Unpaired deep learning for pharmacokinetic parameter estimation from dynamic contrast-enhanced MRI without AIF measurements.

DCE-MRI provides information about vascular permeability and tissue perfusion through the acquisition of pharmacokinetic parameters. However, traditional methods for estimating these pharmacokinetic parameters involve fitting tracer kinetic models, which often suffer from computational complexity and low accuracy due to noisy arterial input function (AIF) measurements. Although some deep learning approaches have been proposed to tackle these challenges, most existing methods rely on supervised learning that requires paired input DCE-MRI and labeled pharmacokinetic parameter maps. This dependency on labeled data introduces significant time and resource constraints and potential noise in the labels, making supervised learning methods often impractical. To address these limitations, we present a novel unpaired deep learning method for estimating pharmacokinetic parameters and the AIF using a physics-driven CycleGAN approach. Our proposed CycleGAN framework is designed based on the underlying physics model, resulting in a simpler architecture with a single generator and discriminator pair. Crucially, our experimental results indicate that our method does not necessitate separate AIF measurements and produces more reliable pharmacokinetic parameters than other techniques.

Bidirectional generation of structure and properties through a single molecular foundation model.

Recent successes of foundation models in artificial intelligence have prompted the emergence of large-scale chemical pre-trained models. Despite the growing interest in large molecular pre-trained models that provide informative representations for downstream tasks, attempts for multimodal pre-training approaches on the molecule domain were limited. To address this, here we present a multimodal molecular pre-trained model that incorporates the modalities of structure and biochemical properties, drawing inspiration from recent advances in multimodal learning techniques. Our proposed model pipeline of data handling and training objectives aligns the structure/property features in a common embedding space, which enables the model to regard bidirectional information between the molecules' structure and properties. These contributions emerge synergistic knowledge, allowing us to tackle both multimodal and unimodal downstream tasks through a single model. Through extensive experiments, we demonstrate that our model has the capabilities to solve various meaningful chemical challenges, including conditional molecule generation, property prediction, molecule classification, and reaction prediction.

Magnitude and angle dynamics in training single ReLU neurons.

Understanding the training dynamics of deep ReLU networks is a significant area of interest in deep learning. However, there remains a lack of complete elucidation regarding the weight vector dynamics, even for single ReLU neurons. To bridge this gap, our study delves into the training dynamics of the gradient flow w(t) for single ReLU neurons under the square loss, dissecting it into its magnitude ‖w(t)‖ and angle φ(t) components. Through this decomposition, we establish upper and lower bounds on these components to elucidate the convergence dynamics. Furthermore, we demonstrate the empirical extension of our findings to general two-layer multi-neuron networks. All theoretical results are generalized to the gradient descent method and rigorously verified through experiments.

Improving Medical Speech-to-Text Accuracy using Vision-Language Pre-training Models.

Automatic Speech Recognition (ASR) is a technology that converts spoken words into text, facilitating interaction between humans and machines. One of the most common applications of ASR is Speech-To-Text (STT) technology, which simplifies user workflows by transcribing spoken words into text. In the medical field, STT has the potential to significantly reduce the workload of clinicians who rely on typists to transcribe their voice recordings. However, developing an STT model for the medical domain is challenging due to the lack of sufficient speech and text datasets. To address this issue, we propose a medical-domain text correction method that modifies the output text of a general STT system using the Vision Language Pre-training (VLP) method. VLP combines textual and visual information to correct text based on image knowledge. Our extensive experiments demonstrate that the proposed method offers quantitatively and clinically significant improvements in STT performance in the medical field. We further show that multi-modal understanding of image and text information outperforms single-modal understanding using only text information.

MS-DINO: Masked Self-Supervised Distributed Learning Using Vision Transformer.

