Pulmonary hypertension (PH) is a fatal pulmonary vascular disease. The standard diagnosis of PH heavily relies on an invasive technique, i.e., right heart catheterization, which leads to a delay in diagnosis and serious consequences. Noninvasive approaches are crucial for detecting PH as early as possible; however, it remains a challenge, especially in detecting mild PH patients. To address this issue, we present a new fully automated framework, hereinafter referred to as PHNet, for noninvasively detecting PH patients, especially improving the detection accuracy of mild PH patients, based on cine cardiac magnetic resonance (CMR) images. The PHNet framework employs a hybrid strategy of adaptive triplet and binary cross-entropy losses (HSATBCL) to enhance discriminative feature learning for classifying PH and non-PH. Triplet pairs in HSATBCL are created using a semi-hard negative mining strategy which maintains the stability of the training process. Experiments show that the detection error rate of PHNet for mild PH is reduced by 24.5% on average compared to state-of-the-art PH detection models. The hybrid strategy can effectively improve the model's ability to detect PH, making PHNet achieve an average area under the curve (AUC) of 0.964, an accuracy of 0.912, and an F1-score of 0.884 in the internal validation dataset. In the external testing dataset, PHNet achieves an average AUC value of 0.828. Thus, PHNet has great potential for noninvasively detecting PH based on cine CMR images in clinical practice. Future research could explore more clinical information and refine feature extraction to further enhance the network performance.

Supervised deep-learning techniques with paired training datasets have been widely studied for low-dose computed tomography (LDCT) imaging with excellent performance. However, the paired training datasets are usually difficult to obtain in clinical routine, which restricts the wide adoption of supervised deep-learning techniques in clinical practices. To address this issue, a general idea is to construct a pseudo paired training dataset based on the widely available unpaired data, after which, supervised deep-learning techniques can be adopted for improving the LDCT imaging performance by training on the pseudo paired training dataset. However, due to the complexity of noise properties in CT imaging, the LDCT data are difficult to generate in order to construct the pseudo paired training dataset. In this article, we propose a simple yet effective cross-domain unpaired learning framework for pseudo LDCT data generation and LDCT image reconstruction, which is denoted as CrossDuL. Specifically, a dedicated pseudo LDCT sinogram generative module is constructed based on a data-dependent noise model in the sinogram domain, and then instead of in the sinogram domain, a pseudo paired dataset is constructed in the image domain to train an LDCT image restoration module. To validate the effectiveness of the proposed framework, clinical datasets are adopted. Experimental results demonstrate that the CrossDuL framework can obtain promising LDCT imaging performance in both quantitative and qualitative measurements.

The lumen of aortic dissection (AD) has important clinical value for preoperative diagnosis, interoperative intervention, and post-operative evaluation of AD diseases. AD segmentation is challenging because (i) fitting its irregular profile by using traditional models is difficult, and (ii) the size of the AD image is usually so big that many algorithms have to perform down-sampling to reduce the computational burden, thereby reducing the resolution of the result. In this paper, an automatic AD segmentation algorithm, in which a 3D mesh is gradually moved to the surface of AD based on the offset estimated by a deep mesh deformation module, is presented. AD morphology is used to constrain the initial mesh and guide the deformation, which improves the efficiency of the deep network and avoids down-sampling. Moreover, a stepwise regression strategy is introduced to solve the mesh folding problem and improve the uniformity of the mesh points. On an AD database that involves 35 images, the proposed method obtains the mean Dice of 94.12% and symmetric 95% Hausdorff distance of 2.85 mm, which outperforms five state-of-the-art AD segmentation methods. The average processing time is 16.6 s, and the memory used to train the network is only 0.36 GB, indicating that this method is easy to apply in clinical practice.

Automatic estimation of indices from medical images is the main goal of computer-aided quantification (CADq), which speeds up diagnosis and lightens the workload of radiologists. Deep learning technique is a good choice for implementing CADq. Usually, to acquire high-accuracy quantification, specific network architecture needs to be designed for a given CADq task. In this study, considering that the target organs are the intervertebral disc and the dural sac, we propose an object-specific bi-path network (OSBP-Net) for axial spine image quantification. Each path of the OSBP-Net comprises a shallow feature extraction layer (SFE) and a deep feature extraction sub-network (DFE). The SFEs use different convolution strides because the two target organs have different anatomical sizes. The DFEs use average pooling for downsampling based on the observation that the target organs have lower intensity than the background. In addition, an inter-path dissimilarity constraint is proposed and applied to the output of the SFEs, taking into account that the activated regions in the feature maps of two paths should be different theoretically. An inter-index correlation regularization is introduced and applied to the output of the DFEs based on the observation that the diameter and area of the same object express an approximately linear relation. The prediction results of OSBP-Net are compared to several state-of-the-art machine learning-based CADq methods. The comparison reveals that the proposed methods precede other competing methods extensively, indicating its great potential for spine CADq.

