Bladder cancer is one of the most prevalent malignancies worldwide, with a recurrence rate of up to 78%, necessitating accurate post-operative monitoring for effective patient management. Multi-sequence contrast-enhanced MRI is commonly used for recurrence detection; however, interpreting these scans remains challenging, even for experienced radiologists, due to post-surgical alterations such as scarring, swelling, and tissue remodeling. AI-assisted diagnostic tools have shown promise in improving bladder cancer recurrence prediction, yet progress in this field is hindered by the lack of dedicated multi-sequence MRI datasets for recurrence assessment study. In this work, we first introduce a curated multi-sequence, multi-modal MRI dataset specifically designed for bladder cancer recurrence prediction, establishing a valuable benchmark for future research. We then propose H-CNN-ViT, a new Hierarchical Gated Attention Multi-Branch model that enables selective weighting of features from the global (ViT) and local (CNN) paths based on contextual demands, achieving a balanced and targeted feature fusion. Our multi-branch architecture processes each modality independently, ensuring that the unique properties of each imaging channel are optimally captured and integrated. Evaluated on our dataset, H-CNN-ViT achieves an AUC of 78.6%, surpassing state-of-the-art models. Our model is publicly available at https://github.com/XLIAaron/H-CNN-ViT.

The analysis of carotid arteries, particularly plaques, in multi-sequence Magnetic Resonance Imaging (MRI) data is crucial for assessing the risk of atherosclerosis and ischemic stroke. In order to evaluate metrics and radiomic features, quantifying the state of atherosclerosis, accurate segmentation is important. However, the complex morphology of plaques and the scarcity of labeled data poses significant challenges. In this work, we address these problems and propose a semi-supervised deep learning-based approach designed to effectively integrate multi-sequence MRI data for the segmentation of carotid artery vessel wall and plaque. The proposed algorithm consists of two networks: a coarse localization model identifies the region of interest guided by some prior knowledge on the position and number of carotid arteries, followed by a fine segmentation model for precise delineation of vessel walls and plaques. To effectively integrate complementary information across different MRI sequences, we investigate different fusion strategies and introduce a multi-level multi-sequence version of U-Net architecture. To address the challenges of limited labeled data and the complexity of carotid artery MRI, we propose a semi-supervised approach that enforces consistency under various input transformations. Our approach is evaluated on 52 patients with arteriosclerosis, each with five MRI sequences. Comprehensive experiments demonstrate the effectiveness of our approach and emphasize the role of fusion point selection in U-Net-based architectures. To validate the accuracy of our results, we also include an expert-based assessment of model performance. Our findings highlight the potential of fusion strategies and semi-supervised learning for improving carotid artery segmentation in data-limited MRI applications.

This research paper presents a novel approach to the prediction of hypoxia in brain tumors, using multi-parametric Magnetic Resonance Imaging (MRI). Hypoxia, a condition characterized by low oxygen levels, is a common feature of malignant brain tumors associated with poor prognosis. Fluoromisonidazole Positron Emission Tomography (FMISO PET) is a well-established method for detecting hypoxia in vivo, but it is expensive and not widely available. Our study proposes the use of MRI, a more accessible and cost-effective imaging modality, to predict FMISO PET signals. We investigate deep learning models (DL) trained on the ACRIN 6684 dataset, a resource that contains paired MRI and FMISO PET images from patients with brain tumors. Our trained models effectively learn the complex relationships between the MRI features and the corresponding FMISO PET signals, thereby enabling the prediction of hypoxia from MRI scans alone. The results show a strong correlation between the predicted and actual FMISO PET signals, with an overall PSNR score above 29.6 and a SSIM score greater than 0.94, confirming MRI as a promising option for hypoxia prediction in brain tumors. This approach could significantly improve the accessibility of hypoxia detection in clinical settings, with the potential for more timely and targeted treatments.

Compressed Sensing (CS) significantly speeds up Magnetic Resonance Image (MRI) processing and achieves accurate MRI reconstruction from under-sampled k-space data. According to the current research, there are still several problems with dynamic MRI k-space reconstruction based on CS. 1) There are differences between the Fourier domain and the Image domain, and the differences between MRI processing of different domains need to be considered. 2) As three-dimensional data, dynamic MRI has its spatial-temporal characteristics, which need to calculate the difference and consistency of surface textures while preserving structural integrity and uniqueness. 3) Dynamic MRI reconstruction is time-consuming and computationally resource-dependent. In this paper, we propose a novel robust low-rank dynamic MRI reconstruction optimization model via highly under-sampled and Discrete Fourier Transform (DFT) called the Robust Depth Linear Error Decomposition Model (RDLEDM). Our method mainly includes linear decomposition, double Total Variation (TV), and double Nuclear Norm (NN) regularizations. By adding linear image domain error analysis, the noise is reduced after under-sampled and DFT processing, and the anti-interference ability of the algorithm is enhanced. Double TV and NN regularizations can utilize both spatial-temporal characteristics and explore the complementary relationship between different dimensions in dynamic MRI sequences. In addition, Due to the non-smoothness and non-convexity of TV and NN terms, it is difficult to optimize the unified objective model. To address this issue, we utilize a fast algorithm by solving a primal-dual form of the original problem. Compared with five state-of-the-art methods, extensive experiments on dynamic MRI data demonstrate the superior performance of the proposed method in terms of both reconstruction accuracy and time complexity.

