Mortality Prediction of Pulmonary Embolism Patients with Deep Learning and XGBoost

Pulmonary Embolism (PE) is a serious cardiovascular condition that remains a leading cause of mortality and critical illness, underscoring the need for enhanced diagnostic strategies. Conventional clinical methods have limited success in predicting 30-day in-hospital mortality of PE patients. In this study, we present a new algorithm, called PEP-Net, for 30-day mortality prediction of PE patients based on the initial imaging data (CT) that opportunistically integrates a 3D Residual Network (3DResNet) with Extreme Gradient Boosting (XGBoost) algorithm with patient level binary labels without annotations of the emboli and its extent. Our proposed system offers a comprehensive prediction strategy by handling class imbalance problems, reducing overfitting via regularization, and reducing the prediction variance for more stable predictions. PEP-Net was tested in a cohort of 193 volumetric CT scans diagnosed with Acute PE, and it demonstrated a superior performance by significantly outperforming baseline models (76-78\%) with an accuracy of 94.5\% (+/-0.3) and 94.0\% (+/-0.7) when the input image is either lung region (Lung-ROI) or heart region (Cardiac-ROI). Our results advance PE prognostics by using only initial imaging data, setting a new benchmark in the field. While purely deep learning models have become the go-to for many medical classification (diagnostic) tasks, combined ResNet and XGBoost models herein outperform sole deep learning models due to a potential reason for having lack of enough data.

IPMN Risk Assessment under Federated Learning Paradigm

Accurate classification of Intraductal Papillary Mucinous Neoplasms (IPMN) is essential for identifying high-risk cases that require timely intervention. In this study, we develop a federated learning framework for multi-center IPMN classification utilizing a comprehensive pancreas MRI dataset. This dataset includes 653 T1-weighted and 656 T2-weighted MRI images, accompanied by corresponding IPMN risk scores from 7 leading medical institutions, making it the largest and most diverse dataset for IPMN classification to date. We assess the performance of DenseNet-121 in both centralized and federated settings for training on distributed data. Our results demonstrate that the federated learning approach achieves high classification accuracy comparable to centralized learning while ensuring data privacy across institutions. This work marks a significant advancement in collaborative IPMN classification, facilitating secure and high-accuracy model training across multiple centers.

A New Logic For Pediatric Brain Tumor Segmentation

In this paper, we present a novel approach for segmenting pediatric brain tumors using a deep learning architecture, inspired by expert radiologists' segmentation strategies. Our model delineates four distinct tumor labels and is benchmarked on a held-out PED BraTS 2024 test set (i.e., pediatric brain tumor datasets introduced by BraTS). Furthermore, we evaluate our model's performance against the state-of-the-art (SOTA) model using a new external dataset of 30 patients from CBTN (Children's Brain Tumor Network), labeled in accordance with the PED BraTS 2024 guidelines. We compare segmentation outcomes with the winning algorithm from the PED BraTS 2023 challenge as the SOTA model. Our proposed algorithm achieved an average Dice score of 0.642 and an HD95 of 73.0 mm on the CBTN test data, outperforming the SOTA model, which achieved a Dice score of 0.626 and an HD95 of 84.0 mm. Our results indicate that the proposed model is a step towards providing more accurate segmentation for pediatric brain tumors, which is essential for evaluating therapy response and monitoring patient progress.

Adaptive Aggregation Weights for Federated Segmentation of Pancreas MRI

Federated learning (FL) enables collaborative model training across institutions without sharing sensitive data, making it an attractive solution for medical imaging tasks. However, traditional FL methods, such as Federated Averaging (FedAvg), face difficulties in generalizing across domains due to variations in imaging protocols and patient demographics across institutions. This challenge is particularly evident in pancreas MRI segmentation, where anatomical variability and imaging artifacts significantly impact performance. In this paper, we conduct a comprehensive evaluation of FL algorithms for pancreas MRI segmentation and introduce a novel approach that incorporates adaptive aggregation weights. By dynamically adjusting the contribution of each client during model aggregation, our method accounts for domain-specific differences and improves generalization across heterogeneous datasets. Experimental results demonstrate that our approach enhances segmentation accuracy and reduces the impact of domain shift compared to conventional FL methods while maintaining privacy-preserving capabilities. Significant performance improvements are observed across multiple hospitals (centers).

