary, shape, and location of the target, and serves as a crucial step toward accurate diagnosis. Despite recent efforts in developing machine learning algorithms to automate this process, problems remain due to the blurry or occluded edges and highly irregular nodule shapes. Existing methods often produce over-smooth or inaccurate results, failing the need of identifying detailed boundary structures which are of clinical interest. To overcome these challenges, we propose a novel boundary-rendering framework that explicitly highlights the importance of boundary for automated nodule segmentation in BUS images. It utilizes a boundary selection module to automatically focuses on the ambiguous boundary region and a graph convolutional-based boundary rendering module to exploit global contour information. Furthermore, the proposed framework embeds nodule classification via semantic segmentation and encourages co-learning across tasks. Validation experiments were performed on different BUS datasets to verify the robustness of the proposed method. Results show that the proposed method outperforms states-of-art segmentation approaches (Dice=0.854, IOU=0.919, HD=17.8) in nodule delineation, as well as obtains a higher classification accuracy than classical classification models.


Assuntos
Algoritmos , Processamento de Imagem Assistida por Computador , Mama/diagnóstico por imagem , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Ultrassonografia , Ultrassonografia Mamária/métodos
9.
Neuroimage ; 258: 119341, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35654376

RESUMO

Brain extraction (masking of extra-cerebral tissues) and alignment are fundamental first steps of most neuroimage analysis pipelines. The lack of automated solutions for 3D ultrasound (US) has therefore limited its potential as a neuroimaging modality for studying fetal brain development using routinely acquired scans. In this work, we propose a convolutional neural network (CNN) that accurately and consistently aligns and extracts the fetal brain from minimally pre-processed 3D US scans. Our multi-task CNN, Brain Extraction and Alignment Network (BEAN), consists of two independent branches: 1) a fully-convolutional encoder-decoder branch for brain extraction of unaligned scans, and 2) a two-step regression-based branch for similarity alignment of the brain to a common coordinate space. BEAN was tested on 356 fetal head 3D scans spanning the gestational range of 14 to 30 weeks, significantly outperforming all current alternatives for fetal brain extraction and alignment. BEAN achieved state-of-the-art performance for both tasks, with a mean Dice Similarity Coefficient (DSC) of 0.94 for the brain extraction masks, and a mean DSC of 0.93 for the alignment of the target brain masks. The presented experimental results show that brain structures such as the thalamus, choroid plexus, cavum septum pellucidum, and Sylvian fissure, are consistently aligned throughout the dataset and remain clearly visible when the scans are averaged together. The BEAN implementation and related code can be found under www.github.com/felipemoser/kelluwen.


Assuntos
Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Encéfalo/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Redes Neurais de Computação , Neuroimagem/métodos
10.
Med Image Anal ; 80: 102490, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35717873

RESUMO

Ultrasound (US) plays a vital role in breast cancer screening, especially for women with dense breasts. Common practice requires a sonographer to recognize key diagnostic features of a lesion and record a single or several representative frames during the dynamic scanning before performing the diagnosis. However, existing computer-aided diagnosis tools often focus on the final diagnosis process while neglecting the influence of the keyframe selection. Moreover, the lesions could have highly-irregular shapes, varying sizes, and locations during the scanning. The recognition of diagnostic characteristics associated with the lesions is challenging and also faces severe class imbalance. To address these, we proposed a reinforcement learning-based framework that can automatically extract keyframes from breast US videos of unfixed length. It is equipped with a detection-based nodule filtering module and a novel reward mechanism that can integrate anatomical and diagnostic features of the lesions into keyframe searching. A simple yet effective loss function was also designed to alleviate the class imbalance issue. Extensive experiments illustrate that the proposed framework can benefit from both innovations and is able to generate representative keyframe sequences in various screening conditions.


Assuntos
Neoplasias da Mama , Ultrassonografia Mamária , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Diagnóstico por Computador , Detecção Precoce de Câncer , Feminino , Humanos
11.
Biomater Sci ; 10(10): 2692-2705, 2022 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-35438690

