Jiantao Pu

Zixue Zeng, Xiaoyan Zhao, Matthew Cartier et al.

We introduce a novel segmentation-aware joint training framework called generative reinforcement network (GRN) that integrates segmentation loss feedback to optimize both image generation and segmentation performance in a single stage. An image enhancement technique called segmentation-guided enhancement (SGE) is also developed, where the generator produces images tailored specifically for the segmentation model. Two variants of GRN were also developed, including GRN for sample-efficient learning (GRN-SEL) and GRN for semi-supervised learning (GRN-SSL). GRN's performance was evaluated using a dataset of 69 fully annotated 3D ultrasound scans from 29 subjects. The annotations included six anatomical structures: dermis, superficial fat, superficial fascial membrane (SFM), deep fat, deep fascial membrane (DFM), and muscle. Our results show that GRN-SEL with SGE reduces labeling efforts by up to 70% while achieving a 1.98% improvement in the Dice Similarity Coefficient (DSC) compared to models trained on fully labeled datasets. GRN-SEL alone reduces labeling efforts by 60%, GRN-SSL with SGE decreases labeling requirements by 70%, and GRN-SSL alone by 60%, all while maintaining performance comparable to fully supervised models. These findings suggest the effectiveness of the GRN framework in optimizing segmentation performance with significantly less labeled data, offering a scalable and efficient solution for ultrasound image analysis and reducing the burdens associated with data annotation.

Zixue Zeng, Anthony M. Perti, Tong Yu et al.

Myofascial pain (MP) is a leading cause of chronic low back pain, yet its tissue-level drivers remain poorly defined and lack reliable image biomarkers. Existing studies focus predominantly on muscle while neglecting fascia, fat, and other soft tissues that play integral biomechanical roles. We developed an anatomically grounded explainable artificial intelligence (AI) framework, LAYER (Layer-wise Analysis for Yielding Explainable Relevance Tissue), that analyses six tissue layers in three-dimensional (3D) ultrasound and quantifies their contribution to MP prediction. By utilizing the largest multi-model 3D ultrasound cohort consisting of over 4,000 scans, LAYER reveals that non-muscle tissues contribute substantially to pain prediction. In B-mode imaging, the deep fascial membrane (DFM) showed the highest saliency (0.420), while in combined B-mode and shear-wave images, the collective saliency of non-muscle layers (0.316) nearly matches that of muscle (0.317), challenging the conventional muscle-centric paradigm in MP research and potentially affecting the therapy methods. LAYER establishes a quantitative, interpretable framework for linking layer-specific anatomy to pain physiology, uncovering new tissue targets and providing a generalizable approach for explainable analysis of soft-tissue imaging.

Yi Zhen, Lei Wang, Han Liu et al.

Objective: To validate and compare the performance of eight available deep learning architectures in grading the severity of glaucoma based on color fundus images. Materials and Methods: We retrospectively collected a dataset of 5978 fundus images and their glaucoma severities were annotated by the consensus of two experienced ophthalmologists. We preprocessed the images to generate global and local regions of interest (ROIs), namely the global field-of-view images and the local disc region images. We then divided the generated images into three independent sub-groups for training, validation, and testing purposes. With the datasets, eight convolutional neural networks (CNNs) (i.e., VGG16, VGG19, ResNet, DenseNet, InceptionV3, InceptionResNet, Xception, and NASNetMobile) were trained separately to grade glaucoma severity, and validated quantitatively using the area under the receiver operating characteristic (ROC) curve and the quadratic kappa score. Results: The CNNs, except VGG16 and VGG19, achieved average kappa scores of 80.36% and 78.22% when trained from scratch on global and local ROIs, and 85.29% and 82.72% when fine-tuned using the pre-trained weights, respectively. VGG16 and VGG19 achieved reasonable accuracy when trained from scratch, but they failed when using pre-trained weights for global and local ROIs. Among these CNNs, the DenseNet had the highest classification accuracy (i.e., 75.50%) based on pre-trained weights when using global ROIs, as compared to 65.50% when using local ROIs. Conclusion: The experiments demonstrated the feasibility of the deep learning technology in grading glaucoma severity. In particular, global field-of-view images contain relatively richer information that may be critical for glaucoma assessment, suggesting that we should use the entire field-of-view of a fundus image for training a deep learning network.