Coronary artery disease (CAD) is a significant health risk that requires early detection for effective treatment. While recent advances in deep learning have shown promise in automating CAD detection from coronary computed to-mography angiography (CCTA) images, the accurate segmentation of coronary vessels remains a challenge, particularly due to the imbalanced presence of plaque in unhealthy vessels. This paper introduces a physiology-aware approach11https://github.com/opensourcetorch/Physiology-aware-PolySnake to coronary vessel segmentation that addresses these challenges. Our proposed pipeline consists of three main components. First, a hybrid UNeXt architecture is designed to segment artery boundaries and predict initial boundary contours by leveraging 3D spatial relations among adjacent slices. Second, we introduce multi-class circular convolution for iterative contour deformation, which generates well-connected contour pairs of the artery wall's inner and outer boundaries through iterative refinement. Finally, we propose a focal smooth Lllossfunction to handle the implicit class imbalance caused by plaque in unhealthy vessels and to enhance the robustness of the physiology-aware polysnake network by explicitly limiting the accuracy of initial contours. Extensive evaluations demonstrate that our methods significantly improve model performance, achieving state-of-the-art results in coronary vessel segmentation.

The volume of medical images stored in hospitals is rapidly increasing; however, the utilization of these accumulated medical images remains limited. Existing content-based medical image retrieval (CBMIR) systems typically require example images, leading to practical limitations, such as the lack of customizable, fine-grained image retrieval, the inability to search without example images, and difficulty in retrieving rare cases. In this paper, we introduce a sketch-based medical image retrieval (SBMIR) system that enables users to find images of interest without the need for example images. The key concept is feature decomposition of medical images, which allows the entire feature of a medical image to be decomposed into and reconstructed from normal and abnormal features. Building on this concept, our SBMIR system provides an easy-to-use two-step graphical user interface: users first select a template image to specify a normal feature and then draw a semantic sketch of the disease on the template image to represent an abnormal feature. The system integrates both types of input to construct a query vector and retrieves reference images. For evaluation, ten healthcare professionals participated in a user test using two datasets. Consequently, our SBMIR system enabled users to overcome previous challenges, including image retrieval based on fine-grained image characteristics, image retrieval without example images, and image retrieval for rare cases. Our SBMIR system provides on-demand, customizable medical image retrieval, thereby expanding the utility of medical image databases.

In medical imaging, the characteristics purely derived from a disease should reflect the extent to which abnormal findings deviate from the normal features. Indeed, physicians often need corresponding images without abnormal findings of interest or, conversely, images that contain similar abnormal findings regardless of normal anatomical context. This is called comparative diagnostic reading of medical images, which is essential for a correct diagnosis. To support comparative diagnostic reading, content-based image retrieval (CBIR) that can selectively utilize normal and abnormal features in medical images as two separable semantic components will be useful. In this study, we propose a neural network architecture to decompose the semantic components of medical images into two latent codes: normal anatomy code and abnormal anatomy code. The normal anatomy code represents counterfactual normal anatomies that should have existed if the sample is healthy, whereas the abnormal anatomy code attributes to abnormal changes that reflect deviation from the normal baseline. By calculating the similarity based on either normal or abnormal anatomy codes or the combination of the two codes, our algorithm can retrieve images according to the selected semantic component from a dataset consisting of brain magnetic resonance images of gliomas. Moreover, it can utilize a synthetic query vector combining normal and abnormal anatomy codes from two different query images. To evaluate whether the retrieved images are acquired according to the targeted semantic component, the overlap of the ground-truth labels is calculated as metrics of the semantic consistency. Our algorithm provides a flexible CBIR framework by handling the decomposed features with qualitatively and quantitatively remarkable results.

Histopathological image analysis is an essential process for the discovery of diseases such as cancer. However, it is challenging to train CNN on whole slide images (WSIs) of gigapixel resolution considering the available memory capacity. Most of the previous works divide high resolution WSIs into small image patches and separately input them into the model to classify it as a tumor or a normal tissue. However, patch-based classification uses only patch-scale local information but ignores the relationship between neighboring patches. If we consider the relationship of neighboring patches and global features, we can improve the classification performance. In this paper, we propose a new model structure combining the patch-based classification model and whole slide-scale segmentation model in order to improve the prediction performance of automatic pathological diagnosis. We extract patch features from the classification model and input them into the segmentation model to obtain a whole slide tumor probability heatmap. The classification model considers patch-scale local features, and the segmentation model can take global information into account. We also propose a new optimization method that retains gradient information and trains the model partially for end-to-end learning with limited GPU memory capacity. We apply our method to the tumor/normal prediction on WSIs and the classification performance is improved compared with the conventional patch-based method.