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Weihua Zhou

Publications and source records attributed to Weihua Zhou.

At least 19 recordsLinked to original sources

Agentic AI-driven Immersive Simulation: A Knowledge-Aware Virtual Training Platform forHigh Dose Rate (HDR) Brachytherapy

The convergence of the Metaverse and Large Language Model (LLM)-based AI agent is catalyzing a shift toward autonomous, immersive, and personalized pedagogical frameworks in medical education. This paper presents a novel agentic AI-driven immersive simulation specifically designed for High Dose Rate (HDR) vaginal cylinder (VC) brachytherapy in cancer care. By integrating Virtual Reality (VR) and mobile computing, the system establishes a high-fidelity, risk-free environment that allows trainees to master complex procedural skills without the facility or safety constraints posed by physical anatomy or live radioactive sources. A core contribution of this work is the seamless integration of a knowledge-aware assistant leveraging Retrieval-Augmented Generation (RAG) to ground agent interactions in authoritative clinical guidelines. This architecture also enables an interactive agent to provide natural language interfaces and hands-free, real-time guidance during intricate medical maneuvers. We validate the proposed system through a prototype deployment comprising a Meta Quest 3 interface linked to a local GPU-accelerated AI backend, demonstrating a feasible architecture for HDR brachytherapy simulation. Experimental results indicate that the system maintains suitable end-to-end latency and high context precision, answer completeness, and relevance in the RAG-enhanced pedagogical support.

cs.AI

Leveraging AI for fine-grained food safety risk forecasting in sparse data conditions

Ensuring food safety represents a critical public health challenge, particularly when inspection resources are limited and regional sampling data are sparse. This study proposes a Transformer-based framework capable of forecasting fine-grained, city-level food safety risks by unifying over 11 million inspection records with supplemental demographic, economic, and environmental indicators extracted from the Statistical Yearbook. A three-stage pretraining design leverages partial supervision from the Wilson interval (capturing both safety and risk rankings), together with semi-supervised label refinement, to effectively utilize historical records even when local sample sizes are insufficient. Experimental evaluations on data from 2022 show that the proposed approach outperforms baselines significantly. A subsequent field experiment in collaboration with the Zhejiang Provincial Administration for Market Regulation further demonstrates improved detection rates and more efficient allocation of inspection resources compared to a manually developed plan. Observations of regulatory decision-making reveal a threshold-based heuristic employed by inspectors, hinting that additional training or decision-support interfaces could further enhance the impact of AI-generated risk scores. Overall, these findings underscore that a rigorous integration of large-scale public inspection data, Wilson interval-based confidence modeling, and advanced deep learning can facilitate earlier and more granular identification of food safety threats. By reducing reliance on reactive measures alone, the proposed framework has the potential to advance proactive, data-driven oversight of the global food supply.

cs.AI

One4Many-StablePacker: An Efficient Deep Reinforcement Learning Framework for the 3D Bin Packing Problem

The three-dimensional bin packing problem (3D-BPP) is widely applied in logistics and warehousing. Existing learning-based approaches often neglect practical stability-related constraints and exhibit limitations in generalizing across diverse bin dimensions. To address these limitations, we propose a novel deep reinforcement learning framework, One4Many-StablePacker (O4M-SP). The primary advantage of O4M-SP is its ability to handle various bin dimensions in a single training process while incorporating support and weight constraints common in practice. Our training method introduces two innovative mechanisms. First, it employs a weighted reward function that integrates loading rate and a new height difference metric for packing layouts, promoting improved bin utilization through flatter packing configurations. Second, it combines clipped policy gradient optimization with a tailored policy drifting method to mitigate policy entropy collapse, encouraging exploration at critical decision nodes during packing to avoid suboptimal solutions. Extensive experiments demonstrate that O4M-SP generalizes successfully across diverse bin dimensions and significantly outperforms baseline methods. Furthermore, O4M-SP exhibits strong practical applicability by effectively addressing packing scenarios with stability constraints.