A Novel Momentum-Based Deep Learning Techniques for Medical Image Classification and Segmentation

Accurately segmenting different organs from medical images is a critical prerequisite for computer-assisted diagnosis and intervention planning. This study proposes a deep learning-based approach for segmenting various organs from CT and MRI scans and classifying diseases. Our study introduces a novel technique integrating momentum within residual blocks for enhanced training dynamics in medical image analysis. We applied our method in two distinct tasks: segmenting liver, lung, & colon data and classifying abdominal pelvic CT and MRI scans. The proposed approach has shown promising results, outperforming state-of-the-art methods on publicly available benchmarking datasets. For instance, in the lung segmentation dataset, our approach yielded significant enhancements over the TransNetR model, including a 5.72% increase in dice score, a 5.04% improvement in mean Intersection over Union (mIoU), an 8.02% improvement in recall, and a 4.42% improvement in precision. Hence, incorporating momentum led to state-of-the-art performance in both segmentation and classification tasks, representing a significant advancement in the field of medical imaging.

Towards Synergistic Deep Learning Models for Volumetric Cirrhotic Liver Segmentation in MRIs

Liver cirrhosis, a leading cause of global mortality, requires precise segmentation of ROIs for effective disease monitoring and treatment planning. Existing segmentation models often fail to capture complex feature interactions and generalize across diverse datasets. To address these limitations, we propose a novel synergistic theory that leverages complementary latent spaces for enhanced feature interaction modeling. Our proposed architecture, nnSynergyNet3D integrates continuous and discrete latent spaces for 3D volumes and features auto-configured training. This approach captures both fine-grained and coarse features, enabling effective modeling of intricate feature interactions. We empirically validated nnSynergyNet3D on a private dataset of 628 high-resolution T1 abdominal MRI scans from 339 patients. Our model outperformed the baseline nnUNet3D by approximately 2%. Additionally, zero-shot testing on healthy liver CT scans from the public LiTS dataset demonstrated superior cross-modal generalization capabilities. These results highlight the potential of synergistic latent space models to improve segmentation accuracy and robustness, thereby enhancing clinical workflows by ensuring consistency across CT and MRI modalities.

Optimizing Synthetic Data for Enhanced Pancreatic Tumor Segmentation

Pancreatic cancer remains one of the leading causes of cancer-related mortality worldwide. Precise segmentation of pancreatic tumors from medical images is a bottleneck for effective clinical decision-making. However, achieving a high accuracy is often limited by the small size and availability of real patient data for training deep learning models. Recent approaches have employed synthetic data generation to augment training datasets. While promising, these methods may not yet meet the performance benchmarks required for real-world clinical use. This study critically evaluates the limitations of existing generative-AI based frameworks for pancreatic tumor segmentation. We conduct a series of experiments to investigate the impact of synthetic \textit{tumor size} and \textit{boundary definition} precision on model performance. Our findings demonstrate that: (1) strategically selecting a combination of synthetic tumor sizes is crucial for optimal segmentation outcomes, and (2) generating synthetic tumors with precise boundaries significantly improves model accuracy. These insights highlight the importance of utilizing refined synthetic data augmentation for enhancing the clinical utility of segmentation models in pancreatic cancer decision making including diagnosis, prognosis, and treatment plans. Our code will be available at https://github.com/lkpengcs/SynTumorAnalyzer.

