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Diagnostic value and efficacy evaluation value of transvaginal color doppler ultrasound parameters for uterine scar pregnancy and sub-type after cesarean section 经阴道彩色多普勒超声参数对剖宫产术后子宫瘢痕妊娠及亚型的诊断价值和疗效评估价值
IF 2.7 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-13 DOI: 10.1186/s12880-024-01405-2
Yuting Peng, Jia Liu, Jun Xie, Quanlv Li
We aimed to probe the diagnostic value of transvaginal color Doppler ultrasound (TV-CDU) parameters in cesarean scar pregnancy (CSP) and CSP sub-types, and the relevant factors affecting patients’ surgical effects. Seventy-five CSP patients (all requested termination of pregnancy) were selected as the observation group, and 75 normal pregnant women with a history of cesarean section were selected as the control group. All the study subjects underwent TV-CDU and their cesarean scar muscle (CSM) thickness, minimum sagittal muscle thickness and resistance index (RI) of blood flow in the anterior wall of the lower uterine segment were calculated. The diagnostic value of CSM, minimum sagittal muscle thickness, and RI for CSP and CSP sub-types was analyzed. The patients in the observation group were grouped into the effective group and the ineffective group according to whether the surgical treatment was effective or not, and the independent factors affecting CSP efficacy were analyzed. The observation group had lower CSM, minimum sagittal muscle thickness and RI than the control group. CSM, RI, and minimum sagittal thickness in patients with type II CSP were lower than those in patients with type I, and these indicators in patients with type III were lower than those in patients with type II. The area under the curve (AUC) of CSM, RI and minimum sagittal muscle thickness in combination for CSP diagnosis and the AUC for CSP sub-types were higher than those of each indicator alone. Gestational sac size and CSM were independent factors affecting CSP treatment. Changes in TV-CDU parameters facilitates CSP diagnosis after cesarean section. CSM, minimum sagittal muscle thickness changes, and RI in combination possesses high value for CSP diagnosis and CSP sub-types. Gestational sac size and CSM are independent factors affecting CSP treatment.
我们旨在探究经阴道彩色多普勒超声(TV-CDU)参数在剖宫产瘢痕妊娠(CSP)及CSP亚型中的诊断价值,以及影响患者手术效果的相关因素。选取 75 例 CSP 患者(均要求终止妊娠)作为观察组,75 例有剖宫产史的正常孕妇作为对照组。所有研究对象均接受 TV-CDU,并计算其剖宫产瘢痕肌(CSM)厚度、最小矢状肌厚度和子宫下段前壁血流阻力指数(RI)。分析了CSM、最小矢状肌厚度和RI对CSP和CSP亚型的诊断价值。根据手术治疗是否有效将观察组患者分为有效组和无效组,并分析影响 CSP 疗效的独立因素。观察组的 CSM、最小矢状肌厚度和 RI 均低于对照组。II 型 CSP 患者的 CSM、RI 和最小矢状肌厚度均低于 I 型患者,而 III 型患者的这些指标均低于 II 型患者。CSM、RI和最小矢状肌厚度三项指标联合用于CSP诊断的曲线下面积(AUC)以及用于CSP亚型的AUC均高于单独使用每项指标时的曲线下面积(AUC)。妊娠囊大小和CSM是影响CSP治疗的独立因素。TV-CDU参数的变化有助于剖宫产术后的CSP诊断。CSM、最小矢状肌厚度变化和RI的组合对CSP诊断和CSP亚型具有很高的价值。妊娠囊大小和CSM是影响CSP治疗的独立因素。
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引用次数: 0
Predicting invasion in early-stage ground-glass opacity pulmonary adenocarcinoma: a radiomics-based machine learning approach 预测早期磨玻璃不透明肺腺癌的侵袭:基于放射组学的机器学习方法
IF 2.7 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-13 DOI: 10.1186/s12880-024-01421-2
Junjie Bin, Mei Wu, Meiyun Huang, Yuguang Liao, Yuli Yang, Xianqiong Shi, Siqi Tao
To design a pulmonary ground-glass nodules (GGN) classification method based on computed tomography (CT) radiomics and machine learning for prediction of invasion in early-stage ground-glass opacity (GGO) pulmonary adenocarcinoma. This retrospective study included pulmonary GGN patients who were histologically confirmed to have adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), or invasive adenocarcinoma cancer (IAC) from 2020 to 2023. CT images of all patients were automatically segmented and 107 radiomic features were obtained for each patient. Classification models were developed using random forest (RF) and cross-validation, including three one-versus-others models and one three-class model. For each model, features were ranked by normalized Gini importance, and a minimal subset was selected with a cumulative importance exceeding 0.9. These selected features were then used to train the final models. The models’ performance metrics, including area under the curve (AUC), accuracy, sensitivity, and specificity, were computed. AUC and accuracy were compared to determine the final optimal method. The study comprised 193 patients (mean age 54 ± 11 years, 65 men), including 65 AIS, 54 MIA, and 74 IAC, divided into one training cohort (N = 154) and one test cohort (N = 39). The final three-class RF model outperformed three individual one-versus-others models in distinguishing each class from the other two. For the multiclass classification model, the AUC, accuracy, sensitivity, and specificity were 0.87, 0.79, 0.62, and 0.88 for AIS; 0.90, 0.79, 0.54, and 0.89 for MIA; and 0.87, 0.69, 0.73, and 0.67 for IAC, respectively. A radiomics-based multiclass RF model could effectively differentiate three types of pulmonary GGN, which enabled early diagnosis of GGO pulmonary adenocarcinoma.