cs.LG

Artificial Intelligence Across the Cardiac Amyloidosis Diagnostic Pathway: From Single-Modality Detection to Multimodal Clinical Integration

Cardiac amyloidosis (CA) is increasingly recognized but remains substantially underdiagnosed, because its clinical and imaging phenotype overlaps with more common cardiomyopathies. Definitive subtype assignment and management further require integration of multimodal evidence to distinguish transthyretin from light chain disease. Machine learning and deep learning have been applied across the diagnostic and management pathway. These applications span ECG, echocardiography, and health record-based case finding, as well as CMR and nuclear interpretation, including SPECT/CT biomarker quantification, prognostic modeling, and treatment response assessment. This narrative review synthesizes these studies by clinical tasks, namely screening, detection, quantification, prognosis, and treatment response monitoring, rather than by input modality. This task-based organization clarifies why apparently similar AI models require different cohorts, reference standards, evaluation metrics, and implementation thresholds. The evidence reveals a maturity gradient. Binary detection and AI assisted quantification on bone scintigraphy and SPECT/CT are closest to clinical translation. Detection is supported by large externally validated cohorts, and quantification by interpretable, outcome linked measurement of myocardial tracer burden. By contrast, subtype aware classification, prognostic risk stratification, and treatment response monitoring remain at an early stage. These tasks are limited by small cohorts, enriched retrospective designs, heterogeneous labels, incomplete external validation, and uncertain calibration in realistic prevalence settings. Across tasks, high discrimination alone is insufficient.

physics.med-ph

MVMGNN;Multi-View Masked Graph Neural Network for Alzheimer's Disease Diagnosis using Structural MRI

Alzheimer's disease (AD) is a common neurodegenerative disorder, and early diagnosis is of great significance for delaying disease progression and enabling timely intervention. Mild cognitive impairment (MCI), which represents an intermediate clinical stage between cognitively normal aging and AD. Structural magnetic resonance imaging (sMRI) provides detailed characterization of anatomical structures and plays an important role in AD-related brain analysis. However, existing sMRI-based brain network methods typically rely on a single graph construction strategy, limiting their ability to jointly capture spatial relationships and morphological similarities between brain regions. To address these issues, this paper proposes an sMRI-based multi-view masked graph neural network model (MVMGNN) for AD diagnosis. A joint node-edge masking mechanism is proposed to simultaneously select radiomics feature dimensions and structural connections, reducing redundancy during graph learning. Furthermore, a patient-level cross-view gated fusion mechanism is proposed to integrate multi-view representations. Experimental results on the ADNI dataset demonstrate that MVMGNN outperforms several competing approaches in AD classification. Interpretability analysis further demonstrates that MVMGNN is able to identify key brain regions associated with AD, providing useful insights into discriminative patterns in sMRI-based brain networks.Our implementation is publicly available at https://github.com/chenzhao2023/MVMGNN_AD

cs.CV

GMN4AD: Graph Matching Network for Alzheimer's Disease Diagnosis with Test-Time Domain Adaptation using Multi-centered Structure Magnetic Resonance Imaging

Alzheimer's Disease (AD) is a progressive neurodegenerative disorder that affects millions of older adults, with prevalence expected to rise significantly in the coming years. Early diagnosis, particularly during the mild cognitive impairment (MCI) stage, is critical for timely intervention. Structural Magnetic Resonance Imaging (sMRI) has emerged as a key modality for detecting AD-related brain changes, but traditional graph-based approaches often struggle with modality and inter-site heterogeneity, limiting diagnostic performance. In this paper, we propose Graph Matching Network for Alzheimer's Disease Diagnosis (GMN4AD), designed to model interactions between heterogeneous brain graphs derived from neuroimaging data. Unlike conventional methods that treat each brain graph independently, GMN4AD leverages graph matching to capture cross-graph relationships, enhancing diagnostic precision. Furthermore, we introduce a test-time domain adaptation strategy that combines contrastive learning to mitigate domain shifts during inference. Extensive experiments on three public AD datasets demonstrate that GMN4AD achieves superior performance compared to state-of-the-art methods, offering a robust and generalizable solution for AD diagnosis.

