Objective To study the effect of using improved 2D computer-assisted fluoroscopic navigation through simulating 3D vertebrae image to guide pedicle screw internal fixation.Methods Posterior pedicle screw internal fixa...Objective To study the effect of using improved 2D computer-assisted fluoroscopic navigation through simulating 3D vertebrae image to guide pedicle screw internal fixation.Methods Posterior pedicle screw internal fixation,distraction展开更多
The aim of this study was to compare the sperm nuclear and acrosomal morphometry of three species of domestic artiodactyls; cattle （Bos taurus）, sheep （Ovis aries）, and pigs （Sus scrofa）. Semen smears of twenty ...The aim of this study was to compare the sperm nuclear and acrosomal morphometry of three species of domestic artiodactyls; cattle （Bos taurus）, sheep （Ovis aries）, and pigs （Sus scrofa）. Semen smears of twenty ejaculates from each species were fixed and labeled with a propidium iodide-Pisum sativum agglutinin （PI/PSA） combination. Digital images of the sperm nucleus, acrosome, and whole sperm head were captured and analyzed. The use of the PI/PSA combination and CASA-Morph fluorescence-based method allowed the capture, morphometric analysis, and differentiation of most sperm nuclei, acrosomes and whole heads, and the assessment of acrosomal integrity with a high precision in the three species studied. For the size of the head and nuclear area, the relationship between the three species may be summarized as bull 〉 ram 〉 boar. However, for the other morphometric parameters （length, width, and perimeter）, there were differences in the relationships between species for sperm nuclei and whole sperm heads. Bull sperm acrosomes were clearly smaller than those in the other species studied and covered a smaller proportion of the sperm head. The acrosomal morphology, small in the bull, large and broad in the sheep, and large, long, and with a pronounced equatorial segment curve in the boar, was species-characteristic. It was concluded that there are clear variations in the size and shape of the sperm head components between the three species studied, the acrosome being the structure showing the most variability, allowing a clear distinction of the spermatozoa of each species.展开更多
BACKGROUND A recently developed method enables automated measurement of the hallux valgus angle(HVA)and the first intermetatarsal angle(IMA)from weightbearing foot radiographs.This approach employs bone segmentation t...BACKGROUND A recently developed method enables automated measurement of the hallux valgus angle(HVA)and the first intermetatarsal angle(IMA)from weightbearing foot radiographs.This approach employs bone segmentation to identify anatomical landmarks and provides standardized angle measurements based on established guidelines.While effective for HVA and IMA,preoperative radiograph analysis remains complex and requires additional measurements,such as the hallux interphalangeal angle(IPA),which has received limited research attention.AIM To expand the previous method,which measured HVA and IMA,by incorporating the automatic measurement of IPA,evaluating its accuracy and clinical relevance.METHODS A preexisting database of manually labeled foot radiographs was used to train a U-Net neural network for segmenting bones and identifying landmarks necessary for IPA measurement.Of the 265 radiographs in the dataset,161 were selected for training and 20 for validation.The U-Net neural network achieves a high mean Sørensen-Dice index(>0.97).The remaining 84 radiographs were used to assess the reliability of automated IPA measurements against those taken manually by two orthopedic surgeons(OA and OB)using computer-based tools.Each measurement was repeated to assess intraobserver(OA1 and OA2)and interobserver(O_(A2) and O_(B))reliability.Agreement between automated and manual methods was evaluated using the Intraclass Correlation Coefficient(ICC),and Bland-Altman analysis identified systematic differences.Standard error of measurement(SEM)and Pearson correlation coefficients quantified precision and linearity,and measurement times were recorded to evaluate efficiency.RESULTS The artificial intelligence(AI)-based system demonstrated excellent reliability,with ICC3.1 values of 0.92(AI vs OA2)and 0.88(AI vs O_(B)),both statistically significant(P<0.001).For manual measurements,ICC values were 0.95(OA2 vs OA1)and 0.95(OA2 vs OB),supporting both intraobserver and interobserver reliability.Bland-Altman analysis revealed minimal biases of:(1)1.61°(AI vs O_(A2));and(2)2.54°(AI vs O_(B)),with clinically acceptable limits of agreement.The AI system also showed high precision,as evidenced by low SEM values:(1)1.22°(O_(A2) vs O_(B));(2)1.77°(AI vs O_(A2));and(3)2.09°(AI vs O_(B)).Furthermore,Pearson correlation coefficients confirmed strong linear relationships between automated and manual measurements,with r=0.85(AI vs O_(A2))and r=0.90(AI vs O_(B)).The AI method significantly improved efficiency,completing all 84 measurements 8 times faster than manual methods,reducing the time required from an average 36 minutes to just 4.5 minutes.CONCLUSION The proposed AI-assisted IPA measurement method shows strong clinical potential,effectively corresponding with manual measurements.Integrating IPA with HVA and IMA assessments provides a comprehensive tool for automated forefoot deformity analysis,supporting hallux valgus severity classification and preoperative planning,while offering substantial time savings in high-volume clinical settings.展开更多
Computer-aided diagnosis(CAD) systems have been proposed to assist radiologists in making diagnostic decisions by providing helpful information. As one of the most important sequences in prostate magnetic resonance im...Computer-aided diagnosis(CAD) systems have been proposed to assist radiologists in making diagnostic decisions by providing helpful information. As one of the most important sequences in prostate magnetic resonance imaging(MRI), image features from T2-weighted images(T2WI) were extracted and evaluated for the diagnostic performances by using CAD. We extracted 12 quantitative image features from prostate T2-weighted MR images. The importance of each feature in cancer identification was compared in the peripheral zone(PZ) and central gland(CG), respectively. The performance of the computer-aided diagnosis system supported by an artificial neural network was tested. With computer-aided analysis of T2-weighted images, many characteristic features with different diagnostic capabilities can be extracted. We discovered most of the features(10/12) had significant difference(P<0.01) between PCa and non-PCa in the PZ, while only five features(sum average, minimum value, standard deviation, 10 th percentile, and entropy) had significant difference in CG. CAD prediction by features from T2 w images can reach high accuracy and specificity while maintaining acceptable sensitivity. The outcome is convictive and helpful in medical diagnosis.展开更多