设计一种基于计算机断层扫描(CT)放射组学和机器学习的肺磨玻璃结节(GGN)分类方法,用于预测早期磨玻璃不透明(GGO)肺腺癌的侵袭情况。这项回顾性研究纳入了2020年至2023年经组织学证实为原位腺癌(AIS)、微侵袭性腺癌(MIA)或侵袭性腺癌(IAC)的肺GGN患者。对所有患者的 CT 图像进行了自动分割,并获得了每位患者的 107 个放射学特征。利用随机森林(RF)和交叉验证建立了分类模型,其中包括三个 "单对单 "模型和一个 "三类 "模型。对于每个模型,根据归一化基尼重要性对特征进行排序,并选择累计重要性超过 0.9 的最小子集。这些选定的特征随后被用于训练最终模型。计算模型的性能指标,包括曲线下面积(AUC)、准确率、灵敏度和特异性。对 AUC 和准确性进行比较,以确定最终的最佳方法。研究对象包括 193 名患者(平均年龄 54 ± 11 岁,65 名男性),其中包括 65 名 AIS 患者、54 名 MIA 患者和 74 名 IAC 患者,分为一个训练队列(N = 154)和一个测试队列(N = 39)。最终的三类 RF 模型在区分每一类和其他两类方面优于三个单独的 "单对单 "模型。就多级分类模型而言,AIS 的 AUC、准确性、灵敏度和特异性分别为 0.87、0.79、0.62 和 0.88;MIA 的 AUC、准确性、灵敏度和特异性分别为 0.90、0.79、0.54 和 0.89;IAC 的 AUC、准确性、灵敏度和特异性分别为 0.87、0.69、0.73 和 0.67。基于放射组学的多分类射频模型可有效区分三种类型的肺GGN,从而实现GGO肺腺癌的早期诊断。
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引用次数: 0
Deep learning-based techniques for estimating high-quality full-dose positron emission tomography images from low-dose scans: a systematic review 从低剂量扫描中估算高质量全剂量正电子发射断层扫描图像的深度学习技术:系统性综述
IF 2.7 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-11 DOI: 10.1186/s12880-024-01417-y
Negisa Seyyedi, Ali Ghafari, Navisa Seyyedi, Peyman Sheikhzadeh
This systematic review aimed to evaluate the potential of deep learning algorithms for converting low-dose Positron Emission Tomography (PET) images to full-dose PET images in different body regions. A total of 55 articles published between 2017 and 2023 by searching PubMed, Web of Science, Scopus and IEEE databases were included in this review, which utilized various deep learning models, such as generative adversarial networks and UNET, to synthesize high-quality PET images. The studies involved different datasets, image preprocessing techniques, input data types, and loss functions. The evaluation of the generated PET images was conducted using both quantitative and qualitative methods, including physician evaluations and various denoising techniques. The findings of this review suggest that deep learning algorithms have promising potential in generating high-quality PET images from low-dose PET images, which can be useful in clinical practice.
