Segmentation of carotid artery vessel wall and diagnosis of carotid atherosclerosis on black blood magnetic resonance imaging with multi-task learning.

BACKGROUND: Atherosclerotic cardiovascular disease is the leading cause of death worldwide. Early detection of carotid atherosclerosis can prevent the progression of cardiovascular disease. Many (semi-) automatic methods have been designed for the segmentation of carotid vessel wall and the diagnosis of carotid atherosclerosis (i.e., the lumen segmentation, the outer wall segmentation, and the carotid atherosclerosis diagnosis) on black blood magnetic resonance imaging (BB-MRI). However, most of these methods ignore the intrinsic correlation among different tasks on BB-MRI, leading to limited performance. PURPOSE: Thus, we model the intrinsic correlation among the lumen segmentation, the outer wall segmentation, and the carotid atherosclerosis diagnosis tasks on BB-MRI by using the multi-task learning technique and propose a gated multi-task network (GMT-Net) to perform three related tasks in a neural network (i.e., carotid artery lumen segmentation, outer wall segmentation, and carotid atherosclerosis diagnosis). METHODS: In the proposed method, the GMT-Net is composed of three modules, including the sharing module, the segmentation module, and the diagnosis module, which interact with each other to achieve better learning performance. At the same time, two new adaptive layers, namely, the gated exchange layer and the gated fusion layer, are presented to exchange and merge branch features. RESULTS: The proposed method is applied to the CAREII dataset (i.e., 1057 scans) for the lumen segmentation, the outer wall segmentation, and the carotid atherosclerosis diagnosis. The proposed method can achieve promising segmentation performances (0.9677 Dice for the lumen and 0.9669 Dice for the outer wall) and better diagnosis accuracy of carotid atherosclerosis (0.9516 AUC and 0.9024 Accuracy) in the "CAREII test" dataset (i.e., 106 scans). The results show that the proposed method has statistically significant accuracy and efficiency. CONCLUSIONS: Even without the intervention of reviewers required for the previous works, the proposed method automatically segments the lumen and outer wall together and diagnoses carotid atherosclerosis with high performance. The proposed method can be used in clinical trials to help radiologists get rid of tedious reading tasks, such as screening review to separate normal carotid arteries from atherosclerotic arteries and to outline vessel wall contours.

Diffeomorphic Transformer-based Abdomen MRI-CT Deformable Image Registration.

Background: Stereotactic body radiotherapy (SBRT) is a well-established treatment modality for liver metastases in patients unsuitable for surgery. Both CT and MRI are useful during treatment planning for accurate target delineation and to reduce potential organs-at-risk (OAR) toxicity from radiation. MRI-CT deformable image registration (DIR) is required to propagate the contours defined on high-contrast MRI to CT images. An accurate DIR method could lead to more precisely defined treatment volumes and superior OAR sparing on the treatment plan. Therefore, it is beneficial to develop an accurate MRI-CT DIR for liver SBRT. Purpose: To create a new deep learning model that can estimate the deformation vector field (DVF) for directly registering abdominal MRI-CT images. Methods: The proposed method assumed a diffeomorphic deformation. By using topology-preserved deformation features extracted from the probabilistic diffeomorphic registration model, abdominal motion can be accurately obtained and utilized for DVF estimation. The model integrated Swin transformers, which have demonstrated superior performance in motion tracking, into the convolutional neural network (CNN) for deformation feature extraction. The model was optimized using a cross-modality image similarity loss and a surface matching loss. To compute the image loss, a modality-independent neighborhood descriptor (MIND) was used between the deformed MRI and CT images. The surface matching loss was determined by measuring the distance between the warped coordinates of the surfaces of contoured structures on the MRI and CT images. To evaluate the performance of the model, a retrospective study was carried out on a group of 50 liver cases that underwent rigid registration of MRI and CT scans. The deformed MRI image was assessed against the CT image using the target registration error (TRE), Dice similarity coefficient (DSC), and mean surface distance (MSD) between the deformed contours of the MRI image and manual contours of the CT image. Results: When compared to only rigid registration, DIR with the proposed method resulted in an increase of the mean DSC values of the liver and portal vein from 0.850±0.102 and 0.628±0.129 to 0.903±0.044 and 0.763±0.073, a decrease of the mean MSD of the liver from 7.216±4.513 mm to 3.232±1.483 mm, and a decrease of the TRE from 26.238±2.769 mm to 8.492±1.058 mm. Conclusion: The proposed DIR method based on a diffeomorphic transformer provides an effective and efficient way to generate an accurate DVF from an MRI-CT image pair of the abdomen. It could be utilized in the current treatment planning workflow for liver SBRT.