Diffusion-weighted imaging(DWI) is considered to be one of the dominant modalities used in prostate cancer(PCa) detection and the assessment of lesion aggressiveness,especially for peripheral zone(PZ) PCa.Computer-aid...Diffusion-weighted imaging(DWI) is considered to be one of the dominant modalities used in prostate cancer(PCa) detection and the assessment of lesion aggressiveness,especially for peripheral zone(PZ) PCa.Computer-aided diagnosis(CAD),which is capable of automatically extracting and evaluating image features,can integrate multiple parameters and improve the detection of PCa.In this study,13 quantitative image features were extracted from DWI by CAD,and diagnostic efficacy was analyzed in both the PZ and transition zone(TZ).The results demonstrated that there was a significant difference(P<0.05) between PCa and non-PCa for nine of the 13 features in the PZ and five of the 13 features in the TZ.Besides,the prediction outcome of CAD had a strong correlation with the DWI scores that were graded by experienced radiologists according to the Prostate Imaging-Reporting and Data System Version 2(PI-RADS v2).展开更多
AIMTo assess the effect of long-term oral nucleos(t)ide analogues (NUCs) therapy on liver volume change in patients with suppress hepatitis B virus (HBV)-related liver cirrhosis.METHODSWe reviewed the data of na&#...AIMTo assess the effect of long-term oral nucleos(t)ide analogues (NUCs) therapy on liver volume change in patients with suppress hepatitis B virus (HBV)-related liver cirrhosis.METHODSWe reviewed the data of naïve patients with HBV-related liver cirrhosis, who had taken oral NUCs therapy, between 2003 and 2007 at Chonbuk University Hospital. We analyzed two consecutive sets of abdominal computerized tomography scans-one at the time of treatment initiation and another at the second-year follow-up. Liver volume was calculated by 3-dimensional liver extraction volumetry program.RESULTSA total of 55 patients (34 males) were included. There was 114.3 mL ± 167.8 mL (12.9% ± 17.9%) of increase in liver volume during the two years of NUCs therapy (993.8 mL ± 242.8 mL at baseline vs 1108.1 mL ± 263.3 mL at two-year follow-up, P < 0.001). The ratio of the measured baseline liver volume to the estimated standard liver volume was improved from 70.8% to 78.0%. An increase in liver volume was shown not only in patients with compensated cirrhosis (P = 0.046) but also in those with decompensated cirrhosis (P < 0.001). Significant factors for volume increases were Child-Turcotte-Pugh grade and model for end-stage liver disease score improvement without virological breakthrough. In multiple linear regression analysis, delta albumin and delta alanine aminotransferase levels showed a significant association with the increase in liver volume (P = 0.002 and 0.005, respectively).CONCLUSIONLong-term oral NUCs therapy in patients with HBV-related liver cirrhosis lead to significant increase in liver volume assessed with 3-dimensional liver extraction volumetry program.展开更多
Three-dimensional （3D） image reconstruction technologies can reveal previously hidden microstruc-tures in human tissue. However, the lack of ideal, non-destructive cross-sectional imaging techniques is still a probl...Three-dimensional （3D） image reconstruction technologies can reveal previously hidden microstruc-tures in human tissue. However, the lack of ideal, non-destructive cross-sectional imaging techniques is still a problem. Despite some drawbacks, histological sectioning remains one of the most powerful methods for accurate high-resolution representation of tissue structures. Computer technologies can produce 3D representations of interesting human tissue and organs that have been serial-sectioned, dyed or stained, imaged, and segmented for 3D visualization. 3D reconstruction also has great potential in the fields of tissue engineering and 3D printing. This article outlines the most common methods for 3D tissue section reconstruction. We describe the most important academic concepts in this field, and provide critical explanations and comparisons. We also note key steps in the reconstruction procedures, and highlight recent progress in the development of new reconstruction methods.展开更多
Computed tomography(CT)has seen a rapid increase in use in recent years.Radiation from CT accounts for a significant proportion of total medical radiation.However,given the known harmful impact of radiation exposure t...Computed tomography(CT)has seen a rapid increase in use in recent years.Radiation from CT accounts for a significant proportion of total medical radiation.However,given the known harmful impact of radiation exposure to the human body,the excessive use of CT in medical environments raises concerns.Concerns over increasing CT use and its associated radiation burden have prompted efforts to reduce radiation dose during the procedure.Therefore,low-dose CT has attracted major attention in the radiology,since CT-associated x-ray radiation carries health risks for patients.The reduction of the CT radiation dose,however,compromises the signal-to-noise ratio,which affects image quality and diagnostic performance.Therefore,several denoising methods have been developed and applied to image processing technologies with the goal of reducing image noise.Recently,deep learning applications that improve image quality by reducing the noise and artifacts have become commercially available for diagnostic imaging.Deep learning image reconstruction shows great potential as an advanced reconstruction method to improve the quality of clinical CT images.These improvements can provide significant benefit to patients regardless of their disease,and further advances are expected in the near future.展开更多
