Artificial Intelligence-Enhanced Couinaud Segmentation for Precision Liver Cancer Therapy

Precision therapy for liver cancer necessitates accurately delineating liver sub-regions to protect healthy tissue while targeting tumors, which is essential for reducing recurrence and improving survival rates. However, the segmentation of hepatic segments, known as Couinaud segmentation, is challenging due to indistinct sub-region boundaries and the need for extensive annotated datasets. This study introduces LiverFormer, a novel Couinaud segmentation model that effectively integrates global context with low-level local features based on a 3D hybrid CNN-Transformer architecture. Additionally, a registration-based data augmentation strategy is equipped to enhance the segmentation performance with limited labeled data. Evaluated on CT images from 123 patients, LiverFormer demonstrated high accuracy and strong concordance with expert annotations across various metrics, allowing for enhanced treatment planning for surgery and radiation therapy. It has great potential to reduces complications and minimizes potential damages to surrounding tissue, leading to improved outcomes for patients undergoing complex liver cancer treatments.

TauAD: MRI-free Tau Anomaly Detection in PET Imaging via Conditioned Diffusion Models

The emergence of tau PET imaging over the last decade has enabled Alzheimer's disease (AD) researchers to examine tau pathology in vivo and more effectively characterize the disease trajectories of AD. Current tau PET analysis methods, however, typically perform inferences on large cortical ROIs and are limited in the detection of localized tau pathology that varies across subjects. Furthermore, a high-resolution MRI is required to carry out conventional tau PET analysis, which is not commonly acquired in clinical practices and may not be acquired for many elderly patients with dementia due to strong motion artifacts, claustrophobia, or certain metal implants. In this work, we propose a novel conditional diffusion model to perform MRI-free anomaly detection from tau PET imaging data. By including individualized conditions and two complementary loss maps from pseudo-healthy and pseudo-unhealthy reconstructions, our model computes an anomaly map across the entire brain area that allows simply training a support vector machine (SVM) for classifying disease severity. We train our model on ADNI subjects (n=534) and evaluate its performance on a separate dataset from the preclinical subjects of the A4 clinical trial (n=447). We demonstrate that our method outperforms baseline generative models and the conventional Z-score-based method in anomaly localization without mis-detecting off-target bindings in sub-cortical and out-of-brain areas. By classifying the A4 subjects according to their anomaly map using the SVM trained on ADNI data, we show that our method can successfully group preclinical subjects with significantly different cognitive functions, which further demonstrates the effectiveness of our method in capturing biologically relevant anomaly in tau PET imaging.

Evolving the pulmonary nodules diagnosis from classical approaches to deep learning aided decision support: three decades development course and future prospect

Lung cancer is the commonest cause of cancer deaths worldwide, and its mortality can be reduced significantly by performing early diagnosis and screening. Since the 1960s, driven by the pressing needs to accurately and effectively interpret the massive volume of chest images generated daily, computer-assisted diagnosis of pulmonary nodule has opened up new opportunities to relax the limitation from physicians subjectivity, experiences and fatigue. It has been witnessed that significant and remarkable advances have been achieved since the 1980s, and consistent endeavors have been exerted to deal with the grand challenges on how to accurately detect the pulmonary nodules with high sensitivity at low false-positives rate as well as on how to precisely differentiate between benign and malignant nodules. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the computer-assisted nodules detection and benign-malignant classification techniques developed over three decades, which have evolved from the complicated ad hoc analysis pipeline of conventional approaches to the simplified seamlessly integrated deep learning techniques. This review also identifies challenges and highlights opportunities for future work in learning models, learning algorithms and enhancement schemes for bridging current state to future prospect and satisfying future demand. As far as the authors know, it is the first review of the literature of the past thirty years development in computer-assisted diagnosis of lung nodules. We acknowledge the value of potential multidisciplinary researches that will make the computer-assisted diagnosis of pulmonary nodules enter into the main stream of clinical medicine, and raise the state-of-the-art clinical applications as well as increase both welfares of physicians and patients.