Michael D. Abràmoff

Yiwen Lu, Lu Li, Dazheng Zhang et al.

Sample size calculations for power analysis are critical for clinical research and trial design, yet their complexity and reliance on statistical expertise create barriers for many researchers. We introduce PowerGPT, an AI-powered system integrating large language models (LLMs) with statistical engines to automate test selection and sample size estimation in trial design. In a randomized trial to evaluate its effectiveness, PowerGPT significantly improved task completion rates (99.3% vs. 88.9% for test selection, 99.3% vs. 77.8% for sample size calculation) and accuracy (94.1% vs. 55.4% in sample size estimation, p < 0.001), while reducing average completion time (4.0 vs. 9.3 minutes, p < 0.001). These gains were consistent across various statistical tests and benefited both statisticians and non-statisticians as well as bridging expertise gaps. Already under deployment across multiple institutions, PowerGPT represents a scalable AI-driven approach that enhances accessibility, efficiency, and accuracy in statistical power analysis for clinical research.

Abhay Shah, Michael Abramoff, Xiaodong Wu

The task of automatically segmenting 3-D surfaces representing boundaries of objects is important for quantitative analysis of volumetric images, and plays a vital role in biomedical image analysis. Recently, graph-based methods with a global optimization property have been developed and optimized for various medical imaging applications. Despite their widespread use, these require human experts to design transformations, image features, surface smoothness priors, and re-design for a different tissue, organ or imaging modality. Here, we propose a Deep Learning based approach for segmentation of the surfaces in volumetric medical images, by learning the essential features and transformations from training data, without any human expert intervention. We employ a regional approach to learn the local surface profiles. The proposed approach was evaluated on simultaneous intraretinal layer segmentation of optical coherence tomography (OCT) images of normal retinas and retinas affected by age related macular degeneration (AMD). The proposed approach was validated on 40 retina OCT volumes including 20 normal and 20 AMD subjects. The experiments showed statistically significant improvement in accuracy for our approach compared to state-of-the-art graph based optimal surface segmentation with convex priors (G-OSC). A single Convolution Neural Network (CNN) was used to learn the surfaces for both normal and diseased images. The mean unsigned surface positioning errors obtained by G-OSC method 2.31 voxels (95% CI 2.02-2.60 voxels) was improved to $1.27$ voxels (95% CI 1.14-1.40 voxels) using our new approach. On average, our approach takes 94.34 s, requiring 95.35 MB memory, which is much faster than the 2837.46 s and 6.87 GB memory required by the G-OSC method on the same computer system.

Pedro Costa, Adrian Galdran, Maria Inês Meyer et al.

Synthesizing images of the eye fundus is a challenging task that has been previously approached by formulating complex models of the anatomy of the eye. New images can then be generated by sampling a suitable parameter space. In this work, we propose a method that learns to synthesize eye fundus images directly from data. For that, we pair true eye fundus images with their respective vessel trees, by means of a vessel segmentation technique. These pairs are then used to learn a mapping from a binary vessel tree to a new retinal image. For this purpose, we use a recent image-to-image translation technique, based on the idea of adversarial learning. Experimental results show that the original and the generated images are visually different in terms of their global appearance, in spite of sharing the same vessel tree. Additionally, a quantitative quality analysis of the synthetic retinal images confirms that the produced images retain a high proportion of the true image set quality.

Raheleh Kafieh, Hossein Rabbani, Fedra Hajizadeh et al.

Purpose. This study was conducted to determine the thickness map of eleven retinal layers in normal subjects by spectral domain optical coherence tomography (SD-OCT) and evaluate their association with sex and age. Methods. Mean regional retinal thickness of 11 retinal layers were obtained by automatic three-dimensional diffusion-map-based method in 112 normal eyes of 76 Iranian subjects. Results. The thickness map of central foveal area in layer 1, 3, and 4 displayed the minimum thickness (P<0.005 for all). Maximum thickness was observed in nasal to the fovea of layer 1 (P<0.001) and in a circular pattern in the parafoveal retinal area of layers 2, 3 and 4 and in central foveal area of layer 6 (P<0.001). Temporal and inferior quadrants of the total retinal thickness and most of other quadrants of layer 1 were significantly greater in the men than in the women. Surrounding eight sectors of total retinal thickness and a limited number of sectors in layer 1 and 4 significantly correlated with age. Conclusion. SD-OCT demonstrated the three-dimensional thickness distribution of retinal layers in normal eyes. Thickness of layers varied with sex and age and in different sectors. These variables should be considered while evaluating macular thickness.

Raheleh Kafieh, Hossein Rabbani, Michael D. Abramoff et al.

Optical coherence tomography (OCT) is a powerful and noninvasive method for retinal imaging. In this paper, we introduce a fast segmentation method based on a new variant of spectral graph theory named diffusion maps. The research is performed on spectral domain (SD) OCT images depicting macular and optic nerve head appearance. The presented approach does not require edge-based image information and relies on regional image texture. Consequently, the proposed method demonstrates robustness in situations of low image contrast or poor layer-to-layer image gradients. Diffusion mapping is applied to 2D and 3D OCT datasets composed of two steps, one for partitioning the data into important and less important sections, and another one for localization of internal layers.In the first step, the pixels/voxels are grouped in rectangular/cubic sets to form a graph node.The weights of a graph are calculated based on geometric distances between pixels/voxels and differences of their mean intensity.The first diffusion map clusters the data into three parts, the second of which is the area of interest. The other two sections are eliminated from the remaining calculations. In the second step, the remaining area is subjected to another diffusion map assessment and the internal layers are localized based on their textural similarities.The proposed method was tested on 23 datasets from two patient groups (glaucoma and normals). The mean unsigned border positioning errors(mean - SD) was 8.52 - 3.13 and 7.56 - 2.95 micrometer for the 2D and 3D methods, respectively.