AIM To evaluate reproducibility of pulmonary embolism(PE) clot volume quantification using computed tomography pulmonary angiogram(CTPA) in a multicenter setting.METHODS This study was performed using anonymized data ...AIM To evaluate reproducibility of pulmonary embolism(PE) clot volume quantification using computed tomography pulmonary angiogram(CTPA) in a multicenter setting.METHODS This study was performed using anonymized data in conformance with HIPAA and IRB Regulations(March 2015-November 2016). Anonymized CTPA data was acquired from 23 scanners from 18 imaging centers using each site's standard PE protocol. Two independent analysts measured PE volumes using a semi-automated region-growing algorithm on an FDA-approved image analysis platform. Total thrombus volume(TTV) was calculated per patient as the primary endpoint. Secondary endpoints were individual thrombus volume(ITV), Qanadli score and modified Qanadli score per patient. Inter-and intra-observer reproducibility were assessed using intra-class correlation coefficient(ICC) and BlandAltman analysis. RESULTS Analyst 1 found 72 emboli in the 23 patients with a mean number of emboli of 3.13 per patient with a range of 0-11 emboli per patient. The clot volumes ranged from 0.0041-47.34 cm3(mean +/-SD, 5.93 +/-10.15 cm3). On the second read, analyst 1 found the same number and distribution of emboli with a range of volumes for read 2 from 0.0041 – 45.52 cm3(mean +/-SD, 5.42 +/-9.53 cm3). Analyst 2 found 73 emboli in the 23 patients with a mean number of emboli of 3.17 per patient with a range of 0-11 emboli per patient. The clot volumes ranged from 0.00459-46.29 cm3(mean +/-SD, 5.91 +/-10.06 cm3). Inter-and intraobserver variability measurements indicated excellent reproducibility of the semi-automated method for quantifying PE volume burden. ICC for all endpoints was greater than 0.95 for inter-and intra-observer analysis. Bland-Altman analysis indicated no significant biases.CONCLUSION Semi-automated region growing algorithm for quantifying PE is reproducible using data from multiple scanners and is a suitable method for image analysis in multicenter clinical trials.展开更多
AIM To examine effects of computed tomography(CT)image acquisition/reconstruction parameters on clot volume quantification in vitro for research method validation purposes.METHODS This study was performed in conforman...AIM To examine effects of computed tomography(CT)image acquisition/reconstruction parameters on clot volume quantification in vitro for research method validation purposes.METHODS This study was performed in conformance with HIPAA and IRB Regulations(March 2015-November 2016).A ten blood clot phantom was designed and scanned on a dual-energy CT scanner(SOMATOM Force,Siemens Healthcare Gm BH,Erlangen,Germany)with varying pitch,iterative reconstruction,energy level and slicethickness.A range of clot and tube sizes were used in an attempt to replicate in vivo emboli found within central and segmental branches of the pulmonary arteries in patients with pulmonary emboli.Clot volume was the measured parameter and was analyzed by a single image analyst using a semi-automated region growing algorithm implemented in the FDA-approved Siemens syngo.via image analysis platform.Mixed model analysis was performed on the data.RESULTS On the acquisition side,the continuous factor of energy showed no statistically significant effect on absolute clot volume quantification(P=0.9898).On the other hand,when considering the fixed factor of pitch,there were statistically significant differences in clot volume quantification(P<0.0001).On the reconstruction side,with the continuous factor of reconstruction slice thickness no statistically significant effect on absolute clot volume quantification was demonstrated(P=0.4500).Also on the reconstruction side,with the fixed factor of using iterative reconstructions there was also no statistically significant effect on absolute clot volume quantification(P=0.3011).In addition,there was excellent R^2 correlation between the scale-measured mass of the clots both with respect to the CT measured volumes and with respect to volumes measure by the water displacement method.CONCLUSION Aside from varying pitch,changing CT acquisition parameters and using iterative reconstructions had no significant impact on clot volume quantification with a semi-automated region growing algorithm.展开更多
Background This study was designed to analyze three tibial axis reference lines including the anterior tibial cortex （ATC） line, the fibular line （FL）, and the anatomical axis of tibia （AAT） line, to determine w...Background This study was designed to analyze three tibial axis reference lines including the anterior tibial cortex （ATC） line, the fibular line （FL）, and the anatomical axis of tibia （AAT） line, to determine which line most closely parallels the mechanical axis （MA） of the tibia in the sagittal plane. The clinical relevance of the study is that through finding a reliable landmark on the leg, a surgeon may minimize posterior tibial slope measurement errors thereby and improving the technique for assuring proper alignment of total knee arthroplasty.展开更多
AIM：To evaluate the effect of strabismus surgery on retinal vessels calibers with digital color fundus photographs.METHODS：Two hundred consecutive strabismus patients underwent surgery,and 118 patients（female/male,...AIM：To evaluate the effect of strabismus surgery on retinal vessels calibers with digital color fundus photographs.METHODS：Two hundred consecutive strabismus patients underwent surgery,and 118 patients（female/male,55/63） who finished 6-month follow-up were finally included in this study.Optic disc-centered digital color fundus photographs of both eyes of all patients were taken prior to surgery and 6mo post surgery.The retinal vascular caliber of 116 operated eyes were measured using the computer program IVAN.The operated eyes were divided into 3 groups according to the surgical methods,recession of one muscle,one muscle recession and one muscle folding,one muscle resection and one muscle recession.The effect of number of altered muscles on retinal vessels was analyzed using statistic software SPSS 16.0.RESULTS：The mean age was 12.4±8.6y.Averaged central retinal artery equivalent（CRAE） of all patients was 120.31 ±23.02 μm preoperatively,and 122.87 ±15.93 μm six months after surgery.Averaged central retinal vein equivalent（CRVE） was 171.11 ±31.73 μm preoperatively and175.02±21.00 μm postoperatively.There was no significant difference of averaged CRAE（P=0.22） or CRVE（P=0.19）before and after operation.Averaged arteriole to venule ratio（AVR） was 0.71 ±0.07 before surgery and 0.70±0.07 after surgery.Comparison of preoperative and postoperative retinal vessels calibers among different surgical groups did not show significant differences.Also,there was no advantage of rectus muscle folding to muscle resection.CONCLUSION：Up to 6mo after strabismus surgery,the retinal vascular calibers were not altered.No more than two muscles in one surgery are safe for retinal perfusion.展开更多
