Traditional CT image acquisition uses bowtie filters to reduce dose, x-ray scatter, and detector dynamic range requirements. However, accurate patient centering within the bore of the CT scanner takes time and is often difficult to achieve precisely. Patient miscentering combined with a static bowtie filter can result in significant increases in dose, reconstruction noise, and CT number variations, and consequently raise overall exposure requirements. Approaches to estimate the patient position from scout scans and perform dynamic spatial beam filtration during acquisition are developed and applied in physical experiments on a CT test bench using different beam filtration strategies. While various dynamic beam modulation strategies have been developed, we focus on two approaches: (1) a simple approach using attenuation-based beam modulation using a translating bowtie filter and (2) dynamic beam modulation using multiple aperture devices (MADs)—an emerging beam filtration strategy based on binary filtration of the x-ray beam using variable width slits in a high-density beam blocker. Improved dose utilization and more consistent image performance with respect to an unmodulated baseline (static filter) are demonstrated for miscentered objects and dynamic beam filtration in physical experiments. For a homogeneous object miscentered by 4 cm, the dynamic filter reduced the maximum regional noise and dose penalties (compared with a centered object) from 173% to 16% and 42% to 14%, respectively, for a traditional bowtie, 29% to 8% and 24% to 15%, respectively, for a single MAD, and 275% to 11% and 56% to 18%, respectively, for a dual-MAD filter. The proposed methodology has the potential to relax patient centering requirements within the scanner, reduce setup time, and facilitate additional CT dose reduction.

Photon counting detectors (PCD) have the potential to improve x-ray imaging; however, they are still hindered by high costs and performance limitations. By using amorphous selenium (a-Se), the cost of PCDs can be significantly reduced compared with modern crystalline semiconductors, and enable large-area deposition. We are developing a direct conversion field-shaping multiwell avalanche detector (SWAD) to overcome the limitation of low carrier mobility and low charge conversion gain in a-Se. SWAD’s dual-grid design creates separate nonavalanche interaction (bulk) and avalanche sensing (well) regions, achieving depth-independent avalanche gain. Unipolar time differential (UTD) charge sensing, combined with tunable avalanche gain in the well region allows for fast response and high charge gain. We developed a probability-based numerical simulation to investigate the impact of UTD charge sensing and avalanche gain on the photon counting performance of different a-Se detector configurations. Pulse height spectra (PHS) for 59.5 and 30 keV photons were simulated. We observed excellent agreement between our model and previously published PHS measurements for a planar detector. The energy resolution significantly improved from 33 keV for the planar detector to ∼7  keV for SWAD. SWAD was found to have a linear response approaching 200  kcps  /  pixel.

We assess the performance of a cadmium zinc telluride (CZT)-based Medipix3RX energy-resolving and photon-counting x-ray detector as a candidate for spectral microcomputed tomography (micro-CT) imaging. It features an array of 128  ×  128, 110-μm² pixels, each with four simultaneous threshold counters that utilize real-time charge summing. Each pixel’s response is assessed by imaging with a range of incident x-ray intensities and detector integration times. Energy-related assessments are made by exposing the detector to the emission from an I-125 radioisotope brachytherapy seed. Long-term stability is assessed by repeating identical exposures over the course of 1 h. The high yield of properly functioning pixels (98.8%), long-term stability (linear regression of whole-chip response over 1 h of acquisitions: y  =    −  0.0038x  +  2284; standard deviation: 3.7 counts), and energy resolution [2.5 keV full-width half-maximum (FWHM) (single pixel), 3.7 keV FWHM (across the full image)] make this device suitable for spectral micro-CT.

We develop a learning-based method to generate patient-specific pseudo computed tomography (CT) from routinely acquired magnetic resonance imaging (MRI) for potential MRI-based radiotherapy treatment planning. The proposed pseudo CT (PCT) synthesis method consists of a training stage and a synthesizing stage. During the training stage, patch-based features are extracted from MRIs. Using a feature selection, the most informative features are identified as an anatomical signature to train a sequence of alternating random forests based on an iterative refinement model. During the synthesizing stage, we feed the anatomical signatures extracted from an MRI into the sequence of well-trained forests for a PCT synthesis. Our PCT was compared with original CT (ground truth) to quantitatively assess the synthesis accuracy. The mean absolute error, peak signal-to-noise ratio, and normalized cross-correlation indices were 60.87  ±  15.10  HU, 24.63  ±  1.73  dB, and 0.954  ±  0.013 for 14 patients’ brain data and 29.86  ±  10.4  HU, 34.18  ±  3.31  dB, and 0.980  ±  0.025 for 12 patients’ pelvic data, respectively. We have investigated a learning-based approach to synthesize CTs from routine MRIs and demonstrated its feasibility and reliability. The proposed PCT synthesis technique can be a useful tool for MRI-based radiation treatment planning.