本系统综述旨在评估深度学习算法将不同身体区域的低剂量正电子发射断层扫描(PET)图像转换为全剂量 PET 图像的潜力。本综述通过搜索 PubMed、Web of Science、Scopus 和 IEEE 数据库,共收录了 55 篇发表于 2017 年至 2023 年间的文章,这些文章利用生成式对抗网络和 UNET 等各种深度学习模型来合成高质量 PET 图像。这些研究涉及不同的数据集、图像预处理技术、输入数据类型和损失函数。使用定量和定性方法对生成的 PET 图像进行了评估,包括医生评估和各种去噪技术。综述结果表明,深度学习算法在从低剂量正电子发射计算机断层图像生成高质量正电子发射计算机断层图像方面具有广阔的前景,可在临床实践中发挥作用。
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引用次数: 0
The reliability of virtual non-contrast reconstructions of photon-counting detector CT scans in assessing abdominal organs 光子计数探测器 CT 扫描的虚拟非对比重建在评估腹部器官方面的可靠性
IF 2.7 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-09 DOI: 10.1186/s12880-024-01419-w
Ibolyka Dudás, Leona Schultz, Márton Benke, Ákos Szücs, Pál Novák Kaposi, Attila Szijártó, Pál Maurovich-Horvat, Bettina Katalin Budai
Spectral imaging of photon-counting detector CT (PCD-CT) scanners allows for generating virtual non-contrast (VNC) reconstruction. By analyzing 12 abdominal organs, we aimed to test the reliability of VNC reconstructions in preserving HU values compared to real unenhanced CT images. Our study included 34 patients with pancreatic cystic neoplasm (PCN). The VNC reconstructions were generated from unenhanced, arterial, portal, and venous phase PCD-CT scans using the Liver-VNC algorithm. The observed 11 abdominal organs were segmented by the TotalSegmentator algorithm, the PCNs were segmented manually. Average densities were extracted from unenhanced scans (HUunenhanced), postcontrast (HUpostcontrast) scans, and VNC reconstructions (HUVNC). The error was calculated as HUerror=HUVNC–HUunenhanced. Pearson’s or Spearman’s correlation was used to assess the association. Reproducibility was evaluated by intraclass correlation coefficients (ICC). Significant differences between HUunenhanced and HUVNC[unenhanced] were found in vertebrae, paraspinal muscles, liver, and spleen. HUVNC[unenhanced] showed a strong correlation with HUunenhanced in all organs except spleen (r = 0.45) and kidneys (r = 0.78 and 0.73). In all postcontrast phases, the HUVNC had strong correlations with HUunenhanced in all organs except the spleen and kidneys. The HUerror had significant correlations with HUunenhanced in the muscles and vertebrae; and with HUpostcontrast in the spleen, vertebrae, and paraspinal muscles in all postcontrast phases. All organs had at least one postcontrast VNC reconstruction that showed good-to-excellent agreement with HUunenhanced during ICC analysis except the vertebrae (ICC: 0.17), paraspinal muscles (ICC: 0.64–0.79), spleen (ICC: 0.21–0.47), and kidneys (ICC: 0.10–0.31). VNC reconstructions are reliable in at least one postcontrast phase for most organs, but further improvement is needed before VNC can be utilized to examine the spleen, kidneys, and vertebrae.
光子计数探测器 CT(PCD-CT)扫描仪的光谱成像可生成虚拟非对比度(VNC)重建。通过分析 12 个腹部器官,我们旨在测试 VNC 重建与真实未增强 CT 图像相比在保留 HU 值方面的可靠性。我们的研究包括 34 名胰腺囊性肿瘤(PCN)患者。VNC 重建是使用 Liver-VNC 算法从未增强、动脉、门脉和静脉相 PCD-CT 扫描中生成的。观察到的 11 个腹部器官采用 TotalSegmentator 算法进行分割,PCN 则采用人工分割。从未增强扫描(HUunenhanced)、对比后扫描(HUpostcontrast)和 VNC 重建(HUVNC)中提取平均密度。误差计算公式为:HUerror=HUVNC-HUunenhanced。皮尔逊或斯皮尔曼相关性用于评估相关性。再现性通过类内相关系数(ICC)进行评估。在脊椎、脊柱旁肌肉、肝脏和脾脏中,HU 增强与 HUVNC[未增强]之间存在显著差异。除脾脏(r = 0.45)和肾脏(r = 0.78 和 0.73)外,HUVNC[未增强]与 HUunenhanced 在所有器官中都显示出很强的相关性。在所有对比后阶段,除脾脏和肾脏外,所有器官的 HUVNC 与 HUunenhanced 都有很强的相关性。在肌肉和椎骨中,HUerror 与 HUunenhanced 有显著相关性;在所有对比后阶段,脾脏、椎骨和脊柱旁肌肉与 HUpostcontrast 有显著相关性。除脊椎(ICC:0.17)、脊柱旁肌肉(ICC:0.64-0.79)、脾脏(ICC:0.21-0.47)和肾脏(ICC:0.10-0.31)外,在 ICC 分析期间,所有器官都至少有一个对比后 VNC 重构与 HU 增强显示出良好到极佳的一致性。VNC 重建在大多数器官的至少一个对比后阶段是可靠的,但在利用 VNC 检查脾脏、肾脏和脊椎骨之前还需要进一步改进。
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引用次数: 0
Clinical performance of deep learning-enhanced ultrafast whole-body scintigraphy in patients with suspected malignancy 深度学习增强型超快全身闪烁扫描在疑似恶性肿瘤患者中的临床表现
IF 2.7 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-09 DOI: 10.1186/s12880-024-01422-1