AIM: To assess potential contributions of biliary IgA for crystal agglomeration into gallstones, we visualized cholesterol crystal binding of biliary IgA. METHODS: Crystal binding biliary proteins were extracted from ...AIM: To assess potential contributions of biliary IgA for crystal agglomeration into gallstones, we visualized cholesterol crystal binding of biliary IgA. METHODS: Crystal binding biliary proteins were extracted from human gallbladder bile using lectin affinity chromatography.Biliary IgA was isolated from the bound protein fraction by immunoaffinity chromatography. Pure cholesterol monohydrate crystals were incubated with biliary IgA and fluoresceine isothiocyanate (FITC)conjugated anti IgA at 37 degree. Samples were examined under polarizing and fluorescence light microscopy with digital image processing. RESULTS: Binding of biliary IgA to cholesterol monohydrate crystals could be visualized with FITC conjugated anti IgA antibodies.Peak fluorescence occurred at crystal edges and dislocations. Controls without biliary IgA or with biliary IgG showed no significant fluorescence. CONCLUSION: Fluorescence light microscopy provided evidence for cholesterol crystal binding of biliary IgA. Cholesterol crystal binding proteins like IgA might be important mediators of crystal agglomeration and growth of cholesterol gallstones by modifying the evolving crystal structures in vivo.展开更多
AIM: To further clarify the changes occurred in the testicular capsulotomized rats. METHODS: In testicular capsulotomized and sham-operated rats, the cross sectional area, the nucleus diameter and the number of Leydig...AIM: To further clarify the changes occurred in the testicular capsulotomized rats. METHODS: In testicular capsulotomized and sham-operated rats, the cross sectional area, the nucleus diameter and the number of Leydig cells were morphologically analyzed by the Vidas Image Processing System connected to a microscope. RESULTS: In the capsulotomized animals, the cross sectional area of Leydig cells was gradually increased from 30 days onwards. There was no obvious change in the nucleus diameter of Leydig cells. However, The Leydig cell number was significantly increased from day 30 onwards. CONCLUSION: In rats, testicular capsulotomy may induce hyperplasia/hypertrophy of Leydig cells in the testis.展开更多
Background With the gradual increase of infertility in the world,among which male sperm problems are the main factor for infertility,more and more couples are using computer-assisted sperm analysis(CASA)to assist in t...Background With the gradual increase of infertility in the world,among which male sperm problems are the main factor for infertility,more and more couples are using computer-assisted sperm analysis(CASA)to assist in the analysis and treatment of infertility.Meanwhile,the rapid development of deep learning(DL)has led to strong results in image classification tasks.However,the classification of sperm images has not been well studied in current deep learning methods,and the sperm images are often affected by noise in practical CASA applications.The purpose of this article is to investigate the anti-noise robustness of deep learning classification methods applied on sperm images.Methods The SVIA dataset is a publicly available large-scale sperm dataset containing three subsets.In this work,we used subset-C,which provides more than 125,000 independent images of sperms and impurities,including 121,401 sperm images and 4,479 impurity images.To investigate the anti-noise robustness of deep learning classification methods applied on sperm images,we conducted a comprehensive comparative study of sperm images using many convolutional neural network(CNN)and visual transformer(VT)deep learning methods to find the deep learning model with the most stable anti-noise robustness.Results This study proved that VT had strong robustness for the classification of tiny object(sperm and impurity)image datasets under some types of conventional noise and some adversarial attacks.In particular,under the influence of Poisson noise,accuracy changed from 91.45%to 91.08%,impurity precison changed from 92.7%to 91.3%,impurity recall changed from 88.8%to 89.5%,and impurity F1-score changed 90.7%to 90.4%.Meanwhile,sperm precision changed from 90.9%to 90.5%,sperm recall changed from 92.5%to 93.8%,and sperm F1-score changed from 92.1%to 90.4%.Conclusion Sperm image classification may be strongly affected by noise in current deep learning methods;the robustness with regard to noise of VT methods based on global information is greater than that of CNN methods based on local information,indicating that the robustness with regard to noise is reflected mainly in global information.展开更多
OBJECTIVE To investigate the available parameters in gynecological screening for cervical lesions by liquid-based cytology technology （ThinPrep Cytology Test, TCT） and The Bethesda System （TBS）, also with computer...OBJECTIVE To investigate the available parameters in gynecological screening for cervical lesions by liquid-based cytology technology （ThinPrep Cytology Test, TCT） and The Bethesda System （TBS）, also with computer image analysis. METHODS With application of the image analysis system, all grades of cervical lesion cells were detected quantitatively and sorted in atypical squamous cells of undetermined significance （ASCUS）, atypical squamous cells-cannot exclude HSIL （ASC-H）, low-grade squamous intraepithelial lesion （LSIL）, high-grade squamous intraepithelial lesion （HSIL） and cervical squamous cell carcinoma （SCC） with the mean optical density （MOD）, average grey （AG）, positive units （PU）, and nucleus to cytoplasmic ratio （N： C）. Differences between each group of cells were compared and analyzed statistically. RESULTS Apart from four stereologic parameters in LSIL and HSIL groups there were no differences among them, in the other groups, there was statistically significant in differences between MOD, AG and PU values. Differences between them in the ratio of nucleus to cytoplasm were highly statistically significant. CONCLUSION Stereological indexes may serve as a screening tool for cervical lesions. The image analysis system is expected to become a new means of cytological assisted diagnosis.展开更多