Diffeomorphic transformer-based abdomen MRI-CT deformable image registration.

BACKGROUND: Stereotactic body radiotherapy (SBRT) is a well-established treatment modality for liver metastases in patients unsuitable for surgery. Both CT and MRI are useful during treatment planning for accurate target delineation and to reduce potential organs-at-risk (OAR) toxicity from radiation. MRI-CT deformable image registration (DIR) is required to propagate the contours defined on high-contrast MRI to CT images. An accurate DIR method could lead to more precisely defined treatment volumes and superior OAR sparing on the treatment plan. Therefore, it is beneficial to develop an accurate MRI-CT DIR for liver SBRT. PURPOSE: To create a new deep learning model that can estimate the deformation vector field (DVF) for directly registering abdominal MRI-CT images. METHODS: The proposed method assumed a diffeomorphic deformation. By using topology-preserved deformation features extracted from the probabilistic diffeomorphic registration model, abdominal motion can be accurately obtained and utilized for DVF estimation. The model integrated Swin transformers, which have demonstrated superior performance in motion tracking, into the convolutional neural network (CNN) for deformation feature extraction. The model was optimized using a cross-modality image similarity loss and a surface matching loss. To compute the image loss, a modality-independent neighborhood descriptor (MIND) was used between the deformed MRI and CT images. The surface matching loss was determined by measuring the distance between the warped coordinates of the surfaces of contoured structures on the MRI and CT images. To evaluate the performance of the model, a retrospective study was carried out on a group of 50 liver cases that underwent rigid registration of MRI and CT scans. The deformed MRI image was assessed against the CT image using the target registration error (TRE), Dice similarity coefficient (DSC), and mean surface distance (MSD) between the deformed contours of the MRI image and manual contours of the CT image. RESULTS: When compared to only rigid registration, DIR with the proposed method resulted in an increase of the mean DSC values of the liver and portal vein from 0.850 ± 0.102 and 0.628 ± 0.129 to 0.903 ± 0.044 and 0.763 ± 0.073, a decrease of the mean MSD of the liver from 7.216 ± 4.513 mm to 3.232 ± 1.483 mm, and a decrease of the TRE from 26.238 ± 2.769 mm to 8.492 ± 1.058 mm. CONCLUSION: The proposed DIR method based on a diffeomorphic transformer provides an effective and efficient way to generate an accurate DVF from an MRI-CT image pair of the abdomen. It could be utilized in the current treatment planning workflow for liver SBRT.

Deep Q-learning to globally optimize a k-D parameter search for medical imaging.

Background: Estimation of the global optima of multiple model parameters is valuable for precisely extracting parameters that characterize a physical environment. This is especially useful for imaging purposes, to form reliable, meaningful physical images with good reproducibility. However, it is challenging to avoid different local minima when the objective function is nonconvex. The problem of global searching of multiple parameters was formulated to be a k-D move in the parameter space and the parameter updating scheme was converted to be a state-action decision-making problem. Methods: We proposed a novel Deep Q-learning of Model Parameters (DQMP) method for global optimization which updated the parameter configurations through actions that maximized the Q-value and employed a Deep Reward Network (DRN) designed to learn global reward values from both visible fitting errors and hidden parameter errors. The DRN was constructed with Long Short-Term Memory (LSTM) layers followed by fully connected layers and a rectified linear unit (ReLU) nonlinearity. The depth of the DRN depended on the number of parameters. Through DQMP, the k-D parameter search in each step resembled the decision-making of action selections from 3k configurations in a k-D board game. Results: The DQMP method was evaluated by widely used general functions that can express a variety of experimental data and further validated on imaging applications. The convergence of the proposed DRN was evaluated, which showed that the loss values of six general functions all converged after 12 epochs. The parameters estimated by the DQMP method had relative errors of less than 4% for all cases, whereas the relative errors achieved by Q-learning (QL) and the Least Squares Method (LSM) were 17% and 21%, respectively. Furthermore, the imaging experiments demonstrated that the imaging of the parameters estimated by the proposed DQMP method were the closest to the ground truth simulation images when compared to other methods. Conclusions: The proposed DQMP method was able to achieve global optima, thus yielding accurate model parameter estimates. DQMP is promising for estimating multiple high-dimensional parameters and can be generalized to global optimization for many other complex nonconvex functions and imaging of physical parameters.

