Cardiomegaly is associated with poor clinical outcomes and is assessed by routine monitoring of the cardiothoracic ratio (CTR) from chest X-rays (CXRs). Judgment of the margins of the heart and lungs is subjective and may vary between different operators. Methods: Patients aged > 19 years in our hemodialysis unit from March 2021 to October 2021 were enrolled. The borders of the lungs and heart on CXRs were labeled by two nephrologists as the ground truth (nephrologist-defined mask). We implemented AlbuNet-34, a U-Net variant, to predict the heart and lung margins from CXR images and to automatically calculate the CTRs. Results: The coefficient of determination (R²) obtained using the neural network model was 0.96, compared with an R² of 0.90 obtained by nurse practitioners. The mean difference between the CTRs calculated by the nurse practitioners and senior nephrologists was 1.52 ± 1.46%, and that between the neural network model and the nephrologists was 0.83 ± 0.87% (p < 0.001). The mean CTR calculation duration was 85 s using the manual method and less than 2 s using the automated method (p < 0.001). Conclusions: Our study confirmed the validity of automated CTR calculations. By achieving high accuracy and saving time, our model can be implemented in clinical practice.

Image segmentation is the process of partitioning an image into multiple segments where the goal is to simplify the representation of the image and make the image more meaningful and easier to analyze. In particular, semantic segmentation is an approach of detecting the classes of objects, based on each pixel. In the past, most semantic segmentation models were for only one single style, such as urban street views, medical images, or even manga. In this paper, we propose a semantic segmentation model called the Dual-Pyramid Wide Residual Network (DPWRN) to solve the segmentation on cross-style datasets, which is suitable for diverse segmentation applications. The DPWRN integrated the Pyramid of Kernel paralleled with Dilation (PKD) and Multi-Feature Fusion (MFF) to improve the accuracy of segmentation. To evaluate the generalization of the DPWRN and its superiority over most state-of-the-art models, three datasets with completely different styles are tested in the experiments. As a result, our model achieves 75.95% of mIoU on CamVid, 83.60% of F1-score on DRIVE, and 86.87% of F1-score on eBDtheque. This verifies that the DPWRN can be generalized and shows its superiority in semantic segmentation on cross-style datasets.

PurposeSquamous cell carcinoma (SCC) accounts for 90% of head and neck cancer. The majority of cases can be diagnosed and even treated with endoscopic examination and surgery. Deep learning models have been adopted for various medical endoscopy exams. However, few reports have been on deep learning algorithms for segmenting head and neck SCC.ApproachHead and neck SCC pre-treatment endoscopic images during 2016–2020 were collected from the Kaohsiung Veterans General Hospital Department of Otolaryngology-Head and Neck Surgery. We present a new modification of the neural architecture search-U-Net-based model called SCC-Net for segmenting our enrolled endoscopic photos. The modification included a new technique called “Learnable Discrete Wavelet Pooling” to design a new formulation that combines the outputs of different layers using a channel attention module and assigns weights based on their importance in the information flow. We also incorporated the cross-stage-partial design from CSPnet. The performance was compared with other eight state-of-the-art image segmentation models.ResultsWe collected a total of 556 pathologically confirmed SCC photos. The new SCC-Net algorithm achieves a high mean intersection over union (mIOU) of 87.2%, accuracy of 97.17%, and recall of 97.15%. When comparing the performance of our proposed model with eight different state-of-the-art image segmentation artificial neural network models, our model performed best in mIOU, Dice similarity coefficient, accuracy, and recall.ConclusionsOur proposed SCC-Net architecture was able to successfully segment lesions from white light endoscopic images with promising accuracy, with a single model performing well in all upper aerodigestive tracts.