T he scientific, academic, medical and data science communities have come together in the face of the COVID-19 pandemic crisis to rapidly assess novel paradigms in artificial intelligence (AI) that are rapid and secure, and potentially incentivize data sharing and model training and testing without the usual privacy and data ownership hurdles of conventional collaborations 1,2 . Healthcare providers, researchers and industry have pivoted their focus to address unmet and critical clinical needs created by the crisis, with remarkable results [3][4][5][6][7][8][9] . Clinical trial recruitment has been expedited and facilitated by national regulatory bodies and an international cooperative spirit 10-12 . The data analytics and AI disciplines have always fostered open

Dose reduction in computed tomography (CT) is essential for decreasing radiation risk in clinical applications. Iterative reconstruction algorithms are one of the most promising way to compensate for the increased noise due to reduction of photon flux. Most iterative reconstruction algorithms incorporate manually designed prior functions of the reconstructed image to suppress noises while maintaining structures of the image. These priors basically rely on smoothness constraints and cannot exploit more complex features of the image. The recent development of artificial neural networks and machine learning enabled learning of more complex features of image, which has the potential to improve reconstruction quality. In this work, K-sparse autoencoder (KSAE) was used for unsupervised feature learning. A manifold was learned from normal-dose images and the distance between the reconstructed image and the manifold was minimized along with data fidelity during reconstruction. Experiments on 2016 Low-dose CT Grand Challenge were used for the method verification, and results demonstrated the noise reduction and detail preservation abilities of the proposed method.

Motivated by the great potential of deep learning in medical imaging, we propose an iterative positron emission tomography reconstruction framework using a deep learning-based prior. We utilized the denoising convolutional neural network (DnCNN) method and trained the network using full-dose images as the ground truth and low dose images reconstructed from downsampled data by Poisson thinning as input. Since most published deep networks are trained at a predetermined noise level, the noise level disparity of training and testing data is a major problem for their applicability as a generalized prior. In particular, the noise level significantly changes in each iteration, which can potentially degrade the overall performance of iterative reconstruction. Due to insufficient existing studies, we conducted simulations and evaluated the degradation of performance at various noise conditions. Our findings indicated that DnCNN produces additional bias induced by the disparity of noise levels. To address this issue, we propose a local linear fitting function incorporated with the DnCNN prior to improve the image quality by preventing unwanted bias. We demonstrate that the resultant method is robust against noise level disparities despite the network being trained at a predetermined noise level. By means of bias and standard deviation studies via both simulations and clinical experiments, we show that the proposed method outperforms conventional methods based on total variation and non-local means penalties. We thereby confirm that the proposed method improves the reconstruction result both quantitatively and qualitatively.

The essential role of the nurse as a provider of emotional support in the development or implementation of similar programmes with MDR-TB should, in future, be taken into account.

Deep neural networks have been proved efficient for medical image denoising. Current training methods require both noisy and clean images. However, clean images cannot be acquired for many practical medical applications due to naturally noisy signal, such as dynamic imaging, spectral computed tomography, arterial spin labeling magnetic resonance imaging, etc. In this paper we proposed a training method which learned denoising neural networks from noisy training samples only. Training data in the acquisition domain was split to two subsets and the network was trained to map one noisy set to the other. A consensus loss function was further proposed to efficiently combine the outputs from both subsets. A mathematical proof was provided that the proposed training scheme was equivalent to training with noisy and clean samples when the noise in the two subsets was uncorrelated and zeromean. The method was validated on Low-dose CT Challenge dataset and NYU MRI dataset and achieved improved performance compared to existing unsupervised methods.