Na Qi, Boyang Pan, Qingyuan Meng, Yihong Yang, Jie Ding, Zengbei Yuan, Nan-Jie Gong, Jun Zhao
To evaluate the clinical performance of two deep learning methods, one utilizing real clinical pairs and the other utilizing simulated datasets, in enhancing image quality for two-dimensional (2D) fast whole-body scintigraphy (WBS). A total of 83 patients with suspected bone metastasis were retrospectively enrolled. All patients underwent single-photon emission computed tomography (SPECT) WBS at speeds of 20 cm/min (1x), 40 cm/min (2x), and 60 cm/min (3x). Two deep learning models were developed to generate high-quality images from real and simulated fast scans, designated 2x-real and 3x-real (images from real fast data) and 2x-simu and 3x-simu (images from simulated fast data), respectively. A 5-point Likert scale was used to evaluate the image quality of each acquisition. Accuracy, sensitivity, specificity, and the area under the curve (AUC) were used to evaluate diagnostic efficacy. Learned perceptual image patch similarity (LPIPS) and the Fréchet inception distance (FID) were used to assess image quality. Additionally, the count-level consistency of WBS was compared between the two models. Subjective assessments revealed that the 1x images had the highest general image quality (Likert score: 4.40 ± 0.45). The 2x-real, 2x-simu and 3x-real, 3x-simu images demonstrated significantly better quality than the 2x and 3x images (Likert scores: 3.46 ± 0.47, 3.79 ± 0.55 vs. 2.92 ± 0.41, P < 0.0001; 2.69 ± 0.40, 2.61 ± 0.41 vs. 1.36 ± 0.51, P < 0.0001), respectively. Notably, the quality of the 2x-real images was inferior to that of the 2x-simu images (Likert scores: 3.46 ± 0.47 vs. 3.79 ± 0.55, P = 0.001). The diagnostic efficacy for the 2x-real and 2x-simu images was indistinguishable from that of the 1x images (accuracy: 81.2%, 80.7% vs. 84.3%; sensitivity: 77.27%, 77.27% vs. 87.18%; specificity: 87.18%, 84.63% vs. 87.18%. All P > 0.05), whereas the diagnostic efficacy for the 3x-real and 3x-simu was better than that for the 3x images (accuracy: 65.1%, 66.35% vs. 59.0%; sensitivity: 63.64%, 63.64% vs. 64.71%; specificity: 66.67%, 69.23% vs. 55.1%. All P < 0.05). Objectively, both the real and simulated models achieved significantly enhanced image quality from the accelerated scans in the 2x and 3x groups (FID: 0.15 ± 0.18, 0.18 ± 0.18 vs. 0.47 ± 0.34; 0.19 ± 0.23, 0.20 ± 0.22 vs. 0.98 ± 0.59. LPIPS: 0.17 ± 0.05, 0.16 ± 0.04 vs. 0.19 ± 0.05; 0.18 ± 0.05, 0.19 ± 0.05 vs. 0.23 ± 0.04. All P < 0.05). The count-level consistency with the 1x images was excellent for all four sets of model-generated images (P < 0.0001). Ultrafast 2x speed (real and simulated) images achieved comparable diagnostic value to that of standardly acquired images, but the simulation algorithm does not necessarily reflect real data.
目的评估两种深度学习方法在提高二维(2D)快速全身闪烁扫描(WBS)图像质量方面的临床性能,其中一种方法利用真实临床数据对,另一种方法利用模拟数据集。研究人员回顾性地纳入了83名疑似骨转移患者。所有患者都以20厘米/分钟(1次)、40厘米/分钟(2次)和60厘米/分钟(3次)的速度接受了单光子发射计算机断层扫描(SPECT)全身扫描。我们开发了两种深度学习模型,用于从真实和模拟快速扫描中生成高质量图像,分别称为 2x-real 和 3x-real(从真实快速数据中生成的图像)以及 2x-simu 和 3x-simu(从模拟快速数据中生成的图像)。采用 5 点李克特量表评估每次采集的图像质量。准确性、灵敏度、特异性和曲线下面积(AUC)用于评估诊断效果。学习感知图像斑块相似度(LPIPS)和弗雷谢特起始距离(FID)用于评估图像质量。此外,还比较了两种模型在 WBS 计数水平上的一致性。主观评估结果显示,1x 图像的总体图像质量最高(Likert 分数:4.40 ± 0.45)。2x-real、2x-simu 和 3x-real、3x-simu 图像的质量明显优于 2x 和 3x 图像(Likert 评分:3.46 ± 0.47、3.79 ± 0.55 vs. 2.92 ± 0.41,P 0.05),而 3x 真实图像和 3x 模拟图像的诊断效果优于 3x 图像(准确率:65.1%、66.35% vs. 59.0%;灵敏度:63.64%、63.64% vs. 64.71%;特异性:66.67%、69.23% vs. 55.1%。所有数据均小于 0.05)。客观地说,真实模型和模拟模型在 2x 和 3x 组的加速扫描中都显著提高了图像质量(FID:0.15 ± 0.18、0.18 ± 0.18 vs. 0.47 ± 0.34;0.19 ± 0.23、0.20 ± 0.22 vs. 0.98 ± 0.59。LPIPS:0.17 ± 0.05、0.16 ± 0.04 vs. 0.19 ± 0.05;0.18 ± 0.05、0.19 ± 0.05 vs. 0.23 ± 0.04。所有 P < 0.05)。在所有四组模型生成的图像中,计数水平与 1x 图像的一致性都非常好(P < 0.0001)。超快 2 倍速(真实和模拟)图像的诊断价值与标准采集图像相当,但模拟算法并不一定反映真实数据。
