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Hans R, Sharma SK, Aickelin U. Optimised deep k-nearest neighbour's based diabetic retinopathy diagnosis(ODeep-NN) using retinal images. Health Inf Sci Syst 2024; 12:23. [PMID: 38469456 PMCID: PMC10924814 DOI: 10.1007/s13755-024-00282-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/18/2024] [Indexed: 03/13/2024] Open
Abstract
Diabetes mellitus has been regarded as one of the prime health issues in present days, which can often lead to diabetic retinopathy, a complication of the disease that affects the eyes, causing loss of vision. For precisely detecting the condition's existence, clinicians are required to recognise the presence of lesions in colour fundus images, making it an arduous and time-consuming task. To deal with this problem, a lot of work has been undertaken to develop deep learning-based computer-aided diagnosis systems that assist clinicians in making accurate diagnoses of the diseases in medical images. Contrariwise, the basic operations involved in deep learning models lead to the extraction of a bulky set of features, further taking a long period of training to predict the existence of the disease. For effective execution of these models, feature selection becomes an important task that aids in selecting the most appropriate features, with an aim to increase the classification accuracy. This research presents an optimised deep k-nearest neighbours'-based pipeline model in a bid to amalgamate the feature extraction capability of deep learning models with nature-inspired metaheuristic algorithms, further using k-nearest neighbour algorithm for classification. The proposed model attains an accuracy of 97.67 and 98.05% on two different datasets considered, outperforming Resnet50 and AlexNet deep learning models. Additionally, the experimental results also portray an analysis of five different nature-inspired metaheuristic algorithms, considered for feature selection on the basis of various evaluation parameters.
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Affiliation(s)
- Rahul Hans
- Department of Computer Science and Engineering, DAV University, Jalandhar, Punjab India
| | - Sanjeev Kumar Sharma
- Department of Computer Science and Applications, DAV University, Jalandhar, Punjab India
| | - Uwe Aickelin
- School of Computing and Information Systems, University of Melbourne, Melbourne, Australia
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Wang B, Li M, Haihambo N, Qiu Z, Sun M, Guo M, Zhao X, Han C. Characterizing Major Depressive Disorder (MDD) using alpha-band activity in resting-state electroencephalogram (EEG) combined with MATRICS Consensus Cognitive Battery (MCCB). J Affect Disord 2024; 355:254-264. [PMID: 38561155 DOI: 10.1016/j.jad.2024.03.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The diagnosis of major depressive disorder (MDD) is commonly based on the subjective evaluation by experienced psychiatrists using clinical scales. Hence, it is particularly important to find more objective biomarkers to aid in diagnosis and further treatment. Alpha-band activity (7-13 Hz) is the most prominent component in resting electroencephalogram (EEG), which is also thought to be a potential biomarker. Recent studies have shown the existence of multiple sub-oscillations within the alpha band, with distinct neural underpinnings. However, the specific contribution of these alpha sub-oscillations to the diagnosis and treatment of MDD remains unclear. METHODS In this study, we recorded the resting-state EEG from MDD and HC populations in both open and closed-eye state conditions. We also assessed cognitive processing using the MATRICS Consensus Cognitive Battery (MCCB). RESULTS We found that the MDD group showed significantly higher power in the high alpha range (10.5-11.5 Hz) and lower power in the low alpha range (7-8.5 Hz) compared to the HC group. Notably, high alpha power in the MDD group is negatively correlated with working memory performance in MCCB, whereas no such correlation was found in the HC group. Furthermore, using five established classification algorithms, we discovered that combining alpha oscillations with MCCB scores as features yielded the highest classification accuracy compared to using EEG or MCCB scores alone. CONCLUSIONS Our results demonstrate the potential of sub-oscillations within the alpha frequency band as a potential distinct biomarker. When combined with psychological scales, they may provide guidance relevant for the diagnosis and treatment of MDD.
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Affiliation(s)
- Bin Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100191 Beijing, China
| | - Meijia Li
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Naem Haihambo
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Zihan Qiu
- Avenues the World School Shenzhen Campus, Shenzhen 518000, China
| | - Meirong Sun
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Mingrou Guo
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong
| | - Xixi Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100191 Beijing, China.
| | - Chuanliang Han
- School of Biomedical Sciences and Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong, Hong Kong.
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Li L, Zhang J, Zhe X, Tang M, Zhang L, Lei X, Zhang X. Prediction of histopathologic grades of bladder cancer with radiomics based on MRI: Comparison with traditional MRI. Urol Oncol 2024; 42:176.e9-176.e20. [PMID: 38556403 DOI: 10.1016/j.urolonc.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 02/01/2024] [Accepted: 02/20/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE To compare biparametric magnetic resonance imaging (bp-MRI) radiomics signatures and traditional MRI model for the preoperative prediction of bladder cancer (BCa) grade. MATERIALS AND METHODS This retrospective study included 255 consecutive patients with pathologically confirmed 113 low-grade and 142 high-grade BCa. The traditional MRI nomogram model was developed using univariate and multivariate logistic regression by the mean apparent diffusion coefficient (ADC), vesical imaging reporting and data system, tumor size, and the number of tumors. Volumes of interest were manually drawn on T2-weighted imaging (T2WI) and ADC maps by 2 radiologists. Using one-way analysis of variance, correlation, and least absolute shrinkage and selection operator methods to select features. Then, a logistic regression classifier was used to develop the radiomics signatures. Receiver operating characteristic (ROC) analysis was used to compare the diagnostic abilities of the radiomics and traditional MRI models by the DeLong test. Finally, decision curve analysis was performed by estimating the clinical usefulness of the 2 models. RESULTS The area under the ROC curves (AUCs) of the traditional MRI model were 0.841 in the training cohort and 0.806 in the validation cohort. The AUCs of the 3 groups of radiomics model [ADC, T2WI, bp-MRI (ADC and T2WI)] were 0.888, 0.875, and 0.899 in the training cohort and 0.863, 0.805, and 0.867 in the validation cohort, respectively. The combined radiomics model achieved higher AUCs than the traditional MRI model. decision curve analysis indicated that the radiomics model had higher net benefits than the traditional MRI model. CONCLUSION The bp-MRI radiomics model may help distinguish high-grade and low-grade BCa and outperforming the traditional MRI model. Multicenter validation is needed to acquire high-level evidence for its clinical application.
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Affiliation(s)
- Longchao Li
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Jing Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Xia Zhe
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Li Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
| | - Xiaoyan Lei
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
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Musicant O, Richmond-Hacham B, Botzer A. Cardiac indices of driver fatigue across in-lab and on-road studies. Appl Ergon 2024; 117:104202. [PMID: 38215606 DOI: 10.1016/j.apergo.2023.104202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 10/31/2023] [Accepted: 12/05/2023] [Indexed: 01/14/2024]
Abstract
Driver fatigue is a major contributor to road accidents. Therefore, driver assistance systems (DAS) that would monitor drivers' states may contribute to road safety. Such monitoring can potentially be achieved with input from ECG indices (e.g., heart rate). We reviewed the empirical literature on responses of cardiac measures to driver fatigue and on detecting fatigue with cardiac indices and classification algorithms. We used meta-analytical methods to explore the pooled effect sizes of different cardiac indices of fatigue, their heterogeneity, and the consistency of their responses across studies. Our large pool of studies (N = 39) allowed us to stratify the results across on-road and simulator studies. We found that despite the large heterogeneity of the effect sizes between the studies, many indices had significant pooled effect sizes across the studies, and more frequently across the on-road studies. We also found that most indices showed consistent responses across both on-road and simulator studies. Regarding the detection accuracy, we found that even on-road classification could have been as accurate as 70% with only 2-min of data. However, we could only find two on-road studies that employed fatigue classification algorithms. Overall, our findings are encouraging with respect to the prospect of using cardiac measures for detecting driver fatigue. Yet, to fully explore this possibility, there is a need for additional on-road studies that would employ a similar set of cardiac indices and detection algorithms, a unified definition of fatigue, and additional levels of fatigue than the two fatigue vs alert states.
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Affiliation(s)
- Oren Musicant
- Industrial Engineering & Management, Ariel University, Kiriat Hamada, Ariel, Israel.
| | - Bar Richmond-Hacham
- Industrial Engineering & Management, Ariel University, Kiriat Hamada, Ariel, Israel.
| | - Assaf Botzer
- Industrial Engineering & Management, Ariel University, Kiriat Hamada, Ariel, Israel.
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Wang L, Wang Q, Wang X, Ma Y, Zhang L, Liu M. Triplet-constrained deep hashing for chest X-ray image retrieval in COVID-19 assessment. Neural Netw 2024; 173:106182. [PMID: 38387203 DOI: 10.1016/j.neunet.2024.106182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/15/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024]
Abstract
Radiology images of the chest, such as computer tomography scans and X-rays, have been prominently used in computer-aided COVID-19 analysis. Learning-based radiology image retrieval has attracted increasing attention recently, which generally involves image feature extraction and finding matches in extensive image databases based on query images. Many deep hashing methods have been developed for chest radiology image search due to the high efficiency of retrieval using hash codes. However, they often overlook the complex triple associations between images; that is, images belonging to the same category tend to share similar characteristics and vice versa. To this end, we develop a triplet-constrained deep hashing (TCDH) framework for chest radiology image retrieval to facilitate automated analysis of COVID-19. The TCDH consists of two phases, including (a) feature extraction and (b) image retrieval. For feature extraction, we have introduced a triplet constraint and an image reconstruction task to enhance discriminative ability of learned features, and these features are then converted into binary hash codes to capture semantic information. Specifically, the triplet constraint is designed to pull closer samples within the same category and push apart samples from different categories. Additionally, an auxiliary image reconstruction task is employed during feature extraction to help effectively capture anatomical structures of images. For image retrieval, we utilize learned hash codes to conduct searches for medical images. Extensive experiments on 30,386 chest X-ray images demonstrate the superiority of the proposed method over several state-of-the-art approaches in automated image search. The code is now available online.
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Affiliation(s)
- Linmin Wang
- School of Mathematics Science, Liaocheng University, Liaocheng, Shandong, 252000, China
| | - Qianqian Wang
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Xiaochuan Wang
- School of Mathematics Science, Liaocheng University, Liaocheng, Shandong, 252000, China
| | - Yunling Ma
- School of Mathematics Science, Liaocheng University, Liaocheng, Shandong, 252000, China
| | - Limei Zhang
- School of Computer Science and Technology, Shandong Jianzhu University, Jinan, Shandong, 250101, China.
| | - Mingxia Liu
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Ghosh S, Patra S, Younis MH, Chakraborty A, Guleria A, Gupta SK, Singh K, Rakhshit S, Chakraborty S, Cai W, Chakravarty R. Brachytherapy at the nanoscale with protein functionalized and intrinsically radiolabeled [ 169Yb]Yb 2O 3 nanoseeds. Eur J Nucl Med Mol Imaging 2024; 51:1558-1573. [PMID: 38270686 DOI: 10.1007/s00259-024-06612-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE Classical brachytherapy of solid malignant tumors is an invasive procedure which often results in an uneven dose distribution, while requiring surgical removal of sealed radioactive seed sources after a certain period of time. To circumvent these issues, we report the synthesis of intrinsically radiolabeled and gum Arabic glycoprotein functionalized [169Yb]Yb2O3 nanoseeds as a novel nanoscale brachytherapy agent, which could directly be administered via intratumoral injection for tumor therapy. METHODS 169Yb (T½ = 32 days) was produced by neutron irradiation of enriched (15.2% in 168Yb) Yb2O3 target in a nuclear reactor, radiochemically converted to [169Yb]YbCl3 and used for nanoparticle (NP) synthesis. Intrinsically radiolabeled NP were synthesized by controlled hydrolysis of Yb3+ ions in gum Arabic glycoprotein medium. In vivo SPECT/CT imaging, autoradiography, and biodistribution studies were performed after intratumoral injection of radiolabeled NP in B16F10 tumor bearing C57BL/6 mice. Systematic tumor regression studies and histopathological analyses were performed to demonstrate therapeutic efficacy in the same mice model. RESULTS The nanoformulation was a clear solution having high colloidal and radiochemical stability. Uniform distribution and retention of the radiolabeled nanoformulation in the tumor mass were observed via SPECT/CT imaging and autoradiography studies. In a tumor regression study, tumor growth was significantly arrested with different doses of radiolabeled NP compared to the control and the best treatment effect was observed with ~ 27.8 MBq dose. In histopathological analysis, loss of mitotic cells was apparent in tumor tissue of treated groups, whereas no significant damage in kidney, lungs, and liver tissue morphology was observed. CONCLUSIONS These results hold promise for nanoscale brachytherapy to become a clinically practical treatment modality for unresectable solid cancers.
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Affiliation(s)
- Sanchita Ghosh
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, 400094, India
| | - Sourav Patra
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, 400094, India
| | - Muhsin H Younis
- Departments of Radiology and Medical Physics, University of Wisconsin-Madison, Madison, USA
| | - Avik Chakraborty
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, 400094, India
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Parel, Mumbai, 400012, India
| | - Apurav Guleria
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, 400094, India
- Radiation and Photochemistry Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Santosh K Gupta
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, 400094, India
- Radiochemistry Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Khajan Singh
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Sutapa Rakhshit
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Parel, Mumbai, 400012, India
| | - Sudipta Chakraborty
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, 400094, India
| | - Weibo Cai
- Departments of Radiology and Medical Physics, University of Wisconsin-Madison, Madison, USA.
| | - Rubel Chakravarty
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India.
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, 400094, India.
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Schmierer T, Li T, Li Y. Harnessing machine learning for EEG signal analysis: Innovations in depth of anaesthesia assessment. Artif Intell Med 2024; 151:102869. [PMID: 38593683 DOI: 10.1016/j.artmed.2024.102869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/31/2024] [Accepted: 04/03/2024] [Indexed: 04/11/2024]
Abstract
Anaesthesia, crucial to surgical practice, is undergoing renewed scrutiny due to the integration of artificial intelligence in its medical use. The precise control over the temporary loss of consciousness is vital to ensure safe, pain-free procedures. Traditional methods of depth of anaesthesia (DoA) assessment, reliant on physical characteristics, have proven inconsistent due to individual variations. In response, electroencephalography (EEG) techniques have emerged, with indices such as the Bispectral Index offering quantifiable assessments. This literature review explores the current scope and frontier of DoA research, emphasising methods utilising EEG signals for effective clinical monitoring. This review offers a critical synthesis of recent advances, specifically focusing on electroencephalography (EEG) techniques and their role in enhancing clinical monitoring. By examining 117 high-impact papers, the review delves into the nuances of feature extraction, model building, and algorithm design in EEG-based DoA analysis. Comparative assessments of these studies highlight their methodological approaches and performance, including clinical correlations with established indices like the Bispectral Index. The review identifies knowledge gaps, particularly the need for improved collaboration for data access, which is essential for developing superior machine learning models and real-time predictive algorithms for patient management. It also calls for refined model evaluation processes to ensure robustness across diverse patient demographics and anaesthetic agents. The review underscores the potential of technological advancements to enhance precision, safety, and patient outcomes in anaesthesia, paving the way for a new standard in anaesthetic care. The findings of this review contribute to the ongoing discourse on the application of EEG in anaesthesia, providing insights into the potential for technological advancement in this critical area of medical practice.
