IEEE transactions on medical imaging最新文献

Surgical instrument segmentation is fundamentally important for facilitating cognitive intelligence in robot-assisted surgery. Although existing methods have achieved accurate instrument segmentation results, they simultaneously generate segmentation masks of all instruments, which lack the capability to specify a target object and allow an interactive experience. This paper focuses on a novel and essential task in robotic surgery, i.e., Referring Surgical Video Instrument Segmentation (RSVIS), which aims to automatically identify and segment the target surgical instruments from each video frame, referred by a given language expression. This interactive feature offers enhanced user engagement and customized experiences, greatly benefiting the development of the next generation of surgical education systems. To achieve this, this paper constructs two surgery video datasets to promote the RSVIS research. Then, we devise a novel Video-Instrument Synergistic Network (VIS-Net) to learn both video-level and instrument-level knowledge to boost performance, while previous work only utilized video-level information. Meanwhile, we design a Graph-based Relation-aware Module (GRM) to model the correlation between multi-modal information (i.e., textual description and video frame) to facilitate the extraction of instrument-level information. Extensive experimental results on two RSVIS datasets exhibit that the VIS-Net can significantly outperform existing state-of-the-art referring segmentation methods. We will release our code and dataset for future research (Git).

Medical Visual Question Answering (VQA-Med) is a challenging task that involves answering clinical questions related to medical images. However, most current VQA-Med methods ignore the causal correlation between specific lesion or abnormality features and answers, while also failing to provide accurate explanations for their decisions. To explore the interpretability of VQA-Med, this paper proposes a novel CCIS-MVQA model for VQA-Med based on a counterfactual causal-effect intervention strategy. This model consists of the modified ResNet for image feature extraction, a GloVe decoder for question feature extraction, a bilinear attention network for vision and language feature fusion, and an interpretability generator for producing the interpretability and prediction results. The proposed CCIS-MVQA introduces a layer-wise relevance propagation method to automatically generate counterfactual samples. Additionally, CCIS-MVQA applies counterfactual causal reasoning throughout the training phase to enhance interpretability and generalization. Extensive experiments on three benchmark datasets show that the proposed CCIS-MVQA model outperforms the state-of-the-art methods. Enough visualization results are produced to analyze the interpretability and performance of CCIS-MVQA.

The potential of automated radiology report generation in alleviating the time-consuming tasks of radiologists is increasingly being recognized in medical practice. Existing report generation methods have evolved from using image-level features to the latest approach of utilizing anatomical regions, significantly enhancing interpretability. However, directly and simplistically using region features for report generation compromises the capability of relation reasoning and overlooks the common attributes potentially shared across regions. To address these limitations, we propose a novel region-based Attribute Prototype-guided Iterative Scene Graph generation framework (AP-ISG) for report generation, utilizing scene graph generation as an auxiliary task to further enhance interpretability and relational reasoning capability. The core components of AP-ISG are the Iterative Scene Graph Generation (ISGG) module and the Attribute Prototype-guided Learning (APL) module. Specifically, ISSG employs an autoregressive scheme for structural edge reasoning and a contextualization mechanism for relational reasoning. APL enhances intra-prototype matching and reduces inter-prototype semantic overlap in the visual space to fully model the potential attribute commonalities among regions. Extensive experiments on the MIMIC-CXR with Chest ImaGenome datasets demonstrate the superiority of AP-ISG across multiple metrics.