Using cytochemical method,microspectrophotometry and image analysis,effects of va-soactive intestinal peptide(VIP)on activities of succinic dehydrogenase(SDH)and alkalinephosphatase(ALP)in rat hepatoma cells were stud...Using cytochemical method,microspectrophotometry and image analysis,effects of va-soactive intestinal peptide(VIP)on activities of succinic dehydrogenase(SDH)and alkalinephosphatase(ALP)in rat hepatoma cells were studied in vitro.The results showed that thehepatoma cell expressed potent positive reactions of SDH and ALP,the positive positionswere located at the cell membranes and/or cytoplasm.Having been treated with VIP,ALPdecreased obviously in activity(P【0. 01,compared with hepatoma cells untreated by VIP).The sites of ALP activty were chiefly located at the cell membranes,particularly at the cell-cell contacts.Cultured rat hepatoma cells had intensive SDH activity in their cytoplasm.Compared with untreated eclls,there was no marked difference in the intensity of SDH activ-ity in VIP-treated hepatoma cells(P】0.05).展开更多
文摘Objective To study the effect of using improved 2D computer-assisted fluoroscopic navigation through simulating 3D vertebrae image to guide pedicle screw internal fixation.Methods Posterior pedicle screw internal fixation,distraction
文摘The aim of this study was to compare the sperm nuclear and acrosomal morphometry of three species of domestic artiodactyls; cattle （Bos taurus）, sheep （Ovis aries）, and pigs （Sus scrofa）. Semen smears of twenty ejaculates from each species were fixed and labeled with a propidium iodide-Pisum sativum agglutinin （PI/PSA） combination. Digital images of the sperm nucleus, acrosome, and whole sperm head were captured and analyzed. The use of the PI/PSA combination and CASA-Morph fluorescence-based method allowed the capture, morphometric analysis, and differentiation of most sperm nuclei, acrosomes and whole heads, and the assessment of acrosomal integrity with a high precision in the three species studied. For the size of the head and nuclear area, the relationship between the three species may be summarized as bull 〉 ram 〉 boar. However, for the other morphometric parameters （length, width, and perimeter）, there were differences in the relationships between species for sperm nuclei and whole sperm heads. Bull sperm acrosomes were clearly smaller than those in the other species studied and covered a smaller proportion of the sperm head. The acrosomal morphology, small in the bull, large and broad in the sheep, and large, long, and with a pronounced equatorial segment curve in the boar, was species-characteristic. It was concluded that there are clear variations in the size and shape of the sperm head components between the three species studied, the acrosome being the structure showing the most variability, allowing a clear distinction of the spermatozoa of each species.
文摘BACKGROUND A recently developed method enables automated measurement of the hallux valgus angle(HVA)and the first intermetatarsal angle(IMA)from weightbearing foot radiographs.This approach employs bone segmentation to identify anatomical landmarks and provides standardized angle measurements based on established guidelines.While effective for HVA and IMA,preoperative radiograph analysis remains complex and requires additional measurements,such as the hallux interphalangeal angle(IPA),which has received limited research attention.AIM To expand the previous method,which measured HVA and IMA,by incorporating the automatic measurement of IPA,evaluating its accuracy and clinical relevance.METHODS A preexisting database of manually labeled foot radiographs was used to train a U-Net neural network for segmenting bones and identifying landmarks necessary for IPA measurement.Of the 265 radiographs in the dataset,161 were selected for training and 20 for validation.The U-Net neural network achieves a high mean Sørensen-Dice index(>0.97).The remaining 84 radiographs were used to assess the reliability of automated IPA measurements against those taken manually by two orthopedic surgeons(OA and OB)using computer-based tools.Each measurement was repeated to assess intraobserver(OA1 and OA2)and interobserver(O_(A2) and O_(B))reliability.Agreement between automated and manual methods was evaluated using the Intraclass Correlation Coefficient(ICC),and Bland-Altman analysis identified systematic differences.Standard error of measurement(SEM)and Pearson correlation coefficients quantified precision and linearity,and measurement times were recorded to evaluate efficiency.RESULTS The artificial intelligence(AI)-based system demonstrated excellent reliability,with ICC3.1 values of 0.92(AI vs OA2)and 0.88(AI vs O_(B)),both statistically significant(P<0.001).For manual measurements,ICC values were 0.95(OA2 vs OA1)and 0.95(OA2 vs OB),supporting both intraobserver and interobserver reliability.Bland-Altman analysis revealed minimal biases of:(1)1.61°(AI vs O_(A2));and(2)2.54°(AI vs O_(B)),with clinically acceptable limits of agreement.The AI system also showed high precision,as evidenced by low SEM values:(1)1.22°(O_(A2) vs O_(B));(2)1.77°(AI vs O_(A2));and(3)2.09°(AI vs O_(B)).Furthermore,Pearson correlation coefficients confirmed strong linear relationships between automated and manual measurements,with r=0.85(AI vs O_(A2))and r=0.90(AI vs O_(B)).The AI method significantly improved efficiency,completing all 84 measurements 8 times faster than manual methods,reducing the time required from an average 36 minutes to just 4.5 minutes.CONCLUSION The proposed AI-assisted IPA measurement method shows strong clinical potential,effectively corresponding with manual measurements.Integrating IPA with HVA and IMA assessments provides a comprehensive tool for automated forefoot deformity analysis,supporting hallux valgus severity classification and preoperative planning,while offering substantial time savings in high-volume clinical settings.