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Affiliation(s)
- Thomas Schmierer
- School of Mathematics, Physics and Computing, University of Southern Queensland, Australia.
| | - Tianning Li
- School of Mathematics, Physics and Computing, University of Southern Queensland, Australia.
| | - Yan Li
- School of Mathematics, Physics and Computing, University of Southern Queensland, Australia.
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He C, Xu P, Pei X, Wang Q, Yue Y, Han C. Fatigue at the wheel: A non-visual approach to truck driver fatigue detection by multi-feature fusion. Accid Anal Prev 2024; 199:107511. [PMID: 38387154 DOI: 10.1016/j.aap.2024.107511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/28/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Monitoring of long-haul truck driver fatigue state has attracted considerable interest. Conventional fatigue driving detection methods based on the physiological and visual features are scarcely applicable, due to the intrusiveness, reliability, and cost-effectiveness concerns. METHODS We elaborately developed a fatigue driving detection method by fusion of non-visual features derived from the customized wristbands, vehicle-mounted equipment, and trip logs. To capture the spatiotemporal information within the sequential data, the bidirectional long short-term memory network with attention mechanism was proposed to determine whether the truck driver was fatigued within a fine-grained episode of one minute. The model was validated using a natural driving dataset with nine truck drivers on real-world roads in Guiyang, China during June and July 2021. RESULTS Our approach yielded 99.21 %, 84.44 %, 82.01 %, 99.63 %, and 83.21 % in accuracy, precision, recall, specificity, and F1-score, respectively. Compared with the mainstream visual-based methods, our approach outperformed particularly in terms of precision and recall. Photoplethysmogram stood out as the most important feature for truck driver fatigue state detection. Vehicle load, driving forward angle, cumulative driving time, midnight, and recent working hours were found to be positively associated with the probability of fatigue driving, while the galvanic skin response, vehicle acceleration, current time, and recent rest hours had a negative relationship. Specifically, truck drivers were more likely to fatigue when driving at 20-40 km/h, braking abruptly at 5-10 m/s2, with vehicle loads over 70 tons, and driving more than 100 min consecutively. CONCLUSIONS Our study is among the first to harness the natural driving dataset to delve into the real-life fatigue pattern of long-haul truck drivers without disruptions on routine driving tasks. The proposed method holds pragmatic prospects by providing a privacy-preserving, robust, real-time, and non-intrusive technical pathway for truck driver fatigue monitoring.
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Affiliation(s)
- Chen He
- Department of Automation, BNRIST, Tsinghua University, Beijing 100084, China
| | - Pengpeng Xu
- School of Civil Engineering and Transportation, South China University of Technology, Guangzhou 510641, Guangdong, China; Hunan Key Laboratory of Smart Roadway and Cooperative Vehicle-Infrastructure Systems, Changsha University of Science & Technology, Changsha 410114, Hunan, China
| | - Xin Pei
- Department of Automation, BNRIST, Tsinghua University, Beijing 100084, China.
| | - Qianfang Wang
- School of Civil Engineering and Transportation, South China University of Technology, Guangzhou 510641, Guangdong, China
| | - Yun Yue
- Department of Automation, BNRIST, Tsinghua University, Beijing 100084, China
| | - Chunyang Han
- Faculty of Transportation Engineering, Kunming University of Science and Technology, Kunming 650500, Yunnan, China
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Baumann AN, Orellana K, Oleson CJ, Curtis DP, Cahill P, Flynn J, Baldwin KD. The impact of patient scoliosis-specific exercises for adolescent idiopathic scoliosis: a systematic review and meta-analysis of randomized controlled trials with subgroup analysis using observational studies. Spine Deform 2024; 12:545-559. [PMID: 38243155 DOI: 10.1007/s43390-023-00810-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/16/2023] [Indexed: 01/21/2024]
Abstract
PURPOSE Adolescent idiopathic scoliosis (AIS) is a common pediatric spinal deformity frequently treated with patient scoliosis-specific exercises (PSSE). The purpose of this study is to perform a systematic review and meta-analysis of randomized controlled trials and sensitivity analysis of observational studies to determine the impact of PSSE on outcomes for AIS. METHODS A systematic review and meta-analysis on impact of PSSE for patients with AIS was performed. Databases used included PubMed, CINAHL, MEDLINE, Cochrane, and ScienceDirect database inception to October 2022. Inclusion criteria included use of PSSE, patient population of AIS, and full text. RESULTS A total of 26 articles out of 628 initial retrieved met final inclusion criteria (10 randomized controlled trials (RCTs), 16 observational studies). Total included patients (n = 2083) had a frequency weighted mean age of 13.2 ± 0.9 years and a frequency weighted mean follow-up of 14.5 ± 20.0 months. Based on only data from RCTs with direct comparison groups (n = 7 articles), there was a statistically significant but clinically insignificant improvement in Cobb angle of 2.5 degrees in the PSSE group (n = 152) as compared to the control group (n = 148; p = 0.017). There was no statistically significant improvement in Cobb angle when stratified by small curve (< 30 degrees) or large curve (> 30 degrees) with PSSE (p = 0.140 and p = 0.142, respectively). There was no statistically significant improvement in ATR (p = 0.326) or SRS-22 score (p = 0.370). CONCLUSION PSSE may not provide any clinically significant improvements in Cobb angle, ATR, or SRS-22 scores in patients with AIS. PSSE did not significantly improve Cobb angle when stratified by curve size. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Anthony N Baumann
- Department of Rehabilitation Services, University Hospitals, Cleveland, OH, USA
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Kevin Orellana
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Caleb J Oleson
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Deven P Curtis
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Patrick Cahill
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - John Flynn
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - Keith D Baldwin
- Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
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McKenzie RJ, Iskra S, Knipe P. Assessment of radio frequency fields in the 2.45 GHz band produced by smart home devices. Bioelectromagnetics 2024; 45:184-192. [PMID: 38014861 DOI: 10.1002/bem.22492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/02/2023] [Accepted: 11/03/2023] [Indexed: 11/29/2023]
Abstract
This paper describes the assessment of the electromagnetic fields produced by consumer "smart" devices used to control and monitor everyday equipment and appliances in a modern "smart" home. The assessment is based on the careful measurement of fields produced by a range of such devices in a laboratory environment configured to operate in a condition simulating high user activity. All devices included in this study operate in the 2.4 GHz band utilizing either Wi-Fi or Bluetooth connectivity. Overall results indicate very low levels of electromagnetic fields for all IoT smart devices in terms of human exposure safety standards (typically much less than 1%) with very low duty cycles (also less than 1%) resulting in even lower time-averaged exposure levels. These low levels of exposure, along with rapid reduction of levels with distance from the devices, suggests that the cumulative effect of multiple devices in a "smart" home are not significant.
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Affiliation(s)
- Raymond J McKenzie
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Steve Iskra
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Hawthorn, Victoria, Australia
- Global Networks and Technology, Telstra Corporation Ltd., Melbourne, Australia
| | - Phillip Knipe
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Hawthorn, Victoria, Australia
- Total Radiation Solutions, Perth, Australia
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Chen Y, Guo Z, Yuan J, Li X, Yu H. Dual-TranSpeckle: Dual-pathway transformer based encoder-decoder network for medical ultrasound image despeckling. Comput Biol Med 2024; 173:108313. [PMID: 38531247 DOI: 10.1016/j.compbiomed.2024.108313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 03/03/2024] [Accepted: 03/12/2024] [Indexed: 03/28/2024]
Abstract
The majority of existing deep learning-based image denoising algorithms mainly focus on processing the overall image features, ignoring the fine differences between the semantic and pixel features. Hence, we propose Dual-TranSpeckle (DTS), a medical ultrasound image despeckling network built on a dual-path Transformer. The DTS introduces two different paths, named "semantic path" and "pixel path," to facilitate the parallel transfer of feature information within the image. The semantic path passes a global view of the input semantic features, and the image features are passed through a Semantic Block to extract global semantic information from pixel-level features. The pixel path is employed to transmit finer-grained pixel features. Within the dual-path network framework, two essential modules, namely Dual Block and Merge Block, are designed. These leverage the Transformer architecture during the encoding and decoding stages. The Dual Block module facilitates information interaction between the semantic and pixel features by considering the interdependencies across both paths. Meanwhile, the Merge Block module enables parallel transfer of feature information by merging the dual path features, thereby facilitating the self-attention calculations for the overall feature representation. Our DTS is extensively evaluated on two public datasets and one private dataset. The DTS network demonstrates significant enhancements in quantitative evaluation results in terms of peak signal-to-noise ratio (PSNR), structural similarity (SSIM), feature similarity (FSIM), and naturalness image quality evaluator (NIQE). Furthermore, our qualitative analysis confirms that the DTS has significant improvements in despeckling performance, effectively suppressing speckle noise while preserving essential image structures.
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Affiliation(s)
- Yuqing Chen
- School of Electronic and Information Engineering, Hebei University of Technology, Tianjin, 300401, China.
| | - Zhitao Guo
- School of Electronic and Information Engineering, Hebei University of Technology, Tianjin, 300401, China; The Innovation and Research Institute of Hebei University of Technology in Shijiazhuang, Shijiazhuang, 050299, China.
| | - Jinli Yuan
- School of Electronic and Information Engineering, Hebei University of Technology, Tianjin, 300401, China.
| | - Xiaozeng Li
- School of Electronic and Information Engineering, Hebei University of Technology, Tianjin, 300401, China.
| | - Hengyong Yu
- Department of Electrical and Computer Engineering, University of Massachusetts Lowell, Lowell, MA, 01854, USA.
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Zhang X, Heo GS, Li A, Lahad D, Detering L, Tao J, Gao X, Zhang X, Luehmann H, Sultan D, Lou L, Venkatesan R, Li R, Zheng J, Amrute J, Lin CY, Kopecky BJ, Gropler RJ, Bredemeyer A, Lavine K, Liu Y. Development of a CD163-Targeted PET Radiotracer That Images Resident Macrophages in Atherosclerosis. J Nucl Med 2024; 65:775-780. [PMID: 38548349 PMCID: PMC11064833 DOI: 10.2967/jnumed.123.266910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/26/2024] [Indexed: 05/03/2024] Open
Abstract
Tissue-resident macrophages are complementary to proinflammatory macrophages to promote the progression of atherosclerosis. The noninvasive detection of their presence and dynamic variation will be important to the understanding of their role in the pathogenesis of atherosclerosis. The goal of this study was to develop a targeted PET radiotracer for imaging CD163-positive (CD163+) macrophages in multiple mouse atherosclerosis models and assess the potential of CD163 as a biomarker for atherosclerosis in humans. Methods: CD163-binding peptide was identified using phage display and conjugated with a NODAGA chelator for 64Cu radiolabeling ([64Cu]Cu-ICT-01). CD163-overexpressing U87 cells were used to measure the binding affinity of [64Cu]Cu-ICT-01. Biodistribution studies were performed on wild-type C57BL/6 mice at multiple time points after tail vein injection. The sensitivity and specificity of [64Cu]Cu-ICT-01 in imaging CD163+ macrophages upregulated on the surface of atherosclerotic plaques were assessed in multiple mouse atherosclerosis models. Immunostaining, flow cytometry, and single-cell RNA sequencing were performed to characterize the expression of CD163 on tissue-resident macrophages. Human carotid atherosclerotic plaques were used to measure the expression of CD163+ resident macrophages and test the binding specificity of [64Cu]Cu-ICT-01. Results: [64Cu]Cu-ICT-01 showed high binding affinity to U87 cells. The biodistribution study showed rapid blood and renal clearance with low retention in all major organs at 1, 2, and 4 h after injection. In an ApoE-/- mouse model, [64Cu]Cu-ICT-01 demonstrated sensitive and specific detection of CD163+ macrophages and capability for tracking the progression of atherosclerotic lesions; these findings were further confirmed in Ldlr-/- and PCSK9 mouse models. Immunostaining showed elevated expression of CD163+ macrophages across the plaques. Flow cytometry and single-cell RNA sequencing confirmed the specific expression of CD163 on tissue-resident macrophages. Human tissue characterization demonstrated high expression of CD163+ macrophages on atherosclerotic lesions, and ex vivo autoradiography revealed specific binding of [64Cu]Cu-ICT-01 to human CD163. Conclusion: This work reported the development of a PET radiotracer binding CD163+ macrophages. The elevated expression of CD163+ resident macrophages on human plaques indicated the potential of CD163 as a biomarker for vulnerable plaques. The sensitivity and specificity of [64Cu]Cu-ICT-01 in imaging CD163+ macrophages warrant further investigation in translational settings.
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Affiliation(s)
- Xiuli Zhang
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Gyu Seong Heo
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Alexandria Li
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Divangana Lahad
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Lisa Detering
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Joan Tao
- Department of Medicine, University of Missouri, Columbia, Missouri
| | - Xuefeng Gao
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Xiaohui Zhang
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Hannah Luehmann
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Deborah Sultan
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Lanlan Lou
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Rajiu Venkatesan
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Ran Li
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Jie Zheng
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Junedh Amrute
- Department of Medicine, Washington University in St. Louis, St. Louis, Missouri; and
| | - Chieh-Yu Lin
- Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, Missouri
| | - Benjamin J Kopecky
- Department of Medicine, Washington University in St. Louis, St. Louis, Missouri; and
| | - Robert J Gropler
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri
| | - Andrea Bredemeyer
- Department of Medicine, Washington University in St. Louis, St. Louis, Missouri; and
| | - Kory Lavine
- Department of Medicine, Washington University in St. Louis, St. Louis, Missouri; and
| | - Yongjian Liu
- Mallinckrodt Institute of Radiology, University of Missouri, Columbia, Missouri;
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Robar JL, Cherpak A, MacDonald RL, Yashayaeva A, McAloney D, McMaster N, Zhan K, Cwajna S, Patil N, Dahn H. Novel Technology Allowing Cone Beam Computed Tomography in 6 Seconds: A Patient Study of Comparative Image Quality. Pract Radiat Oncol 2024; 14:277-286. [PMID: 37939844 DOI: 10.1016/j.prro.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/20/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023]
Abstract
PURPOSE The goal of this study was to evaluate the image quality provided by a novel cone beam computed tomography (CBCT) platform (HyperSight, Varian Medical Systems), a platform with enhanced reconstruction algorithms as well as rapid acquisition times. Image quality was compared with both status quo CBCT for image guidance, and to fan beam CT (FBCT) acquired on a CT simulator (CTsim). METHODS AND MATERIALS In a clinical study, 30 individuals were recruited for whom either deep inspiration (DIBH) or deep exhalation breath hold (DEBH) was used during imaging and radiation treatment of tumors involving liver, lung, breast, abdomen, chest wall, and pancreatic sites. All subjects were imaged during breath hold with CBCT on a standard image guidance platform (TrueBeam 2.7, Varian Medical Systems) and FBCT CT (CTsim, GE Optima). HyperSight imaging with both breath hold (HSBH) and free breathing (HSFB) was performed in a single session. The 4 image sets thus acquired were registered and compared using metrics quantifying artifact index, image nonuniformity, contrast, contrast-to-noise ratio, and difference of Hounsfield unit (HU) from CTsim. RESULTS HSBH provided less severe artifacts compared with both HSFB and TrueBeam. The severity of artifacts in HSBH images was similar to that in CTsim images, with statistically similar artifact index values. CTsim provided the best image uniformity; however, HSBH provided improved uniformity compared with both HSFB and TrueBeam. CTsim demonstrated elevated contrast compared with HyperSight imaging, but both HSBH and HSFB imaging showed superior contrast-to-noise ratio characteristics compared with TrueBeam. The median HU difference of HSBH from CTsim was within 1 HU for muscle/fat tissue, 12 HU for bone, and 14 HU for lung. CONCLUSIONS The HyperSight system provides 6-second CBCT acquisition with image artifacts that are significantly reduced compared with TrueBeam and comparable to those in CTsim FBCT imaging. HyperSight breath hold imaging was of higher quality compared with free breathing imaging on the same system. The median HU value in HyperSight breath hold imaging is within 15 HU of that in CTsim imaging for muscle, fat, bone, and lung tissue types, indicating the utility of image data for direct dose calculation in adaptive workflows.