eess.IV

ProMUSE: Progressive Multi-modal Uncertainty-guided Staged Evidential Alzheimer Disease Classification

Alzheimer's disease (AD) is a fatal disorder that destroys memory and cognitive skills in the elderly population. Most treatments for AD are effective in the early stage, leading to an increasing demand for early AD diagnosis. AD diagnosis increasingly relies on multimodal data such as clinical assessments, structural Magnetic Resonance Imaging (MRI), and Positron Emission Tomography (PET) imaging. However, MRI and PET acquisition remain costly and not universally accessible, making full-modality inference impractical in real-world clinical workflows. We propose ProMUSE, a Progressive Multi-modal Uncertainty Guided Staged Evidential Network that adaptively determines when additional modalities are necessary, helping reduce the overall cost of data acquisition while maintaining accuracy. ProMUSE first performs evidential classification using low-cost clinical data and quantifies uncertainty via a Dirichlet-based subjective logic model. When uncertainty exceeds a learned threshold, ProMUSE progressively incorporates MRI or PET features, fusing modality-wise belief and uncertainty through Dempster-Shafer theory to obtain a calibrated multimodal prediction. This staged acquisition strategy enables accurate diagnosis while minimizing reliance on expensive imaging. Experiments on ADNI, AIBL, and OASIS across CN-AD, CN-MCI, and MCI-AD tasks demonstrate that ProMUSE achieves competitive or superior accuracy compared to full-modality baselines while reducing MRI/PET usage by 50-90%, yielding substantial cost savings. These results highlight ProMUSE as a practical, uncertainty-aware, and resource-efficient solution for real-world AD screening.

cs.LG

DXA-Derived Skeletal Phenotypes and Hip Fracture Risk: A Backdoor-Adjusted Causal Analysis

Purpose: To compare dual-energy X-ray absorptiometry (DXA)-derived hip skeletal phenotypes in relation to hip fracture risk using prespecified confounder adjustment and to assess whether phenotypes ranked by their backdoor-adjusted average treatment effects (ATEs) improve risk stratification. Methods: We analyzed 21,098 UK Biobank participants with linked health records, hip DXA-derived skeletal measures, and prespecified covariates. Sixteen phenotypes spanning bone mineral content (BMC), bone mineral density (BMD), and T-score across hip-related regions were evaluated. Confounder selection was guided by a prespecified directed acyclic graph (DAG). Backdoor-adjusted ATEs were estimated on the absolute risk-difference scale per standard deviation (SD) increase. Effect heterogeneity was evaluated for total femur BMD, and downstream prediction was assessed using clinical variables combined with phenotypes ranked by ATE magnitude. Results: Among 21,098 participants, 115 had hip fractures. All 16 phenotypes showed negative backdoor-adjusted ATEs per SD increase. The largest ATEs were observed for total femur BMC and total femur BMD, each with a risk difference of -0.0047, corresponding to approximately 4.7 fewer hip fractures per 1,000 participants per SD higher phenotype value. Conditional effects of total femur BMD were stronger among older participants and those with lower BMI. In prediction, clinical variables plus the top 11 ATE-ranked phenotypes achieved higher AUC than FRAX with femoral neck BMD (0.842 vs. 0.709), with higher sensitivity (0.748 vs. 0.443) and similar specificity (0.793 vs. 0.777). Conclusion: DXA-derived hip skeletal phenotypes differed in their backdoor-adjusted ATEs. Phenotype-level causal evaluation may help identify informative DXA measures for risk stratification.