Multiple Sclerosis (MS) is a chronic disease developed in human brain and spinal cord, which can cause permanent damage or deterioration of the nerves. The severity of MS disease is monitored by the Expanded Disability Status Scale (EDSS), composed of several functional sub-scores. Early and accurate classification of MS disease severity is critical for slowing down or preventing disease progression via applying early therapeutic intervention strategies. Recent advances in deep learning and the wide use of Electronic Health Records (EHR) creates opportunities to apply data-driven and predictive modeling tools for this goal. Previous studies focusing on using single-modal machine learning and deep learning algorithms were limited in terms of prediction accuracy due to the data insufficiency or model simplicity. In this paper, we proposed an idea of using patients' multimodal longitudinal and longitudinal EHR data to predict multiple sclerosis disease severity at the hospital visit. This work has two important contributions. First, we describe a pilot effort to leverage structured EHR data, neuroimaging data and clinical notes to build a multi-modal deep learning framework to predict patient's MS disease severity. The proposed pipeline demonstrates up to 25% increase in terms of the area under the Area Under the Receiver Operating Characteristic curve (AUROC) compared to models using single-modal data. Second, the study also provides insights regarding the amount useful signal embedded in each data modality with respect to MS disease prediction, which may improve data collection processes.

Background: Synthetic computed tomography (sCT) has been proposed and increasingly clinically adopted to enable magnetic resonance imaging (MRI)-based radiotherapy. Deep learning (DL) has recently demonstrated the ability to generate accurate sCT from fixed MRI acquisitions. However, MRI protocols may change over time or differ between centres resulting in low-quality sCT due to poor model generalisation. Purpose: investigating domain randomisation (DR) to increase the generalisation of a DL model for brain sCT generation. Methods: CT and corresponding T1-weighted MRI with/without contrast, T2-weighted, and FLAIR MRI from 95 patients undergoing RT were collected, considering FLAIR the unseen sequence where to investigate generalisation. A ``Baseline'' generative adversarial network was trained with/without the FLAIR sequence to test how a model performs without DR. Image similarity and accuracy of sCT-based dose plans were assessed against CT to select the best-performing DR approach against the Baseline. Results: The Baseline model had the poorest performance on FLAIR, with mean absolute error (MAE)=106$\pm$20.7 HU (mean$\pm\sigma$). Performance on FLAIR significantly improved for the DR model with MAE=99.0$\pm$14.9 HU, but still inferior to the performance of the Baseline+FLAIR model (MAE=72.6$\pm$10.1 HU). Similarly, an improvement in $\gamma$-pass rate was obtained for DR vs Baseline. Conclusions: DR improved image similarity and dose accuracy on the unseen sequence compared to training only on acquired MRI. DR makes the model more robust, reducing the need for re-training when applying a model on sequences unseen and unavailable for retraining.

In this work, we compare five deep learning solutions to automatically segment the resection cavity in postoperative MRI. The proposed methods are based on the same 3D U-Net architecture. We use a dataset of postoperative MRI volumes, each including four MRI sequences and the ground truth of the corresponding resection cavity. Four solutions are trained with a different MRI sequence. Besides, a method designed with all the available sequences is also presented. Our experiments show that the method trained only with the T1 weighted contrast-enhanced MRI sequence achieves the best results, with a median DICE index of 0.81.

See also article by Sveinsson et al in this issue. Paul H. Yi, MD, was a musculoskeletal radiology fellow at Johns Hopkins Hospital and is affiliate faculty at the Malone Center for Engineering in Healthcare. His research focuses on application and limitations of deep learning in radiology, including the potential for algorithmic bias. He serves on the RSNA Machine Learning Steering Subcommittee and the trainee editorial board of Radiology: Artificial Intelligence and is the journal's podcast co-host. In July 2021, Dr Yi joined the radiology faculty at the University of Maryland and serves as director of the University of Maryland Intelligent Medical Imaging Center.

Standardized body region labelling of individual images provides data that can improve human and computer use of medical images. A CNN-based classifier was developed to identify body regions in CT and MRI. 17 CT (18 MRI) body regions covering the entire human body were defined for the classification task. Three retrospective databases were built for the AI model training, validation, and testing, with a balanced distribution of studies per body region. The test databases originated from a different healthcare network. Accuracy, recall and precision of the classifier was evaluated for patient age, patient gender, institution, scanner manufacturer, contrast, slice thickness, MRI sequence, and CT kernel. The data included a retrospective cohort of 2,934 anonymized CT cases (training: 1,804 studies, validation: 602 studies, test: 528 studies) and 3,185 anonymized MRI cases (training: 1,911 studies, validation: 636 studies, test: 638 studies). 27 institutions from primary care hospitals, community hospitals and imaging centers contributed to the test datasets. The data included cases of all genders in equal proportions and subjects aged from a few months old to +90 years old. An image-level prediction accuracy of 91.9% (90.2 - 92.1) for CT, and 94.2% (92.0 - 95.6) for MRI was achieved. The classification results were robust across all body regions and confounding factors. Due to limited data, performance results for subjects under 10 years-old could not be reliably evaluated. We show that deep learning models can classify CT and MRI images by body region including lower and upper extremities with high accuracy.

MRI is the leading method of evaluation in traumatic shoulder pathologies ranging from soft tissue or bone edema to rupture of tendons or ligaments and subtle fractures of bone. MRI has the power of evaluating both of the soft tissues and bone at the same time. PD weighted MRI sequences are very powerful in demonstrating bone trauma in terms of edema and cortical disruption in the shoulder pathologies. The alterations in the intensity of the metaphyseal bone may be used to predict the presence of the bone trauma or pathologies. Although it is superior to many other imaging modalities to uncover the effects of trauma on the each anatomical structure of shoulder, PD weighted MRI has innate obstacles to image processing like low signal to noise ratio besides close anatomical relations and unclear bony borders.