Carotid atherosclerosis is a major reason of stroke, a leading cause of death and disability. In this paper, a segmentation method based on Active Shape Model (ASM) is developed and evaluated to outline common carotid artery (CCA) for carotid atherosclerosis computer-aided evaluation and diagnosis. The proposed method is used to segment both media-adventitia-boundary (MAB) and lumen-intima-boundary (LIB) on transverse views slices from three-dimensional ultrasound (3D US) images. The data set consists of sixty-eight, 17 × 2 × 2, 3D US volume data acquired from the left and right carotid arteries of seventeen patients (eight treated with 80 mg atorvastatin and nine with placebo), who had carotid stenosis of 60% or more, at baseline and after three months of treatment. Manually outlined boundaries by expert are adopted as the ground truth for evaluation. For the MAB and LIB segmentations, respectively, the algorithm yielded Dice Similarity Coefficient (DSC) of 94.4% ± 3.2% and 92.8% ± 3.3%, mean absolute distances (MAD) of 0.26 ± 0.18 mm and 0.33 ± 0.21 mm, and maximum absolute distances (MAXD) of 0.75 ± 0.46 mm and 0.84 ± 0.39 mm. It took 4.3 ± 0.5 mins to segment single 3D US images, while it took 11.7 ± 1.2 mins for manual segmentation. The method would promote the translation of carotid 3D US to clinical care for the monitoring of the atherosclerotic disease progression and regression.

BackgroundThyroid-associated ophthalmopathy (TAO) is one of the most common orbital diseases that seriously threatens visual function and significantly affects patients’ appearances, rendering them unable to work. This study established an intelligent diagnostic system for TAO based on facial images.MethodsPatient images and data were obtained from medical records of patients with TAO who visited Shanghai Changzheng Hospital from 2013 to 2018. Eyelid retraction, ocular dyskinesia, conjunctival congestion, and other signs were noted on the images. Patients were classified according to the types, stages, and grades of TAO based on the diagnostic criteria. The diagnostic system consisted of multiple task-specific models.ResultsThe intelligent diagnostic system accurately diagnosed TAO in three stages. The built-in models pre-processed the facial images and diagnosed multiple TAO signs, with average areas under the receiver operating characteristic curves exceeding 0.85 (F1 score >0.80).ConclusionThe intelligent diagnostic system introduced in this study accurately identified several common signs of TAO.

Carotid atherosclerosis is a major cause of stroke, a leading cause of death and disability. In this paper, we develop and evaluate a new segmentation method for outlining both lumen and adventitia (inner and outer walls) of common carotid artery (CCA) from three-dimensional ultrasound (3D US) images for carotid atherosclerosis diagnosis and evaluation. The data set consists of sixty-eight, 17 × 2 × 2, 3D US volume data acquired from the left and right carotid arteries of seventeen patients (eight treated with 80mg atorvastain and nine with placebo), who had carotid stenosis of 60% or more, at baseline and after three months of treatment. We investigate the use of Active Shape Models (ASMs) to segment CCA inner and outer walls after statin therapy. The proposed method was evaluated with respect to expert manually outlined boundaries as a surrogate for ground truth. For the lumen and adventitia segmentations, respectively, the algorithm yielded Dice Similarity Coefficient (DSC) of 93.6% ± 2.6%, 91.8% ± 3.5%, mean absolute distances (MAD) of 0.28 ± 0.17mm and 0.34 ± 0.19mm, maximum absolute distances (MAXD) of 0.87 ± 0.37mm and 0.74 ± 0.49mm. The proposed algorithm took 4.4 ± 0.6min to segment a single 3D US images, compared to 11.7 ± 1.2min for manual segmentation. Therefore, the method would promote the translation of carotid 3D US to clinical care for the fast, safety and economical monitoring of the atherosclerotic disease progression and regression during therapy.

In medical image segmentation, it is difficult to mark ambiguous areas accurately with binary masks, especially when dealing with small lesions. Therefore, it is a challenge for radiologists to reach a consensus by using binary masks under the condition of multiple annotations. However, these areas may contain anatomical structures that are conducive to diagnosis. Uncertainty is introduced to study these situations. Nevertheless, the uncertainty is usually measured by the variances between predictions in a multiple trial way. It is not intuitive, and there is no exact correspondence in the image. Inspired by image matting, we introduce matting as a soft segmentation method and a new perspective to deal with and represent uncertain regions into medical scenes, namely medical matting. More specifically, because there is no available medical matting dataset, we first labeled two medical datasets with alpha matte. Secondly, the matting method applied to the natural image is not suitable for the medical scene, so we propose a new architecture to generate binary masks and alpha matte in a row. Thirdly, the uncertainty map is introduced to highlight the ambiguous regions from the binary results and improve the matting performance. Evaluated on these datasets, the proposed model outperformed state-of-the-art matting algorithms by a large margin, and alpha matte is proved to be a more efficient labeling form than a binary mask.

Stroke and heart attack, which could be led by a kind of cerebrovascular and cardiovascular disease named as atherosclerosis, would seriously cause human morbidity and mortality. It is important for the early stage diagnosis and monitoring medical intervention of the atherosclerosis. Carotid stenosis is a classical atherosclerotic lesion with vessel wall narrowing down and accumulating plaques burden. The carotid artery of intima-media thickness (IMT) is a key indicator to the disease. With the development of computer assisted diagnosis technology, the imaging techniques, segmentation algorithms, measurement methods, and evaluation tools have made considerable progress. Ultrasound imaging, being real-time, economic, reliable, and safe, now seems to become a standard in vascular assessment methodology especially for the measurement of IMT. This review firstly attempts to discuss the clinical relevance of measurements in clinical practice at first, and then followed by the challenges that one has to face when approaching the segmentation of ultrasound images. Secondly, the commonly used methods for the IMT segmentation and measurement are presented. Thirdly, discussion and evaluation of different segmentation techniques are performed. An overview of summary and future perspectives is given finally.