q-bio.QM

Point Cloud Registration for Fusion between SPECT MPI and CTA Images

Clinical fusion of Single Photon Emission Computed Tomography Myocardial Perfusion Imaging (SPECT MPI) and Computed Tomography Angiography (CTA) remains limited by cross-modality misregistration and reliance on manual landmarks, which can hinder accurate ischemia localization and lesion-level functional assessment. To address this issue, we propose a registration and fusion framework for SPECT MPI and CTA that integrates functional and structural information for comprehensive cardiac evaluation. The proposed pipeline performs U-Net-based segmentation on both modalities. On SPECT MPI, only the left ventricle (LV) is extracted, and anatomical landmarks are automatically derived from characteristic LV structures. On CTA, both ventricles are segmented, and their spatial relationship is used to automatically define landmarks at the interventricular septal junction. Scale-space consistency preprocessing and landmark-driven coarse registration are applied to mitigate initial misalignment. Based on this initialization, multiple fine registration methods are evaluated on LV epicardial surface point clouds, including ICP, SICP, CPD, CluReg, FFD, and BCPD-plus-plus. The resulting transformations are then propagated to voxel-level resampling for high-precision SPECT-CTA fusion. In a retrospective cohort of 60 patients, the proposed framework preserved sub-millimeter coronary detail from CTA while accurately overlaying quantitative SPECT perfusion. Among the evaluated methods, BCPD-plus-plus achieved the highest accuracy with a mean point cloud distance of 1.7 mm. By combining robust initialization, comparative fine registration, and voxel-level fusion, the proposed approach provides a practical solution for myocardial ischemia localization and functional evaluation of coronary lesions, while remaining independent of any specific fine registration algorithm.

cs.CV

Imaging-Derived Coronary Fractional Flow Reserve: Advances in Physics-Based, Machine Learning, and Physics-Informed Methods

Purpose of Review Imaging derived fractional flow reserve (FFR) is rapidly evolving beyond conventional computational fluid dynamics (CFD) based pipelines toward machine learning (ML), deep learning (DL), and physics informed approaches that enable fast, wire free, and scalable functional assessment of coronary artery stenosis. This review synthesizes recent advances in computed tomography (CT)- and angiography-based FFR measurement, with particular emphasis on emerging physics-informed neural networks and neural operators (PINNs and PINOs), as well as key considerations for their clinical translation. Recent Findings ML/DL approaches have markedly improved automation and computational speed, enabling prediction of pressure and FFR from anatomical descriptors or angiographic contrast dynamics. However, their real-world performance and generalizability can remain variable and sensitive to domain shift, due to multi-center heterogeneity, interpretability challenges, and differences in acquisition protocols and image quality. Physics informed learning introduces conservation structure and boundary condition consistency into model training, improving generalizability and reducing dependence on dense supervision while maintaining rapid inference. Recent evaluation trends increasingly highlight deployment oriented metrics, including calibration, uncertainty quantification, and quality control gatekeeping, as essential for safe clinical use. Summary The field is converging toward imaging derived FFR methods that are faster, more automated, and more reliable. While ML/DL offers substantial efficiency gains, physics informed frameworks such as PINNs and PINOs may provide a more robust balance between speed and physical consistency. Prospective multi center validation and standardized evaluation will be critical to support broad and safe clinical adoption.

physics.med-ph

Vehicle-as-Prompt: A Unified Deep Reinforcement Learning Framework for Heterogeneous Fleet Vehicle Routing Problem

