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Arman Rahmim

Publications and source records attributed to Arman Rahmim.

At least 73 records · Page 4Linked to original sources

Beyond Conventional Parametric Modeling: Data-Driven Framework for Estimation and Prediction of Time Activity Curves in Dynamic PET Imaging

Dynamic Positron Emission Tomography (dPET) imaging and Time-Activity Curve (TAC) analyses are essential for understanding and quantifying the biodistribution of radiopharmaceuticals over time and space. Traditional compartmental modeling, while foundational, commonly struggles to fully capture the complexities of biological systems, including non-linear dynamics and variability. This study introduces an innovative data-driven neural network-based framework, inspired by Reaction Diffusion systems, designed to address these limitations. Our approach, which adaptively fits TACs from dPET, enables the direct calibration of diffusion coefficients and reaction terms from observed data, offering significant improvements in predictive accuracy and robustness over traditional methods, especially in complex biological scenarios. By more accurately modeling the spatio-temporal dynamics of radiopharmaceuticals, our method advances modeling of pharmacokinetic and pharmacodynamic processes, enabling new possibilities in quantitative nuclear medicine.

cs.LG↗

Novel Method to Estimate Kinetic Microparameters from Dynamic Whole-Body Imaging in Regular-Axial Field-of-View PET Scanners

For whole-body (WB) kinetic modeling based on a typical PET scanner, a multi-pass multi-bed scanning protocol is necessary given the limited axial field-of-view. Such a protocol introduces loss of early-dynamics in time-activity curves (TACs) and sparsity in TAC measurements, inducing uncertainty in parameter estimation when using least-squares estimation (LSE) (i.e., common standard) especially for kinetic microparameters. We present a method to reliably estimate microparameters, enabling accurate parametric imaging, on regular-axial field-of-view PET scanners. Our method, denoted parameter combination-driven estimation (PCDE), relies on generation of reference truth TAC database, and subsequently selecting, the best parameter combination as the one arriving at TAC with highest total similarity score (TSS), focusing on general image quality, overall visibility, and tumor detectability metrics. Our technique has two distinctive characteristics: 1) improved probability of having one-on-one mapping between early and late dynamics in TACs (the former missing from typical protocols), and 2) use of multiple aspects of TACs in selection of best fits. To evaluate our method against conventional LSE, we plotted tradeoff curves for noise and bias. In addition, the overall SNR and spatial noise were calculated and compared. Furthermore, CNR and TBR were also calculated. We also tested our proposed method on patient data (18F-DCFPyL PET scans) to further verify clinical applicability. Significantly improved general image quality performance was verified in microparametric images (e.g. noise-bias performance). The overall visibility and tumor detectability were also improved. Finally, for our patient studies, improved overall visibility and tumor detectability were demonstrated in micoparametric images, compared to use of conventional parameter estimation.

physics.med-ph↗

RT-utils: A Minimal Python Library for RT-struct Manipulation

Towards the need for automated and precise AI-based analysis of medical images, we present RT-utils, a specialized Python library tuned for the manipulation of radiotherapy (RT) structures stored in DICOM format. RT-utils excels in converting the polygon contours into binary masks, ensuring accuracy and efficiency. By converting DICOM RT structures into standardized formats such as NumPy arrays and SimpleITK Images, RT-utils optimizes inputs for computational solutions such as AI-based automated segmentation techniques or radiomics analysis. Since its inception in 2020, RT-utils has been used extensively with a focus on simplifying complex data processing tasks. RT-utils offers researchers a powerful solution to enhance workflows and drive significant advancements in medical imaging.

physics.med-ph↗

Mathematical Modeling of $^{18}$F-Fluoromisonidazole ($^{18}$F-FMISO) Radiopharmaceutical Transport in Vascularized Solid Tumors

