Gregory E. Tasian

Stanley Bryan Z. Hua, Mandy Rickard, John Weaver et al.

Previous work has shown the potential of deep learning to predict renal obstruction using kidney ultrasound images. However, these image-based classifiers have been trained with the goal of single-visit inference in mind. We compare methods from video action recognition (i.e. convolutional pooling, LSTM, TSM) to adapt single-visit convolutional models to handle multiple visit inference. We demonstrate that incorporating images from a patient's past hospital visits provides only a small benefit for the prediction of obstructive hydronephrosis. Therefore, inclusion of prior ultrasounds is beneficial, but prediction based on the latest ultrasound is sufficient for patient risk stratification.

Sheng Wang, Tianming Du, Katherine Fischer et al.

Computer-aided diagnosis systems hold great promise to aid radiologists and clinicians in radiological clinical practice and enhance diagnostic accuracy and efficiency. However, the conventional systems primarily focus on delivering diagnostic results through text report generation or medical image classification, positioning them as standalone decision-makers rather than helpers and ignoring radiologists' expertise. This study introduces an innovative paradigm to create an assistive co-pilot system for empowering radiologists by leveraging Large Language Models (LLMs) and medical image analysis tools. Specifically, we develop a collaborative framework to integrate LLMs and quantitative medical image analysis results generated by foundation models with radiologists in the loop, achieving efficient and safe generation of radiology reports and effective utilization of computational power of AI and the expertise of medical professionals. This approach empowers radiologists to generate more precise and detailed diagnostic reports, enhancing patient outcomes while reducing the burnout of clinicians. Our methodology underscores the potential of AI as a supportive tool in medical diagnostics, promoting a harmonious integration of technology and human expertise to advance the field of radiology.

Shi Yin, Zhengqiang Zhang, Hongming Li et al.

It remains challenging to automatically segment kidneys in clinical ultrasound images due to the kidneys' varied shapes and image intensity distributions, although semi-automatic methods have achieved promising performance. In this study, we developed a novel boundary distance regression deep neural network to segment the kidneys, informed by the fact that the kidney boundaries are relatively consistent across images in terms of their appearance. Particularly, we first use deep neural networks pre-trained for classification of natural images to extract high-level image features from ultrasound images, then these feature maps are used as input to learn kidney boundary distance maps using a boundary distance regression network, and finally the predicted boundary distance maps are classified as kidney pixels or non-kidney pixels using a pixel classification network in an end-to-end learning fashion. Experimental results have demonstrated that our method could effectively improve the performance of automatic kidney segmentation, significantly better than deep learning based pixel classification networks.

Shi Yin, Qinmu Peng, Hongming Li et al.

It remains challenging to automatically segment kidneys in clinical ultrasound (US) images due to the kidneys' varied shapes and image intensity distributions, although semi-automatic methods have achieved promising performance. In this study, we propose subsequent boundary distance regression and pixel classification networks to segment the kidneys, informed by the fact that the kidney boundaries have relatively homogenous texture patterns across images. Particularly, we first use deep neural networks pre-trained for classification of natural images to extract high-level image features from US images, then these features are used as input to learn kidney boundary distance maps using a boundary distance regression network, and finally the predicted boundary distance maps are classified as kidney pixels or non-kidney pixels using a pixel classification network in an end-to-end learning fashion. We also adopted a data-augmentation method based on kidney shape registration to generate enriched training data from a small number of US images with manually segmented kidney labels. Experimental results have demonstrated that our method could effectively improve the performance of automatic kidney segmentation, significantly better than deep learning-based pixel classification networks.

Qiang Zheng, Gregory Tasian, Yong Fan

Classification of ultrasound (US) kidney images for diagnosis of congenital abnormalities of the kidney and urinary tract (CAKUT) in children is a challenging task. It is desirable to improve existing pattern classification models that are built upon conventional image features. In this study, we propose a transfer learning-based method to extract imaging features from US kidney images in order to improve the CAKUT diagnosis in children. Particularly, a pre-trained deep learning model (imagenet-caffe-alex) is adopted for transfer learning-based feature extraction from 3-channel feature maps computed from US images, including original images, gradient features, and distanced transform features. Support vector machine classifiers are then built upon different sets of features, including the transfer learning features, conventional imaging features, and their combination. Experimental results have demonstrated that the combination of transfer learning features and conventional imaging features yielded the best classification performance for distinguishing CAKUT patients from normal controls based on their US kidney images.

Qiang Zheng, Steven Warner, Gregory Tasian et al.

Purpose: To improve kidney segmentation in clinical ultrasound (US) images, we develop a new graph cuts based method to segment kidney US images by integrating original image intensity information and texture feature maps extracted using Gabor filters. Methods: To handle large appearance variation within kidney images and improve computational efficiency, we build a graph of image pixels close to kidney boundary instead of building a graph of the whole image. To make the kidney segmentation robust to weak boundaries, we adopt localized regional information to measure similarity between image pixels for computing edge weights to build the graph of image pixels. The localized graph is dynamically updated and the GC based segmentation iteratively progresses until convergence. The proposed method has been evaluated and compared with state of the art image segmentation methods based on clinical kidney US images of 85 subjects. We randomly selected US images of 20 subjects as training data for tuning the parameters, and validated the methods based on US images of the remaining 65 subjects. The segmentation results have been quantitatively analyzed using 3 metrics, including Dice Index, Jaccard Index, and Mean Distance. Results: Experiment results demonstrated that the proposed method obtained segmentation results for bilateral kidneys of 65 subjects with average Dice index of 0.9581, Jaccard index of 0.9204, and Mean Distance of 1.7166, better than other methods under comparison (p<10-19, paired Wilcoxon rank sum tests). Conclusions: The proposed method achieved promising performance for segmenting kidneys in US images, better than segmentation methods that built on any single channel of image information. This method will facilitate extraction of kidney characteristics that may predict important clinical outcomes such progression chronic kidney disease.