Image Quality Evaluation in Clinical Research: A Case Study on Brain and Cardiac MRI Images in Multi-Center Clinical Trials

MRI super-resolution using similarity distance and multi-scale receptive field based feature fusion GAN and pre-trained slice interpolation network

Challenges arise in achieving high-resolution Magnetic Resonance Imaging (MRI) to improve disease diagnosis accuracy due to limitations in hardware, patient discomfort, long acquisition times, and high costs. While Convolutional Neural Networks (CNNs) have shown promising results in MRI super-resolution, they often don't look into the structural similarity and prior information available in consecutive MRI slices. By leveraging information from sequential slices, more robust features can be obtained, potentially leading to higher-quality MRI slices. We propose a multi-slice two-dimensional (2D) MRI super-resolution network that combines a Generative Adversarial Network (GAN) with feature fusion and a pre-trained slice interpolation network to achieve three-dimensional (3D) super-resolution. The proposed model requires consecutively acquired three low-resolution (LR) MRI slices along a specific axis, and achieves the reconstruction of the MRI slices in the remaining two axes. The network effectively enhances both in-plane and out-of-plane resolution along the sagittal axis while addressing computational and memory constraints in 3D super-resolution. The proposed generator has a in-plane and out-of-plane Attention (IOA) network that fuses both in-plane and out-plane features of MRI dynamically. In terms of out-of-plane attention, the network merges features by considering the similarity distance between features and for in-plane attention, the network employs a two-level pyramid structure with varying receptive fields to extract features at different scales, ensuring the inclusion of both global and local features. Subsequently, to achieve 3D MRI super-resolution, a pre-trained slice interpolation network is used that takes two consecutive super-resolved MRI slices to generate a new intermediate slice. To further enhance the network performance and perceptual quality, we introduce a feature up-sampling layer and a feature extraction block with Scaled Exponential Linear Unit (SeLU). Moreover, our super-resolution network incorporates VGG loss from a fine-tuned VGG-19 network to provide additional enhancement. Through experimental evaluations on the IXI dataset and BRATS dataset, using the peak signal-to-noise ratio (PSNR), structural similarity index measure (SSIM) and the number of training parameters, we demonstrate the superior performance of our method compared to the existing techniques. Also, the proposed model can be adapted or modified to achieve super-resolution for both 2D and 3D MRI data.

[Comprehensive evaluation method of real-time non-reference ultrasound image involving soft tissue deformation]

Ultrasound guided percutaneous interventional therapy has been widely used in clinic. Aiming at the problem of soft tissue deformation caused by probe contact force in robot-assisted ultrasound-guided therapy, a real-time non-reference ultrasound image evaluation method considering soft tissue deformation is proposed. On the basis of ultrasound image brightness and sharpness, a multi-dimensional ultrasound image evaluation index was designed, which incorporated the aggregation characteristics of the organization. In order to verify the effectiveness of the proposed method, ultrasound images of four different models were collected for experiments, including prostate phantom, phantom with cyst, pig liver tissue, and pig liver tissue with cyst. In addition, the correlation between subjective and objective evaluations was analyzed based on Spearman's rank correlation coefficient. Experimental results showed that the average evaluation time of a single image was 68.8 milliseconds. The evaluation time could satisfy real-time applications. The proposed method realizes the effective evaluation of real-time ultrasound image quality in robot-assisted therapy, and has good consistency with the evaluation of supervisors.

A Brief Survey on No-Reference Image Quality Assessment Methods for Magnetic Resonance Images

No-reference image quality assessment (NR-IQA) methods automatically and objectively predict the perceptual quality of images without access to a reference image. Therefore, due to the lack of pristine images in most medical image acquisition systems, they play a major role in supporting the examination of resulting images and may affect subsequent treatment. Their usage is particularly important in magnetic resonance imaging (MRI) characterized by long acquisition times and a variety of factors that influence the quality of images. In this work, a survey covering recently introduced NR-IQA methods for the assessment of MR images is presented. First, typical distortions are reviewed and then popular NR methods are characterized, taking into account the way in which they describe MR images and create quality models for prediction. The survey also includes protocols used to evaluate the methods and popular benchmark databases. Finally, emerging challenges are outlined along with an indication of the trends towards creating accurate image prediction models.

An Attention-Preserving Network-Based Method for Assisted Segmentation of Osteosarcoma MRI Images

Osteosarcoma is a malignant bone tumor that is extremely dangerous to human health. Not only does it require a large amount of work, it is also a complicated task to outline the lesion area in an image manually, using traditional methods. With the development of computer-aided diagnostic techniques, more and more researchers are focusing on automatic segmentation techniques for osteosarcoma analysis. However, existing methods ignore the size of osteosarcomas, making it difficult to identify and segment smaller tumors. This is very detrimental to the early diagnosis of osteosarcoma. Therefore, this paper proposes a Contextual Axial-Preserving Attention Network (CaPaN)-based MRI image-assisted segmentation method for osteosarcoma detection. Based on the use of Res2Net, a parallel decoder is added to aggregate high-level features which effectively combines the local and global features of osteosarcoma. In addition, channel feature pyramid (CFP) and axial attention (A-RA) mechanisms are used. A lightweight CFP can extract feature mapping and contextual information of different sizes. A-RA uses axial attention to distinguish tumor tissues by mining, which reduces computational costs and thus improves the generalization performance of the model. We conducted experiments using a real dataset provided by the Second Xiangya Affiliated Hospital and the results showed that our proposed method achieves better segmentation results than alternative models. In particular, our method shows significant advantages with respect to small target segmentation. Its precision is about 2% higher than the average values of other models. For the segmentation of small objects, the DSC value of CaPaN is 0.021 higher than that of the commonly used U-Net method.

Automated image quality evaluation of structural brain MRI using an ensemble of deep learning networks

BACKGROUND

Deep learning (DL) is a promising methodology for automatic detection of abnormalities in brain MRI.

PURPOSE

To automatically evaluate the quality of multicenter structural brain MRI images using an ensemble DL model based on deep convolutional neural networks (DCNNs).

STUDY TYPE

Retrospective.

POPULATION

The study included 1064 brain images of autism patients and healthy controls from the Autism Brain Imaging Data Exchange (ABIDE) database. MRI data from 110 multiple sclerosis patients from the CombiRx study were included for independent testing.

SEQUENCE

T₁ -weighted MR brain images acquired at 3T.

ASSESSMENT

The ABIDE data were separated into training (60%), validation (20%), and testing (20%) sets. The ensemble DL model combined the results from three cascaded networks trained separately on the three MRI image planes (axial, coronal, and sagittal). Each cascaded network consists of a DCNN followed by a fully connected network. The quality of image slices from each plane was evaluated by the DCNN and the resultant image scores were combined into a volumewise quality rating using the fully connected network. The DL predicted ratings were compared with manual quality evaluation by two experts.

STATISTICAL TESTS

Receiver operating characteristic (ROC) curve, area under ROC curve (AUC), sensitivity, specificity, accuracy, and positive (PPV) and negative (NPV) predictive values.

RESULTS

The AUC, sensitivity, specificity, accuracy, PPV, and NPV for image quality evaluation of the ABIDE test set using the ensemble model were 0.90, 0.77, 0.85, 0.84, 0.42, and 0.96, respectively. On the CombiRx set the same model achieved performance of 0.71, 0.41, 0.84, 0.73, 0.48, and 0.80.

DATA CONCLUSION

This study demonstrated the high accuracy of DL in evaluating image quality of structural brain MRI in multicenter studies.

LEVEL OF EVIDENCE

3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1260-1267.