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Affiliation(s)
- James L Robar
- Department of Radiation Oncology, QE2 Cancer Centre, Nova Scotia Health, Halifax, Canada; Departments of Radiation Oncology; Physics and Atmospheric Science, Dalhousie University, Halifax, Canada.
| | - Amanda Cherpak
- Department of Radiation Oncology, QE2 Cancer Centre, Nova Scotia Health, Halifax, Canada; Departments of Radiation Oncology; Physics and Atmospheric Science, Dalhousie University, Halifax, Canada
| | - Robert Lee MacDonald
- Department of Radiation Oncology, QE2 Cancer Centre, Nova Scotia Health, Halifax, Canada; Departments of Radiation Oncology; Physics and Atmospheric Science, Dalhousie University, Halifax, Canada
| | | | - David McAloney
- Department of Radiation Oncology, QE2 Cancer Centre, Nova Scotia Health, Halifax, Canada
| | - Natasha McMaster
- Department of Radiation Oncology, QE2 Cancer Centre, Nova Scotia Health, Halifax, Canada
| | - Kenny Zhan
- Department of Radiation Oncology, QE2 Cancer Centre, Nova Scotia Health, Halifax, Canada
| | - Slawa Cwajna
- Department of Radiation Oncology, QE2 Cancer Centre, Nova Scotia Health, Halifax, Canada; Departments of Radiation Oncology
| | - Nikhilesh Patil
- Department of Radiation Oncology, QE2 Cancer Centre, Nova Scotia Health, Halifax, Canada; Departments of Radiation Oncology
| | - Hannah Dahn
- Department of Radiation Oncology, QE2 Cancer Centre, Nova Scotia Health, Halifax, Canada; Departments of Radiation Oncology
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Hu J, Peng J, Zhou Z, Zhao T, Zhong L, Yu K, Jiang K, Lau TS, Huang C, Lu L, Zhang X. Associating Knee Osteoarthritis Progression with Temporal-Regional Graph Convolutional Network Analysis on MR Images. J Magn Reson Imaging 2024. [PMID: 38686707 DOI: 10.1002/jmri.29412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Artificial intelligence shows promise in assessing knee osteoarthritis (OA) progression on MR images, but faces challenges in accuracy and interpretability. PURPOSE To introduce a temporal-regional graph convolutional network (TRGCN) on MR images to study the association between knee OA progression status and network outcome. STUDY TYPE Retrospective. POPULATION 194 OA progressors (mean age, 62 ± 9 years) and 406 controls (mean age, 61 ± 9 years) from the OA Initiative were randomly divided into training (80%) and testing (20%) cohorts. FIELD STRENGTH/SEQUENCE Sagittal 2D IW-TSE-FS (IW) and 3D-DESS-WE (DESS) at 3T. ASSESSMENT Anatomical subregions of cartilage, subchondral bone, meniscus, and the infrapatellar fat pad at baseline, 12-month, and 24-month were automatically segmented and served as inputs to form compartment-based graphs for a TRGCN model, which containing both regional and temporal information. The performance of models based on (i) clinical variables alone, (ii) radiologist score alone, (iii) combined features (containing i and ii), (iv) composite TRGCN (combining TRGCN, i and ii), (v) radiomics features, (vi) convolutional neural network based on Densenet-169 were compared. STATISTICAL TESTS DeLong test was performed to compare the areas under the ROC curve (AUC) of all models. Additionally, interpretability analysis was done to evaluate the contributions of individual regions. A P value <0.05 was considered significant. RESULTS The composite TRGCN outperformed all other models with AUCs of 0.841 (DESS) and 0.856 (IW) in the testing cohort (all P < 0.05). Interpretability analysis highlighted cartilage's importance over other structures (42%-45%), tibiofemoral joint's (TFJ) dominance over patellofemoral joint (PFJ) (58%-67% vs. 12%-37%), and importance scores changes in compartments over time (TFJ vs. PFJ: baseline: 44% vs. 43%, 12-month: 52% vs. 39%, 24-month: 31% vs. 48%). DATA CONCLUSION The composite TRGCN, capturing temporal and regional information, demonstrated superior discriminative ability compared with other methods, providing interpretable insights for identifying knee OA progression. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY Stage 2.
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Affiliation(s)
- Jiaping Hu
- Department of Medical Imaging, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics· Guangdong Province), Guangzhou, China
| | - Junyi Peng
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
| | - Zidong Zhou
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
| | - Tianyun Zhao
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - Lijie Zhong
- Department of Medical Imaging, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics· Guangdong Province), Guangzhou, China
| | - Keyan Yu
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Kexin Jiang
- Department of Medical Imaging, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics· Guangdong Province), Guangzhou, China
| | - Tzak Sing Lau
- Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Chuan Huang
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA
- Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Lijun Lu
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China
- Guangdong Province Engineering Laboratory for Medical Imaging and Diagnostic Technology, Southern Medical University, Guangzhou, China
- Pazhou Lab, Guangzhou, China
| | - Xiaodong Zhang
- Department of Medical Imaging, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics· Guangdong Province), Guangzhou, China
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Balogh ZA, Barna Z, Majoros E. Comparison of iterative reconstruction implementations for multislice helical CT. Z Med Phys 2024:S0939-3889(24)00046-1. [PMID: 38679541 DOI: 10.1016/j.zemedi.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 02/20/2024] [Accepted: 04/03/2024] [Indexed: 05/01/2024]
Abstract
The most mature image reconstruction algorithms in multislice helical computed tomography are based on analytical and iterative methods. Over the past decades, several methods have been developed for iterative reconstructions that improve image quality by reducing noise and artifacts. In the regularization step of iterative reconstruction, noise can be significantly reduced, thereby making low-dose CT. The quality of the reconstructed image can be further improved by using model-based reconstructions. In these reconstructions, the main focus is on modeling the data acquisition process, including the behavior of the photon beams, the geometry of the system, etc. In this article, we propose two model-based reconstruction algorithms using a virtual detector for multislice helical CT. The aim of this study is to compare the effect of using a virtual detector on image quality for the two proposed algorithms with a model-based iterative reconstruction using the original detector model. Since the algorithms are implemented using multiple GPUs, the merging of separately reconstructed volumes can significantly affect image quality. This issue is often referred to as the "long object" problem, for which we also present a solution that plays an important role in the proposed reconstruction processes. The algorithms were evaluated using mathematical and physical phantoms, as well as patient cases. The SSIM, MS-SSIM and L1 metrics were utilized to evaluate the image quality of the mathematical phantom case. To demonstrate the effectiveness of the algorithms, we used the CatPhan 600 phantom. Additionally, anonymized patient scans were used to showcase the improvements in image quality on real scan data.
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Affiliation(s)
- Zsolt Adam Balogh
- Department of Mathematical Sciences, United Arab Emirates University, Al Ain P.O.Box: 15551, United Arab Emirates.
| | | | - Eva Majoros
- Marton Varga Technical College, Budapest H-1149, Hungary
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16
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Tanner IL, Ye K, Moore MS, Rechenmacher A, Ramirez MM, George SZ, Bolognesi MP, Horn ME. Developing a Computer Vision Model to Automate Quantitative Measurement of Hip-Knee-Ankle Angle in Total Hip and Knee Arthroplasty Patients. J Arthroplasty 2024:S0883-5403(24)00410-8. [PMID: 38679347 DOI: 10.1016/j.arth.2024.04.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 04/19/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND Increasing deformity of the lower extremities, as measured by the Hip-Knee-Ankle Angle (HKAA), is associated with poor patient outcomes after total hip and knee arthroplasty (THA, TKA). Automated calculation of HKAA is imperative to reduce the burden on orthopaedic surgeons. We proposed a detection-based deep learning (DL) model to calculate HKAA in THA and TKA patients and assessed the agreement between DL-derived HKAAs and manual measurement. METHODS We retrospectively identified 1,379 long-leg radiographs (LLR) from patients scheduled for THA or TKA within an academic medical center. There were 1,221 LLRs used to develop the model (randomly split into 70% training, 20% validation, and 10% held-out test sets); 158 LLRs were considered "difficult," as the femoral head was difficult to distinguish from surrounding tissue. There were two raters who annotated the HKAA of both lower extremities, and inter-rater reliability was calculated to compare the DL-derived HKAAs with manual measurement within the test set. RESULTS The DL model achieved a mean average precision of 0.985 on the test set. The average HKAA of the operative leg was 173.05 +/- 4.54°; the non-operative leg was 175.55 +/- 3.56°. The inter-rater reliability between manual and DL-derived HKAA measurements on the operative leg and non-operative leg indicated excellent reliability (Intraclass Correlation (ICC) (2,k) = 0.987 [0.96, 0.99], ICC (2,k) = 0.987 [0.98, 0.99, respectively]). The standard error of measurement for the DL-derived HKAA for the operative and non-operative legs was 0.515° and 0.403°, respectively. CONCLUSION A detection-based DL algorithm can calculate the HKAA in LLRs and is comparable to that calculated by manual measurement. The algorithm can detect the bilateral femoral head, knee, and ankle joints with high precision, even in patients where the femoral head is difficult to visualize.
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Affiliation(s)
- Irene L Tanner
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine.
| | - Ken Ye
- Trinity College of Arts & Sciences, Duke University.
| | - Miles S Moore
- Doctor of Physical Therapy Division, Duke University School of Medicine.
| | | | - Michelle M Ramirez
- Department of Population Health Sciences, Department of Orthopaedic Surgery, Duke University School of Medicine.
| | - Steven Z George
- Department of Orthopaedic Surgery, Department of Population Health Sciences, Duke Clinical Research Institute, Duke University.
| | - Michael P Bolognesi
- Distinguished Professor, Department of Orthopaedic Surgery, Duke University.
| | - Maggie E Horn
- Department of Population Health Sciences, Department of Orthopaedic Surgery, Duke University School of Medicine.
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Calvente I, Núñez MI. Is the sustainability of exposure to non-ionizing electromagnetic radiation possible? Med Clin (Barc) 2024; 162:387-393. [PMID: 38151370 DOI: 10.1016/j.medcli.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 12/29/2023]
Abstract
Technological advances imply an increase in artificially generating sources of electromagnetic fields (EMF), therefore, resulting in a permanent exposure of people and the environment (electromagnetic pollution). Inconsistent results have been published considering the evaluated health effects. The purpose of this study was to review scientific literature on EMF to provide a global and retrospective perspective, on the association between human exposure to non-ionizing radiation (NIR, mainly radiofrequency-EMF) and health and environmental effects. Studies on the health effects of 5G radiation exposure have not yet been performed with sufficient statistical power, as the exposure time is still relatively short and also the latency and intensity of exposure to 5G. The safety standards only consider thermal effects, do not contemplate non-thermal effects. We consider relevant to communicate this knowledge to the general public to improve education in this field, and to healthcare professionals to prevent diseases that may result from RF-EMF exposures.
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Affiliation(s)
- Irene Calvente
- Research Support Unit, Biosanitary Institute of Granada (ibs.GRANADA), University Hospital Complex of Granada, Spain
| | - María Isabel Núñez
- Research Support Unit, Biosanitary Institute of Granada (ibs.GRANADA), University Hospital Complex of Granada, Spain; Department of Radiology and Physical Medicine, School of Medicine, University of Granada, Granada, Spain; Biopathology and Regenerative Medicine Institute (IBIMER), University of Granada, Spain.
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18
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Yousif YAM, Daniel J, Healy B, Hill R. A study of polarity effect for various ionization chambers in kilovoltage x-ray beams. Med Phys 2024. [PMID: 38669346 DOI: 10.1002/mp.17096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/01/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Ionization chambers play an essential role in dosimetry measurements for kilovoltage (kV) x-ray beams. Despite their widespread use, there is limited data on the absolute values for the polarity correction factors across a range of commonly employed ionization chambers. PURPOSE This study aimed to investigate the polarity effects for five different ionization chambers in kV x-ray beams. METHODS Two plane-parallel chambers being the Advanced Markus and Roos and three cylindrical chambers; 3D PinPoint, Semiflex and Farmer chamber (PTW, Freiburg, Germany), were employed to measure the polarity correction factors. The kV x-ray beams were produced from an Xstrahl 300 unit (Xstrahl Ltd., UK). All measurements were acquired at 2 cm depth in a PTW-MP1 water tank for beams between 60 kVp (HVL 1.29 mm Al) and 300 kVp (HVL 3.08 mm Cu), and field sizes of 2-10 cm diameter for 30 cm focus-source distance (FSD) and 4 × 4 cm2 - 20 × 20 cm2 for 50 cm FSD. The ionization chambers were connected to a PTW-UNIDOS electrometer, and the polarity effect was determined using the AAPM TG-61 code of practice methodology. RESULTS The study revealed significant polarity effects in ionization chambers, especially in those with smaller volumes. For the plane-parallel chambers, the Advanced Markus chamber exhibited a maximum polarity effect of 2.5%, whereas the Roos chamber showed 0.3% at 150 KVp with the 10 cm circular diameter open-ended applicator. Among the cylindrical chambers at the same beam energy and applicator, the Pinpoint chamber exhibited a 3% polarity effect, followed by Semiflex with 1.7%, and Farmer with 0.4%. However, as the beam energy increased to 300 kVp, the polarity effect significantly increased reaching 8.5% for the Advanced Markus chamber and 13.5% for the PinPoint chamber at a 20 × 20 cm2 field size. Notably, the magnitude of the polarity effect increased with both the field size and beam energy, and was significantly influenced by the size of the chamber's sensitive volume. CONCLUSIONS The findings demonstrate that ionization chambers can exhibit substantial polarity effects in kV x-ray beams, particularly for those chambers with smaller volumes. Therefore, it is important to account for polarity corrections when conducting relative dose measurements in kV x-ray beams to enhance the dosimetry accuracy and improve patient dose calculations.
