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30 pages, 1577 KiB  
Article
Multidisciplinary, Clinical Assessment of Accelerated Deep-Learning MRI Protocols at 1.5 T and 3 T After Intracranial Tumor Surgery and Their Influence on Residual Tumor Perception
by Christer Ruff, Till-Karsten Hauser, Constantin Roder, Daniel Feucht, Paula Bombach, Leonie Zerweck, Deborah Staber, Frank Paulsen, Ulrike Ernemann and Georg Gohla
Diagnostics 2025, 15(15), 1982; https://doi.org/10.3390/diagnostics15151982 (registering DOI) - 7 Aug 2025
Abstract
Background/Objectives: Postoperative MRI is crucial for detecting residual tumor, identifying complications, and planning subsequent therapy. This study evaluates accelerated deep learning reconstruction (DLR) versus standard clinical protocols for early postoperative MRI following tumor resection. Methods: This study uses a multidisciplinary approach [...] Read more.
Background/Objectives: Postoperative MRI is crucial for detecting residual tumor, identifying complications, and planning subsequent therapy. This study evaluates accelerated deep learning reconstruction (DLR) versus standard clinical protocols for early postoperative MRI following tumor resection. Methods: This study uses a multidisciplinary approach involving a neuroradiologist, neurosurgeon, neuro-oncologist, and radiotherapist to evaluate qualitative aspects using a 5-point Likert scale, the preferred reconstruction variant and potential residual tumor of DLR and conventional reconstruction (CR) of FLAIR, T1-weighted non-contrast and contrast-enhanced (T1), and coronal T2-weighted (T2) sequences for 1.5 and 3 T MRI. Quantitative analysis included the image quality metrics Structural Similarity Index (SSIM), Multi-Scale SSIM (MS-SSIM), Feature Similarity Index (FSIM), Noise Quality Metric (NQM), signal-to-noise ratio (SNR), and Peak SNR (PSNR) with CR as a reference. Results: All raters strongly preferred DLR over CR. This was most pronounced for FLAIR images at 1.5 and 3 T (91% at 1.5 T and 97% at 3 T) and least pronounced for T1 at 1.5 T (79% for non-contrast-enhanced and 84% for contrast-enhanced sequences) and for T2 at 3 T (69%). DLR demonstrated superior qualitative image quality for all sequences and field strengths (p < 0.001), except for T2 at 3 T, which was observed across all raters (p = 0.670). Diagnostic confidence was similar at 3 T with better but non-significant differences for T2 (p = 0.134) and at 1.5 T with better but non-significant differences for non-contrast-enhanced T1 (p = 0.083) and only marginally significant results for FLAIR (p = 0.033). Both the SSIM and MS-SSIM indicated near-perfect similarity between CR and DLR. FSIM performs worse in terms of consistency between CR and DLR. The image quality metrics NQM, SNR, and PSNR showed better results for DLR. Visual assessment of residual tumor was similar at 3 T but differed at 1.5 T, with more residual tumor detected with DLR, especially by the neurosurgeon (n = 4). Conclusions: An accelerated DLR protocol demonstrates clinical feasibility, enabling high-quality reconstructions in challenging postoperative MRIs. DLR sequences received strong multidisciplinary preference, underscoring their potential to improve neuro-oncologic decision making and suitability for clinical implementation. Full article
(This article belongs to the Special Issue Advanced Brain Tumor Imaging)
12 pages, 7552 KiB  
Article
High Resolution Imaging Using Micro-Objectives Fabricated by 2-Photon-Polymerization
by Fabian Thiemicke, Mostafa Agour, Ralf B. Bergmann and Claas Falldorf
Appl. Sci. 2025, 15(15), 8756; https://doi.org/10.3390/app15158756 (registering DOI) - 7 Aug 2025
Abstract
We experimentally demonstrate high-resolution imaging using micro-objectives fabricated by two-photon polymerization (2PP) lithography, highlighting its potential as a flexible and precise fabrication method. The 2PP manufacturing process offers the ability to develop micro-optics with customized geometries and material properties, including tailored refractive indices. [...] Read more.
