Chenyang Qiu

Hantao Zhang, Weidong Guo, Chenyang Qiu et al.

Rectal cancer segmentation of CT image plays a crucial role in timely clinical diagnosis, radiotherapy treatment, and follow-up. Although current segmentation methods have shown promise in delineating cancerous tissues, they still encounter challenges in achieving high segmentation precision. These obstacles arise from the intricate anatomical structures of the rectum and the difficulties in performing differential diagnosis of rectal cancer. Additionally, a major obstacle is the lack of a large-scale, finely annotated CT image dataset for rectal cancer segmentation. To address these issues, this work introduces a novel large scale rectal cancer CT image dataset CARE with pixel-level annotations for both normal and cancerous rectum, which serves as a valuable resource for algorithm research and clinical application development. Moreover, we propose a novel medical cancer lesion segmentation benchmark model named U-SAM. The model is specifically designed to tackle the challenges posed by the intricate anatomical structures of abdominal organs by incorporating prompt information. U-SAM contains three key components: promptable information (e.g., points) to aid in target area localization, a convolution module for capturing low-level lesion details, and skip-connections to preserve and recover spatial information during the encoding-decoding process. To evaluate the effectiveness of U-SAM, we systematically compare its performance with several popular segmentation methods on the CARE dataset. The generalization of the model is further verified on the WORD dataset. Extensive experiments demonstrate that the proposed U-SAM outperforms state-of-the-art methods on these two datasets. These experiments can serve as the baseline for future research and clinical application development.

Weidong Guo, Hantao Zhang, Shouhong Wan et al.

Accurate segmentation of metastatic lymph nodes in rectal cancer is crucial for the staging and treatment of rectal cancer. However, existing segmentation approaches face challenges due to the absence of pixel-level annotated datasets tailored for lymph nodes around the rectum. Additionally, metastatic lymph nodes are characterized by their relatively small size, irregular shapes, and lower contrast compared to the background, further complicating the segmentation task. To address these challenges, we present the first large-scale perirectal metastatic lymph node CT image dataset called Meply, which encompasses pixel-level annotations of 269 patients diagnosed with rectal cancer. Furthermore, we introduce a novel lymph-node segmentation model named CoSAM. The CoSAM utilizes sequence-based detection to guide the segmentation of metastatic lymph nodes in rectal cancer, contributing to improved localization performance for the segmentation model. It comprises three key components: sequence-based detection module, segmentation module, and collaborative convergence unit. To evaluate the effectiveness of CoSAM, we systematically compare its performance with several popular segmentation methods using the Meply dataset. Our code and dataset will be publicly available at: https://github.com/kanydao/CoSAM.

Yujian Hu, Yilang Xiang, Yan-Jie Zhou et al.

The accurate and timely diagnosis of acute aortic syndromes (AAS) in patients presenting with acute chest pain remains a clinical challenge. Aortic CT angiography (CTA) is the imaging protocol of choice in patients with suspected AAS. However, due to economic and workflow constraints in China, the majority of suspected patients initially undergo non-contrast CT as the initial imaging testing, and CTA is reserved for those at higher risk. In this work, we present an artificial intelligence-based warning system, iAorta, using non-contrast CT for AAS identification in China, which demonstrates remarkably high accuracy and provides clinicians with interpretable warnings. iAorta was evaluated through a comprehensive step-wise study. In the multi-center retrospective study (n = 20,750), iAorta achieved a mean area under the receiver operating curve (AUC) of 0.958 (95% CI 0.950-0.967). In the large-scale real-world study (n = 137,525), iAorta demonstrated consistently high performance across various non-contrast CT protocols, achieving a sensitivity of 0.913-0.942 and a specificity of 0.991-0.993. In the prospective comparative study (n = 13,846), iAorta demonstrated the capability to significantly shorten the time to correct diagnostic pathway. For the prospective pilot deployment that we conducted, iAorta correctly identified 21 out of 22 patients with AAS among 15,584 consecutive patients presenting with acute chest pain and under non-contrast CT protocol in the emergency department (ED) and enabled the average diagnostic time of these 21 AAS positive patients to be 102.1 (75-133) mins. Last, the iAorta can help avoid delayed or missed diagnosis of AAS in settings where non-contrast CT remains the unavoidable the initial or only imaging test in resource-constrained regions and in patients who cannot or did not receive intravenous contrast.