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Affiliation(s)
- Yousif A M Yousif
- Crown Princess Mary Cancer Centre, Westmead Hospital, Wentworthville, New South Wales, Australia
- North West Cancer Centre, Tamworth Hospital, Tamworth, New South Wales, Australia
| | - John Daniel
- North West Cancer Centre, Tamworth Hospital, Tamworth, New South Wales, Australia
- Department of Radiation Oncology, Calvary Mater Newcastle, Newcastle, New South Wales, Australia
| | - Brendan Healy
- Australian Clinical Dosimetry Service (ACDS), Yallambie, Victoria, Australia
| | - Robin Hill
- Department of Radiation Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- Institute of Medical Physics, School of Physics, University of Sydney, Camperdown, New South Wales, Australia
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
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Liu Y, Li X, Liu S, Liang T, Wu Y, Wang X, Li Y, Xu Y. Study on Gamma sensory flicker for Insomnia. Int J Neurosci 2024:1-11. [PMID: 38629395 DOI: 10.1080/00207454.2024.2342974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Insomnia has been the subject of much systematic research because it is a risk factor for a variety of diseases. There is some evidence that gamma sensory stimulation therapy has also been demonstrated to improve sleep quality for people with Alzheimer's disease. However, it is unclear whether this method is effective for treating insomnia. The principal objective of this project was to investigate the efficacy and safety of gamma sensory flicker in improving the sleep quality of insomnia patients. METHODS Thirty-seven participants with insomnia were recruited for this prospective observational study. For a duration of 8 weeks, participants were exposed to flicker stimulation through a light and sound device. RESULTS During the main phase of the study, adherence rates averaged 92.21%. Additionally, no severe adverse events were reported for flicker treatment. Analysis of sleep diaries indicated that 40 Hz flickers can enhance sleep quality by reducing sleep onset latencies, and arousals, and increasing total sleep duration. CONCLUSIONS Gamma sensory flicker improves sleep quality in people suffering from insomnia.
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Affiliation(s)
- Yakun Liu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xinrong Li
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, Taiyuan, Shanxi, China
| | - Sha Liu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, Taiyuan, Shanxi, China
| | - Tailing Liang
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yan Wu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaopan Wang
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Ying Li
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yong Xu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- First Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, China
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20
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Sun S, Li L, Xu M, Wei Y, Shi F, Liu S. Epstein-Barr virus positive gastric cancer: the pathological basis of CT findings and radiomics models prediction. Abdom Radiol (NY) 2024:10.1007/s00261-024-04306-8. [PMID: 38656367 DOI: 10.1007/s00261-024-04306-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 03/17/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To analyze the clinicopathologic information and CT imaging features of Epstein-Barr virus (EBV)-positive gastric cancer (GC) and establish CT-based radiomics models to predict the EBV status of GC. METHODS This retrospective study included 144 GC cases, including 48 EBV-positive cases. Pathological and immunohistochemical information was collected. CT enlarged LN and morphological characteristics were also assessed. Radiomics models were constructed to predict the EBV status, including decision tree (DT), logistic regression (LR), random forest (RF), and support vector machine (SVM). RESULTS T stage, Lauren classification, histological differentiation, nerve invasion, VEGFR2, E-cadherin, PD-L1, and Ki67 differed significantly between the EBV-positive and -negative groups (p = 0.015, 0.030, 0.006, 0.022, 0.028, 0.030, < 0.001, and < 0.001, respectively). CT enlarged LN and large ulceration differed significantly between the two groups (p = 0.019 and 0.043, respectively). The number of patients in the training and validation cohorts was 100 (with 33 EBV-positive cases) and 44 (with 15 EBV-positive cases). In the training cohort, the radiomics models using DT, LR, RF, and SVM yielded areas under the curve (AUCs) of 0.905, 0.771, 0.836, and 0.886, respectively. In the validation cohort, the diagnostic efficacy of radiomics models using the four classifiers were 0.737, 0.722, 0.751, and 0.713, respectively. CONCLUSION A significantly higher proportion of CT enlarged LN and a significantly lower proportion of large ulceration were found in EBV-positive GC. The prediction efficiency of radiomics models with different classifiers to predict EBV status in GC was good.
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Affiliation(s)
- Shuangshuang Sun
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
| | - Lin Li
- Department of Pathology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China
| | - Mengying Xu
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China
| | - Ying Wei
- Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd, Shanghai, 200000, China
| | - Feng Shi
- Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd, Shanghai, 200000, China
| | - Song Liu
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
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21
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Mostafavi M, Ko SB, Shokouhi SB, Ayatollahi A. Transfer learning and self-distillation for automated detection of schizophrenia using single-channel EEG and scalogram images. Phys Eng Sci Med 2024:10.1007/s13246-024-01420-1. [PMID: 38652347 DOI: 10.1007/s13246-024-01420-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/25/2024] [Indexed: 04/25/2024]
Abstract
Schizophrenia (SZ) has been acknowledged as a highly intricate mental disorder for a long time. In fact, individuals with SZ experience a blurred line between fantasy and reality, leading to a lack of awareness about their condition, which can pose significant challenges during the treatment process. Due to the importance of the issue, timely diagnosis of this illness can not only assist patients and their families in managing the condition but also enable early intervention, which may help prevent its advancement. EEG is a widely utilized technique for investigating mental disorders like SZ due to its non-invasive nature, affordability, and wide accessibility. In this study, our main goal is to develop an optimized system that can achieve automatic diagnosis of SZ with minimal input information. To optimize the system, we adopted a strategy of using single-channel EEG signals and integrated knowledge distillation and transfer learning techniques into the model. This approach was designed to improve the performance and efficiency of our proposed method for SZ diagnosis. Additionally, to leverage the pre-trained models effectively, we converted the EEG signals into images using Continuous Wavelet Transform (CWT). This transformation allowed us to harness the capabilities of pre-trained models in the image domain, enabling automatic SZ detection with enhanced efficiency. To achieve a more robust estimate of the model's performance, we employed fivefold cross-validation. The accuracy achieved from the 5-s records of the EEG signal, along with the combination of self-distillation and VGG16 for the P4 channel, is 97.81. This indicates a high level of accuracy in diagnosing SZ using the proposed method.
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Affiliation(s)
- Mohammadreza Mostafavi
- Department of Electrical Engineering, Electronic Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Seok-Bum Ko
- Division of Biomedical Engineering, Department of Electrical and Computer Engineering, University of Saskatchewan, Saskatoon, Canada.
| | - Shahriar Baradaran Shokouhi
- Department of Electrical Engineering, Electronic Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Ahmad Ayatollahi
- Department of Electrical Engineering, Electronic Engineering, Iran University of Science and Technology, Tehran, Iran
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22
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Seoni S, Shahini A, Meiburger KM, Marzola F, Rotunno G, Acharya UR, Molinari F, Salvi M. All you need is data preparation: A systematic review of image harmonization techniques in Multi-center/device studies for medical support systems. Comput Methods Programs Biomed 2024; 250:108200. [PMID: 38677080 DOI: 10.1016/j.cmpb.2024.108200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/20/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND AND OBJECTIVES Artificial intelligence (AI) models trained on multi-centric and multi-device studies can provide more robust insights and research findings compared to single-center studies. However, variability in acquisition protocols and equipment can introduce inconsistencies that hamper the effective pooling of multi-source datasets. This systematic review evaluates strategies for image harmonization, which standardizes appearances to enable reliable AI analysis of multi-source medical imaging. METHODS A literature search using PRISMA guidelines was conducted to identify relevant papers published between 2013 and 2023 analyzing multi-centric and multi-device medical imaging studies that utilized image harmonization approaches. RESULTS Common image harmonization techniques included grayscale normalization (improving classification accuracy by up to 24.42 %), resampling (increasing the percentage of robust radiomics features from 59.5 % to 89.25 %), and color normalization (enhancing AUC by up to 0.25 in external test sets). Initially, mathematical and statistical methods dominated, but machine and deep learning adoption has risen recently. Color imaging modalities like digital pathology and dermatology have remained prominent application areas, though harmonization efforts have expanded to diverse fields including radiology, nuclear medicine, and ultrasound imaging. In all the modalities covered by this review, image harmonization improved AI performance, with increasing of up to 24.42 % in classification accuracy and 47 % in segmentation Dice scores. CONCLUSIONS Continued progress in image harmonization represents a promising strategy for advancing healthcare by enabling large-scale, reliable analysis of integrated multi-source datasets using AI. Standardizing imaging data across clinical settings can help realize personalized, evidence-based care supported by data-driven technologies while mitigating biases associated with specific populations or acquisition protocols.
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Affiliation(s)
- Silvia Seoni
- Biolab, PolitoBIOMedLab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Alen Shahini
- Biolab, PolitoBIOMedLab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Kristen M Meiburger
- Biolab, PolitoBIOMedLab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Francesco Marzola
- Biolab, PolitoBIOMedLab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Giulia Rotunno
- Biolab, PolitoBIOMedLab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - U Rajendra Acharya
- School of Mathematics, Physics and Computing, University of Southern Queensland, Springfield, Australia; Centre for Health Research, University of Southern Queensland, Australia
| | - Filippo Molinari
- Biolab, PolitoBIOMedLab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Massimo Salvi
- Biolab, PolitoBIOMedLab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy.
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23
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Driban M, Yan A, Selvam A, Ong J, Vupparaboina KK, Chhablani J. Artificial intelligence in chorioretinal pathology through fundoscopy: a comprehensive review. Int J Retina Vitreous 2024; 10:36. [PMID: 38654344 PMCID: PMC11036694 DOI: 10.1186/s40942-024-00554-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Applications for artificial intelligence (AI) in ophthalmology are continually evolving. Fundoscopy is one of the oldest ocular imaging techniques but remains a mainstay in posterior segment imaging due to its prevalence, ease of use, and ongoing technological advancement. AI has been leveraged for fundoscopy to accomplish core tasks including segmentation, classification, and prediction. MAIN BODY In this article we provide a review of AI in fundoscopy applied to representative chorioretinal pathologies, including diabetic retinopathy and age-related macular degeneration, among others. We conclude with a discussion of future directions and current limitations. SHORT CONCLUSION As AI evolves, it will become increasingly essential for the modern ophthalmologist to understand its applications and limitations to improve patient outcomes and continue to innovate.
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Affiliation(s)
- Matthew Driban
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Audrey Yan
- Department of Medicine, West Virginia School of Osteopathic Medicine, Lewisburg, WV, USA
| | - Amrish Selvam
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, USA
| | | | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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24
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Safari M, Shalbaf R, Bagherzadeh S, Shalbaf A. Classification of mental workload using brain connectivity and machine learning on electroencephalogram data. Sci Rep 2024; 14:9153. [PMID: 38644365 PMCID: PMC11033270 DOI: 10.1038/s41598-024-59652-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 04/12/2024] [Indexed: 04/23/2024] Open
Abstract
Mental workload refers to the cognitive effort required to perform tasks, and it is an important factor in various fields, including system design, clinical medicine, and industrial applications. In this paper, we propose innovative methods to assess mental workload from EEG data that use effective brain connectivity for the purpose of extracting features, a hierarchical feature selection algorithm to select the most significant features, and finally machine learning models. We have used the Simultaneous Task EEG Workload (STEW) dataset, an open-access collection of raw EEG data from 48 subjects. We extracted brain-effective connectivities by the direct directed transfer function and then selected the top 30 connectivities for each standard frequency band. Then we applied three feature selection algorithms (forward feature selection, Relief-F, and minimum-redundancy-maximum-relevance) on the top 150 features from all frequencies. Finally, we applied sevenfold cross-validation on four machine learning models (support vector machine (SVM), linear discriminant analysis, random forest, and decision tree). The results revealed that SVM as the machine learning model and forward feature selection as the feature selection method work better than others and could classify the mental workload levels with accuracy equal to 89.53% (± 1.36).
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Affiliation(s)
| | - Reza Shalbaf
- Institute for Cognitive Science Studies, Tehran, Iran.
| | - Sara Bagherzadeh
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Ahmad Shalbaf
- Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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25
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Hossain T, Shamrat FMJM, Zhou X, Mahmud I, Mazumder MSA, Sharmin S, Gururajan R. Development of a multi-fusion convolutional neural network (MF-CNN) for enhanced gastrointestinal disease diagnosis in endoscopy image analysis. PeerJ Comput Sci 2024; 10:e1950. [PMID: 38660192 PMCID: PMC11041948 DOI: 10.7717/peerj-cs.1950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/29/2024] [Indexed: 04/26/2024]
Abstract
Gastrointestinal (GI) diseases are prevalent medical conditions that require accurate and timely diagnosis for effective treatment. To address this, we developed the Multi-Fusion Convolutional Neural Network (MF-CNN), a deep learning framework that strategically integrates and adapts elements from six deep learning models, enhancing feature extraction and classification of GI diseases from endoscopic images. The MF-CNN architecture leverages truncated and partially frozen layers from existing models, augmented with novel components such as Auxiliary Fusing Layers (AuxFL), Fusion Residual Block (FuRB), and Alpha Dropouts (αDO) to improve precision and robustness. This design facilitates the precise identification of conditions such as ulcerative colitis, polyps, esophagitis, and healthy colons. Our methodology involved preprocessing endoscopic images sourced from open databases, including KVASIR and ETIS-Larib Polyp DB, using adaptive histogram equalization (AHE) to enhance their quality. The MF-CNN framework supports detailed feature mapping for improved interpretability of the model's internal workings. An ablation study was conducted to validate the contribution of each component, demonstrating that the integration of AuxFL, αDO, and FuRB played a crucial part in reducing overfitting and efficiency saturation and enhancing overall model performance. The MF-CNN demonstrated outstanding performance in terms of efficacy, achieving an accuracy rate of 99.25%. It also excelled in other key performance metrics with a precision of 99.27%, a recall of 99.25%, and an F1-score of 99.25%. These metrics confirmed the model's proficiency in accurate classification and its capability to minimize false positives and negatives across all tested GI disease categories. Furthermore, the AUC values were exceptional, averaging 1.00 for both test and validation sets, indicating perfect discriminative ability. The findings of the P-R curve analysis and confusion matrix further confirmed the robust classification performance of the MF-CNN. This research introduces a technique for medical imaging that can potentially transform diagnostics in gastrointestinal healthcare facilities worldwide.
