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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":"24 1","pages":"234"},"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
Fractional differentiation based image enhancement for automatic detection of malignant melanoma. 基于分数分化的图像增强技术自动检测恶性黑色素瘤
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-09-02 DOI: 10.1186/s12880-024-01400-7
Basmah Anber, Kamil Yurtkan

Recent improvements in artificial intelligence and computer vision make it possible to automatically detect abnormalities in medical images. Skin lesions are one broad class of them. There are types of lesions that cause skin cancer, again with several types. Melanoma is one of the deadliest types of skin cancer. Its early diagnosis is at utmost importance. The treatments are greatly aided with artificial intelligence by the quick and precise diagnosis of these conditions. The identification and delineation of boundaries inside skin lesions have shown promise when using the basic image processing approaches for edge detection. Further enhancements regarding edge detections are possible. In this paper, the use of fractional differentiation for improved edge detection is explored on the application of skin lesion detection. A framework based on fractional differential filters for edge detection in skin lesion images is proposed that can improve automatic detection rate of malignant melanoma. The derived images are used to enhance the input images. Obtained images then undergo a classification process based on deep learning. A well-studied dataset of HAM10000 is used in the experiments. The system achieves 81.04% accuracy with EfficientNet model using the proposed fractional derivative based enhancements whereas accuracies are around 77.94% when using original images. In almost all the experiments, the enhanced images improved the accuracy. The results show that the proposed method improves the recognition performance.

人工智能和计算机视觉技术的最新发展使自动检测医学图像中的异常情况成为可能。皮肤病变就是其中的一大类。导致皮肤癌的病变类型也有好几种。黑色素瘤是最致命的皮肤癌之一。其早期诊断至关重要。人工智能可以快速、准确地诊断出这些病症,从而大大有助于治疗。在使用边缘检测的基本图像处理方法时,对皮肤病变内部边界的识别和划分已显示出良好的前景。进一步改进边缘检测是可能的。本文探讨了利用分数微分改进边缘检测在皮肤病变检测中的应用。本文提出了一种基于分数微分滤波器的皮肤病变图像边缘检测框架,可提高恶性黑色素瘤的自动检测率。衍生图像用于增强输入图像。获得的图像随后进行基于深度学习的分类处理。实验中使用了一个经过充分研究的 HAM10000 数据集。该系统使用基于分数导数的增强技术,在 EfficientNet 模型中实现了 81.04% 的准确率,而使用原始图像时的准确率约为 77.94%。在几乎所有实验中,增强图像都提高了准确率。结果表明,建议的方法提高了识别性能。
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引用次数: 0
The value of quantitative shear wave elastography combined with conventional ultrasound in evaluating and guiding fine needle aspiration biopsy of axillary lymph node for early breast cancer: implication for axillary surgical stage. 定量剪切波弹性成像与传统超声相结合在评估和指导早期乳腺癌腋窝淋巴结细针穿刺活检中的价值:对腋窝手术分期的影响。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-30 DOI: 10.1186/s12880-024-01407-0
Xuan Liu, Yi-Ni Huang, Ying-Lan Wu, Xiao-Yao Zhu, Ze-Ming Xie, Jian Li

Objectives: To investigate the value of conventional ultrasonography (US) combined with quantitative shear wave elastography (SWE) in evaluating and identifying target axillary lymph node (TALN) for fine needle aspiration biopsy (FNAB) of patients with early breast cancer.

Materials and methods: A total of 222 patients with 223 ALNs were prospectively recruited from January 2018 to December 2021. All TALNs were evaluated by US, SWE and subsequently underwent FNAB. The diagnostic performances of US, SWE, UEor (either US or SWE was positive) and UEand (both US and SWE were positive), and FNAB guided by the above four methods for evaluating ALN status were assessed using receiver operator characteristic curve (ROC) analyses. Univariate and multivariate logistic regression analyses used to determine the independent predictors of axillary burden.