We experimentally demonstrate high-resolution imaging using micro-objectives fabricated by two-photon polymerization (2PP) lithography, highlighting its potential as a flexible and precise fabrication method. The 2PP manufacturing process offers the ability to develop micro-optics with customized geometries and material properties, including tailored refractive indices. This flexibility introduces new degrees of freedom in optical system design and expands the applicability of micro-optics to advanced imaging tasks where other materials and fabrication methods are insufficient. For our study, bi-convex micro-optics with different geometries with radii of curvature of <15 μm and minimized contact areas (<1 μm2) to ensure easy release from the substrate were fabricated with 2PP and investigated for their optical performance. With these micro-optics, the tracks with a pitch of 320 nm and the pits and lands as small as 130 nm were successfully resolved on a BluRay disc surface, demonstrating for the first time the high-resolution imaging capabilities of bi-convex spherical micro lenses. Full article
15 pages, 9399 KiB  
Article
Analysis of 3D-Printed Zirconia Implant Overdenture Bars
by Les Kalman and João Paulo Mendes Tribst
Appl. Sci. 2025, 15(15), 8751; https://doi.org/10.3390/app15158751 (registering DOI) - 7 Aug 2025
Abstract
Dental implant components are typically fabricated using subtractive manufacturing, often involving metal materials that can be costly, inefficient, and time-consuming. This study explores the use of additive manufacturing (AM) with zirconia for dental implant overdenture bars, focusing on mechanical performance, stress distribution, and [...] Read more.
Dental implant components are typically fabricated using subtractive manufacturing, often involving metal materials that can be costly, inefficient, and time-consuming. This study explores the use of additive manufacturing (AM) with zirconia for dental implant overdenture bars, focusing on mechanical performance, stress distribution, and fit. Solid and lattice-structured bars were designed in Fusion 360 and produced using LithaCon 210 3Y-TZP zirconia (Lithoz GmbH, Vienna, Austria) on a CeraFab 8500 printer. Post-processing included cleaning, debinding, and sintering. A 3D-printed denture was also fabricated to evaluate fit. Thermography and optical imaging were used to assess adaptation. Custom fixtures were developed for flexural testing, and fracture loads were recorded to calculate stress distribution using finite element analysis (ANSYS R2025). The FEA model assumed isotropic, homogeneous, linear-elastic material behavior. Bars were torqued to 15 Ncm on implant analogs. The average fracture loads were 1.2240 kN (solid, n = 12) and 1.1132 kN (lattice, n = 5), with corresponding stress values of 147 MPa and 143 MPa, respectively. No statistically significant difference was observed (p = 0.578; α = 0.05). The fracture occurred near high-stress regions at fixture support points. All bars demonstrated a clinically acceptable fit on the model; however, further validation and clinical evaluation are still needed. Additively manufactured zirconia bars, including lattice structures, show promise as alternatives to conventional superstructures, potentially offering reduced material use and faster production without compromising mechanical performance. Full article
(This article belongs to the Special Issue Recent Advances in Digital Dentistry and Oral Implantology)
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24 pages, 2032 KiB  
Article
BCTDNet: Building Change-Type Detection Networks with the Segment Anything Model in Remote Sensing Images
by Wei Zhang, Jinsong Li, Shuaipeng Wang and Jianhua Wan
Remote Sens. 2025, 17(15), 2742; https://doi.org/10.3390/rs17152742 (registering DOI) - 7 Aug 2025
Abstract
Observing building changes in remote sensing images plays a crucial role in monitoring urban development and promoting sustainable urbanization. Mainstream change detection methods have demonstrated promising performance in identifying building changes. However, buildings have large intra-class variance and high similarity with other objects, [...] Read more.
