William B Weeks

Mohammad R. Salmanpour, Amin Mousavi, Yixi Xu et al.

Purpose: This study examines the core traits of image-to-image translation (I2I) networks, focusing on their effectiveness and adaptability in everyday clinical settings. Methods: We have analyzed data from 794 patients diagnosed with prostate cancer (PCa), using ten prominent 2D/3D I2I networks to convert ultrasound (US) images into MRI scans. We also introduced a new analysis of Radiomic features (RF) via the Spearman correlation coefficient to explore whether networks with high performance (SSIM>85%) could detect subtle RFs. Our study further examined synthetic images by 7 invited physicians. As a final evaluation study, we have investigated the improvement that are achieved using the synthetic MRI data on two traditional machine learning and one deep learning method. Results: In quantitative assessment, 2D-Pix2Pix network substantially outperformed the other 7 networks, with an average SSIM~0.855. The RF analysis revealed that 76 out of 186 RFs were identified using the 2D-Pix2Pix algorithm alone, although half of the RFs were lost during the translation process. A detailed qualitative review by 7 medical doctors noted a deficiency in low-level feature recognition in I2I tasks. Furthermore, the study found that synthesized image-based classification outperformed US image-based classification with an average accuracy and AUC~0.93. Conclusion: This study showed that while 2D-Pix2Pix outperformed cutting-edge networks in low-level feature discovery and overall error and similarity metrics, it still requires improvement in low-level feature performance, as highlighted by Group 3. Further, the study found using synthetic image-based classification outperformed original US image-based methods.

Mohammad R. Salmanpour, Sajad Amiri, Sara Gharibi et al.

We investigate the connection between visual semantic features defined in PI-RADS and associated risk factors, moving beyond abnormal imaging findings, establishing a shared framework between medical and AI professionals by creating a standardized dictionary of biological/radiological RFs. Subsequently, 6 interpretable and seven complex classifiers, linked with nine interpretable feature selection algorithms (FSA) applied to risk factors, were extracted from segmented lesions in T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) multiparametric-prostate MRI sequences to predict the UCLA scores. We then utilized the created dictionary to interpret the best-predictive models. Combining T2WI, DWI, and ADC with FSAs including ANOVA F-test, Correlation Coefficient, and Fisher Score, and utilizing logistic regression, identified key features: The 90th percentile from T2WI, which captures hypo-intensity related to prostate cancer risk; Variance from T2WI, indicating lesion heterogeneity; shape metrics including Least Axis Length and Surface Area to Volume ratio from ADC, describing lesion shape and compactness; and Run Entropy from ADC, reflecting texture consistency. This approach achieved the highest average accuracy of 0.78, significantly outperforming single-sequence methods (p-value<0.05). The developed dictionary for Prostate-MRI (PM1.0) serves as a common language, fosters collaboration between clinical professionals and AI developers to advance trustworthy AI solutions that support reliable/interpretable clinical decisions.