Unlike traditional homogeneous routing problems, the Heterogeneous Fleet Vehicle Routing Problem (HFVRP) involves heterogeneous fixed costs, variable travel costs, and capacity constraints, rendering solution quality highly sensitive to vehicle selection. Furthermore, real-world logistics applications often impose additional complex constraints, markedly increasing computational complexity. However, most existing Deep Reinforcement Learning (DRL)-based methods are restricted to homogeneous scenarios, leading to suboptimal performance when applied to HFVRP and its complex variants. To bridge this gap, we investigate HFVRP under complex constraints and develop a unified DRL framework capable of solving the problem across various variant settings. We introduce the Vehicle-as-Prompt (VaP) mechanism, which formulates the problem as a single-stage autoregressive decision process. Building on this, we propose VaP-CSMV, a framework featuring a cross-semantic encoder and a multi-view decoder that effectively addresses various problem variants and captures the complex mapping relationships between vehicle heterogeneity and customer node attributes. Extensive experimental results demonstrate that VaP-CSMV significantly outperforms existing state-of-the-art DRL-based neural solvers and achieves competitive solution quality compared to traditional heuristic solvers, while reducing inference time to mere seconds. Furthermore, the framework exhibits strong zero-shot generalization capabilities on large-scale and previously unseen problem variants, while ablation studies validate the vital contribution of each component.

cs.LG

Accurate and Efficient Multi-Channel Time Series Forecasting via Sparse Attention Mechanism

The task of multi-channel time series forecasting is ubiquitous in numerous fields such as finance, supply chain management, and energy planning. It is critical to effectively capture complex dynamic dependencies within and between channels for accurate predictions. However, traditional method paid few attentions on learning the interaction among channels. This paper proposes Linear-Network (Li-Net), a novel architecture designed for multi-channel time series forecasting that captures the linear and non-linear dependencies among channels. Li-Net dynamically compresses representations across sequence and channel dimensions, processes the information through a configurable non-linear module and subsequently reconstructs the forecasts. Moreover, Li-Net integrates a sparse Top-K Softmax attention mechanism within a multi-scale projection framework to address these challenges. A core innovation is its ability to seamlessly incorporate and fuse multi-modal embeddings, guiding the sparse attention process to focus on the most informative time steps and feature channels. Through the experiment results on multiple real-world benchmark datasets demonstrate that Li-Net achieves competitive performance compared to state-of-the-art baseline methods. Furthermore, Li-Net provides a superior balance between prediction accuracy and computational burden, exhibiting significantly lower memory usage and faster inference times. Detailed ablation studies and parameter sensitivity analyses validate the effectiveness of each key component in our proposed architecture. Keywords: Multivariate Time Series Forecasting, Sparse Attention Mechanism, Multimodal Information Fusion, Non-linear relationship

cs.AI

Improving Generalizability of Hip Fracture Risk Prediction via Domain Adaptation Across Multiple Cohorts

Clinical risk prediction models often fail to be generalized across cohorts because underlying data distributions differ by clinical site, region, demographics, and measurement protocols. This limitation is particularly pronounced in hip fracture risk prediction, where the performance of models trained on one cohort (the source cohort) can degrade substantially when deployed in other cohorts (target cohorts). We used a shared set of clinical and DXA-derived features across three large cohorts - the Study of Osteoporotic Fractures (SOF), the Osteoporotic Fractures in Men Study (MrOS), and the UK Biobank (UKB), to systematically evaluate the performance of three domain adaptation methods - Maximum Mean Discrepancy (MMD), Correlation Alignment (CORAL), and Domain - Adversarial Neural Networks (DANN) and their combinations. For a source cohort with males only and a source cohort with females only, domain-adaptation methods consistently showed improved performance than the no-adaptation baseline (source-only training), and the use of combinations of multiple domain adaptation methods delivered the largest and most stable gains. The method that combines MMD, CORAL, and DANN achieved the highest discrimination with the area under curve (AUC) of 0.88 for a source cohort with males only and 0.95 for a source cohort with females only), demonstrating that integrating multiple domain adaptation methods could produce feature representations that are less sensitive to dataset differences. Unlike existing methods that rely heavily on supervised tuning or assume known outcomes of samples in target cohorts, our outcome-free approaches enable the model selection under realistic deployment conditions and improve generalization of models in hip fracture risk prediction.

cs.LG

UG-FedDA: Uncertainty-Guided Federated Domain Adaptation for Multi-Center Alzheimer's Disease Detection