Results: The area under the ROC curve (AUC) for diagnosing ALNs using conventional US and SWE were 0.69 and 0.66, respectively, with sensitivities of 78.00% and 65.00% and specificities of 60.98% and 66.67%. The combined method, UEor, demonstrated significantly improved sensitivity of 86.00% (p < 0.001 when compared with US and SWE alone). The AUC of the UEor-guided FNAB [0.85 (95% CI, 0.80-0.90)] was significantly higher than that of US-guided FNAB [0.83 (95% CI, 0.78-0.88), p = 0.042], SWE-guided FNAB [0.79 (95% CI, 0.72-0.84), p = 0.001], and UEand-guided FNAB [0.77 (95% CI, 0.71-0.82), p < 0.001]. Multivariate logistic regression showed that FNAB and number of suspicious ALNs were found independent predictors of axillary burden in patients with early breast cancer.

Conclusion: The UEor had superior sensitivity compared to US or SWE alone in ALN diagnosis. The UEor-guided FNAB achieved a lower false-negative rate compared to FNAB guided solely by US or SWE, which may be a promising tool for the preoperative diagnosis of ALNs in early breast cancer, and had the potential implication for the selection of axillary surgical modality.

研究目的研究常规超声造影(US)结合定量剪切波弹性成像(SWE)在评估和识别早期乳腺癌患者细针穿刺活检(FNAB)目标腋窝淋巴结(TALN)中的价值:自2018年1月至2021年12月,共前瞻性招募了222名患者,其中有223个ALN。所有 TALN 均通过 US、SWE 进行评估,随后进行 FNAB。使用接收器操作者特征曲线(ROC)分析评估了US、SWE、UEor(US或SWE均为阳性)和UEand(US和SWE均为阳性)以及上述四种方法指导下的FNAB对评估ALN状态的诊断性能。单变量和多变量逻辑回归分析用于确定腋窝负荷的独立预测因素:使用传统 US 和 SWE 诊断 ALN 的 ROC 曲线下面积(AUC)分别为 0.69 和 0.66,敏感性分别为 78.00% 和 65.00%,特异性分别为 60.98% 和 66.67%。联合方法 UEor 的灵敏度显著提高了 86.00%(与单独的 US 和 SWE 相比,P < 0.001)。UEor 引导的 FNAB 的 AUC [0.85 (95% CI, 0.80-0.90)] 明显高于 US 引导的 FNAB [0.83 (95% CI, 0.78-0.88), p = 0.042]、SWE 引导的 FNAB [0.79 (95% CI, 0.72-0.84), p = 0.001] 和 UEand 引导的 FNAB [0.77 (95% CI, 0.71-0.82), p 结论:在 ALN 诊断中,UEor 的灵敏度优于单纯 US 或 SWE。UEor 引导的 FNAB 与仅由 US 或 SWE 引导的 FNAB 相比,假阴性率更低,这可能是早期乳腺癌 ALN 术前诊断的一种有前途的工具,并对腋窝手术方式的选择有潜在影响。
{"title":"The value of quantitative shear wave elastography combined with conventional ultrasound in evaluating and guiding fine needle aspiration biopsy of axillary lymph node for early breast cancer: implication for axillary surgical stage.","authors":"Xuan Liu, Yi-Ni Huang, Ying-Lan Wu, Xiao-Yao Zhu, Ze-Ming Xie, Jian Li","doi":"10.1186/s12880-024-01407-0","DOIUrl":"https://doi.org/10.1186/s12880-024-01407-0","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the value of conventional ultrasonography (US) combined with quantitative shear wave elastography (SWE) in evaluating and identifying target axillary lymph node (TALN) for fine needle aspiration biopsy (FNAB) of patients with early breast cancer.</p><p><strong>Materials and methods: </strong>A total of 222 patients with 223 ALNs were prospectively recruited from January 2018 to December 2021. All TALNs were evaluated by US, SWE and subsequently underwent FNAB. The diagnostic performances of US, SWE, UE<sub>or</sub> (either US or SWE was positive) and UE<sub>and</sub> (both US and SWE were positive), and FNAB guided by the above four methods for evaluating ALN status were assessed using receiver operator characteristic curve (ROC) analyses. Univariate and multivariate logistic regression analyses used to determine the independent predictors of axillary burden.</p><p><strong>Results: </strong>The area under the ROC curve (AUC) for diagnosing ALNs using conventional US and SWE were 0.69 and 0.66, respectively, with sensitivities of 78.00% and 65.00% and specificities of 60.98% and 66.67%. The combined method, UE<sub>or</sub>, demonstrated significantly improved sensitivity of 86.00% (p < 0.001 when compared with US and SWE alone). The AUC of the UE<sub>or</sub>-guided FNAB [0.85 (95% CI, 0.80-0.90)] was significantly higher than that of US-guided FNAB [0.83 (95% CI, 0.78-0.88), p = 0.042], SWE-guided FNAB [0.79 (95% CI, 0.72-0.84), p = 0.001], and UE<sub>and</sub>-guided FNAB [0.77 (95% CI, 0.71-0.82), p < 0.001]. Multivariate logistic regression showed that FNAB and number of suspicious ALNs were found independent predictors of axillary burden in patients with early breast cancer.</p><p><strong>Conclusion: </strong>The UE<sub>or</sub> had superior sensitivity compared to US or SWE alone in ALN diagnosis. The UE<sub>or</sub>-guided FNAB achieved a lower false-negative rate compared to FNAB guided solely by US or SWE, which may be a promising tool for the preoperative diagnosis of ALNs in early breast cancer, and had the potential implication for the selection of axillary surgical modality.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"229"},"PeriodicalIF":2.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104051","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
Prediction model for lateral lymph node metastasis of papillary thyroid carcinoma in children and adolescents based on ultrasound imaging and clinical features: a retrospective study. 基于超声成像和临床特征的儿童和青少年甲状腺乳头状癌侧淋巴结转移预测模型:一项回顾性研究。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-29 DOI: 10.1186/s12880-024-01384-4
Shiyang Lin, Yuan Zhong, Yidi Lin, Guangjian Liu