$^{18}$F-Fluoromisonidazole ($^{18}$F-FMISO) is a highly promising positron emission tomography radiopharmaceutical for identifying hypoxic regions in solid tumors. This research employs spatiotemporal multi-scale mathematical modeling to explore how different levels of angiogenesis influence the transport of radiopharmaceuticals within tumors. In this study, two tumor geometries with heterogeneous and uniform distributions of capillary networks were employed to incorporate varying degrees of microvascular density. The synthetic image of the heterogeneous and vascularized tumor was generated by simulating the angiogenesis process. The proposed multi-scale spatiotemporal model accounts for intricate physiological and biochemical factors within the tumor microenvironment, such as the transvascular transport of the radiopharmaceutical agent, its movement into the interstitial space by diffusion and convection mechanisms, and ultimately its uptake by tumor cells. Results showed that both quantitative and semi-quantitative metrics of $^{18}$F-FMISO uptake differ spatially and temporally at different stages during tumor growth. The presence of a high microvascular density in uniformly vascularized tumor increases cellular uptake, as it allows for more efficient release and rapid distribution of radiopharmaceutical molecules. This results in enhanced uptake compared to the heterogeneous vascularized tumor. In both heterogeneous and uniform distribution of microvessels in tumors, the diffusion transport mechanism has a more pronounced than convection. The findings of this study shed light on the transport phenomena behind $^{18}$F-FMISO radiopharmaceutical distribution and its delivery in the tumor microenvironment, aiding oncologists in their routine decision-making processes.

physics.bio-ph↗

MEDDAP: Medical Dataset Enhancement via Diversified Augmentation Pipeline

The effectiveness of Deep Neural Networks (DNNs) heavily relies on the abundance and accuracy of available training data. However, collecting and annotating data on a large scale is often both costly and time-intensive, particularly in medical cases where practitioners are already occupied with their duties. Moreover, ensuring that the model remains robust across various scenarios of image capture is crucial in medical domains, especially when dealing with ultrasound images that vary based on the settings of different devices and the manual operation of the transducer. To address this challenge, we introduce a novel pipeline called MEDDAP, which leverages Stable Diffusion (SD) models to augment existing small datasets by automatically generating new informative labeled samples. Pretrained checkpoints for SD are typically based on natural images, and training them for medical images requires significant GPU resources due to their heavy parameters. To overcome this challenge, we introduce USLoRA (Ultrasound Low-Rank Adaptation), a novel fine-tuning method tailored specifically for ultrasound applications. USLoRA allows for selective fine-tuning of weights within SD, requiring fewer than 0.1\% of parameters compared to fully fine-tuning only the UNet portion of SD. To enhance dataset diversity, we incorporate different adjectives into the generation process prompts, thereby desensitizing the classifiers to intensity changes across different images. This approach is inspired by clinicians' decision-making processes regarding breast tumors, where tumor shape often plays a more crucial role than intensity. In conclusion, our pipeline not only outperforms classifiers trained on the original dataset but also demonstrates superior performance when encountering unseen datasets. The source code is available at https://github.com/yasamin-med/MEDDAP.

eess.IV↗

Semi-supervised learning towards automated segmentation of PET images with limited annotations: Application to lymphoma patients

The time-consuming task of manual segmentation challenges routine systematic quantification of disease burden. Convolutional neural networks (CNNs) hold significant promise to reliably identify locations and boundaries of tumors from PET scans. We aimed to leverage the need for annotated data via semi-supervised approaches, with application to PET images of diffuse large B-cell lymphoma (DLBCL) and primary mediastinal large B-cell lymphoma (PMBCL). We analyzed 18F-FDG PET images of 292 patients with PMBCL (n=104) and DLBCL (n=188) (n=232 for training and validation, and n=60 for external testing). We employed FCM and MS losses for training a 3D U-Net with different levels of supervision: i) fully supervised methods with labeled FCM (LFCM) as well as Unified focal and Dice loss functions, ii) unsupervised methods with Robust FCM (RFCM) and Mumford-Shah (MS) loss functions, and iii) Semi-supervised methods based on FCM (RFCM+LFCM), as well as MS loss in combination with supervised Dice loss (MS+Dice). Unified loss function yielded higher Dice score (mean +/- standard deviation (SD)) (0.73 +/- 0.03; 95% CI, 0.67-0.8) compared to Dice loss (p-value<0.01). Semi-supervised (RFCM+alpha*LFCM) with alpha=0.3 showed the best performance, with a Dice score of 0.69 +/- 0.03 (95% CI, 0.45-0.77) outperforming (MS+alpha*Dice) for any supervision level (any alpha) (p<0.01). The best performer among (MS+alpha*Dice) semi-supervised approaches with alpha=0.2 showed a Dice score of 0.60 +/- 0.08 (95% CI, 0.44-0.76) compared to another supervision level in this semi-supervised approach (p<0.01). Semi-supervised learning via FCM loss (RFCM+alpha*LFCM) showed improved performance compared to supervised approaches. Considering the time-consuming nature of expert manual delineations and intra-observer variabilities, semi-supervised approaches have significant potential for automated segmentation workflows.