The purpose of this study is to understand the phenotypes of thyroid eye disease (TED) through data derived from a multiatlas segmentation of computed tomography (CT) imaging. Images of 170 orbits of 85 retrospectively selected TED patients were analyzed with the developed automated segmentation tool. Twenty-five bilateral orbital structural metrics were used to perform principal component analysis (PCA). PCA of the 25 structural metrics identified the two most dominant structural phenotypes or characteristics, the “big volume phenotype” and the “stretched optic nerve phenotype,” that accounted for 60% of the variance. Most of the subjects in the study have either of these characteristics or a combination of both. A Kendall rank correlation between the principal components (phenotypes) and clinical data showed that the big volume phenotype was very strongly correlated (p-value <0.05) with motility defects, and loss of visual acuity. Whereas, the stretched optic nerve phenotype was strongly correlated (p-value <0.05) with an increased Hertel measurement, relatively better visual acuity, and smoking. Two clinical subtypes of TED, type 1 with enlarged muscles and type 2 with proptosis, are recognizable in CT imaging. Our automated algorithm identifies the phenotypes and finds associations with clinical markers.

Understanding the behavior of cells is an important problem for biologists. Significant research has been done to facilitate this by automating the segmentation of microscopic cellular images. Bright-field images of cells prove to be particularly difficult to segment, due to features such as low contrast, missing boundaries, and broken halos. We present two algorithms for automated segmentation of cellular images. These algorithms are based on a graph-partitioning approach, where each pixel is modeled as a node of a weighted graph. The method combines an effective region force with the Laplacian and total variation boundary forces, respectively, to give the two models. This region force can be interpreted as a conditional probability of a pixel belonging to a certain class (cell or background) given a small set of already labeled pixels. For practicality, we use a small set of only background pixels from the border of cell images as the labeled set. Both algorithms are tested on bright-field images to give good results. Due to faster performance, the Laplacian-based algorithm is also tested on a variety of other datasets, including fluorescent images, phase-contrast images, and 2-D and 3-D simulated images. The results show that the algorithm performs well and consistently across a range of various cell image features, such as the cell shape, size, contrast, and noise levels.

Glaucoma is a progressive optic neuropathy characterized by peripheral visual field loss, which is caused by degeneration of retinal nerve fibers. The peripheral vision loss due to glaucoma is asymptomatic. If not detected and treated at an early stage, it leads to complete blindness, which is irreversible in nature. The retinal nerve fiber layer defect (RNFLD) provides an earliest objective evidence of glaucoma. In this regard, we explore cost-effective redfree fundus imaging for RNFLD detection to be practically useful for computer-assisted early glaucoma risk assessment. RNFLD appears as a wedge shaped arcuate structure radiating from the optic disc. The very low contrast between RNFLD and background makes its visual detection quite challenging even by medical experts. In our study, we formulate a deep convolutional neural network (CNN) based patch classification strategy for RNFLD boundary localization. A large number of RNFLD and background image patches train the deep CNN model, which extracts sufficient discriminative information from the patches and results in accurate RNFLD boundary pixel classification. The proposed approach is found to achieve enhanced RNFLD detection performance with sensitivity of 0.8205 and false positive per image of 0.2000 on a newly created early glaucomatic fundus image database.