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Affiliation(s)
- Tanzim Hossain
- Department of Software Engineering, Daffodil International University, Dhaka, Bangladesh
| | | | - Xujuan Zhou
- School of Business, University of Southern Queensland, Springfield, Australia
| | - Imran Mahmud
- Department of Software Engineering, Daffodil International University, Dhaka, Bangladesh
| | - Md. Sakib Ali Mazumder
- Department of Software Engineering, Daffodil International University, Dhaka, Bangladesh
| | - Sharmin Sharmin
- Department of Computer System and Technology, University of Malaya, Kuala Lumpur, Malaysia
| | - Raj Gururajan
- School of Business, University of Southern Queensland, Springfield, Australia
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26
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Zaeri N. Artificial intelligence and machine learning responses to COVID-19 related inquiries. J Med Eng Technol 2024:1-20. [PMID: 38625639 DOI: 10.1080/03091902.2024.2321846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 02/18/2024] [Indexed: 04/17/2024]
Abstract
Researchers and scientists can use computational-based models to turn linked data into useful information, aiding in disease diagnosis, examination, and viral containment due to recent artificial intelligence and machine learning breakthroughs. In this paper, we extensively study the role of artificial intelligence and machine learning in delivering efficient responses to the COVID-19 pandemic almost four years after its start. In this regard, we examine a large number of critical studies conducted by various academic and research communities from multiple disciplines, as well as practical implementations of artificial intelligence algorithms that suggest potential solutions in investigating different COVID-19 decision-making scenarios. We identify numerous areas where artificial intelligence and machine learning can impact this context, including diagnosis (using chest X-ray imaging and CT imaging), severity, tracking, treatment, and the drug industry. Furthermore, we analyse the dilemma's limits, restrictions, and hazards.
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Affiliation(s)
- Naser Zaeri
- Faculty of Computer Studies, Arab Open University, Kuwait
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27
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Anand V, Koundal D, Alghamdi WY, Alsharbi BM. Smart grading of diabetic retinopathy: an intelligent recommendation-based fine-tuned EfficientNetB0 framework. Front Artif Intell 2024; 7:1396160. [PMID: 38694880 PMCID: PMC11062181 DOI: 10.3389/frai.2024.1396160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/27/2024] [Indexed: 05/04/2024] Open
Abstract
Diabetic retinopathy is a condition that affects the retina and causes vision loss due to blood vessel destruction. The retina is the layer of the eye responsible for visual processing and nerve signaling. Diabetic retinopathy causes vision loss, floaters, and sometimes blindness; however, it often shows no warning signals in the early stages. Deep learning-based techniques have emerged as viable options for automated illness classification as large-scale medical imaging datasets have become more widely available. To adapt to medical image analysis tasks, transfer learning makes use of pre-trained models to extract high-level characteristics from natural images. In this research, an intelligent recommendation-based fine-tuned EfficientNetB0 model has been proposed for quick and precise assessment for the diagnosis of diabetic retinopathy from fundus images, which will help ophthalmologists in early diagnosis and detection. The proposed EfficientNetB0 model is compared with three transfer learning-based models, namely, ResNet152, VGG16, and DenseNet169. The experimental work is carried out using publicly available datasets from Kaggle consisting of 3,200 fundus images. Out of all the transfer learning models, the EfficientNetB0 model has outperformed with an accuracy of 0.91, followed by DenseNet169 with an accuracy of 0.90. In comparison to other approaches, the proposed intelligent recommendation-based fine-tuned EfficientNetB0 approach delivers state-of-the-art performance on the accuracy, recall, precision, and F1-score criteria. The system aims to assist ophthalmologists in early detection, potentially alleviating the burden on healthcare units.
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Affiliation(s)
- Vatsala Anand
- Chitkara University Institute of Engineering and Technology, Chitkara University, Rajpura, Punjab, India
| | - Deepika Koundal
- School of Computer Science, University of Petroleum and Energy Studies, Dehradun, India
- Ho Chi Minh City Open University, Ho Chi Minh City, Vietnam
| | - Wael Y. Alghamdi
- Department of Computer Science, College of Computers and Information Technology, Taif University, Taif, Saudi Arabia
| | - Bayan M. Alsharbi
- Department of Information Technology, College of Computers and Information Technology, Taif University, Taif, Saudi Arabia
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28
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Xu Q, Zhou LL, Xing C, Xu X, Feng Y, Lv H, Zhao F, Chen YC, Cai Y. Tinnitus classification based on resting-state functional connectivity using a convolutional neural network architecture. Neuroimage 2024; 290:120566. [PMID: 38467345 DOI: 10.1016/j.neuroimage.2024.120566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVES Many studies have investigated aberrant functional connectivity (FC) using resting-state functional MRI (rs-fMRI) in subjective tinnitus patients. However, no studies have verified the efficacy of resting-state FC as a diagnostic imaging marker. We established a convolutional neural network (CNN) model based on rs-fMRI FC to distinguish tinnitus patients from healthy controls, providing guidance and fast diagnostic tools for the clinical diagnosis of subjective tinnitus. METHODS A CNN architecture was trained on rs-fMRI data from 100 tinnitus patients and 100 healthy controls using an asymmetric convolutional layer. Additionally, a traditional machine learning model and a transfer learning model were included for comparison with the CNN, and each of the three models was tested on three different brain atlases. RESULTS Of the three models, the CNN model outperformed the other two models with the highest area under the curve, especially on the Dos_160 atlas (AUC = 0.944). Meanwhile, the model with the best classification performance highlights the crucial role of the default mode network, salience network, and sensorimotor network in distinguishing between normal controls and patients with subjective tinnitus. CONCLUSION Our CNN model could appropriately tackle the diagnosis of tinnitus patients using rs-fMRI and confirmed the diagnostic value of FC as measured by rs-fMRI.
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Affiliation(s)
- Qianhui Xu
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, Guangdong Province 510120, China
| | - Lei-Lei Zhou
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing 210006, China
| | - Chunhua Xing
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing 210006, China
| | - Xiaomin Xu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing 210006, China
| | - Yuan Feng
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing 210006, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fei Zhao
- Department of Speech and Language Therapy and Hearing Science, Cardiff Metropolitan University, Cardiff, UK
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing 210006, China.
| | - Yuexin Cai
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, Guangdong Province 510120, China.
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29
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Fan M, Cao X, Lü F, Xie S, Yu Z, Chen Y, Lü Z, Li L. Generative adversarial network-based synthesis of contrast-enhanced MR images from precontrast images for predicting histological characteristics in breast cancer. Phys Med Biol 2024; 69:095002. [PMID: 38537294 DOI: 10.1088/1361-6560/ad3889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/27/2024] [Indexed: 04/16/2024]
Abstract
Objective. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a sensitive tool for assessing breast cancer by analyzing tumor blood flow, but it requires gadolinium-based contrast agents, which carry risks such as brain retention and astrocyte migration. Contrast-free MRI is thus preferable for patients with renal impairment or who are pregnant. This study aimed to investigate the feasibility of generating contrast-enhanced MR images from precontrast images and to evaluate the potential use of synthetic images in diagnosing breast cancer.Approach. This retrospective study included 322 women with invasive breast cancer who underwent preoperative DCE-MRI. A generative adversarial network (GAN) based postcontrast image synthesis (GANPIS) model with perceptual loss was proposed to generate contrast-enhanced MR images from precontrast images. The quality of the synthesized images was evaluated using the peak signal-to-noise ratio (PSNR) and structural similarity (SSIM). The diagnostic performance of the generated images was assessed using a convolutional neural network to predict Ki-67, luminal A and histological grade with the area under the receiver operating characteristic curve (AUC). The patients were divided into training (n= 200), validation (n= 60), and testing sets (n= 62).Main results. Quantitative analysis revealed strong agreement between the generated and real postcontrast images in the test set, with PSNR and SSIM values of 36.210 ± 2.670 and 0.988 ± 0.006, respectively. The generated postcontrast images achieved AUCs of 0.918 ± 0.018, 0.842 ± 0.028 and 0.815 ± 0.019 for predicting the Ki-67 expression level, histological grade, and luminal A subtype, respectively. These results showed a significant improvement compared to the use of precontrast images alone, which achieved AUCs of 0.764 ± 0.031, 0.741 ± 0.035, and 0.797 ± 0.021, respectively.Significance. This study proposed a GAN-based MR image synthesis method for breast cancer that aims to generate postcontrast images from precontrast images, allowing the use of contrast-free images to simulate kinetic features for improved diagnosis.
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Affiliation(s)
- Ming Fan
- Institute of Intelligent Biomedicine, Hangzhou Dianzi University,Hangzhou 310018, Zhejiang, People's Republic of China
| | - Xuan Cao
- Institute of Intelligent Biomedicine, Hangzhou Dianzi University,Hangzhou 310018, Zhejiang, People's Republic of China
| | - Fuqing Lü
- Institute of Intelligent Biomedicine, Hangzhou Dianzi University,Hangzhou 310018, Zhejiang, People's Republic of China
| | - Sangma Xie
- Institute of Intelligent Biomedicine, Hangzhou Dianzi University,Hangzhou 310018, Zhejiang, People's Republic of China
| | - Zhou Yu
- Institute of Intelligent Biomedicine, Hangzhou Dianzi University,Hangzhou 310018, Zhejiang, People's Republic of China
| | - Yuanlin Chen
- Institute of Intelligent Biomedicine, Hangzhou Dianzi University,Hangzhou 310018, Zhejiang, People's Republic of China
| | - Zhong Lü
- Affiliated Dongyang Hospital of Wenzhou Medical University,People's Republic of China
| | - Lihua Li
- Institute of Intelligent Biomedicine, Hangzhou Dianzi University,Hangzhou 310018, Zhejiang, People's Republic of China
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Nair SS, Devi VM, Bhasi S. Enhanced lung cancer detection: Integrating improved random walker segmentation with artificial neural network and random forest classifier. Heliyon 2024; 10:e29032. [PMID: 38617949 PMCID: PMC11015404 DOI: 10.1016/j.heliyon.2024.e29032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 04/16/2024] Open
Abstract
Background Medical image segmentation is a vital yet difficult job because of the multimodality of the acquired images. It is difficult to locate the polluted area before it spreads. Methods This research makes use of several machine learning tools, including an artificial neural network as well as a random forest classifier, to increase the system's reliability of pulmonary nodule classification. Anisotropic diffusion filtering is initially used to remove noise from a picture. After that, a modified random walk method is used to get the region of interest inside the lung parenchyma. Finally, the features corresponding to the consistency of the picture segments are extracted using texture-based feature extraction for pulmonary nodules. The final stage is to identify and classify the pulmonary nodules using a classifier algorithm. Results The studies employ cross-validation to demonstrate the validity of the diagnosis framework. In this instance, the proposed method is tested using CT scan information provided by the Lung Image Database Consortium. A random forest classifier showed 99.6 percent accuracy rate for detecting lung cancer, compared to a artificial neural network's 94.8 percent accuracy rate. Conclusions Due to this, current research is now primarily concerned with identifying lung nodules and classifying them as benign or malignant. The diagnostic potential of machine learning as well as image processing approaches are enormous for the categorization of lung cancer.
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Affiliation(s)
- Sneha S. Nair
- Department of Physics, Noorul Islam Centre for Higher Education, Kumarakovil, Kanyakumari District, Tamil Nadu, India
| | - V.N. Meena Devi
- Department of Physics, Noorul Islam Centre for Higher Education, Kumarakovil, Kanyakumari District, Tamil Nadu, India
| | - Saju Bhasi
- Department of Radiation Physics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Cha J, Kim C, Choi SH. Extrinsic Laryngeal Muscle Activity With Different Diameters and Water Depths in a Semi-Occluded Vocal Tract Exercise. J Speech Lang Hear Res 2024:1-15. [PMID: 38592964 DOI: 10.1044/2024_jslhr-23-00194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
PURPOSE Surface electromyography (sEMG) has been used to evaluate extrinsic laryngeal muscle activity during swallowing and phonation. In the current study, sEMG amplitudes were measured from the infrahyoid and suprahyoid muscles during phonation through a tube submerged in water. METHOD The sEMG amplitude values measured from the extrinsic laryngeal muscles and the electroglottographic contact quotient (CQ) were obtained simultaneously from 62 healthy participants (31 men, 31 women) during phonation through a tube at six different depths (2, 4, 7, 10, 15, and 20 cm) while using two tubes with different diameters (1 and 0.5 cm). RESULTS With increasing depth, the sEMG amplitude for the suprahyoid muscles increased in men and women. However, sEMG amplitudes for the infrahyoid muscles increased significantly only in men. Tube diameter had a significant effect on the suprahyoid sEMG amplitudes only for men, with higher sEMG amplitudes when phonating with a 1.0-cm tube. CQ values increased with submerged depth for both men and women. Tube diameter affected results such than CQ values were higher for men when using the wider tube and for women with the narrower tube. CONCLUSIONS Vocal fold vibratory patterns changed with the depth of tube submersion in water for both men and women, but the patterns of muscle activation differed between the sexes. This suggests that men and women use different strategies when confronted with increased intraoral pressure during semi-occluded vocal tract exercises. In this study, sEMG provided insight into the mechanism for differences between vocally normal individuals and could help detect compensatory muscle activation during tube phonation in water for people with voice disorders.
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Affiliation(s)
- Junseo Cha
- Department of Audiology and Speech-Language Pathology, Research Institute of Biomimetic Sensory Control, Catholic Hearing Voice Speech Center, Daegu Catholic University, Gyeongsan, South Korea
| | - Chaehyun Kim
- Department of Audiology and Speech-Language Pathology, Research Institute of Biomimetic Sensory Control, Catholic Hearing Voice Speech Center, Daegu Catholic University, Gyeongsan, South Korea
| | - Seong Hee Choi
- Department of Audiology and Speech-Language Pathology, Research Institute of Biomimetic Sensory Control, Catholic Hearing Voice Speech Center, Daegu Catholic University, Gyeongsan, South Korea
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Yang J, Ren P, Xin P, Wang Y, Ma Y, Liu W, Wang Y, Wang Y, Zhang G. Automatic measurement of lower limb alignment in portable devices based on deep learning for knee osteoarthritis. J Orthop Surg Res 2024; 19:232. [PMID: 38594698 PMCID: PMC11005281 DOI: 10.1186/s13018-024-04658-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/02/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND For knee osteoarthritis patients, analyzing alignment of lower limbs is essential for therapy, which is currently measured from standing long-leg radiographs of anteroposterior X-ray (LLR) manually. To address the time wasting, poor reproducibility and inconvenience of use caused by existing methods, we present an automated measurement model in portable devices for assessing knee alignment from LLRs. METHOD We created a model and trained it with 837 conforming LLRs, and tested it using 204 LLRs without duplicates in a portable device. Both manual and model measurements were conducted independently, then we recorded knee alignment parameters such as Hip knee ankle angle (HKA), Joint line convergence angle (JCLA), Anatomical mechanical angle (AMA), mechanical Lateral distal femoral angle (mLDFA), mechanical Medial proximal tibial angle (mMPTA), and the time required. We evaluated the model's performance compared with manual results in various metrics. RESULT In both the validation and test sets, the average mean radial errors were 2.778 and 2.447 (P<0.05). The test results for native knee joints showed that 92.22%, 79.38%, 87.94%, 79.82%, and 80.16% of the joints reached angle deviation<1° for HKA, JCLA, AMA, mLDFA, and mMPTA. Additionally, for joints with prostheses, 90.14%, 93.66%, 86.62%, 83.80%, and 85.92% of the joints reached that. The Chi-square test did not reveal any significant differences between the manual and model measurements in subgroups (P>0.05). Furthermore, the Bland-Altman 95% limits of agreement were less than ± 2° for HKA, JCLA, AMA, and mLDFA, and slightly more than ± 2 degrees for mMPTA. CONCLUSION The automatic measurement tool can assess the alignment of lower limbs in portable devices for knee osteoarthritis patients. The results are reliable, reproducible, and time-saving.