Spine parsing (i.e., multi-class segmentation of vertebrae and intervertebral discs (IVDs)) for volumetric magnetic resonance (MR) image plays a significant role in various spinal disease diagnoses and treatments of spine disorders, yet is still a challenge due to the inter-class similarity and intra-class variation of spine images. Existing fully convolutional network based methods failed to explicitly exploit the dependencies between different spinal structures. In this article, we propose a novel two-stage framework named SpineParseNet to achieve automated spine parsing for volumetric MR images. The SpineParseNet consists of a 3D graph convolutional segmentation network (GCSN) for 3D coarse segmentation and a 2D residual U-Net (ResUNet) for 2D segmentation refinement. In 3D GCSN, region pooling is employed to project the image representation to graph representation, in which each node representation denotes a specific spinal structure. The adjacency matrix of the graph is designed according to the connection of spinal structures. The graph representation is evolved by graph convolutions. Subsequently, the proposed region unpooling module re-projects the evolved graph representation to a semantic image representation, which facilitates the 3D GCSN to generate reliable coarse segmentation. Finally, the 2D ResUNet refines the segmentation. Experiments on T2-weighted volumetric MR images of 215 subjects show that SpineParseNet achieves impressive performance with mean Dice similarity coefficients of 87.32 ± 4.75%, 87.78 ± 4.64%, and 87.49 ± 3.81% for the segmentations of 10 vertebrae, 9 IVDs, and all 19 spinal structures respectively. The proposed method has great potential in clinical spinal disease diagnoses and treatments.

Automatic estimation of axial spine indices is clinically desired for various spine computer aided procedures, such as disease diagnosis, therapeutic evaluation, pathophysiological understanding, risk assessment, and biomechanical modeling. Currently, the spine indices are manually measured by physicians, which is time-consuming and laborious. Even worse, the tedious manual procedure might result in inaccurate measurement. To deal with this problem, in this paper, we aim at developing an automatic method to estimate multiple indices from axial spine images. Inspired by the success of deep learning for regression problems and the densely connected network for image classification, we propose a dense enhancing network (DE-Net) which uses the dense enhancing blocks (DEBs) as its main body, where a feature enhancing layer is added to each of the bypass in a dense block. The DEB is designed to enhance discriminative feature embedding from the intervertebral disc and the dural sac areas. In addition, the cross-space distance-preserving regularization (CSDPR), which enforces consistent inter-sample distances between the output and the label spaces, is proposed to regularize the loss function of the DE-Net. To train and validate the proposed method, we collected 895 axial spine MRI images from 143 subjects and manually measured the indices as the ground truth. The results show that all deep learning models obtain very small prediction errors, and the proposed DE-Net with CSDPR acquires the smallest error among all methods, indicating that our method has great potential for spine computer aided procedures.

Hippocampus segmentation plays a significant role in mental disease diagnoses, such as Alzheimer's disease, epilepsy, and so on. Patch-based multi-atlas segmentation (PBMAS) approach is a popular method for hippocampus segmentation and has achieved a promising result. However, the PBMAS approach needs high computation cost due to registration and the segmentation accuracy is subject to the registration accuracy. In this paper, we propose a novel method based on iterative local linear mapping (ILLM) with the representative and local structure-preserved feature embedding to achieve accurate and robust hippocampus segmentation with no need for registration. In the proposed approach, semi-supervised deep autoencoder (SSDA) exploits unsupervised deep autoencoder and local structure-preserved manifold regularization to nonlinearly transform the extracted magnetic resonance (MR) patch to embedded feature manifold, whose adjacent relationship is similar to the signed distance map (SDM) patch manifold. Local linear mapping is used to preliminarily predict SDM patch corresponding to the MR patch. Subsequently, threshold segmentation generates a preliminary segmentation. The ILLM refines the segmentation result iteratively by ensuring the local constraints of embedded feature manifold and SDM patch manifold using a space-constrained dictionary update. Thus, a refined segmentation is obtained with no need for registration. The experiments on 135 subjects from ADNI dataset show that the proposed approach is superior to the state-of-the-art PBMAS and classification-based approaches with mean Dice similarity coefficients of 0.8852±0.0203 and 0.8783 ± 0.0251 for bilateral hippocampus segmentation of 1.5T and 3.0T datasets, respectively.