Ultrasound images acquired during axillary nerve block procedures can be difficult to interpret. Highlighting the important structures, such as nerves and blood vessels, may be useful for the training of inexperienced users. A deep convolutional neural network is used to identify the musculocutaneous, median, ulnar, and radial nerves, as well as the blood vessels in ultrasound images. A dataset of 49 subjects is collected and used for training and evaluation of the neural network. Several image augmentations, such as rotation, elastic deformation, shadows, and horizontal flipping, are tested. The neural network is evaluated using cross validation. The results showed that the blood vessels were the easiest to detect with a precision and recall above 0.8. Among the nerves, the median and ulnar nerves were the easiest to detect with an F-score of 0.73 and 0.62, respectively. The radial nerve was the hardest to detect with an F-score of 0.39. Image augmentations proved effective, increasing F-score by as much as 0.13. A Wilcoxon signed-rank test showed that the improvement from rotation, shadow, and elastic deformation augmentations were significant and the combination of all augmentations gave the best result. The results are promising; however, there is more work to be done, as the precision and recall are still too low. A larger dataset is most likely needed to improve accuracy, in combination with anatomical and temporal models.

The aim of this study is to investigate the benefits of incorporating prior information in list mode, time-of-flight (TOF) positron emission tomography (PET) image reconstruction using the ordered subset expectation maximization (OSEM) algorithm. This investigation consists of an IEC phantom study and a patient study. For the image under reconstruction, the activity profile along a line of response is treated as a priori and is combined with the TOF measurement to define a belief kernel used for forward and backward projections during the OSEM image reconstruction. Activity profiles are smoothed and combined with the TOF kernels to control the adverse impact of noise, and different levels of smoothness are attempted. The standard TOF OSEM reconstruction is used as a baseline for comparison. Image quality is assessed using a combination of visual assessment and quantitative measurement including contrast recovery coefficients (CRC) and background variability. On the IEC phantom study, the reconstruction using belief kernels converges faster and the reconstructed images are more appealing. The CRCs for all sizes of regions of interest on images reconstructed with belief kernels are higher than those of the baseline. The background variability, measured as a coefficient of variation, is generally lower for the images reconstructed using belief kernels. Similar observations occur on the patient study. Particularly, the images reconstructed using belief kernels have better defined lesions, improved contrast, and reduced background noise. OSEM PET image reconstruction using belief kernels that combine the information from prior images and TOF measurements seems promising and worth further investigation.

Biomedical imaging when combined with digital image analysis is capable of quantitative morphological and physiological characterizations of biological structures. Recent fluorescence microscopy techniques can collect hundreds of focal plane images from deeper tissue volumes, thus enabling characterization of three-dimensional (3-D) biological structures at subcellular resolution. Automatic analysis methods are required to obtain quantitative, objective, and reproducible measurements of biological quantities. However, these images typically contain many artifacts such as poor edge details, nonuniform brightness, and distortions that vary along different axes, all of which complicate the automatic image analysis. Another challenge is due to “multitarget labeling,” in which a single probe labels multiple biological entities in acquired images. We present a “jelly filling” method for segmentation of 3-D biological images containing multitarget labeling. Intuitively, our iterative segmentation method is based on filling disjoint tubule regions of an image with a jelly-like fluid. This helps in the detection of components that are “floating” within a labeled jelly. Experimental results show that our proposed method is effective in segmenting important biological quantities.

The amount of coronary artery calcification (CAC) quantified in computed tomography (CT) scans enables prediction of cardiovascular disease (CVD) risk. However, interscan variability of CAC quantification is high, especially in scans made without ECG synchronization. We propose a method for automatic detection of CACs that are severely affected by cardiac motion. Subsequently, we evaluate the impact of such CACs on CAC quantification and CVD risk determination. This study includes 1000 baseline and 585 one-year follow-up low-dose chest CTs from the National Lung Screening Trial. About 415 baseline scans are used to train and evaluate a convolutional neural network that identifies observer determined CACs affected by severe motion artifacts. Therefore, 585 paired scans acquired at baseline and follow-up were used to evaluate the impact of severe motion artifacts on CAC quantification and risk categorization. Based on the CAC amount, the scans were categorized into four standard CVD risk categories. The method identified CACs affected by severe motion artifacts with 85.2% accuracy. Moreover, reproducibility of CAC scores in scan pairs is higher in scans containing mostly CACs not affected by severe cardiac motion. Hence, the proposed method enables identification of scans affected by severe cardiac motion, where CAC quantification may not be reproducible.

