Radiomics-Based Detection of Radionecrosis Using Harmonized Multiparametric MRI

In this study, a radiomics analysis was conducted to provide insights into the differentiation of radionecrosis and tumor progression in multiparametric MRI in the context of a multicentric clinical trial. First, the sensitivity of radiomic features to the unwanted variability caused by different protocol settings was assessed for each modality. Then, the ability of image normalization and ComBat-based harmonization to reduce the scanner-related variability was evaluated. Finally, the performances of several radiomic models dedicated to the classification of MRI examinations were measured. Our results showed that using radiomic models trained on harmonized data achieved better predictive performance for the investigated clinical outcome (balanced accuracy of 0.61 with the model based on raw data and 0.72 with ComBat harmonization). A comparison of several models based on information extracted from different MR modalities showed that the best classification accuracy was achieved with a model based on MR perfusion features in conjunction with clinical observation (balanced accuracy of 0.76 using LASSO feature selection and a Random Forest classifier). Although multimodality did not provide additional benefit in predictive power, the model based on T1-weighted MRI before injection provided an accuracy close to the performance achieved with perfusion.

Intelligent Bone Age Assessment: An Automated System to Detect a Bone Growth Problem Using Convolutional Neural Networks with Attention Mechanism

Skeletal bone age assessment using X-ray images is a standard clinical procedure to detect any anomaly in bone growth among kids and babies. The assessed bone age indicates the actual level of growth, whereby a large discrepancy between the assessed and chronological age might point to a growth disorder. Hence, skeletal bone age assessment is used to screen the possibility of growth abnormalities, genetic problems, and endocrine disorders. Usually, the manual screening is assessed through X-ray images of the non-dominant hand using the Greulich–Pyle (GP) or Tanner–Whitehouse (TW) approach. The GP uses a standard hand atlas, which will be the reference point to predict the bone age of a patient, while the TW uses a scoring mechanism to assess the bone age using several regions of interest information. However, both approaches are heavily dependent on individual domain knowledge and expertise, which is prone to high bias in inter and intra-observer results. Hence, an automated bone age assessment system, which is referred to as Attention-Xception Network (AXNet) is proposed to automatically predict the bone age accurately. The proposed AXNet consists of two parts, which are image normalization and bone age regression modules. The image normalization module will transform each X-ray image into a standardized form so that the regressor network can be trained using better input images. This module will first extract the hand region from the background, which is then rotated to an upright position using the angle calculated from the four key-points of interest. Then, the masked and rotated hand image will be aligned such that it will be positioned in the middle of the image. Both of the masked and rotated images will be obtained through existing state-of-the-art deep learning methods. The last module will then predict the bone age through the Attention-Xception network that incorporates multiple layers of spatial-attention mechanism to emphasize the important features for more accurate bone age prediction. From the experimental results, the proposed AXNet achieves the lowest mean absolute error and mean squared error of 7.699 months and 108.869 months2, respectively. Therefore, the proposed AXNet has demonstrated its potential for practical clinical use with an error of less than one year to assist the experts or radiologists in evaluating the bone age objectively.

Optimal affine image normalization approach for optical character recognition

Optical character recognition (OCR) in images captured from arbitrary angles requires preliminary normalization, i.e. a geometric transformation resulting in an image as if it was captured at an angle suitable for OCR. In most cases, a surface containing characters can be considered flat, and a pinhole model can be adopted for a camera. Thus, in theory, the normalization should be projective. Usually, the camera optical axis is approximately perpendicular to the document surface, so the projective normalization can be replaced with an affine one without a significant loss of accuracy. An affine image transformation is performed significantly faster than a projective normalization, which is important for OCR on mobile devices. In this work, we propose a fast approach for image normalization. It utilizes an affine normalization instead of a projective one if there is no significant loss of accuracy. The approach is based on a proposed criterion for the normalization accuracy: root mean square (RMS) coordinate discrepancies over the region of interest (ROI). The problem of optimal affine normalization according to this criterion is considered. We have established that this unconstrained optimization is quadratic and can be reduced to a problem of fractional quadratic functions integration over the ROI. The latter was solved analytically in the case of OCR where the ROI consists of rectangles. The proposed approach is generalized for various cases when instead of the affine transform its special cases are used: scaling, translation, shearing, and their superposition, allowing the image normalization procedure to be further accelerated.

An Automatic Glioma Segmentation System Using a Multilevel Attention Pyramid Scene Parsing Network

Background: Due to the significant variances in their shape and size, it is a challenging task to automatically segment gliomas. To improve the performance of glioma segmentation tasks, this paper proposed a multilevel attention pyramid scene parsing network (MLAPSPNet) that aggregates the multiscale context and multilevel features. Methods: First, T1 pre-contrast, T2-weighted fluid-attenuated inversion recovery (FLAIR) and T1 post-contrast sequences of each slice are combined to form the input. Afterward, image normalization and augmentation techniques are applied to accelerate the training process and avoid overfitting, respectively. Furthermore, the proposed MLAPSPNet that introduces multilevel pyramid pooling modules (PPMs) and attention gates is constructed. Eventually, the proposed network is compared with some existing networks. Results: The dice similarity coefficient (DSC), sensitivity and Jaccard score of the proposed system can reach 0.885, 0.933 and 0.8, respectively. The introduction of multilevel pyramid pooling modules and attention gates can improve the DSC by 0.029 and 0.022, respectively. Moreover, compared with Res-UNet, Dense-UNet, residual channel attention UNet (RCA-UNet), DeepLab V3+ and UNet++, the DSC is improved by 0.032, 0.026, 0.014, 0.041 and 0.011, respectively. Conclusion: The proposed multilevel attention pyramid scene parsing network can achieve state-of-the-art performance, and the introduction of multilevel pyramid pooling modules and attention gates can improve the performance of glioma segmentation tasks.