Background: The presence of lateral lymph node metastases (LNM) in paediatric patients with papillary thyroid cancer (PTC) is an independent risk factor for recurrence. We aimed to identify risk factors and establish a prediction model for lateral LNM before surgery in children and adolescents with PTC.

Methods: We developed a prediction model based on data obtained from 63 minors with PTC between January 2014 and June 2023. We collected and analysed clinical factors, ultrasound (US) features of the primary tumour, and pathology records of the patients. Multivariate logistic regression analysis was used to determine independent predictors and build a prediction model. We evaluated the predictive performance of risk factors and the prediction model using the area under the receiver operating characteristic (ROC) curve. We assessed the clinical usefulness of the predicting model using decision curve analysis.

Results: Among the minors with PTC, 21 had lateral LNM (33.3%). Logistic regression revealed that independent risk factors for lateral LNM were multifocality, tumour size, sex, and age. The area under the ROC curve for multifocality, tumour size, sex, and age was 0.62 (p = 0.049), 0.61 (p = 0.023), 0.66 (p = 0.003), and 0.58 (p = 0.013), respectively. Compared to a single risk factor, the combined predictors had a significantly higher area under the ROC curve (0.842), with a sensitivity and specificity of 71.4% and 81.0%, respectively (cutoff value = 0.524). Decision curve analysis showed that the prediction model was clinically useful, with threshold probabilities between 2% and 99%.

Conclusions: The independent risk factors for lateral LNM in paediatric PTC patients were multifocality and tumour size on US imaging, as well as sex and age. Our model outperformed US imaging and clinical features alone in predicting the status of lateral LNM.

