27 research outputs found
Multi-Scale Feature Fusion using Parallel-Attention Block for COVID-19 Chest X-ray Diagnosis
Under the global COVID-19 crisis, accurate diagnosis of COVID-19 from Chest
X-ray (CXR) images is critical. To reduce intra- and inter-observer
variability, during the radiological assessment, computer-aided diagnostic
tools have been utilized to supplement medical decision-making and subsequent
disease management. Computational methods with high accuracy and robustness are
required for rapid triaging of patients and aiding radiologists in the
interpretation of the collected data. In this study, we propose a novel
multi-feature fusion network using parallel attention blocks to fuse the
original CXR images and local-phase feature-enhanced CXR images at
multi-scales. We examine our model on various COVID-19 datasets acquired from
different organizations to assess the generalization ability. Our experiments
demonstrate that our method achieves state-of-art performance and has improved
generalization capability, which is crucial for widespread deployment.Comment: Accepted for publication at the Journal of Machine Learning for
Biomedical Imaging (MELBA) https://melba-journal.org/2023:00
Multi-Feature Vision Transformer via Self-Supervised Representation Learning for Improvement of COVID-19 Diagnosis
The role of chest X-ray (CXR) imaging, due to being more cost-effective,
widely available, and having a faster acquisition time compared to CT, has
evolved during the COVID-19 pandemic. To improve the diagnostic performance of
CXR imaging a growing number of studies have investigated whether supervised
deep learning methods can provide additional support. However, supervised
methods rely on a large number of labeled radiology images, which is a
time-consuming and complex procedure requiring expert clinician input. Due to
the relative scarcity of COVID-19 patient data and the costly labeling process,
self-supervised learning methods have gained momentum and has been proposed
achieving comparable results to fully supervised learning approaches. In this
work, we study the effectiveness of self-supervised learning in the context of
diagnosing COVID-19 disease from CXR images. We propose a multi-feature Vision
Transformer (ViT) guided architecture where we deploy a cross-attention
mechanism to learn information from both original CXR images and corresponding
enhanced local phase CXR images. We demonstrate the performance of the baseline
self-supervised learning models can be further improved by leveraging the local
phase-based enhanced CXR images. By using 10\% labeled CXR scans, the proposed
model achieves 91.10\% and 96.21\% overall accuracy tested on total 35,483 CXR
images of healthy (8,851), regular pneumonia (6,045), and COVID-19 (18,159)
scans and shows significant improvement over state-of-the-art techniques. Code
is available https://github.com/endiqq/Multi-Feature-ViTComment: Accepted to the 2022 MICCAI Workshop on Medical Image Learning with
Limited and Noisy Dat
Modern Management of Localized Renal Cell Carcinoma— Is Ablation Part of the Equation?
While the gold-standard for management of localized renal cell carcinoma (RCC) is partial nephrectomy, recent ablative strategies are emerging as alternatives with comparable rates of complications and oncologic outcomes. Thermal ablation, in the form of radiofrequency ablation and cryoablation, is being increasingly accepted by professional societies, and is particularly recommended in patients with a significant comorbidity burden, renal impairment, old age, or in those unwilling to undergo surgery. Maturation of long-term oncologic outcomes has further allowed increased confidence in these management strategies. New and exciting ablation technologies such as microwave ablation, stereotactic body radiotherapy, and irreversible electroporation are emerging. In this article, we review the existing management options for localized RCC, with specific focus on the oncologic outcomes associated with the various ablation modalities
Antegrade pampiniform plexus venography in recurrent varicocele: Case report and anatomy review
Varicoceles are often treated with percutaneous embolization, using fibered coils and sclerosing agents, with the latter targeted at occlusion of pre-existing collateral veins. While various methods of surgical and embolization treatment are available, varicoceles may still recur from venous collateralization. We present a case, where following demonstration of complete occlusion of the right and left gonadal veins, direct puncture of the pampiniform venous plexus under ultrasound guidance revealed recurrent varicoceles supplied by anastomoses from the ipsilateral saphenous and femoral veins to the pampiniform plexus. In doing so, we describe a technique of percutaneous pampiniform venography in a case where the pertinent anatomy was not easily demonstrated by other methods
Repair of a Post-Hepatectomy Posterior Sectoral Duct Injury Secondary to Anomalous Bile Duct Anatomy Using a Novel Combined Surgical-Interventional Radiologic Approach
A 64-year-old woman with a completely transected posterior sectoral duct following extended hepatectomy underwent a combined operative procedure with interventional radiology and surgery to restore biliary-enteric drainage. The anterior and posterior sectoral ducts were identified, and catheters were inserted into both systems. The posterior sectoral catheter was placed intraoperatively through a preoperatively placed sheath, and a new tunnel was created through the regenerated liver surface. Biliary-enteric anastomoses were created over the stents
Balloon-assisted occlusion of the internal iliac arteries in patients with placenta accreta/percreta.
BACKGROUND: Placenta accreta/percreta is a leading cause of third trimester hemorrhage and postpartum maternal death. The current treatment for third trimester hemorrhage due to placenta accreta/percreta is cesarean hysterectomy, which may be complicated by large volume blood loss.
PURPOSE: To determine what role, if any, prophylactic temporary balloon occlusion and transcatheter embolization of the anterior division of the internal iliac arteries plays in the management of patients with placenta accreta/percreta.
METHODS: The records of 28 consecutive patients with a diagnosis of placenta accreta/percreta were retrospectively reviewed. Patients were divided into two groups. Six patients underwent prophylactic temporary balloon occlusion, followed by cesarean section, transcatheter embolization of the anterior division of the internal iliac arteries and cesarean hysterectomy (n = 5) or uterine curettage (n = 1). Twenty-two patients underwent cesarean hysterectomy without endovascular intervention. The following parameters were compared in the two groups: patient age, gravidity, parity, gestational age at delivery, days in the intensive care unit after delivery, total hospital days, volume of transfused blood products, volume of fluid replacement intraoperatively, operating room time, estimated blood loss, and postoperative morbidity and mortality.
RESULTS: Patients in the embolization group had more frequent episodes of third trimester bleeding requiring admission and bedrest prior to delivery (16.7 days vs. 2.9 days), resulting in significantly more hospitalization time in the embolization group (23 days vs. 8.8 days) and delivery at an earlier gestational age than in those in the surgical group (32.5 weeks). There was no statistical difference in mean estimated blood loss, volume of replaced blood products, fluid replacement needs, operating room time or postoperative recovery time.
CONCLUSION: Our findings do not support the contention that in patients with placenta accreta/percreta, prophylactic temporary balloon occlusion and embolization prior to hysterectomy diminishes intraoperative blood loss