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Pathogenesis-based diagnosis is a key step to prevent and control lumbar neural foraminal stenosis (LNFS). It conducts both early diagnosis and comprehensive assessment by drawing crucial pathological links between pathogenic factors and LNFS. Automated pathogenesis-based diagnosis would simultaneously localize and grade multiple spinal organs (neural foramina, vertebrae, intervertebral discs) to diagnose LNFS and discover pathogenic factors. The automated way facilitates planning optimal therapeutic schedules and relieving clinicians from laborious workloads. However, no successful work has been achieved yet due to its extreme challenges since 1) multiple targets: each lumbar spine has at least 17 target organs, 2) multiple scales: each type of target organ has structural complexity and various scales across subjects, and 3) multiple tasks, i.e., simultaneous localization and diagnosis of all lumbar organs, are extremely difficult than individual tasks. To address these huge challenges, we propose a deep multiscale multitask learning network (DMML-Net) integrating a multiscale multi-output learning and a multitask regression learning into a fully convolutional network. 1) DMML-Net merges semantic representations to reinforce the salience of numerous target organs. 2) DMML-Net extends multiscale convolutional layers as multiple output layers to boost the scale-invariance for various organs. 3) DMML-Net joins a multitask regression module and a multitask loss module to prompt the mutual benefit between tasks. Extensive experimental results demonstrate that DMML-Net achieves high performance (0.845 mean average precision) on T1/T2-weighted MRI scans from 200 subjects. This endows our method an efficient tool for clinical LNFS diagnosis.

We quantitatively investigate the influence of image registration, using open-source software (3DSlicer), on kinetic analysis (Tofts model) of dynamic contrast enhanced MRI of early-stage breast cancer patients. We also show that registration computation time can be reduced by reducing the percent sampling (PS) of voxels used for estimation of the cost function. DCE-MRI breast images were acquired on a 3T-PET/MRI system in 13 patients with early-stage breast cancer who were scanned in a prone radiotherapy position. Images were registered using a BSpline transformation with a 2 cm isotropic grid at 100, 20, 5, 1, and 0.5PS (BRAINSFit in 3DSlicer). Signal enhancement curves were analyzed voxel-by-voxel using the Tofts kinetic model. Comparing unregistered with registered groups, we found a significant change in the 90th percentile of the voxel-wise distribution of Ktrans. We also found a significant reduction in the following: (1) in the standard error (uncertainty) of the parameter value estimation, (2) the number of voxel fits providing unphysical values for the extracellular-extravascular volume fraction (ve > 1), and (3) goodness of fit. We found no significant differences in the median of parameter value distributions (Ktrans, ve) between unregistered and registered images. Differences between parameters and uncertainties obtained using 100PS versus 20PS were small and statistically insignificant. As such, computation time can be reduced by a factor of 2, on average, by using 20PS while not affecting the kinetic fit. The methods outlined here are important for studies including a large number of post-contrast images or number of patient images.

Automated quantitative measurement of the spine (i.e., multiple indices estimation of heights, widths, areas, and so on for the vertebral body and disc) is of the utmost importance in clinical spinal disease diagnoses, such as osteoporosis, intervertebral disc degeneration, and lumbar disc herniation, yet still an unprecedented challenge due to the variety of spine structure and the high dimensionality of indices to be estimated. In this paper, we propose a novel cascade amplifier regression network (CARN), which includes the CARN architecture and local shape-constrained manifold regularization (LSCMR) loss function, to achieve accurate direct automated multiple indices estimation. The CARN architecture is composed of a cascade amplifier network (CAN) for expressive feature embedding and a linear regression model for multiple indices estimation. The CAN consists of cascade amplifier units (AUs), which are used for selective feature reuse by stimulating effective feature and suppressing redundant feature during propagating feature map between adjacent layers, thus an expressive feature embedding is obtained. During training, the LSCMR is utilized to alleviate overfitting and generate realistic estimation by learning the multiple indices distribution. Experiments on MR images of 195 subjects show that the proposed CARN achieves impressive performance with mean absolute errors of 1.2496 mm, 1.2887 mm, and 1.2692 mm for estimation of 15 heights of discs, 15 heights of vertebral bodies, and total indices respectively. The proposed method has great potential in clinical spinal disease diagnoses.

Accurate estimation of regional wall thicknesses (RWT) of left ventricular (LV) myocardium from cardiac MR sequences is of significant importance for identification and diagnosis of cardiac disease. Existing RWT estimation still relies on segmentation of LV myocardium, which requires strong prior information and user interaction. No work has been devoted into direct estimation of RWT from cardiac MR images due to the diverse shapes and structures for various subjects and cardiac diseases, as well as the complex regional deformation of LV myocardium during the systole and diastole phases of the cardiac cycle. In this paper, we present a newly proposed Residual Recurrent Neural Network (ResRNN) that fully leverages the spatial and temporal dynamics of LV myocardium to achieve accurate frame-wise RWT estimation. Our ResRNN comprises two paths: 1) a feed forward convolution neural network (CNN) for effective and robust CNN embedding learning of various cardiac images and preliminary estimation of RWT from each frame itself independently, and 2) a recurrent neural network (RNN) for further improving the estimation by modeling spatial and temporal dynamics of LV myocardium. For the RNN path, we design for cardiac sequences a Circle-RNN to eliminate the effect of null hidden input for the first time-step. Our ResRNN is capable of obtaining accurate estimation of cardiac RWT with Mean Absolute Error of 1.44mm (less than 1-pixel error) when validated on cardiac MR sequences of 145 subjects, evidencing its great potential in clinical cardiac function assessment.