The viscoelastic characteristics of in-vitro carotid plaque by Kelvin-Voigt fractional derivative modeling.

Atherosclerotic plaque with a thin fibrous cap can be ruptured by shear force. Exploiting the mechanical properties of plaques within different histological regions can help to better understand the physical mechanisms of the plaque. The association between the plaque components and viscoelasticity was studied when mapping the viscoelasticity to histological features. Eleven in-vitro carotid plaques were tested with ramp-hold relaxation nanoindentation tests. Viscoelasticity (elastic modulus E0, fluidity α, and viscosity τ) was characterized by Kelvin-Voigt fractional derivative (KVFD) modeling. There is a significant difference (p < 0.001) on E0, α, and τ between the collagen-rich (CR) group and the non-collagen-rich (NCR) group. In the CR group, the elastic modulus E0 was higher but the fluidity α and viscosity τ were lower than those of the NCR group. Receiver operating characteristic (ROC) analysis revealed that combinations of E0 and α can be used as a CR indicator with an area under the curve (AUC) of 0.770. There was a negative correlation between E0 and the percentages of myxoid degeneration (r = -0.160, p < 0.001), necrosis (r = -0.229, p < 0.001) and inflammatory cells (r = -0.130, p < 0.001), and a positive correlation between elasticity E0 and the percentage of foam cells (r = 0.121, p < 0.001). There was a positive correlation between fluidity α and the percentage of necrosis (r = 0.308, p < 0.001). The results confirmed the clinical evidence that the CR group with higher elasticity and lower fluidity has higher resisting ability, whereas the NCR group with lower elasticity and higher fluidity has accompanied with more myxoid degeneration, extracellular lipids and necrosis.

Prostate and dominant intraprostatic lesion segmentation on PET/CT using cascaded regional-net.

Focal boost to dominant intraprostatic lesions (DILs) has recently been proposed for prostate radiation therapy. Accurate and fast delineation of the prostate and DILs is thus required during treatment planning. In this paper, we develop a learning-based method using positron emission tomography (PET)/computed tomography (CT) images to automatically segment the prostate and its DILs. To enable end-to-end segmentation, a deep learning-based method, called cascaded regional-Net, is utilized. The first network, referred to as dual attention network, is used to segment the prostate via extracting comprehensive features from both PET and CT images. A second network, referred to as mask scoring regional convolutional neural network (MSR-CNN), is used to segment the DILs from the PET and CT within the prostate region. Scoring strategy is used to diminish the misclassification of the DILs. For DIL segmentation, the proposed cascaded regional-Net uses two steps to remove normal tissue regions, with the first step cropping images based on prostate segmentation and the second step using MSR-CNN to further locate the DILs. The binary masks of DILs and prostates of testing patients are generated on the PET/CT images by the trained model. For evaluation, we retrospectively investigated 49 prostate cancer patients with PET/CT images acquired. The prostate and DILs of each patient were contoured by radiation oncologists and set as the ground truths and targets. We used five-fold cross-validation and a hold-out test to train and evaluate our method. The mean surface distance and DSC values were 0.666 ± 0.696 mm and 0.932 ± 0.059 for the prostate and 0.814 ± 1.002 mm and 0.801 ± 0.178 for the DILs among all 49 patients. The proposed method has shown promise for facilitating prostate and DIL delineation for DIL focal boost prostate radiation therapy.