/pdf/transmorph-transformer-for-unsupervised-medical-image-klizzsno.pdf

TransMorph: Transformer for unsupervised medical image registration

The promise of artificial intelligence and deep learning in PET and SPECT imaging.

This article aims to make a bibliometric literature review using systematic scientific mapping and content analysis of digital twins in healthcare to know the evolution, domain, keywords, content type, and kind and purpose of digital twin's implementation in healthcare, so a consolidation and future improvement of existing knowledge can be made and gaps for new studies can be identified. The increase in publications of digital twins in healthcare is quite recent and it is still concentrated in the domain of technology sources. The subject is majorly concentrated in patient's digital twin group and in precision medicine and aspects, issues and/or policies subgroups, although the publications keywords mirror it only at the group side. Digital twins in healthcare are probably stepping out of the infancy phase. On the other hand, digital twins in hospital group and the device and facilities management subgroups are more mature with all knowledge gathered from the manufacturing sector. There is an absence of some publication's types in general, device and care subgroup and no whole body or hospital digital twin was reported. Based on the presented arguments, guidelines for future research were presented: advance in the creation of general frameworks, in subgroups not as much explored, and in groups and subgroups already explored, but that need more advancement to achieve the main goals of a whole human or hospital digital twin with the main issues resolved. 

Literature review of digital twin in healthcare

Medical devices have increased in complexity where there is a pressing need to consider design thinking and specialist training for manufacturers, healthcare and sterilization providers, and regulators. Appropriately addressing this consideration will positively inform end-to-end supply chain and logistics, production, processing, sterilization, safety, regulation, education, sustainability and circularity. There are significant opportunities to innovate and to develop appropriate digital tools to help unlock efficiencies in these important areas. This constitutes the first paper to create an awareness of and to define different digital technologies for informing and enabling medical device production from a holistic end-to-end life cycle perspective. It describes the added-value of using digital innovations to meet emerging opportunities for many disposable and reusable medical devices. It addresses the value of accessing and using integrated multi-actor HUBs that combine academia, industry, healthcare, regulators and society to help meet these opportunities. Such as cost-effective access to specialist pilot facilities and expertise that converges digital innovation, material science, biocompatibility, sterility assurance, business model and sustainability. It highlights the marked gap in academic R&D activities (PRISMA review of best publications conducted between January 2010 and January 2024) and the actual list of U.S. FDA's approved and marketed artificial intelligence/machine learning (AI/ML), and augmented reality/virtual reality (AR/VR) enabled-medical devices for different healthcare applications. Bespoke examples of benefits underlying future use of digital tools includes potential implementation of machine learning for supporting and enabling parametric release of sterilized products through efficient monitoring of critical process data (complying with ISO 11135:2014) that would benefit stakeholders. This paper also focuses on the transformative potential of combining digital twin with extended reality innovations to inform efficiencies in medical device design thinking, supply chain and training to inform patient safety, circularity and sustainability. 

Digital technologies to unlock safe and sustainable opportunities for medical device and healthcare sectors with a focus on the combined use of digital twin and extended reality applications: A review.

This study aimed to improve patient positioning accuracy by relying on a CT localizer and a deep neural network to optimize image quality and radiation dose.We included 5754 chest CT axial and anterior-posterior (AP) images from two different centers, C1 and C2. After pre-processing, images were split into training (80%) and test (20%) datasets. A deep neural network was trained to generate 3D axial images from the AP localizer. The geometric centerlines of patient bodies were indicated by creating a bounding box on the predicted images. The distance between the body centerline, estimated by the deep learning model and ground truth (BCAP), was compared with patient mis-centering during manual positioning (BCMP). We evaluated the performance of our model in terms of distance between the lung centerline estimated by the deep learning model and the ground truth (LCAP).The error in terms of BCAP was - 0.75 ± 7.73 mm and 2.06 ± 10.61 mm for C1 and C2, respectively. This error was significantly lower than BCMP, which achieved an error of 9.35 ± 14.94 and 13.98 ± 14.5 mm for C1 and C2, respectively. The absolute BCAP was 5.7 ± 5.26 and 8.26 ± 6.96 mm for C1 and C2, respectively. The LCAP metric was 1.56 ± 10.8 and -0.27 ± 16.29 mm for C1 and C2, respectively. The error in terms of BCAP and LCAP was higher for larger patients (p value < 0.01).The accuracy of the proposed method was comparable to available alternative methods, carrying the advantage of being free from errors related to objects blocking the camera visibility.• Patient mis-centering in the anterior-posterior direction (AP) is a common problem in clinical practice which can degrade image quality and increase patient radiation dose. • We proposed a deep neural network for automatic patient positioning using only the CT image localizer, achieving a performance comparable to alternative techniques, such as the external 3D visual camera. • The advantage of the proposed method is that it is free from errors related to objects blocking the camera visibility and that it could be implemented on imaging consoles as a patient positioning support tool. 