Grand challenges stimulate advances within the medical imaging research community; within a competitive yet friendly environment, they allow for a direct comparison of algorithms through a well-defined, centralized infrastructure. The tasks of the two-part PROSTATEx Challenges (the PROSTATEx Challenge and the PROSTATEx-2 Challenge) are (1) the computerized classification of clinically significant prostate lesions and (2) the computerized determination of Gleason Grade Group in prostate cancer, both based on multiparametric magnetic resonance images. The challenges incorporate well-vetted cases for training and testing, a centralized performance assessment process to evaluate results, and an established infrastructure for case dissemination, communication, and result submission. In the PROSTATEx Challenge, 32 groups apply their computerized methods (71 methods total) to 208 prostate lesions in the test set. The area under the receiver operating characteristic curve for these methods in the task of differentiating between lesions that are and are not clinically significant ranged from 0.45 to 0.87; statistically significant differences in performance among the top-performing methods, however, are not observed. In the PROSTATEx-2 Challenge, 21 groups apply their computerized methods (43 methods total) to 70 prostate lesions in the test set. When compared with the reference standard, the quadratic-weighted kappa values for these methods in the task of assigning a five-point Gleason Grade Group to each lesion range from −0.24 to 0.27; superiority to random guessing can be established for only two methods. When approached with a sense of commitment and scientific rigor, challenges foster interest in the designated task and encourage innovation in the field.

Mammographic computer-aided detection (CADe) devices are typically first developed and assessed for a specific “original” acquisition system. When developers are ready to apply their CADe device to a mammographic acquisition system, they typically assess the device with images acquired using the system. Collecting large repositories of clinical images containing verified lesion locations acquired by a system is costly and time consuming. We previously developed an image blending technique that allows users to seamlessly insert regions of interest (ROIs) from one medical image into another image. Our goal is to assess the performance of this technique for inserting microcalcification clusters from one mammogram into another, with the idea that when fully developed, our technique may be useful for reducing the clinical data burden in the assessment of a CADe device for use with an image acquisition system. We first perform a reader study to assess whether experienced observers can distinguish between computationally inserted and native clusters. For this purpose, we apply our insertion technique to 55 clinical cases. ROIs containing microcalcification clusters from one breast of a patient are inserted into the contralateral breast of the same patient. The analysis of the reader ratings using receiver operating characteristic (ROC) methodology indicates that inserted clusters cannot be reliably distinguished from native clusters (area under the ROC curve  =  0.58  ±  0.04). Furthermore, CADe sensitivity is evaluated on mammograms of 68 clinical cases with native and inserted microcalcification clusters using a commercial CADe system. The average by-case sensitivities for native and inserted clusters are equal, 85.3% (58/68). The average by-image sensitivities for native and inserted clusters are 72.3% and 67.6%, respectively, with a difference of 4.7% and a 95% confidence interval of [−2.1 11.6]. These results demonstrate the potential for using the inserted microcalcification clusters for assessing mammographic CADe devices.

The extraction of six standard planes in 3-D cardiac ultrasound plays an important role in clinical examination to analyze cardiac function. A guideline-based learning method for efficient and accurate standard plane extraction is proposed. A cardiac ultrasound guideline determines appropriate operation steps for clinical examinations. The idea of guideline-based learning is incorporating machine learning approaches into each stage of the guideline. First, Hough forest with hierarchical search is applied for 3-D feature point detection. Second, initial planes are determined using anatomical regularities according to the guideline. Finally, a regression forest integrated with constraints of plane regularities is applied for refining each plane. The proposed method was evaluated on a 3-D cardiac ultrasound dataset and a synthetic dataset. Compared with other plane extraction methods, it demonstrated an improved accuracy with a significantly faster running time of 0.8  s  /  volume. Furthermore, it showed the proposed method was robust for a range abnormalities and image qualities, which would be seen in clinical practice.