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引用次数: 0
Utilizing CT imaging for evaluating late gastrointestinal tract side effects of radiotherapy in uterine cervical cancer: a risk regression analysis 利用 CT 成像评估子宫颈癌放疗晚期胃肠道副作用:风险回归分析
IF 2.7 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-09 DOI: 10.1186/s12880-024-01420-3
Pooriwat Muangwong, Nutthita Prukvaraporn, Kittikun Kittidachanan, Nattharika Watthanayuenyong, Imjai Chitapanarux, Wittanee Na Chiangmai
Radiotherapy (RT) is effective for cervical cancer but causes late side effects (SE) to nearby organs. These late SE occur more than 3 months after RT and are rated by clinical findings to determine their severity. While imaging studies describe late gastrointestinal (GI) SE, none demonstrate the correlation between the findings and the toxicity grading. In this study, we demonstrated the late GI toxicity prevalence, CT findings, and their correlation. We retrospectively studied uterine cervical cancer patients treated with RT between 2015 and 2018. Patient characteristics and treatment(s) were obtained from the hospital’s databases. Late RTOG/EORTC GI SE and CT images were obtained during the follow-up. Post-RT GI changes were reviewed from CT images using pre-defined criteria. Risk ratios (RR) were calculated for CT findings, and multivariable log binomial regression determined adjusted RRs. This study included 153 patients, with a median age of 57 years (IQR 49–65). The prevalence of ≥ grade 2 RTOG/EORTC late GI SE was 33 (27.5%). CT findings showed 91 patients (59.48%) with enhanced bowel wall (BW) thickening, 3 (1.96%) with bowel obstruction, 7 (4.58%) with bowel perforation, 6 (3.92%) with fistula, 0 (0%) with bowel ischemia, and 0 (0%) with GI bleeding. Adjusted RRs showed that enhanced BW thickening (RR 9.77, 95% CI 2.64–36.07, p = 0.001), bowel obstruction (RR 5.05, 95% CI 2.30–11.09, p < 0.001), and bowel perforation (RR 3.82, 95% CI 1.96–7.44, p < 0.001) associated with higher late GI toxicity grades. Our study shows CT findings correlate with grade 2–4 late GI toxicity. Future research should validate and refine these findings with different imaging and toxicity grading systems to assess their potential predictive value.
放射治疗(RT)对宫颈癌有效,但会对邻近器官产生晚期副作用(SE)。这些晚期副作用发生在 RT 结束后 3 个月以上,并根据临床发现来确定其严重程度。虽然影像学研究描述了晚期胃肠道(GI)副作用,但没有一项研究证明了这些发现与毒性分级之间的相关性。在本研究中,我们展示了晚期胃肠道毒性的发生率、CT 结果及其相关性。我们回顾性研究了2015年至2018年间接受RT治疗的子宫颈癌患者。患者特征和治疗方法均来自医院数据库。随访期间获得了晚期 RTOG/EORTC GI SE 和 CT 图像。采用预先定义的标准从 CT 图像中审查 RT 后的消化道变化。计算CT结果的风险比(RR),并通过多变量对数二项式回归确定调整后的风险比。该研究共纳入 153 名患者,中位年龄为 57 岁(IQR 49-65)。≥2级RTOG/EORTC晚期消化道SE的发生率为33(27.5%)。CT 结果显示,91 例患者(59.48%)肠壁增厚,3 例(1.96%)肠梗阻,7 例(4.58%)肠穿孔,6 例(3.92%)瘘管,0 例(0%)肠缺血,0 例(0%)消化道出血。调整后的 RRs 显示,BW 增厚(RR 9.77,95% CI 2.64-36.07,p = 0.001)、肠梗阻(RR 5.05,95% CI 2.30-11.09,p < 0.001)和肠穿孔(RR 3.82,95% CI 1.96-7.44,p < 0.001)与较高的晚期消化道毒性等级相关。我们的研究表明,CT 结果与 2-4 级晚期消化道毒性相关。未来的研究应通过不同的成像和毒性分级系统来验证和完善这些结果,以评估其潜在的预测价值。
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引用次数: 0
nnU-Net based segmentation and 3D reconstruction of uterine fibroids with MRI images for HIFU surgery planning. nnU-Net 基于磁共振成像的子宫肌瘤分割和三维重建,用于 HIFU 手术规划。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-06 DOI: 10.1186/s12880-024-01385-3
Ting Wang, Yingang Wen, Zhibiao Wang

High-Intensity Focused Ultrasound (HIFU) ablation represents a rapidly advancing non-invasive treatment modality that has achieved considerable success in addressing uterine fibroids, which constitute over 50% of benign gynecological tumors. Preoperative Magnetic Resonance Imaging (MRI) plays a pivotal role in the planning and guidance of HIFU surgery for uterine fibroids, wherein the segmentation of tumors holds critical significance. The segmentation process was previously manually executed by medical experts, entailing a time-consuming and labor-intensive procedure heavily reliant on clinical