Medical image analysis poses significant challenges due to limited availability of clinical data, which is crucial for training accurate models. This limitation is further compounded by the specialized and labor-intensive nature of the data annotation process. For example, despite the popularity of computed tomography angiography (CTA) in diagnosing atherosclerosis with an abundance of annotated datasets, magnetic resonance (MR) images stand out with better visualization for soft plaque and vessel wall characterization. However, the higher cost and limited accessibility of MR, as well as time-consuming nature of manual labeling, contribute to fewer annotated datasets. To address these issues, we formulate a multi-modal transfer learning network, named MT-Net, designed to learn from unpaired CTA and sparsely-annotated MR data. Additionally, we harness the Segment Anything Model (SAM) to synthesize additional MR annotations, enriching the training process. Specifically, our method first segments vessel lumen regions followed by precise characterization of carotid artery vessel walls, thereby ensuring both segmentation accuracy and clinical relevance. Validation of our method involved rigorous experimentation on publicly available datasets from COSMOS and CARE-II challenge, demonstrating its superior performance compared to existing state-of-the-art techniques.

Multi-modal medical images provide complementary soft-tissue characteristics that aid in the screening and diagnosis of diseases. However, limited scanning time, image corruption and various imaging protocols often result in incomplete multi-modal images, thus limiting the usage of multi-modal data for clinical purposes. To address this issue, in this paper, we propose a novel unified multi-modal image synthesis method for missing modality imputation. Our method overall takes a generative adversarial architecture, which aims to synthesize missing modalities from any combination of available ones with a single model. To this end, we specifically design a Commonality- and Discrepancy-Sensitive Encoder for the generator to exploit both modality-invariant and specific information contained in input modalities. The incorporation of both types of information facilitates the generation of images with consistent anatomy and realistic details of the desired distribution. Besides, we propose a Dynamic Feature Unification Module to integrate information from a varying number of available modalities, which enables the network to be robust to random missing modalities. The module performs both hard integration and soft integration, ensuring the effectiveness of feature combination while avoiding information loss. Verified on two public multi-modal magnetic resonance datasets, the proposed method is effective in handling various synthesis tasks and shows superior performance compared to previous methods.

Medical image segmentation has been significantly advanced with the rapid development of deep learning (DL) techniques. Existing DL-based segmentation models are typically discriminative; i.e., they aim to learn a mapping from the input image to segmentation masks. However, these discriminative methods neglect the underlying data distribution and intrinsic class characteristics, suffering from unstable feature space. In this work, we propose to complement discriminative segmentation methods with the knowledge of underlying data distribution from generative models. To that end, we propose a novel hybrid diffusion framework for medical image segmentation, termed HiDiff, which can synergize the strengths of existing discriminative segmentation models and new generative diffusion models. HiDiff comprises two key components: discriminative segmentor and diffusion refiner. First, we utilize any conventional trained segmentation models as discriminative segmentor, which can provide a segmentation mask prior for diffusion refiner. Second, we propose a novel binary Bernoulli diffusion model (BBDM) as the diffusion refiner, which can effectively, efficiently, and interactively refine the segmentation mask by modeling the underlying data distribution. Third, we train the segmentor and BBDM in an alternate-collaborative manner to mutually boost each other. Extensive experimental results on abdomen organ, brain tumor, polyps, and retinal vessels segmentation datasets, covering four widely-used modalities, demonstrate the superior performance of HiDiff over existing medical segmentation algorithms, including the state-of-the-art transformer- and diffusion-based ones. In addition, HiDiff excels at segmenting small objects and generalizing to new datasets. Source codes are made available at https://github.com/takimailto/HiDiff.