We develop neural-network-based methods for classifying plaque types in clinical intravascular optical coherence tomography (IVOCT) images of coronary arteries. A single IVOCT pullback can consist of >500 microscopic-resolution images, creating both a challenge for physician interpretation during an interventional procedure and an opportunity for automated analysis. In the proposed method, we classify each A-line, a datum element that better captures physics and pathophysiology than a voxel, as a fibrous layer followed by calcification (fibrocalcific), a fibrous layer followed by a lipidous deposit (fibrolipidic), or other. For A-line classification, the usefulness of a convolutional neural network (CNN) is compared with that of a fully connected artificial neural network (ANN). A total of 4469 image frames across 48 pullbacks that are manually labeled using consensus labeling from two experts are used for training, evaluation, and testing. A 10-fold cross-validation using held-out pullbacks is applied to assess classifier performance. Noisy A-line classifications are cleaned by applying a conditional random field (CRF) and morphological processing to pullbacks in the en-face view. With CNN (ANN) approaches, we achieve an accuracy of 77.7  %    ±  4.1  %   (79.4  %    ±  2.9  %  ) for fibrocalcific, 86.5  %    ±  2.3  %   (83.4  %    ±  2.6  %  ) for fibrolipidic, and 85.3  %    ±  2.5  %   (82.4  %    ±  2.2  %  ) for other, across all folds following CRF noise cleaning. The results without CRF cleaning are typically reduced by 10% to 15%. The enhanced performance of the CNN was likely due to spatial invariance of the convolution operation over the input A-line. The predicted en-face classification maps of entire pullbacks agree favorably to the annotated counterparts. In some instances, small error regions are actually hard to call when re-examined by human experts. Even in worst-case pullbacks, it can be argued that the results will not negatively impact usage by physicians, as there is a preponderance of correct calls.

Given the increased need for consistent quantitative image analysis, variations in radiomics feature calculations due to differences in radiomics software were investigated. Two in-house radiomics packages and two freely available radiomics packages, MaZda and IBEX, were utilized. Forty 256  ×  256-pixel regions of interest (ROIs) from 40 digital mammograms were studied along with 39 manually delineated ROIs from the head and neck (HN) computed tomography (CT) scans of 39 patients. Each package was used to calculate first-order histogram and second-order gray-level co-occurrence matrix (GLCM) features. Friedman tests determined differences in feature values across packages, whereas intraclass-correlation coefficients (ICC) quantified agreement. All first-order features computed from both mammography and HN cases (except skewness in mammography) showed significant differences across all packages due to systematic biases introduced by each package; however, based on ICC values, all but one first-order feature calculated on mammography ROIs and all but two first-order features calculated on HN CT ROIs showed excellent agreement, indicating the observed differences were small relative to the feature values but the bias was systematic. All second-order features computed from the two databases both differed significantly and showed poor agreement among packages, due largely to discrepancies in package-specific default GLCM parameters. Additional differences in radiomics features were traced to variations in image preprocessing, algorithm implementation, and naming conventions. Large variations in features among software packages indicate that increased efforts to standardize radiomics processes must be conducted.

Despite the remarkable progress that has been made to reduce global malaria mortality by 29% in the past 5 years, malaria is still a serious global health problem. Inadequate diagnostics is one of the major obstacles in fighting the disease. An automated system for malaria diagnosis can help to make malaria screening faster and more reliable. We present an automated system to detect and segment red blood cells (RBCs) and identify infected cells in Wright–Giemsa stained thin blood smears. Specifically, using image analysis and machine learning techniques, we process digital images of thin blood smears to determine the parasitemia in each smear. We use a cell extraction method to segment RBCs, in particular overlapping cells. We show that a combination of RGB color and texture features outperforms other features. We evaluate our method on microscopic blood smear images from human and mouse and show that it outperforms other techniques. For human cells, we measure an absolute error of 1.18% between the true and the automatic parasite counts. For mouse cells, our automatic counts correlate well with expert and flow cytometry counts. This makes our system the first one to work for both human and mouse.

Multiparametric magnetic resonance imaging (mpMRI) of the prostate aids in early diagnosis of prostate cancer, but is difficult to interpret and subject to interreader variability. Our objective is to generate probability maps, overlaid on original mpMRI images to help radiologists identify where a cancer is suspected as a computer-aided diagnostic (CAD). We optimized the holistically nested edge detection (HED) deep convolutional neural network. Our dataset contains T2, apparent diffusion coefficient, and high b-value images from 186 patients across six institutions worldwide: 92 with an endorectal coil (ERC) and 94 without. Ground-truth was based on tumor segmentations manually drawn by expert radiologists based on histologic evidence of cancer. The training set consisted of 120 patients and the validation set and test set included 19 and 47, respectively. Slice-level probability maps are evaluated at the lesion level of analysis. The best model: HED using 5  ×  5 convolutional kernels, batch normalization, and optimized using Adam. This CAD performed significantly better (p  <  0.001) in the peripheral zone (AUC  =  0.94  ±  0.01) than the transition zone. It outperforms a previous CAD from our group in a head-to-head comparison on the same ERC-only test cases (AUC  =  0.97  ±  0.01; p  <  0.001). Our CAD establishes a state-of-the-art performance for predicting prostate cancer lesions on mpMRIs.