expertise. This study introduced deep learning-based nnU-Net models, offering a cost-effective approach for their application in the segmentation of uterine fibroids utilizing preoperative MRI images. Furthermore, 3D reconstruction of the segmented targets was implemented to guide HIFU surgery. The evaluation of segmentation and 3D reconstruction performance was conducted with a focus on enhancing the safety and effectiveness of HIFU surgery. Results demonstrated the nnU-Net's commendable performance in the segmentation of uterine fibroids and their surrounding organs. Specifically, 3D nnU-Net achieved Dice Similarity Coefficients (DSC) of 92.55% for the uterus, 95.63% for fibroids, 92.69% for the spine, 89.63% for the endometrium, 97.75% for the bladder, and 90.45% for the urethral orifice. Compared to other state-of-the-art methods such as HIFUNet, U-Net, R2U-Net, ConvUNeXt and 2D nnU-Net, 3D nnU-Net demonstrated significantly higher DSC values, highlighting its superior accuracy and robustness. In conclusion, the efficacy of the 3D nnU-Net model for automated segmentation of the uterus and its surrounding organs was robustly validated. When integrated with intra-operative ultrasound imaging, this segmentation method and 3D reconstruction hold substantial potential to enhance the safety and efficiency of HIFU surgery in the clinical treatment of uterine fibroids.

高强度聚焦超声消融术(HIFU)是一种快速发展的非侵入性治疗方式,在治疗占妇科良性肿瘤50%以上的子宫肌瘤方面取得了相当大的成功。术前磁共振成像(MRI)在 HIFU 治疗子宫肌瘤手术的计划和指导中起着关键作用,其中肿瘤的分割至关重要。以前的分割过程都是由医学专家手工完成的,耗时耗力,严重依赖临床专业知识。本研究引入了基于深度学习的 nnU-Net 模型,为其在利用术前核磁共振图像分割子宫肌瘤方面的应用提供了一种经济高效的方法。此外,还对分割后的目标进行了三维重建,以指导 HIFU 手术。对分割和三维重建性能进行评估的重点是提高 HIFU 手术的安全性和有效性。结果表明,nnU-Net 在分割子宫肌瘤及其周围器官方面的性能值得称赞。具体来说,3D nnU-Net的子宫骰子相似系数(DSC)为92.55%,子宫肌瘤为95.63%,脊柱为92.69%,子宫内膜为89.63%,膀胱为97.75%,尿道口为90.45%。与其他最先进的方法(如 HIFUNet、U-Net、R2U-Net、ConvUNeXt 和 2D nnU-Net)相比,3D nnU-Net 的 DSC 值明显更高,凸显了其卓越的准确性和稳健性。总之,三维 nnU-Net 模型在自动分割子宫及其周围器官方面的功效得到了有力的验证。如果与术中超声成像相结合,这种分割方法和三维重建在提高 HIFU 手术治疗子宫肌瘤的安全性和效率方面具有很大的潜力。
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引用次数: 0
The scoring system combined with radiomics and imaging features in predicting the malignant potential of incidental indeterminate small (<20 mm) solid pulmonary nodules. 评分系统结合放射组学和影像学特征,预测偶发的不确定小(<20 毫米)实性肺结节的恶性可能性。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-06 DOI: 10.1186/s12880-024-01413-2
Bai-Qiang Qu, Yun Wang, Yue-Peng Pan, Pei-Wei Cao, Xue-Ying Deng

Objective: Develop a practical scoring system based on radiomics and imaging features, for predicting the malignant potential of incidental indeterminate small solid pulmonary nodules (IISSPNs) smaller than 20 mm.

Methods: A total of 360 patients with malignant IISSPNs (n = 213) and benign IISSPNs (n = 147) confirmed after surgery were retrospectively analyzed. The whole cohort was randomly divided into training and validation groups at a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) algorithm was used to debase the dimensions of radiomics features. Multivariate logistic analysis was performed to establish models. The receiver operating characteristic (ROC) curve, area under the curve (AUC), 95% confidence interval (CI), sensitivity and specificity of each model were recorded. Scoring system based on odds ratio was developed.

Results: Three radiomics features were selected for further model establishment. After multivariate logistic analysis, the combined model including Mean, age, emphysema, lobulated and size, reached highest AUC of 0.877 (95%CI: 0.830-0.915), accuracy rate of 83.3%, sensitivity of 85.3% and specificity of 80.2% in the training group, followed by radiomics model (AUC: 0.804) and imaging model (AUC: 0.773). A scoring system with a cutoff value greater than 4 points was developed. If the score was larger than 8 points, the possibility of diagnosing malignant IISSPNs could reach at least 92.7%.