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Affiliation(s)
- Jianfeng Yang
- Department of Orthopedics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
- Senior Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Peng Ren
- Senior Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Peng Xin
- Department of Orthopedics, Chinese PLA Southern Theater Command General Hospital, Guangzhou, China
| | - Yiming Wang
- Department of Orthopedics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
- Senior Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese People's Liberation Army, Beijing, China
| | - Yonglei Ma
- Department of Anesthesiology, Guangzhou First People's Hospital, Guangzhou, China
| | - Wei Liu
- Damo Academy, Alibaba Group, Hangzhou, China
| | - Yu Wang
- Damo Academy, Alibaba Group, Hangzhou, China
| | - Yan Wang
- Department of Orthopedics, the First Medical Center of Chinese PLA General Hospital, Beijing, China.
- Senior Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.
- Department of Orthopedics, the First Medical Center, PLA General Hospital, Fuxing Road, Haidian District, Beijing, China.
| | - Guoqiang Zhang
- Department of Orthopedics, the First Medical Center of Chinese PLA General Hospital, Beijing, China.
- Senior Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.
- Department of Orthopedics, the First Medical Center, PLA General Hospital, Fuxing Road, Haidian District, Beijing, China.
- Department of Orthopedic Surgery, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, People's Republic of China.
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Yenikaya MA, Kerse G, Oktaysoy O. Artificial intelligence in the healthcare sector: comparison of deep learning networks using chest X-ray images. Front Public Health 2024; 12:1386110. [PMID: 38660365 PMCID: PMC11039909 DOI: 10.3389/fpubh.2024.1386110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024] Open
Abstract
Purpose Artificial intelligence has led to significant developments in the healthcare sector, as in other sectors and fields. In light of its significance, the present study delves into exploring deep learning, a branch of artificial intelligence. Methods In the study, deep learning networks ResNet101, AlexNet, GoogLeNet, and Xception were considered, and it was aimed to determine the success of these networks in disease diagnosis. For this purpose, a dataset of 1,680 chest X-ray images was utilized, consisting of cases of COVID-19, viral pneumonia, and individuals without these diseases. These images were obtained by employing a rotation method to generate replicated data, wherein a split of 70 and 30% was adopted for training and validation, respectively. Results The analysis findings revealed that the deep learning networks were successful in classifying COVID-19, Viral Pneumonia, and Normal (disease-free) images. Moreover, an examination of the success levels revealed that the ResNet101 deep learning network was more successful than the others with a 96.32% success rate. Conclusion In the study, it was seen that deep learning can be used in disease diagnosis and can help experts in the relevant field, ultimately contributing to healthcare organizations and the practices of country managers.
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Affiliation(s)
| | - Gökhan Kerse
- Faculty of Economics and Administrative Sciences, Department of Management Information Systems, Kafkas University, Kars, Türkiye
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Miyama K, Akiyama T, Bise R, Nakamura S, Nakashima Y, Uchida S. Development of an automatic surgical planning system for high tibial osteotomy using artificial intelligence. Knee 2024; 48:128-137. [PMID: 38599029 DOI: 10.1016/j.knee.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/06/2024] [Accepted: 03/19/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND This study proposed an automatic surgical planning system for high tibial osteotomy (HTO) using deep learning-based artificial intelligence and validated its accuracy. The system simulates osteotomy and measures lower-limb alignment parameters in pre- and post-osteotomy simulations. METHODS A total of 107 whole-leg standing radiographs were obtained from 107 patients who underwent HTO. First, the system detected anatomical landmarks on radiographs. Then, it simulated osteotomy and automatically measured five parameters in pre- and post-osteotomy simulation (hip knee angle [HKA], weight-bearing line ratio [WBL ratio], mechanical lateral distal femoral angle [mLDFA], mechanical medial proximal tibial angle [mMPTA], and mechanical lateral distal tibial angle [mLDTA]). The accuracy of the measured parameters was validated by comparing them with the ground truth (GT) values given by two orthopaedic surgeons. RESULTS All absolute errors of the system were within 1.5° or 1.5%. All inter-rater correlation confidence (ICC) values between the system and GT showed good reliability (>0.80). Excellent reliability was observed in the HKA (0.99) and WBL ratios (>0.99) for the pre-osteotomy simulation. The intra-rater difference of the system exhibited excellent reliability with an ICC value of 1.00 for all lower-limb alignment parameters in pre- and post-osteotomy simulations. In addition, the measurement time per radiograph (0.24 s) was considerably shorter than that of an orthopaedic surgeon (118 s). CONCLUSION The proposed system is practically applicable because it can measure lower-limb alignment parameters accurately and quickly in pre- and post-osteotomy simulations. The system has potential applications in surgical planning systems.
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Affiliation(s)
- Kazuki Miyama
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan; Department of Advanced Information Technology, Kyushu University, 744 Motooka, Nishi-Ku, Fukuoka 819-0395, Japan; Akiyama Clinic, 2-28-39, Noke, Sawaraku, Fukuoka City, Fukuoka 814-0171, Japan.
| | - Takenori Akiyama
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan; Akiyama Clinic, 2-28-39, Noke, Sawaraku, Fukuoka City, Fukuoka 814-0171, Japan
| | - Ryoma Bise
- Department of Advanced Information Technology, Kyushu University, 744 Motooka, Nishi-Ku, Fukuoka 819-0395, Japan
| | - Shunsuke Nakamura
- Akiyama Clinic, 2-28-39, Noke, Sawaraku, Fukuoka City, Fukuoka 814-0171, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan
| | - Seiichi Uchida
- Department of Advanced Information Technology, Kyushu University, 744 Motooka, Nishi-Ku, Fukuoka 819-0395, Japan
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Nair SSK, David LR, Shariff A, Maskari SA, Mawali AA, Weis S, Fouad T, Ozsahin DU, Alshuweihi A, Obaideen A, Elshami W. CovMediScanX: A medical imaging solution for COVID-19 diagnosis from chest X-ray images. J Med Imaging Radiat Sci 2024:S1939-8654(24)00100-0. [PMID: 38594085 DOI: 10.1016/j.jmir.2024.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/17/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Radiologists have extensively employed the interpretation of chest X-rays (CXR) to identify visual markers indicative of COVID-19 infection, offering an alternative approach for the screening of infected individuals. This research article presents CovMediScanX, a deep learning-based framework designed for a rapid and automated diagnosis of COVID-19 from CXR scan images. METHODS The proposed approach encompasses gathering and preprocessing CXR image datasets, training deep learning-based custom-made Convolutional Neural Network (CNN), pre-trained and hybrid transfer learning models, identifying the highest-performing model based on key evaluation metrics, and embedding this model into a web interface called CovMediScanX, designed for radiologists to detect the COVID-19 status in new CXR images. RESULTS The custom-made CNN model obtained a remarkable testing accuracy of 94.32% outperforming other models. CovMediScanX, employing the custom-made CNN underwent evaluation with an independent dataset also. The images in the independent dataset are sourced from a scanning machine that is entirely different from those used for the training dataset, highlighting a clear distinction of datasets in their origins. The evaluation outcome highlighted the framework's capability to accurately detect COVID-19 cases, showcasing encouraging results with a precision of 73% and a recall of 84% for positive cases. However, the model requires further enhancement, particularly in improving its detection of normal cases, as evidenced by lower precision and recall rates. CONCLUSION The research proposes CovMediScanX framework that demonstrates promising potential in automatically identifying COVID-19 cases from CXR images. While the model's overall performance on independent data needs improvement, it is evident that addressing bias through the inclusion of diverse data sources during training could further enhance accuracy and reliability.
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Affiliation(s)
| | - Leena R David
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, United Arab Emirates
| | - Abdulwahid Shariff
- Department of Postgraduate Studies, University of Dar es Salaam, Tanzania
| | - Saqar Al Maskari
- Department of Computing and Electronics Engineering, Middle East College, Sultanate of Oman
| | - Adhra Al Mawali
- Quality Assurance and Planning, German University of Technology (GUtech), Sultanate of Oman
| | - Sammy Weis
- University Hospital, Sharjah, United Arab Emirates
| | - Taha Fouad
- University Hospital, Sharjah, United Arab Emirates
| | - Dilber Uzun Ozsahin
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, United Arab Emirates
| | | | | | - Wiam Elshami
- Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, United Arab Emirates
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Mira JJ, Matarredona V, Tella S, Sousa P, Ribeiro Neves V, Strametz R, López-Pineda A. Unveiling the hidden struggle of healthcare students as second victims through a systematic review. BMC Med Educ 2024; 24:378. [PMID: 38589877 PMCID: PMC11000311 DOI: 10.1186/s12909-024-05336-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND When healthcare students witness, engage in, or are involved in an adverse event, it often leads to a second victim experience, impacting their mental well-being and influencing their future professional practice. This study aimed to describe the efforts, methods, and outcomes of interventions to help students in healthcare disciplines cope with the emotional experience of being involved in or witnessing a mistake causing harm to a patient during their clerkships or training. METHODS This systematic review followed the PRISMA guidelines and includes the synthesis of eighteen studies, published in diverse languages from 2011 to 2023, identified from the databases MEDLINE, EMBASE, SCOPUS and APS PsycInfo. PICO method was used for constructing a research question and formulating eligibility criteria. The selection process was conducted through Rayyan. Titles and abstracts of were independently screened by two authors. The critical appraisal tools of the Joanna Briggs Institute was used to assess the risk of bias of the included studies. RESULTS A total of 1354 studies were retrieved, 18 met the eligibility criteria. Most studies were conducted in the USA. Various educational interventions along with learning how to prevent mistakes, and resilience training were described. In some cases, this experience contributed to the student personal growth. Psychological support in the aftermath of adverse events was scattered. CONCLUSION Ensuring healthcare students' resilience should be a fundamental part of their training. Interventions to train them to address the second victim phenomenon during their clerkships are scarce, scattered, and do not yield conclusive results on identifying what is most effective and what is not.
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Affiliation(s)
- José Joaquín Mira
- Atenea Research. FISABIO, Alicante, Spain.
- Universidad Miguel Hernández, Elche, Spain.
| | | | - Susanna Tella
- Faculty of Health and Social Care, LAB University of Applied Sciences, Lappeenranta, Finland
| | - Paulo Sousa
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | | | - Reinhard Strametz
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), RheinMain UAS, Wiesbaden, Germany
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Li Y, Zhang Y, Tian L, Li J, Li H, Wang X, Wang C. 3D amide proton transfer-weighted imaging may be useful for diagnosing early-stage breast cancer: a prospective monocentric study. Eur Radiol Exp 2024; 8:41. [PMID: 38584248 PMCID: PMC10999404 DOI: 10.1186/s41747-024-00439-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/17/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND We investigated the value of three-dimensional amide proton transfer-weighted imaging (3D-APTWI) in the diagnosis of early-stage breast cancer (BC) and its correlation with the immunohistochemical characteristics of malignant lesions. METHODS Seventy-eight women underwent APTWI and dynamic contrast-enhanced (DCE)-MRI. Pathological results were categorized as either benign (n = 43) or malignant (n = 37) lesions. The parameters of APTWI and DCE-MRI were compared between the benign and malignant groups. The diagnostic value of 3D-APTWI was evaluated using the area under the receiver operating characteristic curve (ROC-AUC) to establish a diagnostic threshold. Pearson's correlation was used to analyze the correlation between the magnetization transfer asymmetry (MTRasym) and immunohistochemical characteristics. RESULTS The MTRasym and time-to-peak of malignancies were significantly lower than those of benign lesions (all p < 0.010). The volume transfer constant, rate constant, and wash-in and wash-out rates of malignancies were all significantly greater than those of benign lesions (all p < 0.010). ROC-AUCs of 3D-APTWI, DCE-MRI, and 3D-APTWI+DCE to differential diagnosis between early-stage BC and benign lesions were 0.816, 0.745, and 0.858, respectively. Only the difference between AUCAPT+DCE and AUCDCE was significant (p < 0.010). When a threshold of MTRasym for malignancy for 2.42%, the sensitivity and specificity of 3D-APTWI for BC diagnosis were 86.5% and 67.6%, respectively; MTRasym was modestly positively correlated with pathological grade (r = 0.476, p = 0.003) and Ki-67 (r = 0.419, p = 0.020). CONCLUSIONS 3D-APTWI may be used as a supplementary method for patients with contraindications of DCE-MRI. MTRasym can imply the proliferation activities of early-stage BC. RELEVANCE STATEMENT 3D-APTWI can be an alternative diagnostic method for patients with early-stage BC who are not suitable for contrast injection. KEY POINTS • 3D-APTWI reflects the changes in the microenvironment of early-stage breast cancer. • Combined 3D-APTWI is superior to DCE-MRI alone for early-stage breast cancer diagnosis. • 3D-APTWI improves the diagnostic accuracy of early-stage breast cancer.
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Affiliation(s)
- Yeqin Li
- Department of Radiology, Shandong Province Hospital of Traditional Chinese Medicine, Jinan, 250014, China
| | - Yan Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China
| | - Liwen Tian
- Department of Radiology, Shandong Public Health Clinical Center, Jinan, 250100, China
| | - Ju Li
- Department of Radiology, Shandong Public Health Clinical Center, Jinan, 250100, China
- Binzhou Medical University, Yantai, 264003, China
| | - Huihua Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China
| | - Cuiyan Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medcial University, Jinan, 250021, China.
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Ajjan RA, Battelino T, Cos X, Del Prato S, Philips JC, Meyer L, Seufert J, Seidu S. Continuous glucose monitoring for the routine care of type 2 diabetes mellitus. Nat Rev Endocrinol 2024:10.1038/s41574-024-00973-1. [PMID: 38589493 DOI: 10.1038/s41574-024-00973-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/10/2024]
Abstract
Although continuous glucose monitoring (CGM) devices are now considered the standard of care for people with type 1 diabetes mellitus, the uptake among people with type 2 diabetes mellitus (T2DM) has been slower and is focused on those receiving intensive insulin therapy. However, increasing evidence now supports the inclusion of CGM in the routine care of people with T2DM who are on basal insulin-only regimens or are managed with other medications. Expanding CGM to these groups could minimize hypoglycaemia while allowing efficient adaptation and escalation of therapies. Increasing evidence from randomized controlled trials and observational studies indicates that CGM is of clinical value in people with T2DM on non-intensive treatment regimens. If further studies confirm this finding, CGM could soon become a part of routine care for T2DM. In this Perspective we explore the potential benefits of widening the application of CGM in T2DM, along with the challenges that must be overcome for the evidence-based benefits of this technology to be delivered for all people with T2DM.