physics.med-ph↗

A cascaded deep network for automated tumor detection and segmentation in clinical PET imaging of diffuse large B-cell lymphoma

Accurate detection and segmentation of diffuse large B-cell lymphoma (DLBCL) from PET images has important implications for estimation of total metabolic tumor volume, radiomics analysis, surgical intervention and radiotherapy. Manual segmentation of tumors in whole-body PET images is time-consuming, labor-intensive and operator-dependent. In this work, we develop and validate a fast and efficient three-step cascaded deep learning model for automated detection and segmentation of DLBCL tumors from PET images. As compared to a single end-to-end network for segmentation of tumors in whole-body PET images, our three-step model is more effective (improves 3D Dice score from 58.9% to 78.1%) since each of its specialized modules, namely the slice classifier, the tumor detector and the tumor segmentor, can be trained independently to a high degree of skill to carry out a specific task, rather than a single network with suboptimal performance on overall segmentation.

eess.IV↗

A slice classification neural network for automated classification of axial PET/CT slices from a multi-centric lymphoma dataset

Automated slice classification is clinically relevant since it can be incorporated into medical image segmentation workflows as a preprocessing step that would flag slices with a higher probability of containing tumors, thereby directing physicians attention to the important slices. In this work, we train a ResNet-18 network to classify axial slices of lymphoma PET/CT images (collected from two institutions) depending on whether the slice intercepted a tumor (positive slice) in the 3D image or if the slice did not (negative slice). Various instances of the network were trained on 2D axial datasets created in different ways: (i) slice-level split and (ii) patient-level split; inputs of different types were used: (i) only PET slices and (ii) concatenated PET and CT slices; and different training strategies were employed: (i) center-aware (CAW) and (ii) center-agnostic (CAG). Model performances were compared using the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC), and various binary classification metrics. We observe and describe a performance overestimation in the case of slice-level split as compared to the patient-level split training. The model trained using patient-level split data with the network input containing only PET slices in the CAG training regime was the best performing/generalizing model on a majority of metrics. Our models were additionally more closely compared using the sensitivity metric on the positive slices from their respective test sets.

eess.IV↗

Neural blind deconvolution for deblurring and supersampling PSMA PET

Objective: To simultaneously deblur and supersample prostate specific membrane antigen (PSMA) positron emission tomography (PET) images using neural blind deconvolution. Approach: Blind deconvolution is a method of estimating the hypothetical "deblurred" image along with the blur kernel (related to the point spread function) simultaneously. Traditional \textit{maximum a posteriori} blind deconvolution methods require stringent assumptions and suffer from convergence to a trivial solution. A method of modelling the deblurred image and kernel with independent neural networks, called "neural blind deconvolution" had demonstrated success for deblurring 2D natural images in 2020. In this work, we adapt neural blind deconvolution for PVE correction of PSMA PET images with simultaneous supersampling. We compare this methodology with several interpolation methods, using blind image quality metrics, and test the model's ability to predict kernels by re-running the model after applying artificial "pseudokernels" to deblurred images. The methodology was tested on a retrospective set of 30 prostate patients as well as phantom images containing spherical lesions of various volumes. Results: Neural blind deconvolution led to improvements in image quality over other interpolation methods in terms of blind image quality metrics, recovery coefficients, and visual assessment. Predicted kernels were similar between patients, and the model accurately predicted several artificially-applied pseudokernels. Localization of activity in phantom spheres was improved after deblurring, allowing small lesions to be more accurately defined. Significance: The intrinsically low spatial resolution of PSMA PET leads to PVEs which negatively impact uptake quantification in small regions. The proposed method can be used to mitigate this issue, and can be straightforwardly adapted for other imaging modalities.