Conclusion: The combined model demonstrated good diagnostic performance in predicting the malignant potential of IISSPNs. A perfect accuracy rate of 100% can be achieved with a score exceeding 12 points in the user-friendly scoring system.

目的:根据放射组学和影像学特征开发一套实用的评分系统,用于预测小于20毫米的偶发不确定肺小实体结节(IISSPN)的恶性可能性:基于放射组学和影像学特征,开发一套实用的评分系统,用于预测小于20毫米的偶发不确定肺实性小结节(IISSPN)的恶性可能性:回顾性分析了360例经手术确诊的恶性IISSPN(213例)和良性IISSPN(147例)患者。整个组群按 7:3 的比例随机分为训练组和验证组。采用最小绝对收缩和选择算子(LASSO)算法对放射组学特征进行降维处理。通过多变量逻辑分析建立模型。记录了每个模型的接受者操作特征曲线(ROC)、曲线下面积(AUC)、95% 置信区间(CI)、灵敏度和特异性。根据几率比建立了评分系统:结果:选择了三个放射组学特征进一步建立模型。经过多变量逻辑分析,在训练组中,包括平均值、年龄、肺气肿、分叶和大小的组合模型的AUC最高,为0.877(95%CI:0.830-0.915),准确率为83.3%,灵敏度为85.3%,特异性为80.2%,其次是放射组学模型(AUC:0.804)和成像模型(AUC:0.773)。制定了一个分界值大于 4 分的评分系统。如果评分大于 8 分,诊断恶性 IISSPN 的可能性至少可达 92.7%:综合模型在预测 IISSPN 的恶性可能性方面表现出良好的诊断性能。结论:该综合模型在预测 IISSPN 的恶性可能性方面表现出了良好的诊断性能,在用户友好型评分系统中,只要得分超过 12 分,准确率就能达到 100%。
{"title":"The scoring system combined with radiomics and imaging features in predicting the malignant potential of incidental indeterminate small (<20 mm) solid pulmonary nodules.","authors":"Bai-Qiang Qu, Yun Wang, Yue-Peng Pan, Pei-Wei Cao, Xue-Ying Deng","doi":"10.1186/s12880-024-01413-2","DOIUrl":"10.1186/s12880-024-01413-2","url":null,"abstract":"<p><strong>Objective: </strong>Develop a practical scoring system based on radiomics and imaging features, for predicting the malignant potential of incidental indeterminate small solid pulmonary nodules (IISSPNs) smaller than 20 mm.</p><p><strong>Methods: </strong>A total of 360 patients with malignant IISSPNs (n = 213) and benign IISSPNs (n = 147) confirmed after surgery were retrospectively analyzed. The whole cohort was randomly divided into training and validation groups at a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) algorithm was used to debase the dimensions of radiomics features. Multivariate logistic analysis was performed to establish models. The receiver operating characteristic (ROC) curve, area under the curve (AUC), 95% confidence interval (CI), sensitivity and specificity of each model were recorded. Scoring system based on odds ratio was developed.</p><p><strong>Results: </strong>Three radiomics features were selected for further model establishment. After multivariate logistic analysis, the combined model including Mean, age, emphysema, lobulated and size, reached highest AUC of 0.877 (95%CI: 0.830-0.915), accuracy rate of 83.3%, sensitivity of 85.3% and specificity of 80.2% in the training group, followed by radiomics model (AUC: 0.804) and imaging model (AUC: 0.773). A scoring system with a cutoff value greater than 4 points was developed. If the score was larger than 8 points, the possibility of diagnosing malignant IISSPNs could reach at least 92.7%.</p><p><strong>Conclusion: </strong>The combined model demonstrated good diagnostic performance in predicting the malignant potential of IISSPNs. A perfect accuracy rate of 100% can be achieved with a score exceeding 12 points in the user-friendly scoring system.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multimodal medical image fusion based on interval gradients and convolutional neural networks. 基于区间梯度和卷积神经网络的多模态医学图像融合。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-05 DOI: 10.1186/s12880-024-01418-x
Xiaolong Gu, Ying Xia, Jie Zhang

Many image fusion methods have been proposed to leverage the advantages of functional and anatomical images while compensating for their shortcomings. These methods integrate functional and anatomical images while presenting physiological and metabolic organ information, making their diagnostic efficiency far greater than that of single-modal images. Currently, most existing multimodal medical imaging fusion methods are based on multiscale transformation, which involves obtaining pyramid features through multiscale transformation. Low-resolution images are used to analyse approximate image features, and high-resolution images are used to analyse detailed image features. Different fusion rules are applied to achieve feature fusion at different scales. Although these fusion methods based on multiscale transformation can effectively achieve multimodal medical image fusion, much detailed information is lost during multiscale and inverse transformation, resulting in blurred edges and a loss of detail in the fusion images. A multimodal medical image fusion method based on interval gradients and convolutional neural networks is proposed to overcome this problem. First, this method uses interval gradients for image decomposition to obtain structure and texture images. Second, deep neural networks are used to extract perception images. Three methods are used to fuse structure, texture, and perception images. Last, the images are combined to obtain the final fusion image after colour transformation. Compared with the reference algorithms, the proposed method performs better in multiple objective indicators of Q EN , Q NIQE , Q SD , Q SSEQ and Q TMQI .