Accurate tracking and localization of ultrasound (US) images are used in various computer-assisted interventions. US calibration is a preoperative procedure to recover the transformation bridging the tracking sensor and the US image coordinate systems. Although many calibration phantom designs have been proposed, a limitation that hinders the resulted calibration accuracy is US elevational beam thickness. Previous studies have proposed an active-echo (AE)-based calibration concept to overcome this limitation by utilizing dynamic active US feedback from a single PZT element-based phantom, which assists in placing the phantom within the US elevational plane. However, the process of searching elevational midplane is time-consuming and requires dedicated hardware to enable “AE” functionality. Extending this active phantom, we present a US calibration concept and associated mathematical framework enabling fast and accurate US calibration using multiple “active” points. The proposed US calibration can simplify the calibration procedure by minimizing the number of times midplane search is performed and shortening calibration time. This concept is demonstrated with a configuration mechanically tracking a US probe using a robot arm. We validated the concept through simulation and experiment, and achieved submillimeter calibration accuracy. This result indicates that the multiple active-point phantom has potential to provide superior calibration performance for applications requiring high tracking accuracy.

The purpose of this investigation is to test whether a poroelastic model with enhanced structure can capture in vivo interstitial pressure dynamics in a brain undergoing mock surgical loads. Using interstitial pressure data from a porcine study, we use an inverse model to reconstruct material properties in an effort to capture these in vivo brain tissue dynamics. Four distinct models for the reconstruction of parameters are investigated (full anatomical condition description, condition without dural septa description, condition without ventricle boundary description, and the conventional fully saturated model). These models are systematic in their development to isolate the influence of three model characteristics: the dural septa, the treatment of the ventricles, and the treatment of the brain as a saturated media. This study demonstrates that to capture appropriate pressure compartmentalization, interstitial pressure gradients, pressure transient effects, and deformations within the brain, the proposed boundary conditions and structural enhancement coupled with a heterogeneous description invoking partial saturation are needed in a biphasic poroelastic model. These findings suggest that with enhanced anatomical modeling and appropriate model assumptions, poroelastic models can be used to capture quite complex brain deformations and interstitial pressure dynamics.

Multiobjective optimization approaches for deformable image registration (DIR) remove the need for manual adjustment of key parameters and provide a set of solutions that represent high-quality trade-offs between objectives of interest. Choosing a desired outcome a posteriori is potentially far more insightful as differences between solutions can be immediately visualized. The purpose of this work is to investigate whether such an approach allows clinical experts to intuitively select their preferred DIR outcome. To this end, we developed a simplex-based tool for solution navigation and asked 10 clinical experts to use it to choose their preferred DIR outcome from sets of trade-off solutions obtained for 10 breast magnetic resonance DIR cases of low (prone-prone DIR; n  =  5) and high (prone-supine DIR; n  =  5) difficulty, of patients and volunteers, respectively. The usability of the software is subsequently evaluated by the observers using the system usability scale. Further, the quality of the selected DIR outcomes is evaluated using the mean target registration error. Results show that the users are able to identify and select high-quality DIR outcomes, and attested to high learnability and usability of our software, supporting the validity of the presumed added value of taking a multiobjective perspective on DIR in clinical practice.

The purpose of this study is to (1) develop metrics to characterize the regional anatomical complexity of the lungs, and (2) relate these metrics with lung nodule detection in chest CT. A free-scrolling reader-study with virtually inserted nodules (13 radiologists × 157 total nodules = 2041 responses) is used to characterize human detection performance. Metrics of complexity based on the local density and orientation of distracting vasculature are developed for two-dimensional (2-D) and three-dimensional (3-D) considerations of the image volume. Assessed characteristics included the distribution of 2-D/3-D vessel structures of differing orientation (dubbed “2-D/3-D and dot-like/line-like distractor indices”), contiguity of inserted nodules with local vasculature, mean local gray-level surrounding each nodule, the proportion of lung voxels to total voxels in each section, and 3-D distance of each nodule from the trachea bifurcation. A generalized linear mixed-effects statistical model is used to determine the influence of each these metrics on nodule detectability. In order of decreasing effect size: 3-D line-like distractor index, 2-D line-like distractor index, 2-D dot-like distractor index, local mean gray-level, contiguity with 2-D dots, lung area, and contiguity with 3-D lines all significantly affect detectability (P  &lt;  0.05). These data demonstrate that local lung complexity degrades detection of lung nodules.