Observing building changes in remote sensing images plays a crucial role in monitoring urban development and promoting sustainable urbanization. Mainstream change detection methods have demonstrated promising performance in identifying building changes. However, buildings have large intra-class variance and high similarity with other objects, limiting the generalization ability of models in diverse scenarios. Moreover, most existing methods only detect whether changes have occurred but ignore change types, such as new construction and demolition. To address these issues, we present a building change-type detection network (BCTDNet) based on the Segment Anything Model (SAM) to identify newly constructed and demolished buildings. We first construct a dual-feature interaction encoder that employs SAM to extract image features, which are then refined through trainable multi-scale adapters for learning architectural structures and semantic patterns. Moreover, an interactive attention module bridges SAM with a Convolutional Neural Network, enabling seamless interaction between fine-grained structural information and deep semantic features. Furthermore, we develop a change-aware attribute decoder that integrates building semantics into the change detection process via an extraction decoding network. Subsequently, an attribute-aware strategy is adopted to explicitly generate distinct maps for newly constructed and demolished buildings, thereby establishing clear temporal relationships among different change types. To evaluate BCTDNet’s performance, we construct the JINAN-MCD dataset, which covers Jinan’s urban core area over a six-year period, capturing diverse change scenarios. Moreover, we adapt the WHU-CD dataset into WHU-MCD to include multiple types of changing. Experimental results on both datasets demonstrate the superiority of BCTDNet. On JINAN-MCD, BCTDNet achieves improvements of 12.64% in IoU and 11.95% in F1 compared to suboptimal methods. Similarly, on WHU-MCD, it outperforms second-best approaches by 2.71% in IoU and 1.62% in F1. BCTDNet’s effectiveness and robustness in complex urban scenarios highlight its potential for applications in land-use analysis and urban planning. Full article
24 pages, 3567 KiB  
Article
Investigation of the Load-Bearing Capacity of Resin-Printed Components Under Different Printing Strategies
by Brigitta Fruzsina Szívós, Vivien Nemes, Szabolcs Szalai and Szabolcs Fischer
Appl. Sci. 2025, 15(15), 8747; https://doi.org/10.3390/app15158747 (registering DOI) - 7 Aug 2025
Abstract
This study examines the influence of different printing orientations and infill settings on the strength and flexibility of components produced using resin-based 3D printing, particularly with masked stereolithography (MSLA). Using a common photopolymer resin and a widely available desktop MSLA printer, we produced [...] Read more.
This study examines the influence of different printing orientations and infill settings on the strength and flexibility of components produced using resin-based 3D printing, particularly with masked stereolithography (MSLA). Using a common photopolymer resin and a widely available desktop MSLA printer, we produced and tested a series of samples with varying tilt angles and internal structures. To understand their mechanical behavior, we applied a custom bending test combined with high-precision deformation tracking through the GOM ARAMIS digital image correlation system. The results obtained clearly show that both the angle of printing and the density of the internal infill structure play a significant role in how much strain the printed parts can handle before breaking. Notably, a 75° orientation provided the best deformation performance, and infill rates between 60% and 90% offered a good balance between strength and material efficiency. These findings highlight how adjusting print settings can lead to stronger parts while also saving time and resources—an important consideration for practical applications in engineering, design, and manufacturing. Full article
(This article belongs to the Special Issue Sustainable Mobility and Transportation (SMTS 2025))
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16 pages, 3847 KiB  
Article
Water Body Extraction Methods for SAR Images Fusing Sentinel-1 Dual-Polarized Water Index and Random Forest
by Min Zhai, Huayu Shen, Qihang Cao, Xuanhao Ding and Mingzhen Xin
Sensors 2025, 25(15), 4868; https://doi.org/10.3390/s25154868 (registering DOI) - 7 Aug 2025
Abstract
Synthetic Aperture Radar (SAR) technology has the characteristics of all-day and all-weather functionality; accordingly, it is not affected by rainy weather, overcoming the limitations of optical remote sensing, and it provides irreplaceable technical support for efficient water body extraction. To address the issues [...] Read more.
Synthetic Aperture Radar (SAR) technology has the characteristics of all-day and all-weather functionality; accordingly, it is not affected by rainy weather, overcoming the limitations of optical remote sensing, and it provides irreplaceable technical support for efficient water body extraction. To address the issues of low accuracy and unstable results in water body extraction from Sentinel-1 SAR images using a single method, a water body extraction method fusing the Sentinel-1 dual-polarized water index and random forest is proposed. This novel method enhances water extraction accuracy by integrating the results of two different algorithms, reducing the biases associated with single-method water body extraction. Taking Dalu Lake, Yinfu Reservoir, and Huashan Reservoir as the study areas, water body information was extracted from SAR images using the dual-polarized water body index, the random forest method, and the fusion method. Taking the normalized difference water body index extraction results obtained via Sentinel-2 optical images as a reference, the accuracy of different water body extraction methods when used with SAR images was quantitatively evaluated. The experimental results show that, compared with the dual-polarized water body index and the random forest method, the fusion method, on average, increased overall water body extraction accuracy and Kappa coefficients by 3.9% and 8.2%, respectively, in the Dalu Lake experimental area; by 1.8% and 3.5%, respectively, in the Yinfu Reservoir experimental area; and by 4.1% and 8.1%, respectively, in the Huashan Reservoir experimental area. Therefore, the fusion method of the dual-polarized water index and random forest effectively improves the accuracy and reliability of water body extraction from SAR images. Full article
(This article belongs to the Section Radar Sensors)
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21 pages, 4368 KiB  
Article
Damage Mechanism Characterization of Glass Fiber-Reinforced Polymer Composites: A Study Using Acoustic Emission Technique and Unsupervised Machine Learning Algorithms
by Jorge Palacios Moreno, Hadi Nazaripoor and Pierre Mertiny
J. Compos. Sci. 2025, 9(8), 426; https://doi.org/10.3390/jcs9080426 - 7 Aug 2025
Abstract
Recent advancements in composite materials design have made glass fiber-reinforced polymer composites (GFRPC) a viable choice for a wide range of engineering and industrial applications. Although GFRPCs boast attractive characteristics such as low specific mass and high specific mechanical strength, identifying and characterizing [...] Read more.