人们提出了许多图像融合方法,以充分利用功能图像和解剖图像的优势,同时弥补它们的不足。这些方法整合了功能和解剖图像,同时呈现了生理和代谢器官信息,使其诊断效率远远高于单模态图像。目前,现有的多模态医学成像融合方法大多基于多尺度变换,即通过多尺度变换获得金字塔特征。低分辨率图像用于分析近似图像特征,高分辨率图像用于分析详细图像特征。不同的融合规则用于实现不同尺度的特征融合。虽然这些基于多尺度变换的融合方法能有效实现多模态医学图像融合,但在多尺度变换和反变换过程中会丢失很多细节信息,导致融合图像的边缘模糊和细节丢失。为了克服这一问题,本文提出了一种基于区间梯度和卷积神经网络的多模态医学图像融合方法。首先,该方法使用区间梯度进行图像分解,以获得结构和纹理图像。其次,利用深度神经网络提取感知图像。使用三种方法融合结构、纹理和感知图像。最后,图像经过色彩转换后得到最终的融合图像。与参考算法相比,所提出的方法在 Q EN、Q NIQE、Q SD、Q SSEQ 和 Q TMQI 等多个客观指标上表现更好。
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引用次数: 0
Revolutionizing breast ultrasound diagnostics with EfficientNet-B7 and Explainable AI. 利用 EfficientNet-B7 和可解释人工智能革新乳腺超声诊断。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-02 DOI: 10.1186/s12880-024-01404-3
M Latha, P Santhosh Kumar, R Roopa Chandrika, T R Mahesh, V Vinoth Kumar, Suresh Guluwadi

Breast cancer is a leading cause of mortality among women globally, necessitating precise classification of breast ultrasound images for early diagnosis and treatment. Traditional methods using CNN architectures such as VGG, ResNet, and DenseNet, though somewhat effective, often struggle with class imbalances and subtle texture variations, leading to reduced accuracy for minority classes such as malignant tumors. To address these issues, we propose a methodology that leverages EfficientNet-B7, a scalable CNN architecture, combined with advanced data augmentation techniques to enhance minority class representation and improve model robustness. Our approach involves fine-tuning EfficientNet-B7 on the BUSI dataset, implementing RandomHorizontalFlip, RandomRotation, and ColorJitter to balance the dataset and improve model robustness. The training process includes early stopping to prevent overfitting and optimize performance metrics. Additionally, we integrate Explainable AI (XAI) techniques, such as Grad-CAM, to enhance the interpretability and transparency of the model's predictions, providing visual and quantitative insights into the features and regions of ultrasound images influencing classification outcomes. Our model achieves a classification accuracy of 99.14%, significantly outperforming existing CNN-based approaches in breast ultrasound image classification. The incorporation of XAI techniques enhances our understanding of the model's decision-making process, thereby increasing its reliability and facilitating clinical adoption. This comprehensive framework offers a robust and interpretable tool for the early detection and diagnosis of breast cancer, advancing the capabilities of automated diagnostic systems and supporting clinical decision-making processes.

乳腺癌是全球妇女死亡的主要原因,因此有必要对乳腺超声图像进行精确分类,以便早期诊断和治疗。使用 VGG、ResNet 和 DenseNet 等 CNN 架构的传统方法虽然有一定的效果,但往往难以解决类别不平衡和微妙纹理变化的问题,导致恶性肿瘤等少数类别的准确性降低。为了解决这些问题,我们提出了一种方法,利用 EfficientNet-B7(一种可扩展的 CNN 架构)与先进的数据增强技术相结合,来增强少数类别的代表性并提高模型的鲁棒性。我们的方法包括在 BUSI 数据集上微调 EfficientNet-B7,实施 RandomHorizontalFlip、RandomRotation 和 ColorJitter,以平衡数据集并提高模型的鲁棒性。训练过程包括早期停止,以防止过拟合并优化性能指标。此外,我们还整合了可解释人工智能(XAI)技术,如 Grad-CAM,以增强模型预测的可解释性和透明度,为影响分类结果的超声图像特征和区域提供可视化和定量的见解。我们的模型达到了 99.14% 的分类准确率,明显优于现有的基于 CNN 的乳腺超声图像分类方法。XAI 技术的融入增强了我们对模型决策过程的理解,从而提高了模型的可靠性,促进了临床应用。这个综合框架为乳腺癌的早期检测和诊断提供了一个稳健且可解释的工具,提高了自动诊断系统的能力,并为临床决策过程提供了支持。
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引用次数: 0
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BMC Medical Imaging
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