Alzheimer's disease (AD) is an irreversible neurodegenerative disorder, and early diagnosis is critical for timely intervention. However, most existing classification frameworks face challenges in multicenter studies, as they often neglect inter-site heterogeneity and lack mechanisms to quantify uncertainty, which limits their robustness and clinical applicability. To address these issues, we proposed Uncertainty-Guided Federated Domain Adaptation (UG-FedDA), a novel multicenter AD classification framework that integrates uncertainty quantification (UQ) with federated domain adaptation to handle cross-site structure magnetic resonance imaging (MRI) heterogeneity under privacy constraints. Our approach extracts multi-template region-of-interest (RoI) features using a self-attention transformer, capturing both regional representations and their interactions. UQ is integrated to guide feature alignment, mitigating source-target distribution shifts by down-weighting uncertain samples. Experiments are conducted on three public datasets: the Alzheimer's Disease Neuroimaging Initiative (ADNI), the Australian Imaging, Biomarkers and Lifestyle study (AIBL), and the Open Access Series of Imaging Studies (OASIS). UG-FedDA achieved consistent cross-domain improvements in accuracy, sensitivity, and area under the ROC curve across three classification tasks: AD vs. normal controls (NC), mild cognitive impairment (MCI) vs. AD, and NC vs. MCI. For NC vs. AD, UG-FedDA achieves accuracies of 90.54%, 89.04%, and 77.78% on ADNI, AIBL and OASIS datasets, respectively. For MCI vs. AD, accuracies are 80.20% (ADNI), 71.91% (AIBL), and 79.73% (OASIS). For NC vs. MCI, results are 76.87% (ADNI), 73.91% (AIBL), and 83.73% (OASIS). These results demonstrate that the proposed framework not only adapts efficiently across multiple sites but also preserves strict privacy.

cs.CV

PF-DAformer: Proximal Femur Segmentation via Domain Adaptive Transformer for Dual-Center QCT

Quantitative computed tomography (QCT) plays a crucial role in assessing bone strength and fracture risk by enabling volumetric analysis of bone density distribution in the proximal femur. However, deploying automated segmentation models in practice remains difficult because deep networks trained on one dataset often fail when applied to another. This failure stems from domain shift, where scanners, reconstruction settings, and patient demographics vary across institutions, leading to unstable predictions and unreliable quantitative metrics. Overcoming this barrier is essential for multi-center osteoporosis research and for ensuring that radiomics and structural finite element analysis results remain reproducible across sites. In this work, we developed a domain-adaptive transformer segmentation framework tailored for multi-institutional QCT. Our model is trained and validated on one of the largest hip fracture related research cohorts to date, comprising 1,024 QCT images scans from Tulane University and 384 scans from Rochester, Minnesota for proximal femur segmentation. To address domain shift, we integrate two complementary strategies within a 3D TransUNet backbone: adversarial alignment via Gradient Reversal Layer (GRL), which discourages the network from encoding site-specific cues, and statistical alignment via Maximum Mean Discrepancy (MMD), which explicitly reduces distributional mismatches between institutions. This dual mechanism balances invariance and fine-grained alignment, enabling scanner-agnostic feature learning while preserving anatomical detail.

cs.CV

An Advanced Two-Stage Model with High Sensitivity and Generalizability for Prediction of Hip Fracture Risk Using Multiple Datasets

Hip fractures are a major cause of disability, mortality, and healthcare burden in older adults, underscoring the need for early risk assessment. However, commonly used tools such as the DXA T-score and FRAX often lack sensitivity and miss individuals at high risk, particularly those without prior fractures or with osteopenia. To address this limitation, we propose a sequential two-stage model that integrates clinical and imaging information to improve prediction accuracy. Using data from the Osteoporotic Fractures in Men Study (MrOS), the Study of Osteoporotic Fractures (SOF), and the UK Biobank, Stage 1 (Screening) employs clinical, demographic, and functional variables to estimate baseline risk, while Stage 2 (Imaging) incorporates DXA-derived features for refinement. The model was rigorously validated through internal and external testing, showing consistent performance and adaptability across cohorts. Compared to T-score and FRAX, the two-stage framework achieved higher sensitivity and reduced missed cases, offering a cost-effective and personalized approach for early hip fracture risk assessment. Keywords: Hip Fracture, Two-Stage Model, Risk Prediction, Sensitivity, DXA, FRAX

cs.LG

UPMAD-Net: A Brain Tumor Segmentation Network with Uncertainty Guidance and Adaptive Multimodal Feature Fusion