RESUMO

Bacterial infection and excessive reactive oxygen species (ROS) remain challenging factors contributing to the delayed healing of chronic wounds. Although various antibacterial and antioxidant hydrogel dressings have been developed to accelerate wound healing, multifunctional hydrogels fabricated by rationally designing and introducing carbonized polymer dots (CPDs) have rarely been reported. Herein, inspired by the mussel biomimetic approach, we synthesized 3,4-dihydroxybenzaldehyde functionalized chitosan (DFC), and then the polymeric precursor was pyrolyzed into CPDs with abundant amino and catechol groups on the surface, which endowed it with a highly positively charged surface that could activate the photothermal effect under near-infrared (NIR) light irradiation. Finally, the nanocomposite hydrogel (PVA@CPDs) was simply constructed by directly mixing polyvinyl alcohol (PVA) with CPDs, utilizing the freeze-thaw cycle method to form a gel, in which, CPDs as a center of polyfunctional nanoparticles drove the formation of PVA microcrystalline crosslinking and endowed the PVA substrate with versatile functionalities. Remarkable and comprehensive improvements in the swelling behavior, mechanical properties and adhesive strength of the hydrogel could be conveniently achieved with the suitable loading of CPDs. The in vitro experiments demonstrated that the PVA@CPDs hydrogel presented broad-spectrum and rapid bactericidal activity, concurrently acting as an effective antioxidant being able to scavenge free radicals. In addition, no obvious cytotoxicity was observed for the multifunctional hydrogel after incubation with L02 cells. In vivo evaluation in an infected full-thickness skin wound model demonstrated that the PVA@CPDs hydrogel promoted wound closure without any side effects. As a consequence, the current work manifests a facile yet versatile strategy to develop effective and biocompatible multifunctional hydrogel dressings for bacteria-infected wound healing.


Assuntos
Quitosana , Infecção dos Ferimentos , Antibacterianos/química , Antibacterianos/farmacologia , Antioxidantes/farmacologia , Bandagens , Catecóis/farmacologia , Quitosana/química , Humanos , Hidrogéis/química , Polímeros
12.
Mater Sci Eng C Mater Biol Appl ; 127: 112225, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34225870

RESUMO

Many medical and chemical applications require the precise supply of antimicrobial components in a controlled manner at the location of mature biofilm deposits. This work reports a facile strategy to fabricate nanoscale metal-organic frameworks (NMOFs) coencapsulating the antibacterial ligand (lysine carbon dots, Lys-CDs) and targeted drug (folic acid, FA) in one pot to improve antibiofilm efficiency against established biofilms. The resulting products are characterized by transmission electron microscopy, field-emission scanning electron microscopy, powder x-ray diffraction, and ultraviolet-visible spectroscopy. The results show that Lys-CDs could coordinate with Zn2+ and the adding of FA inhibits the coordination of Lys-CDs with central ions of Zn. The Lys-CDs and FA are successfully exposed with the NMOFs disintegrating in the acid environment of bacterial metabolites. We are surprised to find a sharp increase of reactive oxygen species (ROS) inside the bacterial cells by FA functionalizing NMOFs, which undoubtedly enhance the antibacterial and antibiofilm activity. The as-synthesized ZIF-8-based nanocomposites also show the peroxidase-like activity in an acid environment, and produce extremely active hydroxyl radicals resulting in the improved antibacterial and antibiofilm activity. The possible mechanisms of antibacterial activities indicate that the presence of FA is significant in the sense of targeting bacteria. This study shows a novel approach to construct acid stimulation supply system which may be helpful for the research of antibiofilms.


Assuntos
Ácido Fólico , Estruturas Metalorgânicas , Antibacterianos/farmacologia , Bactérias , Biofilmes , Espécies Reativas de Oxigênio
13.
Med Image Anal ; 72: 102137, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34216958

RESUMO

Recently, more clinicians have realized the diagnostic value of multi-modal ultrasound in breast cancer identification and began to incorporate Doppler imaging and Elastography in the routine examination. However, accurately recognizing patterns of malignancy in different types of sonography requires expertise. Furthermore, an accurate and robust diagnosis requires proper weights of multi-modal information as well as the ability to process missing data in practice. These two aspects are often overlooked by existing computer-aided diagnosis (CAD) approaches. To overcome these challenges, we propose a novel framework (called AW3M) that utilizes four types of sonography (i.e. B-mode, Doppler, Shear-wave Elastography, and Strain Elastography) jointly to assist breast cancer diagnosis. It can extract both modality-specific and modality-invariant features using a multi-stream CNN model equipped with self-supervised consistency loss. Instead of assigning the weights of different streams empirically, AW3M automatically learns the optimal weights using reinforcement learning techniques. Furthermore, we design a light-weight recovery block that can be inserted to a trained model to handle different modality-missing scenarios. Experimental results on a large multi-modal dataset demonstrate that our method can achieve promising performance compared with state-of-the-art methods. The AW3M framework is also tested on another independent B-mode dataset to prove its efficacy in general settings. Results show that the proposed recovery block can learn from the joint distribution of multi-modal features to further boost the classification accuracy given single modality input during the test.


