Automated X-ray image segmentation would accelerate research and development in diagnostic and interventional precision medicine. Prior efforts have contributed task-specific models capable of solving specific image analysis problems, but the utility of these models is restricted to their particular task domain, and expanding to broader use requires additional data, labels, and retraining efforts. Recently, foundation models (FMs) -- machine learning models trained on large amounts of highly variable data thus enabling broad applicability -- have emerged as promising tools for automated image analysis. Existing FMs for medical image analysis focus on scenarios and modalities where objects are clearly defined by visually apparent boundaries, such as surgical tool segmentation in endoscopy. X-ray imaging, by contrast, does not generally offer such clearly delineated boundaries or structure priors. During X-ray image formation, complex 3D structures are projected in transmission onto the imaging plane, resulting in overlapping features of varying opacity and shape. To pave the way toward an FM for comprehensive and automated analysis of arbitrary medical X-ray images, we develop FluoroSAM, a language-aligned variant of the Segment-Anything Model, trained from scratch on 1.6M synthetic X-ray images. FluoroSAM is trained on data including masks for 128 organ types and 464 non-anatomical objects, such as tools and implants. In real X-ray images of cadaveric specimens, FluoroSAM is able to segment bony anatomical structures based on text-only prompting with 0.51 and 0.79 DICE with point-based refinement, outperforming competing SAM variants for all structures. FluoroSAM is also capable of zero-shot generalization to segmenting classes beyond the training set thanks to its language alignment, which we demonstrate for full lung segmentation on real chest X-rays.

X-ray computed tomography is a versatile technique for 3D structure characterization, and the pursuit of a faster yet reliable scan is never ended. A lot of methods, such as the maximum likelihood expectation maximization (MLEM) and maximum-a-posteriori (MAP), have been proposed and developed to improve the speed, but most of they are mainly for the "step-scan" mode. At synchrotron facilities such as the FXI beamline at Brookhaven National Laboratory, data is normally collected in the high-speed "fly-scan" mode, which inevitably results in a blurred image using traditional reconstruction algorithms. Figure 1 illustrates how a "fly-scan" mode can introduce artifacts due to the nature of rotation. MLEM and MAP TV methods can be employed on top of the FBP reconstruction algorithm, however, their performance is still limited (see Figure 3).

Detection of unwanted (`foreign') objects within products is a common procedure in many branches of industry for maintaining production quality. X-ray imaging is a fast, non-invasive and widely applicable method for foreign object detection. Deep learning has recently emerged as a powerful approach for recognizing patterns in radiographs (i.e., X-ray images), enabling automated X-ray based foreign object detection. However, these methods require a large number of training examples and manual annotation of these examples is a subjective and laborious task. In this work, we propose a Computed Tomography (CT) based method for producing training data for supervised learning of foreign object detection, with minimal labour requirements. In our approach, a few representative objects are CT scanned and reconstructed in 3D. The radiographs that have been acquired as part of the CT-scan data serve as input for the machine learning method. High-quality ground truth locations of the foreign objects are obtained through accurate 3D reconstructions and segmentations. Using these segmented volumes, corresponding 2D segmentations are obtained by creating virtual projections. We outline the benefits of objectively and reproducibly generating training data in this way compared to conventional radiograph annotation. In addition, we show how the accuracy depends on the number of objects used for the CT reconstructions. The results show that in this workflow generally only a relatively small number of representative objects (i.e., fewer than 10) are needed to achieve adequate detection performance in an industrial setting. Moreover, for real experimental data we show that the workflow leads to higher foreign object detection accuracies than with standard radiograph annotation.

Art and conservation experts regularly rely on X-ray imaging to find out what's going on underneath the surface of a painting. It allows them to learn more about the paint used, the technique, or the painted surface. Now, researchers have found a way to improve this technology with artificial intelligence. Some of the X-ray images of this work have now been further analysed using artificial intelligence. Even though X-ray imaging is an effective way to study the hidden layers of a painting, it doesn't discriminate between the actual layer of interest and everything else.