Large-Scale Multi-Center CT and MRI Segmentation of Pancreas with Deep Learning

Automated volumetric segmentation of the pancreas on cross-sectional imaging is needed for diagnosis and follow-up of pancreatic diseases. While CT-based pancreatic segmentation is more established, MRI-based segmentation methods are understudied, largely due to a lack of publicly available datasets, benchmarking research efforts, and domain-specific deep learning methods. In this retrospective study, we collected a large dataset (767 scans from 499 participants) of T1-weighted (T1W) and T2-weighted (T2W) abdominal MRI series from five centers between March 2004 and November 2022. We also collected CT scans of 1,350 patients from publicly available sources for benchmarking purposes. We developed a new pancreas segmentation method, called PanSegNet, combining the strengths of nnUNet and a Transformer network with a new linear attention module enabling volumetric computation. We tested PanSegNet's accuracy in cross-modality (a total of 2,117 scans) and cross-center settings with Dice and Hausdorff distance (HD95) evaluation metrics. We used Cohen's kappa statistics for intra and inter-rater agreement evaluation and paired t-tests for volume and Dice comparisons, respectively. For segmentation accuracy, we achieved Dice coefficients of 88.3% (std: 7.2%, at case level) with CT, 85.0% (std: 7.9%) with T1W MRI, and 86.3% (std: 6.4%) with T2W MRI. There was a high correlation for pancreas volume prediction with R^2 of 0.91, 0.84, and 0.85 for CT, T1W, and T2W, respectively. We found moderate inter-observer (0.624 and 0.638 for T1W and T2W MRI, respectively) and high intra-observer agreement scores. All MRI data is made available at https://osf.io/kysnj/. Our source code is available at https://github.com/NUBagciLab/PaNSegNet.

MDNet: Multi-Decoder Network for Abdominal CT Organs Segmentation

Accurate segmentation of organs from abdominal CT scans is essential for clinical applications such as diagnosis, treatment planning, and patient monitoring. To handle challenges of heterogeneity in organ shapes, sizes, and complex anatomical relationships, we propose a \textbf{\textit{\ac{MDNet}}}, an encoder-decoder network that uses the pre-trained \textit{MiT-B2} as the encoder and multiple different decoder networks. Each decoder network is connected to a different part of the encoder via a multi-scale feature enhancement dilated block. With each decoder, we increase the depth of the network iteratively and refine segmentation masks, enriching feature maps by integrating previous decoders' feature maps. To refine the feature map further, we also utilize the predicted masks from the previous decoder to the current decoder to provide spatial attention across foreground and background regions. MDNet effectively refines the segmentation mask with a high dice similarity coefficient (DSC) of 0.9013 and 0.9169 on the Liver Tumor segmentation (LiTS) and MSD Spleen datasets. Additionally, it reduces Hausdorff distance (HD) to 3.79 for the LiTS dataset and 2.26 for the spleen segmentation dataset, underscoring the precision of MDNet in capturing the complex contours. Moreover, \textit{\ac{MDNet}} is more interpretable and robust compared to the other baseline models.

Detection of Peri-Pancreatic Edema using Deep Learning and Radiomics Techniques

Identifying peri-pancreatic edema is a pivotal indicator for identifying disease progression and prognosis, emphasizing the critical need for accurate detection and assessment in pancreatitis diagnosis and management. This study \textit{introduces a novel CT dataset sourced from 255 patients with pancreatic diseases, featuring annotated pancreas segmentation masks and corresponding diagnostic labels for peri-pancreatic edema condition}. With the novel dataset, we first evaluate the efficacy of the \textit{LinTransUNet} model, a linear Transformer based segmentation algorithm, to segment the pancreas accurately from CT imaging data. Then, we use segmented pancreas regions with two distinctive machine learning classifiers to identify existence of peri-pancreatic edema: deep learning-based models and a radiomics-based eXtreme Gradient Boosting (XGBoost). The LinTransUNet achieved promising results, with a dice coefficient of 80.85\%, and mIoU of 68.73\%. Among the nine benchmarked classification models for peri-pancreatic edema detection, \textit{Swin-Tiny} transformer model demonstrated the highest recall of $98.85 \pm 0.42$ and precision of $98.38\pm 0.17$. Comparatively, the radiomics-based XGBoost model achieved an accuracy of $79.61\pm4.04$ and recall of $91.05\pm3.28$, showcasing its potential as a supplementary diagnostic tool given its rapid processing speed and reduced training time. Our code is available \url{https://github.com/NUBagciLab/Peri-Pancreatic-Edema-Detection}.