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Affiliation(s)
- Ramzi A Ajjan
- The LIGHT Laboratories, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Tadej Battelino
- Faculty of Medicine, University of Ljubljana Medical Centre, Ljubljana, Slovenia
| | - Xavier Cos
- DAP Cat Research Group, Foundation University Institute for Primary Health Care Research Jordi Gol i Gorina, Barcelona, Spain
| | - Stefano Del Prato
- Section of Diabetes and Metabolic Diseases, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Laurent Meyer
- Department of Endocrinology, Diabetes and Nutrition, University Hospital, Strasbourg, France
| | - Jochen Seufert
- Division of Endocrinology and Diabetology, Department of Medicine II, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Samuel Seidu
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK.
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Gopatoti A, Jayakumar R, Billa P, Patteeswaran V. DDA-SSNets: Dual decoder attention-based semantic segmentation networks for COVID-19 infection segmentation and classification using chest X-Ray images. J Xray Sci Technol 2024:XST230421. [PMID: 38607728 DOI: 10.3233/xst-230421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
BACKGROUND COVID-19 needs to be diagnosed and staged to be treated accurately. However, prior studies' diagnostic and staging abilities for COVID-19 infection needed to be improved. Therefore, new deep learning-based approaches are required to aid radiologists in detecting and quantifying COVID-19-related lung infections. OBJECTIVE To develop deep learning-based models to classify and quantify COVID-19-related lung infections. METHODS Initially, Dual Decoder Attention-based Semantic Segmentation Networks (DDA-SSNets) such as Dual Decoder Attention-UNet (DDA-UNet) and Dual Decoder Attention-SegNet (DDA-SegNet) are proposed to facilitate the dual segmentation tasks such as lung lobes and infection segmentation in chest X-ray (CXR) images. The lung lobe and infection segmentations are mapped to grade the severity of COVID-19 infection in both the lungs of CXRs. Later, a Genetic algorithm-based Deep Convolutional Neural Network classifier with the optimum number of layers, namely GADCNet, is proposed to classify the extracted regions of interest (ROI) from the CXR lung lobes into COVID-19 and non-COVID-19. RESULTS The DDA-SegNet shows better segmentation with an average BCSSDC of 99.53% and 99.97% for lung lobes and infection segmentations, respectively, compared with DDA-UNet with an average BCSSDC of 99.14% and 99.92%. The proposed DDA-SegNet with GADCNet classifier offered excellent classification results with an average BCCAC of 99.98%, followed by the GADCNet with DDA-UNet with an average BCCAC of 99.92% after extensive testing and analysis. CONCLUSIONS The results show that the proposed DDA-SegNet has superior performance in the segmentation of lung lobes and COVID-19-infected regions in CXRs, along with improved severity grading compared to the DDA-UNet and improved accuracy of the GADCNet classifier in classifying the CXRs into COVID-19, and non-COVID-19.
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Affiliation(s)
- Anandbabu Gopatoti
- Department of Electronics and Communication Engineering, Hindusthan College of Engineering and Technology, Coimbatore, Tamil Nadu, India
| | - Ramya Jayakumar
- Department of Electronics and Communication Engineering, Hindusthan College of Engineering and Technology, Coimbatore, Tamil Nadu, India
| | - Poornaiah Billa
- Department of Electronics and Communication Engineering, Lakireddy Bali Reddy College of Engineering, Mylavaram, Andhra Pradesh, India
| | - Vijayalakshmi Patteeswaran
- Department of Electronics and Communication Engineering, Hindusthan College of Engineering and Technology, Coimbatore, Tamil Nadu, India
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Barnsley H, Robertson S, Cruickshank S, McNair HA. Radiographer training for screening of patients referred for Magnetic Resonance Imaging: A scoping review. Radiography (Lond) 2024; 30:843-855. [PMID: 38579383 DOI: 10.1016/j.radi.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 04/07/2024]
Abstract
INTRODUCTION Strict safety practices are essential to ensure the safety of patients and staff in Magnetic Resonance Imaging (MRI). Training regarding the fundamentals of MRI safety is well-established and commonly agreed upon. However, more complex aspect of screening patients, such as image review or screening of unconscious patients/patients with communication difficulties is less well discussed. The current UK and USA guidelines do not suggest the use of communication training for MRI staff nor indicate any training to encourage reviewing images in the screening process. This review aims to map the current guidance regarding safety and patient screening training for MRI diagnostic and therapeutic radiographers. METHODS A systematic search of PubMed, Trip Medical database and Radiography journal was conducted. Studies were chosen based on the review objectives and pre-determined inclusion/exclusion criteria using the PRISMA-ScR framework. RESULTS Twenty-four studies were included in the review, which identified some key concepts including MRI safety training and delivery methods, screening and communication, screening of unconscious or non-ambulatory patients and the use of imaging. CONCLUSION Training gaps lie within the more complex elements of screening such as the inclusiveness of question phrasing, particularly to the neurodivergent population, how we teach radiographers to screen unconscious/unresponsive patients and using imaging to detect implants. IMPLICATIONS FOR PRACTICE The consequences of incomplete or inaccurate pre-MRI safety screening could be the introduction of unexpected implants into the scanner or forgoing MRI for a less desirable modality. The development of enhanced training programs in implant recognition using imaging and communication could complement existing training.
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Affiliation(s)
- H Barnsley
- The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London, SW3 6JJ, UK
| | - S Robertson
- The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London, SW3 6JJ, UK
| | - S Cruickshank
- The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London, SW3 6JJ, UK
| | - H A McNair
- The Royal Marsden NHS Foundation Trust, 203 Fulham Road, London, SW3 6JJ, UK; The Institute of Cancer Research, UK.
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Chin V, Finnegan RN, Chlap P, Holloway L, Thwaites DI, Otton J, Delaney GP, Vinod SK. Dosimetric Impact of Delineation and Motion Uncertainties on the Heart and Substructures in Lung Cancer Radiotherapy. Clin Oncol (R Coll Radiol) 2024:S0936-6555(24)00143-2. [PMID: 38649309 DOI: 10.1016/j.clon.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024]
Abstract
AIMS Delineation variations and organ motion produce difficult-to-quantify uncertainties in planned radiation doses to targets and organs at risk. Similar to manual contouring, most automatic segmentation tools generate single delineations per structure; however, this does not indicate the range of clinically acceptable delineations. This study develops a method to generate a range of automatic cardiac structure segmentations, incorporating motion and delineation uncertainty, and evaluates the dosimetric impact in lung cancer. MATERIALS AND METHODS Eighteen cardiac structures were delineated using a locally developed auto-segmentation tool. It was applied to lung cancer planning CTs for 27 curative (planned dose ≥50 Gy) cases, and delineation variations were estimated by using ten mapping-atlases to provide separate substructure segmentations. Motion-related cardiac segmentation variations were estimated by auto-contouring structures on ten respiratory phases for 9/27 cases that had 4D-planning CTs. Dose volume histograms (DVHs) incorporating these variations were generated for comparison. RESULTS Variations in mean doses (Dmean), defined as the range in values across ten feasible auto-segmentations, were calculated for each cardiac substructure. Over the study cohort the median variations for delineation uncertainty and motion were 2.20-11.09 Gy and 0.72-4.06 Gy, respectively. As relative values, variations in Dmean were between 18.7%-65.3% and 7.8%-32.5% for delineation uncertainty and motion, respectively. Doses vary depending on the individual planned dose distribution, not simply on segmentation differences, with larger dose variations to cardiac structures lying within areas of steep dose gradient. CONCLUSION Radiotherapy dose uncertainties from delineation variations and respiratory-related heart motion were quantified using a cardiac substructure automatic segmentation tool. This predicts the 'dose range' where doses to structures are most likely to fall, rather than single DVH curves. This enables consideration of these uncertainties in cardiotoxicity research and for future plan optimisation. The tool was designed for cardiac structures, but similar methods are potentially applicable to other OARs.
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Affiliation(s)
- V Chin
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Department of Radiation Oncology, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia; University of Sydney, Image X Institute, Sydney, Australia.
| | - R N Finnegan
- Ingham Institute for Applied Medical Research, Sydney, Australia; University of Sydney, Institute of Medical Physics, Sydney, Australia; Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia
| | - P Chlap
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Department of Radiation Oncology, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia
| | - L Holloway
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Department of Radiation Oncology, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia; University of Sydney, Institute of Medical Physics, Sydney, Australia
| | - D I Thwaites
- University of Sydney, Institute of Medical Physics, Sydney, Australia; St James's Hospital and University of Leeds, Leeds Institute of Medical Research, Radiotherapy Research Group, Leeds, United Kingdom
| | - J Otton
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool Hospital, Department of Cardiology, Sydney, Australia
| | - G P Delaney
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Department of Radiation Oncology, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia
| | - S K Vinod
- University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Department of Radiation Oncology, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia
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Xu K, Zhang F, Huang Y, Huang X. 2.5D UNet with context-aware feature sequence fusion for accurate esophageal tumor semantic segmentation. Phys Med Biol 2024; 69:085002. [PMID: 38484399 DOI: 10.1088/1361-6560/ad3419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/14/2024] [Indexed: 04/04/2024]
Abstract
Segmenting esophageal tumor from computed tomography (CT) sequence images can assist doctors in diagnosing and treating patients with this malignancy. However, accurately extracting esophageal tumor features from CT images often present challenges due to their small area, variable position, and shape, as well as the low contrast with surrounding tissues. This results in not achieving the level of accuracy required for practical applications in current methods. To address this problem, we propose a 2.5D context-aware feature sequence fusion UNet (2.5D CFSF-UNet) model for esophageal tumor segmentation in CT sequence images. Specifically, we embed intra-slice multiscale attention feature fusion (Intra-slice MAFF) in each skip connection of UNet to improve feature learning capabilities, better expressing the differences between anatomical structures within CT sequence images. Additionally, the inter-slice context fusion block (Inter-slice CFB) is utilized in the center bridge of UNet to enhance the depiction of context features between CT slices, thereby preventing the loss of structural information between slices. Experiments are conducted on a dataset of 430 esophageal tumor patients. The results show an 87.13% dice similarity coefficient, a 79.71% intersection over union and a 2.4758 mm Hausdorff distance, which demonstrates that our approach can improve contouring consistency and can be applied to clinical applications.
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Affiliation(s)
- Kai Xu
- Scholl of the Internet, Anhui university, Anhui, 230039, People's Republic of China
| | - Feixiang Zhang
- Scholl of the Internet, Anhui university, Anhui, 230039, People's Republic of China
| | - Yong Huang
- Department of Medical Oncology, The Second People's Hospital of Hefei, Hefei, 230011, People's Republic of China
| | - Xiaoyu Huang
- Department of Chinese Integrative Medicine Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People's Republic of China
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Matilainen N, Kataja J, Laakso I. Verification of neuronavigated TMS accuracy using structured-light 3D scans. Phys Med Biol 2024; 69:085004. [PMID: 38479018 DOI: 10.1088/1361-6560/ad33b8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
Objective.To investigate the reliability and accuracy of the manual three-point co-registration in neuronavigated transcranial magnetic stimulation (TMS). The effect of the error in landmark pointing on the coil placement and on the induced electric and magnetic fields was examined.Approach.The position of the TMS coil on the head was recorded by the neuronavigation system and by 3D scanning for ten healthy participants. The differences in the coil locations and orientations and the theoretical error values for electric and magnetic fields between the neuronavigated and 3D scanned coil positions were calculated. In addition, the sensitivity of the coil location on landmark accuracy was calculated.Main results.The measured distances between the neuronavigated and 3D scanned coil locations were on average 10.2 mm, ranging from 3.1 to 18.7 mm. The error in angles were on average from two to three degrees. The coil misplacement caused on average a 29% relative error in the electric field with a range from 9% to 51%. In the magnetic field, the same error was on average 33%, ranging from 10% to 58%. The misplacement of landmark points could cause a 1.8-fold error for the coil location.Significance.TMS neuronavigation with three landmark points can cause a significant error in the coil position, hampering research using highly accurate electric field calculations. Including 3D scanning to the process provides an efficient method to achieve a more accurate coil position.
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Affiliation(s)
- Noora Matilainen
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Juhani Kataja
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Ilkka Laakso
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
- Aalto Neuroimaging, Aalto University, Espoo, Finland
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Aghababa MP, Andrysek J. Exploration and demonstration of explainable machine learning models in prosthetic rehabilitation-based gait analysis. PLoS One 2024; 19:e0300447. [PMID: 38564508 PMCID: PMC10987001 DOI: 10.1371/journal.pone.0300447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Quantitative gait analysis is important for understanding the non-typical walking patterns associated with mobility impairments. Conventional linear statistical methods and machine learning (ML) models are commonly used to assess gait performance and related changes in the gait parameters. Nonetheless, explainable machine learning provides an alternative technique for distinguishing the significant and influential gait changes stemming from a given intervention. The goal of this work was to demonstrate the use of explainable ML models in gait analysis for prosthetic rehabilitation in both population- and sample-based interpretability analyses. Models were developed to classify amputee gait with two types of prosthetic knee joints. Sagittal plane gait patterns of 21 individuals with unilateral transfemoral amputations were video-recorded and 19 spatiotemporal and kinematic gait parameters were extracted and included in the models. Four ML models-logistic regression, support vector machine, random forest, and LightGBM-were assessed and tested for accuracy and precision. The Shapley Additive exPlanations (SHAP) framework was applied to examine global and local interpretability. Random Forest yielded the highest classification accuracy (98.3%). The SHAP framework quantified the level of influence of each gait parameter in the models where knee flexion-related parameters were found the most influential factors in yielding the outcomes of the models. The sample-based explainable ML provided additional insights over the population-based analyses, including an understanding of the effect of the knee type on the walking style of a specific sample, and whether or not it agreed with global interpretations. It was concluded that explainable ML models can be powerful tools for the assessment of gait-related clinical interventions, revealing important parameters that may be overlooked using conventional statistical methods.