Background: Brain tumor segmentation has a significant impact on the diagnosis and treatment of brain tumors. Accurate brain tumor segmentation remains challenging due to their irregular shapes, vague boundaries, and high variability. Objective: We propose a brain tumor segmentation method that combines deep learning with prior knowledge derived from a region-growing algorithm. Methods: The proposed method utilizes a multi-scale feature fusion (MSFF) module and adaptive attention mechanisms (AAM) to extract multi-scale features and capture global contextual information. To enhance the model's robustness in low-confidence regions, the Monte Carlo Dropout (MC Dropout) strategy is employed for uncertainty estimation. Results: Extensive experiments demonstrate that the proposed method achieves superior performance on Brain Tumor Segmentation (BraTS) datasets, significantly outperforming various state-of-the-art methods. On the BraTS2021 dataset, the test Dice scores are 89.18% for Enhancing Tumor (ET) segmentation, 93.67% for Whole Tumor (WT) segmentation, and 91.23% for Tumor Core (TC) segmentation. On the BraTS2019 validation set, the validation Dice scores are 87.43%, 90.92%, and 90.40% for ET, WT, and TC segmentation, respectively. Ablation studies further confirmed the contribution of each module to segmentation accuracy, indicating that each component played a vital role in overall performance improvement. Conclusion: This study proposed a novel 3D brain tumor segmentation network based on the U-Net architecture. By incorporating the prior knowledge and employing the uncertainty estimation method, the robustness and performance were improved. The code for the proposed method is available at https://github.com/chenzhao2023/UPMAD_Net_BrainSeg.

cs.CV

Myocardial Region-guided Feature Aggregation Net for Automatic Coronary artery Segmentation and Stenosis Assessment using Coronary Computed Tomography Angiography

Coronary artery disease (CAD) remains a leading cause of mortality worldwide, requiring accurate segmentation and stenosis detection using Coronary Computed Tomography angiography (CCTA). Existing methods struggle with challenges such as low contrast, morphological variability and small vessel segmentation. To address these limitations, we propose the Myocardial Region-guided Feature Aggregation Net, a novel U-shaped dual-encoder architecture that integrates anatomical prior knowledge to enhance robustness in coronary artery segmentation. Our framework incorporates three key innovations: (1) a Myocardial Region-guided Module that directs attention to coronary regions via myocardial contour expansion and multi-scale feature fusion, (2) a Residual Feature Extraction Encoding Module that combines parallel spatial channel attention with residual blocks to enhance local-global feature discrimination, and (3) a Multi-scale Feature Fusion Module for adaptive aggregation of hierarchical vascular features. Additionally, Monte Carlo dropout f quantifies prediction uncertainty, supporting clinical interpretability. For stenosis detection, a morphology-based centerline extraction algorithm separates the vascular tree into anatomical branches, enabling cross-sectional area quantification and stenosis grading. The superiority of MGFA-Net was demonstrated by achieving an Dice score of 85.04%, an accuracy of 84.24%, an HD95 of 6.1294 mm, and an improvement of 5.46% in true positive rate for stenosis detection compared to3D U-Net. The integrated segmentation-to-stenosis pipeline provides automated, clinically interpretable CAD assessment, bridging deep learning with anatomical prior knowledge for precision medicine. Our code is publicly available at http://github.com/chenzhao2023/MGFA_CCTA

cs.CV