Despite promising advancements in deep learning in medical domains, challenges still remain owing to data scarcity, compounded by privacy concerns and data ownership disputes. Recent explorations of distributed-learning paradigms, particularly federated learning, have aimed to mitigate these challenges. However, these approaches are often encumbered by substantial communication and computational overhead, and potential vulnerabilities in privacy safeguards. Therefore, we propose a self-supervised masked sampling distillation technique called MS-DINO, tailored to the vision transformer architecture. This approach removes the need for incessant communication and strengthens privacy using a modified encryption mechanism inherent to the vision transformer while minimizing the computational burden on client-side devices. Rigorous evaluations across various tasks confirmed that our method outperforms existing self-supervised distributed learning strategies and fine-tuned baselines.

End-to-End Semi-Supervised Opportunistic Osteoporosis Screening Using Computed Tomography.

BACKGRUOUND: Osteoporosis is the most common metabolic bone disease and can cause fragility fractures. Despite this, screening utilization rates for osteoporosis remain low among populations at risk. Automated bone mineral density (BMD) estimation using computed tomography (CT) can help bridge this gap and serve as an alternative screening method to dual-energy X-ray absorptiometry (DXA). METHODS: The feasibility of an opportunistic and population agnostic screening method for osteoporosis using abdominal CT scans without bone densitometry phantom-based calibration was investigated in this retrospective study. A total of 268 abdominal CT-DXA pairs and 99 abdominal CT studies without DXA scores were obtained from an oncology specialty clinic in the Republic of Korea. The center axial CT slices from the L1, L2, L3, and L4 lumbar vertebrae were annotated with the CT slice level and spine segmentation labels for each subject. Deep learning models were trained to localize the center axial slice from the CT scan of the torso, segment the vertebral bone, and estimate BMD for the top four lumbar vertebrae. RESULTS: Automated vertebra-level DXA measurements showed a mean absolute error (MAE) of 0.079, Pearson's r of 0.852 (P<0.001), and R2 of 0.714. Subject-level predictions on the held-out test set had a MAE of 0.066, Pearson's r of 0.907 (P<0.001), and R2 of 0.781. CONCLUSION: CT scans collected during routine examinations without bone densitometry calibration can be used to generate DXA BMD predictions.

Fundus Image Enhancement Through Direct Diffusion Bridges.

We propose FD3, a fundus image enhancement method based on direct diffusion bridges, which can cope with a wide range of complex degradations, including haze, blur, noise, and shadow. We first propose a synthetic forward model through a human feedback loop with board-certified ophthalmologists for maximal quality improvement of low-quality in-vivo images. Using the proposed forward model, we train a robust and flexible diffusion-based image enhancement network that is highly effective as a stand-alone method, unlike previous diffusion model-based approaches which act only as a refiner on top of pre-trained models. Through extensive experiments, we show that FD3 establishes superior quality not only on synthetic degradations but also on in vivo studies with low-quality fundus photos taken from patients with cataracts or small pupils. To promote further research in this area, we open-source all our code and data used for this research at https://github.com/heeheee888/FD3.

Self-supervised multi-modal training from uncurated images and reports enables monitoring AI in radiology.

The escalating demand for artificial intelligence (AI) systems that can monitor and supervise human errors and abnormalities in healthcare presents unique challenges. Recent advances in vision-language models reveal the challenges of monitoring AI by understanding both visual and textual concepts and their semantic correspondences. However, there has been limited success in the application of vision-language models in the medical domain. Current vision-language models and learning strategies for photographic images and captions call for a web-scale data corpus of image and text pairs which is not often feasible in the medical domain. To address this, we present a model named medical cross-attention vision-language model (Medical X-VL), which leverages key components to be tailored for the medical domain. The model is based on the following components: self-supervised unimodal models in medical domain and a fusion encoder to bridge them, momentum distillation, sentencewise contrastive learning for medical reports, and sentence similarity-adjusted hard negative mining. We experimentally demonstrated that our model enables various zero-shot tasks for monitoring AI, ranging from the zero-shot classification to zero-shot error correction. Our model outperformed current state-of-the-art models in two medical image datasets, suggesting a novel clinical application of our monitoring AI model to alleviate human errors. Our method demonstrates a more specialized capacity for fine-grained understanding, which presents a distinct advantage particularly applicable to the medical domain.

C-DARL: Contrastive diffusion adversarial representation learning for label-free blood vessel segmentation.