Thorium-227 (²²⁷Th)-based α-particle radiopharmaceutical therapies (α-RPTs) are currently being investigated in several clinical and pre-clinical studies. After administration, ²²⁷Th decays to ²²³Ra, another α-particle-emitting isotope, which redistributes within the patient. Reliable dose quantification of both ²²⁷Th and ²²³Ra is clinically important, and SPECT may perform this quantification as these isotopes also emit X- and γ-ray photons. However, reliable quantification is challenging for several reasons: the orders-of-magnitude lower activity compared to conventional SPECT, resulting in a very low number of detected counts, the presence of multiple photopeaks, substantial overlap in the emission spectra of these isotopes, and the image-degrading effects in SPECT. To address these issues, we propose a multiple-energy-window projection-domain quantification (MEW-PDQ) method that jointly estimates the regional activity uptake of both ²²⁷Th and ²²³Ra directly using the SPECT projection data from multiple energy windows. We evaluated the method with realistic simulation studies conducted with anthropomorphic digital phantoms, including a virtual imaging trial, in the context of imaging patients with bone metastases of prostate cancer who were treated with ²²⁷Th-based α-RPTs. The proposed method yielded reliable (accurate and precise) regional uptake estimates of both isotopes and outperformed state-of-the-art methods across different lesion sizes and contrasts, as well as in the virtual imaging trial. This reliable performance was also observed with moderate levels of intra-regional heterogeneous uptake as well as when there were moderate inaccuracies in the definitions of the support of various regions. Additionally, we demonstrated the effectiveness of using multiple energy windows and the variance of the estimated uptake using the proposed method approached the Cramér-Rao-lower-bound-defined theoretical limit. These results provide strong evidence in support of this method for reliable uptake quantification in ²²⁷Th-based α-RPTs.

The presence of metal objects leads to corrupted CT projection measurements, resulting in metal artifacts in the reconstructed CT images. AI promises to offer improved solutions to estimate missing sinogram data for metal artifact reduction (MAR), as previously shown with convolutional neural networks (CNNs) and generative adversarial networks (GANs). Recently, denoising diffusion probabilistic models (DDPM) have shown great promise in image generation tasks, potentially outperforming GANs. In this study, a DDPM-based approach is proposed for inpainting of missing sinogram data for improved MAR. The proposed model is unconditionally trained, free from information on metal objects, which can potentially enhance its generalization capabilities across different types of metal implants compared to conditionally trained approaches. The performance of the proposed technique was evaluated and compared to the state-of-the-art normalized MAR (NMAR) approach as well as to CNN-based and GAN-based MAR approaches. The DDPM-based approach provided significantly higher SSIM and PSNR, as compared to NMAR (SSIM: p < 10^-26; PSNR: p < 10^-21), the CNN (SSIM: p < 10^-25; PSNR: p < 10^-9) and the GAN (SSIM: p < 10^-6; PSNR: p < 0.05) methods. The DDPM-MAR technique was further evaluated based on clinically relevant image quality metrics on clinical CT images with virtually introduced metal objects and metal artifacts, demonstrating superior quality relative to the other three models. In general, the AI-based techniques showed improved MAR performance compared to the non-AI-based NMAR approach. The proposed methodology shows promise in enhancing the effectiveness of MAR, and therefore improving the diagnostic accuracy of CT.

One of the primary sources of suboptimal image quality in ultrasound imaging is phase aberration. It is caused by spatial changes in sound speed over a heterogeneous medium, which disturbs the transmitted waves and prevents coherent summation of echo signals. Obtaining non-aberrated ground truths in real-world scenarios can be extremely challenging, if not impossible. This challenge hinders the performance of deep learning-based techniques due to the domain shift between simulated and experimental data. Here, for the first time, we propose a deep learning-based method that does not require ground truth to correct the phase aberration problem and, as such, can be directly trained on real data. We train a network wherein both the input and target output are randomly aberrated radio frequency (RF) data. Moreover, we demonstrate that a conventional loss function such as mean square error is inadequate for training such a network to achieve optimal performance. Instead, we propose an adaptive mixed loss function that employs both B-mode and RF data, resulting in more efficient convergence and enhanced performance. Finally, we publicly release our dataset, comprising over 180,000 aberrated single plane-wave images (RF data), wherein phase aberrations are modeled as near-field phase screens. Although not utilized in the proposed method, each aberrated image is paired with its corresponding aberration profile and the non-aberrated version, aiming to mitigate the data scarcity problem in developing deep learning-based techniques for phase aberration correction. Source code and trained model are also available along with the dataset at http://code.sonography.ai/main-aaa.