Assuntos
Neoplasias da Mama , Técnicas de Imagem por Elasticidade , Neoplasias da Mama/diagnóstico por imagem , Diagnóstico por Computador , Feminino , Humanos , Ultrassonografia , Ultrassonografia Mamária
14.
Med Image Anal ; 72: 102119, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34144345

RESUMO

3D ultrasound (US) has become prevalent due to its rich spatial and diagnostic information not contained in 2D US. Moreover, 3D US can contain multiple standard planes (SPs) in one shot. Thus, automatically localizing SPs in 3D US has the potential to improve user-independence and scanning-efficiency. However, manual SP localization in 3D US is challenging because of the low image quality, huge search space and large anatomical variability. In this work, we propose a novel multi-agent reinforcement learning (MARL) framework to simultaneously localize multiple SPs in 3D US. Our contribution is four-fold. First, our proposed method is general and it can accurately localize multiple SPs in different challenging US datasets. Second, we equip the MARL system with a recurrent neural network (RNN) based collaborative module, which can strengthen the communication among agents and learn the spatial relationship among planes effectively. Third, we explore to adopt the neural architecture search (NAS) to automatically design the network architecture of both the agents and the collaborative module. Last, we believe we are the first to realize automatic SP localization in pelvic US volumes, and note that our approach can handle both normal and abnormal uterus cases. Extensively validated on two challenging datasets of the uterus and fetal brain, our proposed method achieves the average localization accuracy of 7.03∘/1.59mm and 9.75∘/1.19mm. Experimental results show that our light-weight MARL model has higher accuracy than state-of-the-art methods.


Assuntos
Redes Neurais de Computação , Útero , Feminino , Humanos , Imageamento Tridimensional , Ultrassonografia
15.
IEEE Trans Med Imaging ; 40(7): 1950-1961, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33784618

RESUMO

Accurate standard plane (SP) localization is the fundamental step for prenatal ultrasound (US) diagnosis. Typically, dozens of US SPs are collected to determine the clinical diagnosis. 2D US has to perform scanning for each SP, which is time-consuming and operator-dependent. While 3D US containing multiple SPs in one shot has the inherent advantages of less user-dependency and more efficiency. Automatically locating SP in 3D US is very challenging due to the huge search space and large fetal posture variations. Our previous study proposed a deep reinforcement learning (RL) framework with an alignment module and active termination to localize SPs in 3D US automatically. However, termination of agent search in RL is important and affects the practical deployment. In this study, we enhance our previous RL framework with a newly designed adaptive dynamic termination to enable an early stop for the agent searching, saving at most 67% inference time, thus boosting the accuracy and efficiency of the RL framework at the same time. Besides, we validate the effectiveness and generalizability of our algorithm extensively on our in-house multi-organ datasets containing 433 fetal brain volumes, 519 fetal abdomen volumes, and 683 uterus volumes. Our approach achieves localization error of 2.52mm/10.26° , 2.48mm/10.39° , 2.02mm/10.48° , 2.00mm/14.57° , 2.61mm/9.71° , 3.09mm/9.58° , 1.49mm/7.54° for the transcerebellar, transventricular, transthalamic planes in fetal brain, abdominal plane in fetal abdomen, and mid-sagittal, transverse and coronal planes in uterus, respectively. Experimental results show that our method is general and has the potential to improve the efficiency and standardization of US scanning.


Assuntos
Algoritmos , Ultrassonografia Pré-Natal , Abdome/diagnóstico por imagem , Feminino , Humanos , Imageamento Tridimensional , Gravidez , Ultrassonografia
16.
Med Image Anal ; 69: 101975, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33550007