physics.med-ph↗

Investigating heterogeneous PSMA ligand uptake inside parotid glands

The purpose was to investigate the spatial heterogeneity of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) uptake within parotid glands. We aim to quantify patterns in well-defined regions to facilitate further investigations. Furthermore, we investigate whether uptake is correlated with computed tomography (CT) texture features. Parotid glands from [18F]DCFPyL PSMA PET/CT images of 30 prostate cancer patients were analyzed. Thresholding was used to define high-uptake regions, and uptake statistics were computed within various divisions. Spearman's rank correlation coefficient was calculated between PSMA PET uptake and the Grey Level Run Length Matrix (GLRLM) using a long and short run length emphasis (GLRLML and GLRLMS) in subregions of parotid glands. PSMA PET uptake was significantly higher (p < 0.001) in lateral/posterior regions of the glands than anterior/medial regions. Maximum uptake was found in the lateral half of parotid glands in 50 out of 60 glands. The difference in SUV between parotid halves is greatest when parotids are divided by a plane separating the anterior/medial and posterior/lateral halves symmetrically. PSMA PET uptake was significantly correlated with CT GLRLML (p < 0.001), and anti-correlated with CT GLRLMS (p < 0.001). Uptake of PSMA PET is heterogeneous within parotid glands, with uptake biased towards lateral and posterior regions. Uptake patterns within parotid glands were found to be strongly correlated with CT texture features, suggesting the possible future use of CT texture features as a proxy for inferring PSMA PET uptake in salivary glands.

physics.med-ph↗

PSMA PET/CT as a predictive tool for sub-regional importance estimates in the parotid gland

Xerostomia and radiation-induced salivary gland dysfunction remain a common side effect for head-and-neck radiotherapy patients, and attempts have been made to quantify the heterogeneous dose response within parotid glands. Here several models of parotid gland subregional importance are compared with prostate specific membrane antigen (PSMA) positron emission tomography (PET) uptake. PSMA ligands show high concentrations in salivary glands, whose uptake has been previously found to relate to gland functionality. We develop a predictive model for relative importance estimates using PSMA PET and CT radiomic features, and demonstrate a methodology for predicting patient-specific importance deviations from the population. Intra-parotid gland uptake was compared with four regional importance models using 30 [18F]DCFPyL PSMA PET images. A radiomics-based predictive model of population importance was developed using a double cross-validation methodology. Population importance estimates were supplemented using patient-specific radiomic features. Anticorrelative relationships were found to exist between PSMA PET uptake and four independent models of subregional parotid gland importance from the literature. Kernel Ridge Regression with principal component analysis feature selection performed best over test sets (MAE = 0.08), with GLCM features being particularly important. Deblurring PSMA PET images strengthened correlations and improved model performance. This study suggests that regions of relatively low PSMA PET concentration in parotid glands may exhibit relatively high dose-sensitivity. We've demonstrated the utility of PSMA PET radiomic features for predicting relative importance within the parotid glands. PSMA PET appears promising for analyzing salivary gland functionality.

physics.med-ph↗

Observer study-based evaluation of TGAN architecture used to generate oncological PET images