Blood vessel segmentation in medical imaging is one of the essential steps for vascular disease diagnosis and interventional planning in a broad spectrum of clinical scenarios in image-based medicine and interventional medicine. Unfortunately, manual annotation of the vessel masks is challenging and resource-intensive due to subtle branches and complex structures. To overcome this issue, this paper presents a self-supervised vessel segmentation method, dubbed the contrastive diffusion adversarial representation learning (C-DARL) model. Our model is composed of a diffusion module and a generation module that learns the distribution of multi-domain blood vessel data by generating synthetic vessel images from diffusion latent. Moreover, we employ contrastive learning through a mask-based contrastive loss so that the model can learn more realistic vessel representations. To validate the efficacy, C-DARL is trained using various vessel datasets, including coronary angiograms, abdominal digital subtraction angiograms, and retinal imaging. Experimental results confirm that our model achieves performance improvement over baseline methods with noise robustness, suggesting the effectiveness of C-DARL for vessel segmentation.Our source code is available at https://github.com/boahK/MEDIA_CDARL.2.

Coronary plaque phenotype associated with positive remodeling.

BACKGROUND: Positive remodeling is an integral part of the vascular adaptation process during the development of atherosclerosis, which can be detected by coronary computed tomography angiography (CTA). METHODS: A total of 426 patients who underwent both coronary CTA and optical coherence tomography (OCT) were included. Four machine learning (ML) models, gradient boosting machine (GBM), random forest (RF), deep learning (DL), and support vector machine (SVM), were employed to detect specific plaque features. A total of 15 plaque features assessed by OCT were analyzed. The variable importance ranking was used to identify the features most closely associated with positive remodeling. RESULTS: In the variable importance ranking, lipid index and maximal calcification arc were consistently ranked high across all four ML models. Lipid index and maximal calcification arc were correlated with positive remodeling, showing pronounced influence at the lower range and diminishing influence at the higher range. Patients with more plaques with positive remodeling throughout their entire coronary trees had higher low-density lipoprotein cholesterol levels and were associated with a higher incidence of cardiovascular events during 5-year follow-up (Hazard ratio 2.10 [1.26-3.48], P â€‹= â€‹0.004). CONCLUSION: Greater lipid accumulation and less calcium burden were important features associated with positive remodeling in the coronary arteries. The number of coronary plaques with positive remodeling was associated with a higher incidence of cardiovascular events.

A novel deep learning model for a computed tomography diagnosis of coronary plaque erosion.

Patients with acute coronary syndromes caused by plaque erosion might be managed conservatively without stenting. Currently, the diagnosis of plaque erosion requires an invasive imaging procedure. We sought to develop a deep learning (DL) model that enables an accurate diagnosis of plaque erosion using coronary computed tomography angiography (CTA). A total of 532 CTA scans from 395 patients were used to develop a DL model: 426 CTA scans from 316 patients for training and internal validation, and 106 separate scans from 79 patients for validation. Momentum Distillation-enhanced Composite Transformer Attention (MD-CTA), a novel DL model that can effectively process the entire set of CTA scans to diagnose plaque erosion, was developed. The novel DL model, compared to the convolution neural network, showed significantly improved AUC (0.899 [0.841-0.957] vs. 0.724 [0.622-0.826]), sensitivity (87.1 [70.2-96.4] vs. 71.0 [52.0-85.8]), and specificity (85.3 [75.3-92.4] vs. 68.0 [56.2-78.3]), respectively, for the patient-level prediction. Similar results were obtained at the slice-level prediction AUC (0.897 [0.890-0.904] vs. 0.757 [0.744-0.770]), sensitivity (82.2 [79.8-84.3] vs. 68.9 [66.2-71.6]), and specificity (80.1 [79.1-81.0] vs. 67.3 [66.3-68.4]), respectively. This newly developed DL model enables an accurate CT diagnosis of plaque erosion, which might enable cardiologists to provide tailored therapy without invasive procedures.Clinical Trial Registration: http://www.clinicaltrials.gov , NCT04523194.