Quality Enhancement of Radiographic X-ray Images by Interpretable Mapping

X-ray imaging is the most widely used medical imaging modality. However, in the common practice, inconsistency in the initial presentation of X-ray images is a common complaint by radiologists. Different patient positions, patient habitus and scanning protocols can lead to differences in image presentations, e.g., differences in brightness and contrast globally or regionally. To compensate for this, additional work will be executed by clinical experts to adjust the images to the desired presentation, which can be time-consuming. Existing deep-learning-based end-to-end solutions can automatically correct images with promising performances. Nevertheless, these methods are hard to be interpreted and difficult to be understood by clinical experts. In this manuscript, a novel interpretable mapping method by deep learning is proposed, which automatically enhances the image brightness and contrast globally and locally. Meanwhile, because the model is inspired by the workflow of the brightness and contrast manipulation, it can provide interpretable pixel maps for explaining the motivation of image enhancement. The experiment on the clinical datasets show the proposed method can provide consistent brightness and contrast correction on X-ray images with accuracy of 24.75 dB PSNR and 0.8431 SSIM.

Automated Identification of Failure Cases in Organ at Risk Segmentation Using Distance Metrics: A Study on CT Data

Automated organ at risk (OAR) segmentation is crucial for radiation therapy planning in CT scans, but the generated contours by automated models can be inaccurate, potentially leading to treatment planning issues. The reasons for these inaccuracies could be varied, such as unclear organ boundaries or inaccurate ground truth due to annotation errors. To improve the model's performance, it is necessary to identify these failure cases during the training process and to correct them with some potential post-processing techniques. However, this process can be time-consuming, as traditionally it requires manual inspection of the predicted output. This paper proposes a method to automatically identify failure cases by setting a threshold for the combination of Dice and Hausdorff distances. This approach reduces the time-consuming task of visually inspecting predicted outputs, allowing for faster identification of failure case candidates. The method was evaluated on 20 cases of six different organs in CT images from clinical expert curated datasets. By setting the thresholds for the Dice and Hausdorff distances, the study was able to differentiate between various states of failure cases and evaluate over 12 cases visually. This thresholding approach could be extended to other organs, leading to faster identification of failure cases and thereby improving the quality of radiation therapy planning.

Pristine annotations-based multi-modal trained artificial intelligence solution to triage chest X-ray for COVID-19

The COVID-19 pandemic continues to spread and impact the well-being of the global population. The front-line modalities including computed tomography (CT) and X-ray play an important role for triaging COVID patients. Considering the limited access of resources (both hardware and trained personnel) and decontamination considerations, CT may not be ideal for triaging suspected subjects. Artificial intelligence (AI) assisted X-ray based applications for triaging and monitoring require experienced radiologists to identify COVID patients in a timely manner and to further delineate the disease region boundary are seen as a promising solution. Our proposed solution differs from existing solutions by industry and academic communities, and demonstrates a functional AI model to triage by inferencing using a single x-ray image, while the deep-learning model is trained using both X-ray and CT data. We report on how such a multi-modal training improves the solution compared to X-ray only training. The multi-modal solution increases the AUC (area under the receiver operating characteristic curve) from 0.89 to 0.93 and also positively impacts the Dice coefficient (0.59 to 0.62) for localizing the pathology. To the best our knowledge, it is the first X-ray solution by leveraging multi-modal information for the development.