The application of computer-vision algorithms in medical imaging has increased rapidly in recent years. However, algorithm training is challenging due to limited sample sizes, lack of labeled samples, as well as privacy concerns regarding data sharing. To address these issues, we previously developed (Bergen et al. 2022) a synthetic PET dataset for Head and Neck (H and N) cancer using the temporal generative adversarial network (TGAN) architecture and evaluated its performance segmenting lesions and identifying radiomics features in synthesized images. In this work, a two-alternative forced-choice (2AFC) observer study was performed to quantitatively evaluate the ability of human observers to distinguish between real and synthesized oncological PET images. In the study eight trained readers, including two board-certified nuclear medicine physicians, read 170 real/synthetic image pairs presented as 2D-transaxial using a dedicated web app. For each image pair, the observer was asked to identify the real image and input their confidence level with a 5-point Likert scale. P-values were computed using the binomial test and Wilcoxon signed-rank test. A heat map was used to compare the response accuracy distribution for the signed-rank test. Response accuracy for all observers ranged from 36.2% [27.9-44.4] to 63.1% [54.8-71.3]. Six out of eight observers did not identify the real image with statistical significance, indicating that the synthetic dataset was reasonably representative of oncological PET images. Overall, this study adds validity to the realism of our simulated H&N cancer dataset, which may be implemented in the future to train AI algorithms while favoring patient confidentiality and privacy protection.

physics.med-ph↗

Assessing Privacy Leakage in Synthetic 3-D PET Imaging using Transversal GAN

Training computer-vision related algorithms on medical images for disease diagnosis or image segmentation is difficult in large part due to privacy concerns. For this reason, generative image models are highly sought after to facilitate data sharing. However, 3-D generative models are understudied, and investigation of their privacy leakage is needed. We introduce our 3-D generative model, Transversal GAN (TrGAN), using head & neck PET images which are conditioned on tumour masks as a case study. We define quantitative measures of image fidelity, utility and privacy for our model. These metrics are evaluated in the course of training to identify ideal fidelity, utility and privacy trade-offs and establish the relationships between these parameters. We show that the discriminator of the TrGAN is vulnerable to attack, and that an attacker can identify which samples were used in training with almost perfect accuracy (AUC = 0.99). We also show that an attacker with access to only the generator cannot reliably classify whether a sample had been used for training (AUC = 0.51). This suggests that TrGAN generators, but not discriminators, may be used for sharing synthetic 3-D PET data with minimal privacy risk while maintaining good utility and fidelity.

eess.IV↗

Generalized Dice Focal Loss trained 3D Residual UNet for Automated Lesion Segmentation in Whole-Body FDG PET/CT Images

Automated segmentation of cancerous lesions in PET/CT images is a vital initial task for quantitative analysis. However, it is often challenging to train deep learning-based segmentation methods to high degree of accuracy due to the diversity of lesions in terms of their shapes, sizes, and radiotracer uptake levels. These lesions can be found in various parts of the body, often close to healthy organs that also show significant uptake. Consequently, developing a comprehensive PET/CT lesion segmentation model is a demanding endeavor for routine quantitative image analysis. In this work, we train a 3D Residual UNet using Generalized Dice Focal Loss function on the AutoPET challenge 2023 training dataset. We develop our models in a 5-fold cross-validation setting and ensemble the five models via average and weighted-average ensembling. On the preliminary test phase, the average ensemble achieved a Dice similarity coefficient (DSC), false-positive volume (FPV) and false negative volume (FNV) of 0.5417, 0.8261 ml, and 0.2538 ml, respectively, while the weighted-average ensemble achieved 0.5417, 0.8186 ml, and 0.2538 ml, respectively. Our algorithm can be accessed via this link: https://github.com/ahxmeds/autosegnet.

eess.IV↗

$^{177}$Lu SPECT Imaging in the Presence of $^{90}$Y: Does $^{90}$Y Degrade Image Quantification? A Simulation Study

