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The dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) technique has taken on a significant and increasing role in diagnostic procedures and treatments for patients who suffer from chronic kidney disease. Careful segmentation of kidneys from DCE-MRI scans is an essential early step towards the evaluation of kidney function. Recently, deep convolutional neural networks have increased in popularity in medical image segmentation. To this end, in this paper, we propose a new and fully automated two-phase approach that integrates convolutional neural networks and level set methods to delimit kidneys in DCE-MRI scans. We first develop two convolutional neural networks that rely on the U-Net structure (UNT) to predict a kidney probability map for DCE-MRI scans. Then, to leverage the segmentation performance, the pixel-wise kidney probability map predicted from the deep model is exploited with the shape prior information in a level set method to guide the contour evolution towards the target kidney. Real DCE-MRI datasets of 45 subjects are used for training, validating, and testing the proposed approach. The valuation results demonstrate the high performance of the two-phase approach, achieving a Dice similarity coefficient of 0.95 ± 0.02 and intersection over union of 0.91 ± 0.03, and 1.54 ± 1.6 considering a 95% Hausdorff distance. Our intensive experiments confirm the potential and effectiveness of that approach over both UNT models and numerous recent level set-based methods.

The primary goal of this manuscript is to develop a computer assisted diagnostic (CAD) system to assess pulmonary function and risk of mortality in patients with coronavirus disease 2019 (COVID-19). The CAD system processes chest X-ray data and provides accurate, objective imaging markers to assist in the determination of patients with a higher risk of death and thus are more likely to require mechanical ventilation and/or more intensive clinical care.To obtain an accurate stochastic model that has the ability to detect the severity of lung infection, we develop a second-order Markov-Gibbs random field (MGRF) invariant under rigid transformation (translation or rotation of the image) as well as scale (i.e., pixel size). The parameters of the MGRF model are learned automatically, given a training set of X-ray images with affected lung regions labeled. An X-ray input to the system undergoes pre-processing to correct for non-uniformity of illumination and to delimit the boundary of the lung, using either a fully-automated segmentation routine or manual delineation provided by the radiologist, prior to the diagnosis. The steps of the proposed methodology are: (i) estimate the Gibbs energy at several different radii to describe the inhomogeneity in lung infection; (ii) compute the cumulative distribution function (CDF) as a new representation to describe the local inhomogeneity in the infected region of lung; and (iii) input the CDFs to a new neural network-based fusion system to determine whether the severity of lung infection is low or high. This approach is tested on 200 clinical X-rays from 200 COVID-19 positive patients, 100 of whom died and 100 who recovered using multiple training/testing processes including leave-one-subject-out (LOSO), tenfold, fourfold, and twofold cross-validation tests. The Gibbs energy for lung pathology was estimated at three concentric rings of increasing radii. The accuracy and Dice similarity coefficient (DSC) of the system steadily improved as the radius increased. The overall CAD system combined the estimated Gibbs energy information from all radii and achieved a sensitivity, specificity, accuracy, and DSC of 100%, 97% ± 3%, 98% ± 2%, and 98% ± 2%, respectively, by twofold cross validation. Alternative classification algorithms, including support vector machine, random forest, naive Bayes classifier, K-nearest neighbors, and decision trees all produced inferior results compared to the proposed neural network used in this CAD system. The experiments demonstrate the feasibility of the proposed system as a novel tool to objectively assess disease severity and predict mortality in COVID-19 patients. The proposed tool can assist physicians to determine which patients might require more intensive clinical care, such a mechanical respiratory support.

Kidney image enhancement is challenging due to the unpredictable quality of MRI images, as well as the nature of kidney diseases. The focus of this work is on kidney images enhancement by proposing a new Local Fractional Entropy (LFE)-based model. The proposed model estimates the probability of pixels that represent edges based on the entropy of the neighboring pixels, which results in local fractional entropy. When there is a small change in the intensity values (indicating the presence of edge in the image), the local fractional entropy gives fine image details. Similarly, when no change in intensity values is present (indicating smooth texture), the LFE does not provide fine details, based on the fact that there is no edge information. Tests were conducted on a large dataset of different, poor-quality kidney images to show that the proposed model is useful and effective. A comparative study with the classical methods, coupled with the latest enhancement methods, shows that the proposed model outperforms the existing methods.