文摘Computer-aided diagnosis(CAD) systems have been proposed to assist radiologists in making diagnostic decisions by providing helpful information. As one of the most important sequences in prostate magnetic resonance imaging(MRI), image features from T2-weighted images(T2WI) were extracted and evaluated for the diagnostic performances by using CAD. We extracted 12 quantitative image features from prostate T2-weighted MR images. The importance of each feature in cancer identification was compared in the peripheral zone(PZ) and central gland(CG), respectively. The performance of the computer-aided diagnosis system supported by an artificial neural network was tested. With computer-aided analysis of T2-weighted images, many characteristic features with different diagnostic capabilities can be extracted. We discovered most of the features(10/12) had significant difference(P<0.01) between PCa and non-PCa in the PZ, while only five features(sum average, minimum value, standard deviation, 10 th percentile, and entropy) had significant difference in CG. CAD prediction by features from T2 w images can reach high accuracy and specificity while maintaining acceptable sensitivity. The outcome is convictive and helpful in medical diagnosis.
文摘Diffusion-weighted imaging(DWI) is considered to be one of the dominant modalities used in prostate cancer(PCa) detection and the assessment of lesion aggressiveness,especially for peripheral zone(PZ) PCa.Computer-aided diagnosis(CAD),which is capable of automatically extracting and evaluating image features,can integrate multiple parameters and improve the detection of PCa.In this study,13 quantitative image features were extracted from DWI by CAD,and diagnostic efficacy was analyzed in both the PZ and transition zone(TZ).The results demonstrated that there was a significant difference(P<0.05) between PCa and non-PCa for nine of the 13 features in the PZ and five of the 13 features in the TZ.Besides,the prediction outcome of CAD had a strong correlation with the DWI scores that were graded by experienced radiologists according to the Prostate Imaging-Reporting and Data System Version 2(PI-RADS v2).
文摘AIMTo assess the effect of long-term oral nucleos(t)ide analogues (NUCs) therapy on liver volume change in patients with suppress hepatitis B virus (HBV)-related liver cirrhosis.METHODSWe reviewed the data of naïve patients with HBV-related liver cirrhosis, who had taken oral NUCs therapy, between 2003 and 2007 at Chonbuk University Hospital. We analyzed two consecutive sets of abdominal computerized tomography scans-one at the time of treatment initiation and another at the second-year follow-up. Liver volume was calculated by 3-dimensional liver extraction volumetry program.RESULTSA total of 55 patients (34 males) were included. There was 114.3 mL ± 167.8 mL (12.9% ± 17.9%) of increase in liver volume during the two years of NUCs therapy (993.8 mL ± 242.8 mL at baseline vs 1108.1 mL ± 263.3 mL at two-year follow-up, P < 0.001). The ratio of the measured baseline liver volume to the estimated standard liver volume was improved from 70.8% to 78.0%. An increase in liver volume was shown not only in patients with compensated cirrhosis (P = 0.046) but also in those with decompensated cirrhosis (P < 0.001). Significant factors for volume increases were Child-Turcotte-Pugh grade and model for end-stage liver disease score improvement without virological breakthrough. In multiple linear regression analysis, delta albumin and delta alanine aminotransferase levels showed a significant association with the increase in liver volume (P = 0.002 and 0.005, respectively).CONCLUSIONLong-term oral NUCs therapy in patients with HBV-related liver cirrhosis lead to significant increase in liver volume assessed with 3-dimensional liver extraction volumetry program.
基金This paper was supported by a grant from the National High Technology Research and Development Program of China （863 program） （No. 2012AA020504） and the National Natural Science Foundation of China （Key Program） （No. 81027004）. We thank the authors in our list of references for their excellent work, which led to the main content and structure of this review.
文摘Three-dimensional （3D） image reconstruction technologies can reveal previously hidden microstruc-tures in human tissue. However, the lack of ideal, non-destructive cross-sectional imaging techniques is still a problem. Despite some drawbacks, histological sectioning remains one of the most powerful methods for accurate high-resolution representation of tissue structures. Computer technologies can produce 3D representations of interesting human tissue and organs that have been serial-sectioned, dyed or stained, imaged, and segmented for 3D visualization. 3D reconstruction also has great potential in the fields of tissue engineering and 3D printing. This article outlines the most common methods for 3D tissue section reconstruction. We describe the most important academic concepts in this field, and provide critical explanations and comparisons. We also note key steps in the reconstruction procedures, and highlight recent progress in the development of new reconstruction methods.
文摘Computed tomography(CT)has seen a rapid increase in use in recent years.Radiation from CT accounts for a significant proportion of total medical radiation.However,given the known harmful impact of radiation exposure to the human body,the excessive use of CT in medical environments raises concerns.Concerns over increasing CT use and its associated radiation burden have prompted efforts to reduce radiation dose during the procedure.Therefore,low-dose CT has attracted major attention in the radiology,since CT-associated x-ray radiation carries health risks for patients.The reduction of the CT radiation dose,however,compromises the signal-to-noise ratio,which affects image quality and diagnostic performance.Therefore,several denoising methods have been developed and applied to image processing technologies with the goal of reducing image noise.Recently,deep learning applications that improve image quality by reducing the noise and artifacts have become commercially available for diagnostic imaging.Deep learning image reconstruction shows great potential as an advanced reconstruction method to improve the quality of clinical CT images.These improvements can provide significant benefit to patients regardless of their disease,and further advances are expected in the near future.