The software “Multireader sample size program for diagnostic studies,” written by Kevin Schartz and Stephen Hillis, performs sample size computations for diagnostic reader-performance studies. The program computes the sample size needed to detect a specified difference in a reader-performance measure between two imaging modalities when using the analysis methods initially proposed by Dorfman, Berbaum, and Metz, and Obuchowski and Rockette, and later unified and improved by Hillis and colleagues. A commonly used reader-performance measure is the area under the receiver-operating-characteristic curve. The program has an easy-to-use step-by-step intuitive interface that walks the user through the entry of the needed information. It can be used with several different study designs, inference procedures, hypotheses, and input and output formats. The program is functional in Windows, OS X, and Linux. The methodology underlying the software is discussed for the most common diagnostic study design, where each reader evaluates each case using each modality.

Early detection of cancer can significantly increase the survival chances of patients. Palpation is a traditional method in order to detect cancer; however, in minimally invasive surgery the surgeon is deprived of the sense of touch. We demonstrate how shearing elastography can recover elastic parameters and furthermore can be used to localize stiffness imhomogenities even if hidden underneath the surface. Furthermore, the influence of size and depth of the stiffness imhomogenities on the detection accuracy and localization is investigated.

Magnetic particle imaging (MPI) is a highly sensitive imaging method that enables the visualization of magnetic tracer materials with a temporal resolution of more than 46 volumes per second. In MPI, the size of the field of view (FoV) scales with the strengths of the applied magnetic fields. In clinical applications, those strengths are limited by peripheral nerve stimulation, specific absorption rates, and the requirement to acquire images of high spatial resolution. Therefore, the size of the FoV is usually a few cubic centimeters. To bypass this limitation, additional focus fields and/or external object movements can be applied. The latter approach is investigated. An object is moved through the scanner bore one step at a time, whereas the MPI scanner continuously acquires data from its static FoV. Using a 3-D phantom and dynamic 3-D in vivo data, it is shown that the data from such a moving table experiment can be jointly reconstructed after reordering the data with respect to the stepwise object shifts and heart beat phases.

Atrial fibrillation is the most common cardiac arrhythmia. It is being effectively treated using the radiofrequency ablation (RFA) procedure, which destroys culprit tissue and creates scars that prevent the spread of abnormal electrical activity. Long-term success of RFA could be improved further if ablation lesions can be directly visualized during the surgery. We have shown that autofluorescence-based hyperspectral imaging (aHSI) can help to identify lesions based on spectral unmixing. We show that use of k-means clustering, an unsupervised learning method, is capable of detecting RFA lesions without a priori knowledge of the lesions’ spectral characteristics. We also show that the number of spectral bands required for successful lesion identification can be significantly reduced, enabling the use of increased spectral bandwidth. Together, these findings can help with clinical implementation of a percutaneous aHSI catheter, since by reducing the number of spectral bands one can reduce hypercube acquisition and processing times, and by increasing the spectral width of individual bands one can collect more photons. The latter is of critical importance in low-light applications such as intracardiac aHSI. The ultimate goal of our studies is to help improve clinical outcomes for atrial fibrillation patients.

Prostate cancer is the most common nonskin-related cancer, affecting one in seven men in the United States. Gleason score, a sum of the primary and secondary Gleason patterns, is one of the best predictors of prostate cancer outcomes. Recently, significant progress has been made in molecular subtyping prostate cancer through the use of genomic sequencing. It has been established that prostate cancer patients presented with a Gleason score 7 show heterogeneity in both disease recurrence and survival. We built a unified system using publicly available whole-slide images and genomic data of histopathology specimens through deep neural networks to identify a set of computational biomarkers. Using a survival model, the experimental results on the public prostate dataset showed that the computational biomarkers extracted by our approach had hazard ratio as 5.73 and C-index as 0.74, which were higher than standard clinical prognostic factors and other engineered image texture features. Collectively, the results of this study highlight the important role of neural network analysis of prostate cancer and the potential of such approaches in other precision medicine applications.