Edward Harake

Yiwei Lyu, Sung Jik Cha, Cheng Jiang et al.

High-quality, high-resolution medical imaging is essential for clinical care. Raman-based biomedical optical imaging uses non-ionizing infrared radiation to evaluate human tissues in real time and is used for early cancer detection, brain tumor diagnosis, and intraoperative tissue analysis. Unfortunately, optical imaging is vulnerable to image degradation due to laser scattering and absorption, which can result in diagnostic errors and misguided treatment. Restoration of optical images is a challenging computer vision task because the sources of image degradation are multi-factorial, stochastic, and tissue-dependent, preventing a straightforward method to obtain paired low-quality/high-quality data. Here, we present Restorative Step-Calibrated Diffusion (RSCD), an unpaired diffusion-based image restoration method that uses a step calibrator model to dynamically determine the number of steps required to complete the reverse diffusion process for image restoration. RSCD outperforms other widely used unpaired image restoration methods on both image quality and perceptual evaluation metrics for restoring optical images. Medical imaging experts consistently prefer images restored using RSCD in blinded comparison experiments and report minimal to no hallucinations. Finally, we show that RSCD improves performance on downstream clinical imaging tasks, including automated brain tumor diagnosis and deep tissue imaging. Our code is available at https://github.com/MLNeurosurg/restorative_step-calibrated_diffusion.

Chenhui Zhao, Yiwei Lyu, Asadur Chowdury et al.

The scalability of current language-image pre-training for 3D medical imaging, such as CT and MRI, is constrained by the need for radiologists to manually curate raw clinical studies. In this work, we pioneer pre-training directly on uncurated studies, which both aligns more closely with the radiologist's workflow and provides a natural path to scalability. However, the unique structure of such data presents new challenges for existing model architectures, which were originally designed for 2D slices or single 3D scans. To address this, we introduce a novel hierarchical attention mechanism inspired by the intrinsic hierarchy of radiology data: slice, scan, and study. We denote our framework as Hierarchical attention for Language-Image Pre-training (HLIP). Trained on 220K studies with 3.13 million scans for brain MRI and 240K studies with 1.44 million scans for head CT, HLIP achieves state-of-the-art performance, e.g., +10.5% balanced ACC on the proposed publicly available brain MRI benchmark Pub-Brain-5; +8.3% and +1.7% macro AUC on head CT benchmarks CQ500 and RSNA, respectively. HLIP also exhibits strong generalizability on existing 3D medical language-image pre-training benchmarks, e.g., +4.3% macro AUC on the Rad-ChestCT benchmark when pre-trained on CT-RATE. These results demonstrate that, with HLIP, directly pre-training on uncurated clinical datasets is a scalable and effective direction for language-image pre-training in 3D medical imaging. The code is available at https://github.com/Zch0414/hlip.

Edward S. Harake, Joseph R. Linzey, Cheng Jiang et al.

Objective. Achieving appropriate spinopelvic alignment has been shown to be associated with improved clinical symptoms. However, measurement of spinopelvic radiographic parameters is time-intensive and interobserver reliability is a concern. Automated measurement tools have the promise of rapid and consistent measurements, but existing tools are still limited by some degree of manual user-entry requirements. This study presents a novel artificial intelligence (AI) tool called SpinePose that automatically predicts spinopelvic parameters with high accuracy without the need for manual entry. Methods. SpinePose was trained and validated on 761 sagittal whole-spine X-rays to predict sagittal vertical axis (SVA), pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), T1-pelvic angle (T1PA), and L1-pelvic angle (L1PA). A separate test set of 40 X-rays was labeled by 4 reviewers, including fellowship-trained spine surgeons and a fellowship-trained radiologist with neuroradiology subspecialty certification. Median errors relative to the most senior reviewer were calculated to determine model accuracy on test images. Intraclass correlation coefficients (ICC) were used to assess inter-rater reliability. Results. SpinePose exhibited the following median (interquartile range) parameter errors: SVA: 2.2(2.3)mm, p=0.93; PT: 1.3(1.2)°, p=0.48; SS: 1.7(2.2)°, p=0.64; PI: 2.2(2.1)°, p=0.24; LL: 2.6(4.0)°, p=0.89; T1PA: 1.1(0.9)°, p=0.42; and L1PA: 1.4(1.6)°, p=0.49. Model predictions also exhibited excellent reliability at all parameters (ICC: 0.91-1.0). Conclusions. SpinePose accurately predicted spinopelvic parameters with excellent reliability comparable to fellowship-trained spine surgeons and neuroradiologists. Utilization of predictive AI tools in spinal imaging can substantially aid in patient selection and surgical planning.