文摘AIM To evaluate reproducibility of pulmonary embolism(PE) clot volume quantification using computed tomography pulmonary angiogram(CTPA) in a multicenter setting.METHODS This study was performed using anonymized data in conformance with HIPAA and IRB Regulations(March 2015-November 2016). Anonymized CTPA data was acquired from 23 scanners from 18 imaging centers using each site's standard PE protocol. Two independent analysts measured PE volumes using a semi-automated region-growing algorithm on an FDA-approved image analysis platform. Total thrombus volume(TTV) was calculated per patient as the primary endpoint. Secondary endpoints were individual thrombus volume(ITV), Qanadli score and modified Qanadli score per patient. Inter-and intra-observer reproducibility were assessed using intra-class correlation coefficient(ICC) and BlandAltman analysis. RESULTS Analyst 1 found 72 emboli in the 23 patients with a mean number of emboli of 3.13 per patient with a range of 0-11 emboli per patient. The clot volumes ranged from 0.0041-47.34 cm3(mean +/-SD, 5.93 +/-10.15 cm3). On the second read, analyst 1 found the same number and distribution of emboli with a range of volumes for read 2 from 0.0041 – 45.52 cm3(mean +/-SD, 5.42 +/-9.53 cm3). Analyst 2 found 73 emboli in the 23 patients with a mean number of emboli of 3.17 per patient with a range of 0-11 emboli per patient. The clot volumes ranged from 0.00459-46.29 cm3(mean +/-SD, 5.91 +/-10.06 cm3). Inter-and intraobserver variability measurements indicated excellent reproducibility of the semi-automated method for quantifying PE volume burden. ICC for all endpoints was greater than 0.95 for inter-and intra-observer analysis. Bland-Altman analysis indicated no significant biases.CONCLUSION Semi-automated region growing algorithm for quantifying PE is reproducible using data from multiple scanners and is a suitable method for image analysis in multicenter clinical trials.
文摘AIM To examine effects of computed tomography(CT)image acquisition/reconstruction parameters on clot volume quantification in vitro for research method validation purposes.METHODS This study was performed in conformance with HIPAA and IRB Regulations(March 2015-November 2016).A ten blood clot phantom was designed and scanned on a dual-energy CT scanner(SOMATOM Force,Siemens Healthcare Gm BH,Erlangen,Germany)with varying pitch,iterative reconstruction,energy level and slicethickness.A range of clot and tube sizes were used in an attempt to replicate in vivo emboli found within central and segmental branches of the pulmonary arteries in patients with pulmonary emboli.Clot volume was the measured parameter and was analyzed by a single image analyst using a semi-automated region growing algorithm implemented in the FDA-approved Siemens syngo.via image analysis platform.Mixed model analysis was performed on the data.RESULTS On the acquisition side,the continuous factor of energy showed no statistically significant effect on absolute clot volume quantification(P=0.9898).On the other hand,when considering the fixed factor of pitch,there were statistically significant differences in clot volume quantification(P<0.0001).On the reconstruction side,with the continuous factor of reconstruction slice thickness no statistically significant effect on absolute clot volume quantification was demonstrated(P=0.4500).Also on the reconstruction side,with the fixed factor of using iterative reconstructions there was also no statistically significant effect on absolute clot volume quantification(P=0.3011).In addition,there was excellent R^2 correlation between the scale-measured mass of the clots both with respect to the CT measured volumes and with respect to volumes measure by the water displacement method.CONCLUSION Aside from varying pitch,changing CT acquisition parameters and using iterative reconstructions had no significant impact on clot volume quantification with a semi-automated region growing algorithm.
文摘Background This study was designed to analyze three tibial axis reference lines including the anterior tibial cortex （ATC） line, the fibular line （FL）, and the anatomical axis of tibia （AAT） line, to determine which line most closely parallels the mechanical axis （MA） of the tibia in the sagittal plane. The clinical relevance of the study is that through finding a reliable landmark on the leg, a surgeon may minimize posterior tibial slope measurement errors thereby and improving the technique for assuring proper alignment of total knee arthroplasty.
基金Supported by MEXT-Supported Program for the Strategic Research Foundation at Private Universities of the Japanese Governmentthe Ministry of Health,Labor,and Welfare of the Japanese Government
文摘AIM: To investigate the factors other than fibrosis stage correlating with acoustic radiation force impulse (ARFI) elastograpy in chronic hepatitis C.
基金Supported by Funds for Clinical-Basic Research Cooperation of Capital Medical University(No.14JL04)Beijing Municipal Science&Technology Commission(No.Z141107002514030)
文摘AIM：To evaluate the effect of strabismus surgery on retinal vessels calibers with digital color fundus photographs.METHODS：Two hundred consecutive strabismus patients underwent surgery,and 118 patients（female/male,55/63） who finished 6-month follow-up were finally included in this study.Optic disc-centered digital color fundus photographs of both eyes of all patients were taken prior to surgery and 6mo post surgery.The retinal vascular caliber of 116 operated eyes were measured using the computer program IVAN.The operated eyes were divided into 3 groups according to the surgical methods,recession of one muscle,one muscle recession and one muscle folding,one muscle resection and one muscle recession.The effect of number of altered muscles on retinal vessels was analyzed using statistic software SPSS 16.0.RESULTS：The mean age was 12.4±8.6y.Averaged central retinal artery equivalent（CRAE） of all patients was 120.31 ±23.02 μm preoperatively,and 122.87 ±15.93 μm six months after surgery.Averaged central retinal vein equivalent（CRVE） was 171.11 ±31.73 μm preoperatively and175.02±21.00 μm postoperatively.There was no significant difference of averaged CRAE（P=0.22） or CRVE（P=0.19）before and after operation.Averaged arteriole to venule ratio（AVR） was 0.71 ±0.07 before surgery and 0.70±0.07 after surgery.Comparison of preoperative and postoperative retinal vessels calibers among different surgical groups did not show significant differences.Also,there was no advantage of rectus muscle folding to muscle resection.CONCLUSION：Up to 6mo after strabismus surgery,the retinal vascular calibers were not altered.No more than two muscles in one surgery are safe for retinal perfusion.