背景:儿童甲状腺乳头状癌(PTC)患者出现侧淋巴结转移(LNM)是导致复发的独立风险因素。我们旨在确定儿童和青少年 PTC 患者手术前出现侧淋巴结转移的风险因素并建立预测模型:方法:我们根据 2014 年 1 月至 2023 年 6 月期间 63 名患有 PTC 的未成年人的数据建立了一个预测模型。我们收集并分析了患者的临床因素、原发肿瘤的超声(US)特征和病理记录。我们采用多变量逻辑回归分析来确定独立的预测因素并建立预测模型。我们使用接收者操作特征曲线下面积(ROC)评估了风险因素和预测模型的预测性能。我们利用决策曲线分析评估了预测模型的临床实用性:在患有 PTC 的未成年人中,21 人患有侧位 LNM(33.3%)。逻辑回归显示,侧位 LNM 的独立风险因素包括多灶性、肿瘤大小、性别和年龄。多灶性、肿瘤大小、性别和年龄的ROC曲线下面积分别为0.62(P = 0.049)、0.61(P = 0.023)、0.66(P = 0.003)和0.58(P = 0.013)。与单一风险因素相比,组合预测因子的 ROC 曲线下面积(0.842)明显更高,灵敏度和特异度分别为 71.4% 和 81.0%(临界值 = 0.524)。决策曲线分析表明,该预测模型对临床有用,阈值概率介于 2% 和 99% 之间:结论:儿科 PTC 患者患侧 LNM 的独立风险因素是 US 成像显示的多灶性和肿瘤大小,以及性别和年龄。我们的模型在预测侧位 LNM 的情况方面优于单纯的 US 成像和临床特征。
{"title":"Prediction model for lateral lymph node metastasis of papillary thyroid carcinoma in children and adolescents based on ultrasound imaging and clinical features: a retrospective study.","authors":"Shiyang Lin, Yuan Zhong, Yidi Lin, Guangjian Liu","doi":"10.1186/s12880-024-01384-4","DOIUrl":"https://doi.org/10.1186/s12880-024-01384-4","url":null,"abstract":"<p><strong>Background: </strong>The presence of lateral lymph node metastases (LNM) in paediatric patients with papillary thyroid cancer (PTC) is an independent risk factor for recurrence. We aimed to identify risk factors and establish a prediction model for lateral LNM before surgery in children and adolescents with PTC.</p><p><strong>Methods: </strong>We developed a prediction model based on data obtained from 63 minors with PTC between January 2014 and June 2023. We collected and analysed clinical factors, ultrasound (US) features of the primary tumour, and pathology records of the patients. Multivariate logistic regression analysis was used to determine independent predictors and build a prediction model. We evaluated the predictive performance of risk factors and the prediction model using the area under the receiver operating characteristic (ROC) curve. We assessed the clinical usefulness of the predicting model using decision curve analysis.</p><p><strong>Results: </strong>Among the minors with PTC, 21 had lateral LNM (33.3%). Logistic regression revealed that independent risk factors for lateral LNM were multifocality, tumour size, sex, and age. The area under the ROC curve for multifocality, tumour size, sex, and age was 0.62 (p = 0.049), 0.61 (p = 0.023), 0.66 (p = 0.003), and 0.58 (p = 0.013), respectively. Compared to a single risk factor, the combined predictors had a significantly higher area under the ROC curve (0.842), with a sensitivity and specificity of 71.4% and 81.0%, respectively (cutoff value = 0.524). Decision curve analysis showed that the prediction model was clinically useful, with threshold probabilities between 2% and 99%.</p><p><strong>Conclusions: </strong>The independent risk factors for lateral LNM in paediatric PTC patients were multifocality and tumour size on US imaging, as well as sex and age. Our model outperformed US imaging and clinical features alone in predicting the status of lateral LNM.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"228"},"PeriodicalIF":2.9,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104050","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
Correction: Radiomics diagnostic performance for predicting lymph node metastasis in esophageal cancer: a systematic review and meta-analysis. 更正:预测食管癌淋巴结转移的放射组学诊断性能:系统综述和荟萃分析。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-28 DOI: 10.1186/s12880-024-01411-4
Dong Ma, Teli Zhou, Jing Chen, Jun Chen
{"title":"Correction: Radiomics diagnostic performance for predicting lymph node metastasis in esophageal cancer: a systematic review and meta-analysis.","authors":"Dong Ma, Teli Zhou, Jing Chen, Jun Chen","doi":"10.1186/s12880-024-01411-4","DOIUrl":"10.1186/s12880-024-01411-4","url":null,"abstract":"","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":"24 1","pages":"225"},"PeriodicalIF":2.9,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11351545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092158","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
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BMC Medical Imaging
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