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Affiliation(s)
- Mohammad Pourmahmood Aghababa
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Jan Andrysek
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
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Umar TP, Jain N, Papageorgakopoulou M, Shaheen RS, Alsamhori JF, Muzzamil M, Kostiks A. Artificial intelligence for screening and diagnosis of amyotrophic lateral sclerosis: a systematic review and meta-analysis. Amyotroph Lateral Scler Frontotemporal Degener 2024:1-12. [PMID: 38563056 DOI: 10.1080/21678421.2024.2334836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Amyotrophic lateral sclerosis (ALS) is a rare and fatal neurological disease that leads to progressive motor function degeneration. Diagnosing ALS is challenging due to the absence of a specific detection test. The use of artificial intelligence (AI) can assist in the investigation and treatment of ALS. METHODS We searched seven databases for literature on the application of AI in the early diagnosis and screening of ALS in humans. The findings were summarized using random-effects summary receiver operating characteristic curve. The risk of bias (RoB) analysis was carried out using QUADAS-2 or QUADAS-C tools. RESULTS In the 34 analyzed studies, a meta-prevalence of 47% for ALS was noted. For ALS detection, the pooled sensitivity of AI models was 94.3% (95% CI - 63.2% to 99.4%) with a pooled specificity of 98.9% (95% CI - 92.4% to 99.9%). For ALS classification, the pooled sensitivity of AI models was 90.9% (95% CI - 86.5% to 93.9%) with a pooled specificity of 92.3% (95% CI - 84.8% to 96.3%). Based on type of input for classification, the pooled sensitivity of AI models for gait, electromyography, and magnetic resonance signals was 91.2%, 92.6%, and 82.2%, respectively. The pooled specificity for gait, electromyography, and magnetic resonance signals was 94.1%, 96.5%, and 77.3%, respectively. CONCLUSIONS Although AI can play a significant role in the screening and diagnosis of ALS due to its high sensitivities and specificities, concerns remain regarding quality of evidence reported in the literature.
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Affiliation(s)
- Tungki Pratama Umar
- Department of Medical Profession, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
| | - Nityanand Jain
- Faculty of Medicine, Riga Stradinš University, Riga, Latvia
| | | | | | | | - Muhammad Muzzamil
- Department of Public Health, Health Services Academy, Islamabad, Pakistan, and
| | - Andrejs Kostiks
- Department of Neurology, Riga East University Clinical Hospital, Riga, Latvia
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Müller HP, Kassubek J. Toward diffusion tensor imaging as a biomarker in neurodegenerative diseases: technical considerations to optimize recordings and data processing. Front Hum Neurosci 2024; 18:1378896. [PMID: 38628970 PMCID: PMC11018884 DOI: 10.3389/fnhum.2024.1378896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 02/26/2024] [Indexed: 04/19/2024] Open
Abstract
Neuroimaging biomarkers have shown high potential to map the disease processes in the application to neurodegenerative diseases (NDD), e.g., diffusion tensor imaging (DTI). For DTI, the implementation of a standardized scanning and analysis cascade in clinical trials has potential to be further optimized. Over the last few years, various approaches to improve DTI applications to NDD have been developed. The core issue of this review was to address considerations and limitations of DTI in NDD: we discuss suggestions for improvements of DTI applications to NDD. Based on this technical approach, a set of recommendations was proposed for a standardized DTI scan protocol and an analysis cascade of DTI data pre-and postprocessing and statistical analysis. In summary, considering advantages and limitations of the DTI in NDD we suggest improvements for a standardized framework for a DTI-based protocol to be applied to future imaging studies in NDD, towards the goal to proceed to establish DTI as a biomarker in clinical trials in neurodegeneration.
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Kraan AC, Moglioni M, Battistoni G, Bersani D, Berti A, Carra P, Cerello P, Ciocca M, Ferrero V, Fiorina E, Mazzoni E, Morrocchi M, Muraro S, Orlandi E, Pennazio F, Retico A, Rosso V, Sportelli G, Vischioni B, Vitolo V, Bisogni MG. Using the gamma-index analysis for inter-fractional comparison of in-beam PET images for head-and-neck treatment monitoring in proton therapy: A Monte Carlo simulation study. Phys Med 2024; 120:103329. [PMID: 38492331 DOI: 10.1016/j.ejmp.2024.103329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 02/13/2024] [Accepted: 03/07/2024] [Indexed: 03/18/2024] Open
Abstract
GOAL In-beam Positron Emission Tomography (PET) is a technique for in-vivo non-invasive treatment monitoring for proton therapy. To detect anatomical changes in patients with PET, various analysis methods exist, but their clinical interpretation is problematic. The goal of this work is to investigate whether the gamma-index analysis, widely used for dose comparisons, is an appropriate tool for comparing in-beam PET distributions. Focusing on a head-and-neck patient, we investigate whether the gamma-index map and the passing rate are sensitive to progressive anatomical changes. METHODS/MATERIALS We simulated a treatment course of a proton therapy patient using FLUKA Monte Carlo simulations. Gradual emptying of the sinonasal cavity was modeled through a series of artificially modified CT scans. The in-beam PET activity distributions from three fields were evaluated, simulating a planar dual head geometry. We applied the 3D-gamma evaluation method to compare the PET images with a reference image without changes. Various tolerance criteria and parameters were tested, and results were compared to the CT-scans. RESULTS Based on 210 MC simulations we identified appropriate parameters for the gamma-index analysis. Tolerance values of 3 mm/3% and 2 mm/2% were suited for comparison of simulated in-beam PET distributions. The gamma passing rate decreased with increasing volume change for all fields. CONCLUSION The gamma-index analysis was found to be a useful tool for comparing simulated in-beam PET images, sensitive to sinonasal cavity emptying. Monitoring the gamma passing rate behavior over the treatment course is useful to detect anatomical changes occurring during the treatment course.
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Affiliation(s)
- Aafke Christine Kraan
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy
| | - Martina Moglioni
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy; Dipartimento di Fisica, Università di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy.
| | - Giuseppe Battistoni
- Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Via Giovanni Celoria 16, Milano, 20133, Italy
| | - Davide Bersani
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, Via Pietro Giuria 1, Torino, 10125, Italy
| | - Andrea Berti
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy; Dipartimento di Fisica, Università di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy
| | - Pietro Carra
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy; Dipartimento di Fisica, Università di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy
| | - Piergiorgio Cerello
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, Via Pietro Giuria 1, Torino, 10125, Italy
| | - Mario Ciocca
- Centro Nazionale di Adroterapia Oncologica, Strada Privata Campeggi 53, Pavia, 27100, Italy
| | - Veronica Ferrero
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, Via Pietro Giuria 1, Torino, 10125, Italy
| | - Elisa Fiorina
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, Via Pietro Giuria 1, Torino, 10125, Italy
| | - Enrico Mazzoni
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy
| | - Matteo Morrocchi
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy; Dipartimento di Fisica, Università di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy
| | - Silvia Muraro
- Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Via Giovanni Celoria 16, Milano, 20133, Italy
| | - Ester Orlandi
- Centro Nazionale di Adroterapia Oncologica, Strada Privata Campeggi 53, Pavia, 27100, Italy
| | - Francesco Pennazio
- Istituto Nazionale di Fisica Nucleare, Sezione di Torino, Via Pietro Giuria 1, Torino, 10125, Italy
| | - Alessandra Retico
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy
| | - Valeria Rosso
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy; Dipartimento di Fisica, Università di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy
| | - Giancarlo Sportelli
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy; Dipartimento di Fisica, Università di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy
| | - Barbara Vischioni
- Centro Nazionale di Adroterapia Oncologica, Strada Privata Campeggi 53, Pavia, 27100, Italy
| | - Viviana Vitolo
- Centro Nazionale di Adroterapia Oncologica, Strada Privata Campeggi 53, Pavia, 27100, Italy
| | - Maria Giuseppina Bisogni
- Istituto Nazionale di Fisica Nucleare, Sezione di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy; Dipartimento di Fisica, Università di Pisa, Largo Bruno Pontecorvo 3, Pisa, 56127, Italy
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Shen Y, Ran C, Dong X, Wu Z, Huang W. Dimensionality Engineering of Organic-Inorganic Halide Perovskites for Next-Generation X-Ray Detector. Small 2024; 20:e2308242. [PMID: 38016066 DOI: 10.1002/smll.202308242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/06/2023] [Indexed: 11/30/2023]
Abstract
The next-generation X-ray detectors require novel semiconductors with low material/fabrication cost, excellent X-ray response characteristics, and robust operational stability. The family of organic-inorganic hybrid perovskites (OIHPs) materials comprises a range of crystal configuration (i.e., films, wafers, and single crystals) with tunable chemical composition, structures, and electronic properties, which can perfectly meet the multiple-stringent requirements of high-energy radiation detection, making them emerging as the cutting-edge candidate for next-generation X-ray detectors. From the perspective of molecular dimensionality, the physicochemical and optoelectronic characteristics of OIHPs exhibit dimensionality-dependent behavior, and thus the structural dimensionality is recognized as the key factor that determines the device performance of OIHPs-based X-ray detectors. Nevertheless, the correlation between dimensionality of OIHPs and performance of their X-ray detectors is still short of theoretical guidance, which become a bottleneck that impedes the development of efficient X-ray detectors. In the review, the advanced studies on the dimensionality engineering of OIHPs are critically assessed in X-ray detection application, discussing the current understanding on the "dimensionality-property" relationship of OIHPs and the state-of-the-art progresses on the dimensionality-engineered OIHPs-based X-ray detector, and highlight the open challenges and future outlook of this field.
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Affiliation(s)
- Yue Shen
- Frontiers Science Center for Flexible Electronics, Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Chenxin Ran
- Frontiers Science Center for Flexible Electronics, Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Xue Dong
- Technological Institute of Materials & Energy Science (TIMES), Xijing University, Xi'an, 710123, China
| | - Zhongbin Wu
- Frontiers Science Center for Flexible Electronics, Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Wei Huang
- Frontiers Science Center for Flexible Electronics, Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering, Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
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Khamooshi M, Wickramarachchi A, Byrne T, Seman M, Fletcher DF, Burrell A, Gregory SD. Blood flow and emboli transport patterns during venoarterial extracorporeal membrane oxygenation: A computational fluid dynamics study. Comput Biol Med 2024; 172:108263. [PMID: 38489988 DOI: 10.1016/j.compbiomed.2024.108263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/15/2024] [Accepted: 03/06/2024] [Indexed: 03/17/2024]
Abstract
PROBLEM Despite advances in Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO), a significant mortality rate persists due to complications. The non-physiological blood flow dynamics of VA-ECMO may lead to neurological complications and organ ischemia. Continuous retrograde high-flow oxygenated blood enters through a return cannula placed in the femoral artery which opposes the pulsatile deoxygenated blood ejected by the left ventricle (LV), which impacts upper body oxygenation and subsequent hyperoxemia. The complications underscore the critical need to comprehend the impact of VA-ECMO support level and return cannula size, as mortality remains a significant concern. AIM The aim of this study is to predict and provide insights into the complications associated with VA-ECMO using computational fluid dynamics (CFD) simulations. These complications will be assessed by characterising blood flow and emboli transport patterns through a comprehensive analysis of the influence of VA-ECMO support levels and arterial return cannula sizes. METHODS Patient-specific 3D aortic and major branch models, derived from a male patient's CT scan during VA-ECMO undergoing respiratory dysfunction, were analyzed using CFD. The investigation employed species transport and discrete particle tracking models to study ECMO blood (oxygenated) mixing with LV blood (deoxygenated) and to trace emboli transport patterns from potential sources (circuit, LV, and aorta wall). Two cannula sizes (15 Fr and 19 Fr) were tested alongside varying ECMO pump flow rates (50%, 70%, and 90% of the total cardiac output). RESULTS Cannula size did not significantly affect oxygen transport. At 90% VA-ECMO support, all arteries distal to the aortic arch achieved 100% oxygen saturation. As support level decreased, oxygen transport to the upper body also decreased to a minimum saturation of 73%. Emboli transport varied substantially between emboli origin and VAECMO support level, with the highest risk of cerebral emboli coming from the LV with a 15 Fr cannula at 90% support. CONCLUSION Arterial return cannula sizing minimally impacted blood oxygen distribution; however, it did influence the distribution of emboli released from the circuit and aortic wall. Notably, it was the support level alone that significantly affected the mixing zone of VA-ECMO and cardiac blood, subsequently influencing the risk of embolization of the cardiogenic source and oxygenation levels across various arterial branches.
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Affiliation(s)
- Mehrdad Khamooshi
- Cardio-Respiratory Engineering and Technology Laboratory (CREATElab), Department of Mechanical and Aerospace Engineering, Monash University, Wellington Road, Clayton, 3800, Victoria, Australia.
| | - Avishka Wickramarachchi
- Cardio-Respiratory Engineering and Technology Laboratory (CREATElab), Department of Mechanical and Aerospace Engineering, Monash University, Wellington Road, Clayton, 3800, Victoria, Australia.
| | - Tim Byrne
- Intensive Care Unit, Alfred Hospital, 89 Commercial Road, Melbourne, 3004, Victoria, Australia.
| | - Michael Seman
- Cardio-Respiratory Engineering and Technology Laboratory (CREATElab), Department of Mechanical and Aerospace Engineering, Monash University, Wellington Road, Clayton, 3800, Victoria, Australia.
| | - David F Fletcher
- School of Chemical and Biomolecular Engineering, The University of Sydney, Darlington, 2006, New South Wales, Australia.
| | - Aidan Burrell
- Intensive Care Unit, Alfred Hospital, 89 Commercial Road, Melbourne, 3004, Victoria, Australia.
| | - Shaun D Gregory
- Cardio-Respiratory Engineering and Technology Laboratory (CREATElab), Department of Mechanical and Aerospace Engineering, Monash University, Wellington Road, Clayton, 3800, Victoria, Australia.
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Zhang R, Murray SB, Duval CJ, Wang DJJ, Jann K. Functional connectivity and complexity analyses of resting-state fMRI in pre-adolescents demonstrating the behavioral symptoms of ADHD. Psychiatry Res 2024; 334:115794. [PMID: 38367454 PMCID: PMC10947856 DOI: 10.1016/j.psychres.2024.115794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 01/31/2024] [Accepted: 02/11/2024] [Indexed: 02/19/2024]
Abstract
Attention deficit hyperactivity disorder (ADHD) has been characterized by impairments among distributed functional brain networks, e.g., the frontoparietal network (FPN), default mode network (DMN), reward and motivation-related circuits (RMN), and salience network (SAL). In the current study, we evaluated the complexity and functional connectivity (FC) of resting state fMRI (rsfMRI) in pre-adolescents with the behavioral symptoms of ADHD, for pathology-relevant networks. We leveraged data from the Adolescent Brain and Cognitive Development (ABCD) Study. The final study sample included 63 children demonstrating the behavioral features of ADHD and 92 healthy control children matched on age, sex, and pubertal development status. For selected regions in the relevant networks, ANCOVA compared multiscale entropy (MSE) and FC between the groups. Finally, differences in the association between MSE and FC were evaluated. We found significantly reduced MSE along with increased FC within the FPN of pre-adolescents demonstrating the behavior symptoms of ADHD compared to matched healthy controls. Significant partial correlations between MSE and FC emerged in the FPN and RMN in the healthy controls however the association was absent in the participants demonstrating the behavior symptoms of ADHD. The current findings of complexity and FC in ADHD pathology support hypotheses of altered function of inhibitory control networks in ADHD.
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Affiliation(s)
- Ru Zhang
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States.
| | - Stuart B Murray
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Christina J Duval
- Department of Psychology, St. Louis University, St. Louis, MO, United States
| | - Danny J J Wang
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
| | - Kay Jann
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
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