文摘AIM: To assess potential contributions of biliary IgA for crystal agglomeration into gallstones, we visualized cholesterol crystal binding of biliary IgA. METHODS: Crystal binding biliary proteins were extracted from human gallbladder bile using lectin affinity chromatography.Biliary IgA was isolated from the bound protein fraction by immunoaffinity chromatography. Pure cholesterol monohydrate crystals were incubated with biliary IgA and fluoresceine isothiocyanate (FITC)conjugated anti IgA at 37 degree. Samples were examined under polarizing and fluorescence light microscopy with digital image processing. RESULTS: Binding of biliary IgA to cholesterol monohydrate crystals could be visualized with FITC conjugated anti IgA antibodies.Peak fluorescence occurred at crystal edges and dislocations. Controls without biliary IgA or with biliary IgG showed no significant fluorescence. CONCLUSION: Fluorescence light microscopy provided evidence for cholesterol crystal binding of biliary IgA. Cholesterol crystal binding proteins like IgA might be important mediators of crystal agglomeration and growth of cholesterol gallstones by modifying the evolving crystal structures in vivo.
文摘AIM: To further clarify the changes occurred in the testicular capsulotomized rats. METHODS: In testicular capsulotomized and sham-operated rats, the cross sectional area, the nucleus diameter and the number of Leydig cells were morphologically analyzed by the Vidas Image Processing System connected to a microscope. RESULTS: In the capsulotomized animals, the cross sectional area of Leydig cells was gradually increased from 30 days onwards. There was no obvious change in the nucleus diameter of Leydig cells. However, The Leydig cell number was significantly increased from day 30 onwards. CONCLUSION: In rats, testicular capsulotomy may induce hyperplasia/hypertrophy of Leydig cells in the testis.
基金supported by the National Natural Science Foundation of China(Grant No.82220108007).
文摘Background With the gradual increase of infertility in the world,among which male sperm problems are the main factor for infertility,more and more couples are using computer-assisted sperm analysis(CASA)to assist in the analysis and treatment of infertility.Meanwhile,the rapid development of deep learning(DL)has led to strong results in image classification tasks.However,the classification of sperm images has not been well studied in current deep learning methods,and the sperm images are often affected by noise in practical CASA applications.The purpose of this article is to investigate the anti-noise robustness of deep learning classification methods applied on sperm images.Methods The SVIA dataset is a publicly available large-scale sperm dataset containing three subsets.In this work,we used subset-C,which provides more than 125,000 independent images of sperms and impurities,including 121,401 sperm images and 4,479 impurity images.To investigate the anti-noise robustness of deep learning classification methods applied on sperm images,we conducted a comprehensive comparative study of sperm images using many convolutional neural network(CNN)and visual transformer(VT)deep learning methods to find the deep learning model with the most stable anti-noise robustness.Results This study proved that VT had strong robustness for the classification of tiny object(sperm and impurity)image datasets under some types of conventional noise and some adversarial attacks.In particular,under the influence of Poisson noise,accuracy changed from 91.45%to 91.08%,impurity precison changed from 92.7%to 91.3%,impurity recall changed from 88.8%to 89.5%,and impurity F1-score changed 90.7%to 90.4%.Meanwhile,sperm precision changed from 90.9%to 90.5%,sperm recall changed from 92.5%to 93.8%,and sperm F1-score changed from 92.1%to 90.4%.Conclusion Sperm image classification may be strongly affected by noise in current deep learning methods;the robustness with regard to noise of VT methods based on global information is greater than that of CNN methods based on local information,indicating that the robustness with regard to noise is reflected mainly in global information.
基金This work was supported by a grant from the Natural Science Foundation of Nenan Province, China （No.102300410078）.
文摘OBJECTIVE To investigate the available parameters in gynecological screening for cervical lesions by liquid-based cytology technology （ThinPrep Cytology Test, TCT） and The Bethesda System （TBS）, also with computer image analysis. METHODS With application of the image analysis system, all grades of cervical lesion cells were detected quantitatively and sorted in atypical squamous cells of undetermined significance （ASCUS）, atypical squamous cells-cannot exclude HSIL （ASC-H）, low-grade squamous intraepithelial lesion （LSIL）, high-grade squamous intraepithelial lesion （HSIL） and cervical squamous cell carcinoma （SCC） with the mean optical density （MOD）, average grey （AG）, positive units （PU）, and nucleus to cytoplasmic ratio （N： C）. Differences between each group of cells were compared and analyzed statistically. RESULTS Apart from four stereologic parameters in LSIL and HSIL groups there were no differences among them, in the other groups, there was statistically significant in differences between MOD, AG and PU values. Differences between them in the ratio of nucleus to cytoplasm were highly statistically significant. CONCLUSION Stereological indexes may serve as a screening tool for cervical lesions. The image analysis system is expected to become a new means of cytological assisted diagnosis.
文摘Using cytochemical method,microspectrophotometry and image analysis,effects of va-soactive intestinal peptide(VIP)on activities of succinic dehydrogenase(SDH)and alkalinephosphatase(ALP)in rat hepatoma cells were studied in vitro.The results showed that thehepatoma cell expressed potent positive reactions of SDH and ALP,the positive positionswere located at the cell membranes and/or cytoplasm.Having been treated with VIP,ALPdecreased obviously in activity(P【0. 01,compared with hepatoma cells untreated by VIP).The sites of ALP activty were chiefly located at the cell membranes,particularly at the cell-cell contacts.Cultured rat hepatoma cells had intensive SDH activity in their cytoplasm.Compared with untreated eclls,there was no marked difference in the intensity of SDH activ-ity in VIP-treated hepatoma cells(P】0.05).