This work aims to investigate the accuracy of quantitative SPECT imaging of $^{177}$Lu in the presence of $^{90}$Y, which occurs in dual-isotope radiopharmaceutical therapy (RPT) involving both isotopes. We used the GATE Monte Carlo simulation toolkit to conduct a phantom study, simulating spheres filled with $^{177}$Lu and $^{90}$Y placed in a cylindrical water phantom that was also filled with activity of both radionuclides. We simulated multiple phantom configurations and activity combinations by varying the location of the spheres, the concentrations of $^{177}$Lu and $^{90}$Y in the spheres, and the amount of background activity. We investigated two different scatter window widths to be used with triple energy window (TEW) scatter correction. We also created multiple realizations of each configuration to improve our assessment, leading to a total of 540 simulations. Each configuration was imaged using a simulated Siemens SPECT camera. The projections were reconstructed using the standard 3D OSEM algorithm, and errors associated with $^{177}$Lu activity quantification and contrast-to-noise ratios (CNRs) were determined. In all configurations, the quantification error was within $\pm$6% of the no-$^{90}$Y case, and we found that quantitative accuracy may slightly improve when $^{90}$Y is present because of reduction of errors associated with TEW scatter correction. The CNRs were not significantly impacted by the presence of $^{90}$Y, but they were increased when a wider scatter window width was used for TEW scatter correction. The width of the scatter windows made a small but statistically significant difference of 1-2% on the recovered $^{177}$Lu activity. Based on these results, we can conclude that activity quantification of $^{177}$Lu and lesion detectability is not degraded by the presence of $^{90}$Y.

physics.med-ph↗

A brief history of AI: how to prevent another winter (a critical review)

The field of artificial intelligence (AI), regarded as one of the most enigmatic areas of science, has witnessed exponential growth in the past decade including a remarkably wide array of applications, having already impacted our everyday lives. Advances in computing power and the design of sophisticated AI algorithms have enabled computers to outperform humans in a variety of tasks, especially in the areas of computer vision and speech recognition. Yet, AI's path has never been smooth, having essentially fallen apart twice in its lifetime ('winters' of AI), both after periods of popular success ('summers' of AI). We provide a brief rundown of AI's evolution over the course of decades, highlighting its crucial moments and major turning points from inception to the present. In doing so, we attempt to learn, anticipate the future, and discuss what steps may be taken to prevent another 'winter'.

cs.AI↗

Issues and Challenges in Applications of Artificial Intelligence to Nuclear Medicine -- The Bethesda Report (AI Summit 2022)

The SNMMI Artificial Intelligence (SNMMI-AI) Summit, organized by the SNMMI AI Task Force, took place in Bethesda, MD on March 21-22, 2022. It brought together various community members and stakeholders from academia, healthcare, industry, patient representatives, and government (NIH, FDA), and considered various key themes to envision and facilitate a bright future for routine, trustworthy use of AI in nuclear medicine. In what follows, essential issues, challenges, controversies and findings emphasized in the meeting are summarized.

physics.med-ph↗

Tensor Radiomics: Paradigm for Systematic Incorporation of Multi-Flavoured Radiomics Features

Radiomics features extract quantitative information from medical images, towards the derivation of biomarkers for clinical tasks, such as diagnosis, prognosis, or treatment response assessment. Different image discretization parameters (e.g. bin number or size), convolutional filters, segmentation perturbation, or multi-modality fusion levels can be used to generate radiomics features and ultimately signatures. Commonly, only one set of parameters is used; resulting in only one value or flavour for a given RF. We propose tensor radiomics (TR) where tensors of features calculated with multiple combinations of parameters (i.e. flavours) are utilized to optimize the construction of radiomics signatures. We present examples of TR as applied to PET/CT, MRI, and CT imaging invoking machine learning or deep learning solutions, and reproducibility analyses: (1) TR via varying bin sizes on CT images of lung cancer and PET-CT images of head & neck cancer (HNC) for overall survival prediction. A hybrid deep neural network, referred to as TR-Net, along with two ML-based flavour fusion methods showed improved accuracy compared to regular rediomics features. (2) TR built from different segmentation perturbations and different bin sizes for classification of late-stage lung cancer response to first-line immunotherapy using CT images. TR improved predicted patient responses. (3) TR via multi-flavour generated radiomics features in MR imaging showed improved reproducibility when compared to many single-flavour features. (4) TR via multiple PET/CT fusions in HNC. Flavours were built from different fusions using methods, such as Laplacian pyramids and wavelet transforms. TR improved overall survival prediction. Our results suggest that the proposed TR paradigm has the potential to improve performance capabilities in different medical imaging tasks.

cs.CV↗