RESUMO

The outbreak of COVID-19 around the world has caused great pressure to the health care system, and many efforts have been devoted to artificial intelligence (AI)-based analysis of CT and chest X-ray images to help alleviate the shortage of radiologists and improve the diagnosis efficiency. However, only a few works focus on AI-based lung ultrasound (LUS) analysis in spite of its significant role in COVID-19. In this work, we aim to propose a novel method for severity assessment of COVID-19 patients from LUS and clinical information. Great challenges exist regarding the heterogeneous data, multi-modality information, and highly nonlinear mapping. To overcome these challenges, we first propose a dual-level supervised multiple instance learning module (DSA-MIL) to effectively combine the zone-level representations into patient-level representations. Then a novel modality alignment contrastive learning module (MA-CLR) is presented to combine representations of the two modalities, LUS and clinical information, by matching the two spaces while keeping the discriminative features. To train the nonlinear mapping, a staged representation transfer (SRT) strategy is introduced to maximumly leverage the semantic and discriminative information from the training data. We trained the model with LUS data of 233 patients, and validated it with 80 patients. Our method can effectively combine the two modalities and achieve accuracy of 75.0% for 4-level patient severity assessment, and 87.5% for the binary severe/non-severe identification. Besides, our method also provides interpretation of the severity assessment by grading each of the lung zone (with accuracy of 85.28%) and identifying the pathological patterns of each lung zone. Our method has a great potential in real clinical practice for COVID-19 patients, especially for pregnant women and children, in aspects of progress monitoring, prognosis stratification, and patient management.


Assuntos
COVID-19/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Ultrassonografia , Adulto Jovem
17.
Med Image Anal ; 47: 127-139, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29715691

RESUMO

Three-dimensional (3D) fetal neurosonography is used clinically to detect cerebral abnormalities and to assess growth in the developing brain. However, manual identification of key brain structures in 3D ultrasound images requires expertise to perform and even then is tedious. Inspired by how sonographers view and interact with volumes during real-time clinical scanning, we propose an efficient automatic method to simultaneously localize multiple brain structures in 3D fetal neurosonography. The proposed View-based Projection Networks (VP-Nets), uses three view-based Convolutional Neural Networks (CNNs), to simplify 3D localizations by directly predicting 2D projections of the key structures onto three anatomical views. While designed for efficient use of data and GPU memory, the proposed VP-Nets allows for full-resolution 3D prediction. We investigated parameters that influence the performance of VP-Nets, e.g. depth and number of feature channels. Moreover, we demonstrate that the model can pinpoint the structure in 3D space by visualizing the trained VP-Nets, despite only 2D supervision being provided for a single stream during training. For comparison, we implemented two other baseline solutions based on Random Forest and 3D U-Nets. In the reported experiments, VP-Nets consistently outperformed other methods on localization. To test the importance of loss function, two identical models are trained with binary corss-entropy and dice coefficient loss respectively. Our best VP-Net model achieved prediction center deviation: 1.8 ±â€¯1.4 mm, size difference: 1.9 ±â€¯1.5 mm, and 3D Intersection Over Union (IOU): 63.2 ±â€¯14.7% when compared to the ground truth. To make the whole pipeline intervention free, we also implement a skull-stripping tool using 3D CNN, which achieves high segmentation accuracy. As a result, the proposed processing pipeline takes a raw ultrasound brain image as input, and output a skull-stripped image with five detected key brain structures.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Redes Neurais de Computação , Neuroimagem/métodos , Ultrassonografia Pré-Natal/métodos , Algoritmos , Feminino , Humanos , Gravidez
18.
J Med Imaging (Bellingham) ; 5(1): 014007, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29541649

RESUMO

We present a general framework for automatic segmentation of fetal brain structures in ultrasound images inspired by recent advances in machine learning. The approach is based on a region descriptor that characterizes the shape and local intensity context of different neurological structures without explicit models. To validate our framework, we present experiments to segment two fetal brain structures of clinical importance that have quite different ultrasonic appearances-the corpus callosum (CC) and the choroid plexus (CP). Results demonstrate that our approach achieves high region segmentation accuracy (dice coefficient: [Formula: see text] CC, [Formula: see text] CP) relative to human delineation, whereas the derived automated biometry measurement deviations are within human intra/interobserver variations. The use of our proposed method may help to standardize intracranial anatomy measurements for both the routine examination and the detection of congenital conditions in the future.

19.
Sensors (Basel) ; 14(1): 1740-56, 2014 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-24448168

RESUMO

Implantable devices have important applications in biomedical sensor networks used for biomedical monitoring, diagnosis and treatment, etc. In this paper, an implant intra-body communication (IBC) method based on capacitive coupling has been proposed, and the modeling and characterization of this kind of IBC has been investigated. Firstly, the transfer function of the implant IBC based on capacitive coupling was derived. Secondly, the corresponding parameters of the transfer function are discussed. Finally, both measurements and simulations based on the proposed transfer function were carried out, while some important conclusions have been achieved, which indicate that the achieved transfer function and conclusions are able to help to achieve an implant communication method with the highly desirable characteristics of low power consumption, high data rate, high transmission quality, etc.


Assuntos
Técnicas Biossensoriais/métodos , Humanos , Monitorização Ambulatorial , Telemetria
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