Purpose: Deep neural network-based image reconstruction has demonstrated promising performance in medical imaging for undersampled and low-dose scenarios. However, it requires large amount of memory and extensive time for the training. It is especially challenging to train the reconstruction networks for three-dimensional computed tomography (CT) because of the high resolution of CT images. The purpose of this work is to reduce the memory and time consumption of the training of the reconstruction networks for CT to make it practical for current hardware, while maintaining the quality of the reconstructed images. Methods: We unrolled the proximal gradient descent algorithm for iterative image reconstruction to finite iterations and replaced the terms related to the penalty function with trainable convolutional neural networks (CNN). The network was trained greedily iteration by iteration in the image domain on patches, which requires reasonable amount of memory and time on mainstream graphics processing unit (GPU). To overcome the local-minimum problem caused by greedy learning, we used deep UNet as the CNN and incorporated separable quadratic surrogate with ordered subsets for data fidelity, so that the solution could escape from easy local minimums and achieve better image quality. Results: The proposed method achieved comparable image quality with state-of-the-art neural network for CT image reconstruction on two-dimensional (2D) sparse-view and limited-angle problems on the low-dose CT challenge dataset. The difference in root-mean-square-error (RMSE) and structural similarity index (SSIM) was within [À0.23,0.47] HU and [0,0.001], respectively, with 95% confidence level. For three-dimensional (3D) image reconstruction with ordinary-size CT volume, the proposed method only needed 2 GB graphics processing unit (GPU) memory and 0.45 s per training iteration as minimum requirement, whereas existing methods may require 417 GB and 31 min. The proposed method achieved improved performance compared to total variation-and dictionary learning-based iterative reconstruction for both 2D and 3D problems. Conclusions: We proposed a training-time computationally efficient neural network for CT image reconstruction. The proposed method achieved comparable image quality with state-of-the-art neural network for CT reconstruction, with significantly reduced memory and time requirement during training. The proposed method is applicable to 3D image reconstruction problems such as cone-beam CT and tomosynthesis on mainstream GPUs.

In recent years, deep learning-based image analysis methods have been widely applied in computer-aided detection, diagnosis and prognosis, and has shown its value during the public health crisis of the novel coronavirus disease 2019 (COVID-19) pandemic. Chest radiograph (CXR) has been playing a crucial role in COVID-19 patient triaging, diagnosing and monitoring, particularly in the United States. Considering the mixed and unspecific signals in CXR, an image retrieval model of CXR that provides both similar images and associated clinical information can be more clinically meaningful than a direct image diagnostic model. In this work we develop a novel CXR image retrieval model based on deep metric learning. Unlike traditional diagnostic models which aim at learning the direct mapping from images to labels, the proposed model aims at learning the optimized embedding space of images, where images with the same labels and similar contents are pulled together. The proposed model utilizes multi-similarity loss with hard-mining sampling strategy and attention mechanism to learn the optimized embedding space, and provides similar images, the visualizations of disease-related attention maps and useful clinical information to assist clinical decisions. The model is trained and validated on an international multi-site COVID-19 dataset collected from 3 different sources. Experimental results of COVID-19 image retrieval and diagnosis tasks show that the proposed model can serve as a robust solution for CXR analysis and patient management for COVID-19. The model is also tested on its transferability on a different clinical decision support task for COVID-19, where the pre-trained model is applied to extract image features from a new dataset without any further training. The extracted features are then combined with COVID-19 patient's vitals, lab tests and medical histories to predict the possibility of airway intubation in 72 hours, which is strongly associated with patient prognosis, and is crucial for patient care and hospital resource planning. These results demonstrate our deep metric learning based image retrieval model is highly efficient in the CXR retrieval, diagnosis and prognosis, and thus has great clinical value for the treatment and management of COVID-19 patients.

Currently in photon counting based spectral x-ray computed tomography (CT) imaging, pre-reconstruction basis materials decomposition is an effective way to reconstruct densities of various materials. The iterative maximum-likelihood method requires precise spectrum information and is time-costly. In this paper, a novel non-iterative decomposition method based on polynomials is proposed for spectral CT, whose aim was to optimize the noise performance when there is more energy bins than the number of basis materials. Several subsets were taken from all the energy bins and conventional polynomials were established for each of them. The decomposition results from each polynomial were summed with pre-calculated weighting factors, which were designed to minimize the overall noises. Numerical studies showed that the decomposition noise of the proposed method was close to the Cramer-Rao lower bound under Poisson noises. Furthermore, experiments were carried out with an XCounter Filte X1 photon counting detector for two-material decomposition and three-material decomposition for validation.