Novel-view X-ray Projection Synthesis through Geometry-Integrated Deep Learning

X-ray imaging plays a crucial role in the medical field, providing essential insights into the internal anatomy of patients for diagnostics, image-guided procedures, and clinical decision-making. Traditional techniques often require multiple X-ray projections from various angles to obtain a comprehensive view, leading to increased radiation exposure and more complex clinical processes. This paper explores an innovative approach using the DL-GIPS model, which synthesizes X-ray projections from new viewpoints by leveraging a single existing projection. The model strategically manipulates geometry and texture features extracted from an initial projection to match new viewing angles. It then synthesizes the final projection by merging these modified geometry features with consistent texture information through an advanced image generation process. We demonstrate the effectiveness and broad applicability of the DL-GIPS framework through lung imaging examples, highlighting its potential to revolutionize stereoscopic and volumetric imaging by minimizing the need for extensive data acquisition.

A Category-Fragment Segmentation Framework for Pelvic Fracture Segmentation in X-ray Images

Pelvic fractures, often caused by high-impact trauma, frequently require surgical intervention. Imaging techniques such as CT and 2D X-ray imaging are used to transfer the surgical plan to the operating room through image registration, enabling quick intraoperative adjustments. Specifically, segmenting pelvic fractures from 2D X-ray imaging can assist in accurately positioning bone fragments and guiding the placement of screws or metal plates. In this study, we propose a novel deep learning-based category and fragment segmentation (CFS) framework for the automatic segmentation of pelvic bone fragments in 2D X-ray images. The framework consists of three consecutive steps: category segmentation, fragment segmentation, and post-processing. Our best model achieves an IoU of 0.91 for anatomical structures and 0.78 for fracture segmentation. Results demonstrate that the CFS framework is effective and accurate.

Benchmark of Segmentation Techniques for Pelvic Fracture in CT and X-ray: Summary of the PENGWIN 2024 Challenge

The segmentation of pelvic fracture fragments in CT and X-ray images is crucial for trauma diagnosis, surgical planning, and intraoperative guidance. However, accurately and efficiently delineating the bone fragments remains a significant challenge due to complex anatomy and imaging limitations. The PENGWIN challenge, organized as a MICCAI 2024 satellite event, aimed to advance automated fracture segmentation by benchmarking state-of-the-art algorithms on these complex tasks. A diverse dataset of 150 CT scans was collected from multiple clinical centers, and a large set of simulated X-ray images was generated using the DeepDRR method. Final submissions from 16 teams worldwide were evaluated under a rigorous multi-metric testing scheme. The top-performing CT algorithm achieved an average fragment-wise intersection over union (IoU) of 0.930, demonstrating satisfactory accuracy. However, in the X-ray task, the best algorithm attained an IoU of 0.774, highlighting the greater challenges posed by overlapping anatomical structures. Beyond the quantitative evaluation, the challenge revealed methodological diversity in algorithm design. Variations in instance representation, such as primary-secondary classification versus boundary-core separation, led to differing segmentation strategies. Despite promising results, the challenge also exposed inherent uncertainties in fragment definition, particularly in cases of incomplete fractures. These findings suggest that interactive segmentation approaches, integrating human decision-making with task-relevant information, may be essential for improving model reliability and clinical applicability.