/pdf/fully-automated-accurate-patient-positioning-in-computed-2qkfgxkq.pdf

Fully automated accurate patient positioning in computed tomography using anterior–posterior localizer images and a deep neural network: a dual-center study

Objective: This study aims to develop and validate a novel framework, i Phantom, for automated creation of patient-specific phantoms or “digital-twins (DT)” using patient medical images. The framework is applied to assess radiation dose to radiosensitive organs in CT imaging of individual patients. Method: Given a volume of patient CT images, i Phantom segments selected anchor organs and structures (e.g., liver, bones, pancreas) using a learning-based model developed for multi-organ CT segmentation. Organs which are challenging to segment (e.g., intestines) are incorporated from a matched phantom template, using a diffeomorphic registration model developed for multi-organ phantom-voxels. The resulting digital-twin phantoms are used to assess organ doses during routine CT exams. Result: i Phantom was validated on both with a set of XCAT digital phantoms (n = 50) and an independent clinical dataset (n = 10) with similar accuracy. i Phantom precisely predicted all organ locations yielding Dice Similarity Coefficients (DSC) 0.6 - 1 for anchor organs and DSC of 0.3-0.9 for all other organs. iPhantom showed i Phantom enables automated and accurate creation of patient-specific phantoms and, for the first time, provides sufficient and automated patient-specific dose estimates for CT dosimetry. Significance: The new framework brings the creation and application of CHPs (computational human phantoms) to the level of individual CHPs through automation, achieving wide and precise organ localization, paving the way for clinical monitoring, personalized optimization, and large-scale research.

i Phantom: A Framework for Automated Creation of Individualized Computational Phantoms and Its Application to CT Organ Dosimetry

In [1], the dose estimation accuracy using the alternative baseline method under modulated tube current was not correctly calculated due to an unintentional simulation error.

Corrections to "iPhantom: A Framework for Automated Creation of Individualized Computational Phantoms and its Application to CT Organ Dosimetry"

Objective: This study aims to develop and validate a novel framework, iPhantom, for automated creation of patient-specific phantoms or digital-twins (DT) using patient medical images. The framework is applied to assess radiation dose to radiosensitive organs in CT imaging of individual patients. Method: From patient CT images, iPhantom segments selected anchor organs (e.g. liver, bones, pancreas) using a learning-based model developed for multi-organ CT segmentation. Organs challenging to segment (e.g. intestines) are incorporated from a matched phantom template, using a diffeomorphic registration model developed for multi-organ phantom-voxels. The resulting full-patient phantoms are used to assess organ doses during routine CT exams. Result: iPhantom was validated on both the XCAT (n=50) and an independent clinical (n=10) dataset with similar accuracy. iPhantom precisely predicted all organ locations with good accuracy of Dice Similarity Coefficients (DSC) >0.6 for anchor organs and DSC of 0.3-0.9 for all other organs. iPhantom showed less than 10% dose errors for the majority of organs, which was notably superior to the state-of-the-art baseline method (20-35% dose errors). Conclusion: iPhantom enables automated and accurate creation of patient-specific phantoms and, for the first time, provides sufficient and automated patient-specific dose estimates for CT dosimetry. Significance: The new framework brings the creation and application of CHPs to the level of individual CHPs through automation, achieving a wider and precise organ localization, paving the way for clinical monitoring, and personalized optimization, and large-scale research.

iPhantom: a framework for automated creation of individualized computational phantoms and its application to CT organ dosimetry

Visible infrared imaging radiometer suite (VIIRS) day/night band (DNB) data has been used to detect lit boats during night as it is very sensitive to low radiances. The existing methods for boat detection from VIIRS DNB data are mainly based on thresholds that are estimated by the statistical characteristics of pixels or artificial experience. This may generate detection errors and poor adaptability due to the lack of characterization of boat lights. In this paper, a two-step threshold detection algorithm based on the point spread and the radiative characteristics of nightlight point sources is proposed, so that the interference from adjacent pixels could be reduced as much as possible and a reasonable threshold could be determined. Meanwhile, this algorithm is applied to three study areas, namely the sea area around Tianjin Port in Bohai Sea, the sea area around Shanghai Port in East China Sea, and the sea area around Port Sulphur in Gulf of Mexico. It is demonstrated that the detection precision of the proposed algorithm reaches up to 90% and the recall rate reaches up to 85% in three areas when validated by visual interpretation, and the precision is 85.71% when validated by automatic identification system (AIS) data in the study area of the sea area around Port Sulphur in Gulf of Mexico, which approximately increases by 5% compared with the previous algorithm.

Automatic boat detection based on diffusion and radiation characterization of boat lights during night for VIIRS DNB imaging data.

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i Phantom: A Framework for Automated Creation of Individualized Computational Phantoms and Its Application to CT Organ Dosimetry

Corrections to "iPhantom: A Framework for Automated Creation of Individualized Computational Phantoms and its Application to CT Organ Dosimetry"

iPhantom: a framework for automated creation of individualized computational phantoms and its application to CT organ dosimetry

Automatic boat detection based on diffusion and radiation characterization of boat lights during night for VIIRS DNB imaging data.