Angiographic enhancement of non-contrast CT (NCCT) using AI techniques is essential for diagnosing patients unable to use contrast agents. However, AI angiography remains a challenging task because of the feature fragility, structural complexity, and spatial continuity. In this paper, we propose an angiographic framework based on a conditional multi-view diffusion model called AEGIS with three innovations: multi-view hybrid learning (MHL), conditional angiographic diffusion estimation (CADE), and multi-view map fusion (MMF). 1) MHL targets Contrast Map (CM), the difference between NCCT and CT angiography, from multiple views to perceive 3D features in 2D space, enhancing the stability of feature representation. 2) CADE is a conditional diffusion model using NCCT as spatial guidance, providing crucial information for CM generation. 3) MMF adopts a lightweight AutoEncoder for filtering and fusing multi-view CMs, maintaining coherence between adjacent slices while modifying slight bias in low-dimensional representations, thus optimizing data quality and accuracy. Experiments demonstrate our superior performance, which achieve state-of-the-art image quality (PSNR+6.69, SSIM+3.17, MSE-46.38), segmentation evaluation (CADIR×10.49, HSDIR×5.57) and feature distance (FID-64.27). Visualizations and positive evaluation scores from clinicians further reveals that AEGIS has significant potential in clinical applications.

Federated learning (FL) for histopathology image segmentation involving multiple medical sites plays a crucial role in advancing the field of accurate disease diagnosis and treatment. However, it is still a task of great challenges due to the sample imbalance across clients and large data heterogeneity from disparate organs, variable segmentation tasks, and diverse distribution. Thus, we propose a novel FL approach for histopathology nuclei and tissue segmentation, FedSODA, via synthetic-driven cross-assessment operation (SO) and dynamic stratified-layer aggregation (DA). Our SO constructs a cross-assessment strategy to connect clients and mitigate the representation bias under sample imbalance. Our DA utilizes layer-wise interaction and dynamic aggregation to diminish heterogeneity and enhance generalization. The effectiveness of our FedSODA has been evaluated on the most extensive histopathology image segmentation dataset from 7 independent datasets. The code is available at https://github.com/yuanzhang7/FedSODA.

The segmentation of cardiac structure in magnetic resonance images (CMR) is paramount in diagnosing and managing cardiovascular illnesses, given its 3D+Time (3D+T) sequence. The existing deep learning methods are constrained in their ability to 3D+T CMR segmentation, due to: (1) Limited motion perception. The complexity of heart beating renders the motion perception in 3D+T CMR, including the long-range and cross-slice motions. The existing methods' local perception and slice-fixed perception directly limit the performance of 3D+T CMR perception. (2) Lack of labels. Due to the expensive labeling cost of the 3D+T CMR sequence, the labels of 3D+T CMR only contain the end-diastolic and end-systolic frames. The incomplete labeling scheme causes inefficient supervision. Hence, we propose a novel spatio-temporal adaptation network with clinical prior embedding learning (STANet) to ensure efficient spatio-temporal perception and optimization on 3D+T CMR segmentation. (1) A spatio-temporal adaptive convolution (STAC) treats the 3D+T CMR sequence as a whole for perception. The long-distance motion correlation is embedded into the structural perception by learnable weight regularization to balance long-range motion perception. The structural similarity is measured by cross-attention to adaptively correlate the cross-slice motion. (2) A clinical prior embedding learning strategy (CPE) is proposed to optimize the partially labeled 3D+T CMR segmentation dynamically by embedding clinical priors into optimization. STANet achieves outstanding performance with Dice of 0.917 and 0.94 on two public datasets (ACDC and STACOM), which indicates STANet has the potential to be incorporated into computer-aided diagnosis tools for clinical application.

Accurate segmentation of topological tubular structures, such as blood vessels and roads, is crucial in various fields, ensuring accuracy and efficiency in downstream tasks. However, many factors complicate the task, including thin local structures and variable global morphologies. In this work, we note the specificity of tubular structures and use this knowledge to guide our DSCNet to simultaneously enhance perception in three stages: feature extraction, feature fusion, and loss constraint. First, we propose a dynamic snake convolution to accurately capture the features of tubular structures by adaptively focusing on slender and tortuous local structures. Subsequently, we propose a multi-view feature fusion strategy to complement the attention to features from multiple perspectives during feature fusion, ensuring the retention of important information from different global morphologies. Finally, a continuity constraint loss function, based on persistent homology, is proposed to constrain the topological continuity of the segmentation better. Experiments on 2D and 3D datasets show that our DSCNet provides better accuracy and continuity on the tubular structure segmentation task compared with several methods. Our codes are publicly available1.

Accurate coronary lumen segmentation on coronary-computed tomography angiography (CCTA) images is crucial for quantification of coronary stenosis and the subsequent computation of fractional flow reserve. Many factors including difficulty in labeling coronary lumens, various morphologies in stenotic lesions, thin structures and small volume ratio with respect to the imaging field complicate the task. In this work, we fused the continuity topological information of centerlines which are easily accessible, and proposed a novel weakly supervised model, Examinee-Examiner Network (EE-Net), to overcome the challenges in automatic coronary lumen segmentation. First, the EE-Net was proposed to address the fracture in segmentation caused by stenoses by combining the semantic features of lumens and the geometric constraints of continuous topology obtained from the centerlines. Then, a Centerline Gaussian Mask Module was proposed to deal with the insensitiveness of the network to the centerlines. Subsequently, a weakly supervised learning strategy, Examinee-Examiner Learning, was proposed to handle the weakly supervised situation with few lumen labels by using our EE-Net to guide and constrain the segmentation with customized prior conditions. Finally, a general network layer, Drop Output Layer, was proposed to adapt to the class imbalance by dropping well-segmented regions and weights the classes dynamically. Extensive experiments on two different data sets demonstrated that our EE-Net has good continuity and generalization ability on coronary lumen segmentation task compared with several widely used CNNs such as 3D-UNet. The results revealed our EE-Net with great potential for achieving accurate coronary lumen segmentation in patients with coronary artery disease. Code at http://github.com/qiyaolei/Examinee-Examiner-Network.