Recent advancements in composite materials design have made glass fiber-reinforced polymer composites (GFRPC) a viable choice for a wide range of engineering and industrial applications. Although GFRPCs boast attractive characteristics such as low specific mass and high specific mechanical strength, identifying and characterizing damage mechanisms in these materials is challenging. Several scientific studies have examined the root causes of GFRPC failure using various methods, including non-destructive techniques and learning algorithms. Despite this, ongoing investigations aim to accurately detect mechanical defects in GFRPCs. This study explores the use of non-destructive testing (NDT) combined with unsupervised learning algorithms to identify and classify damage mechanisms in GFRPCs. The NDT method employed in this study is acoustic emission (AE), which identifies waveforms associated with various failure mechanisms during testing. These waveforms are categorized using unsupervised learning methods such as principal component analysis (PCA) and self-organizing maps. PCA selects the most appropriate AE descriptors for distinguishing between different damage mechanisms, while the self-organizing maps algorithm performs clustering analysis and classifies failure mechanisms. Scanning electron microscope images of the observed failures are provided to sup-port the findings derived from AE data. Full article
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24 pages, 3629 KiB  
Article
Chlorography or Chlorotyping from the Decomposition of Chlorophyll and Natural Pigments in Leaves and Flowers as a Natural Alternative for Photographic Development
by Andrea D. Larrea Solórzano, Iván P. Álvarez Lizano, Pablo R. Morales Fiallos, Carolina E. Maldonado Cherrez and Carlos S. Suárez Naranjo
J. Zool. Bot. Gard. 2025, 6(3), 41; https://doi.org/10.3390/jzbg6030041 - 7 Aug 2025
Abstract
This study explores the use of chlorography as a natural photographic developing technique that utilizes the decomposition of chlorophyll and other plant pigments through the action of sunlight. The developed images corresponded to previous research on changes in the iconography of the indigenous [...] Read more.
This study explores the use of chlorography as a natural photographic developing technique that utilizes the decomposition of chlorophyll and other plant pigments through the action of sunlight. The developed images corresponded to previous research on changes in the iconography of the indigenous Salasaka people. In this context, this experimental project on natural photography is oriented toward the conservation of the ancestral knowledge of this community and the understanding of the native flora of Ecuador. We investigated the application of the contact image transfer technique with positive transparencies on leaves and flowers of 30 different species that grow in the Ecuadorian highlands, including leaves of vascular plants, as well as rose petals. The results showed that the clarity and contrast of chlorography depended on the plant species and exposure time. It was observed that fruit-bearing species produced more visible images than the leaves of other plants and rose petals, with species from the Passifloraceae family proving particularly effective. We interpreted these findings within the framework of plant photophysical mechanisms, proposing an inverse relationship between development efficiency and species’ non-photochemical quenching (NPQ) capacity. Furthermore, we interpreted the findings in relation to the photobleaching of pigments and compared chlorography with other natural photographic processes such as anthotypes. Key factors influencing the process were identified, such as the type of leaf, the intensity and duration of light, and the hydration of the plant material. It is concluded that chlorography is a viable, non-toxic, and environmentally friendly photographic alternative with potential applications in art, education, and research, although it presents challenges in terms of image permanence and reproducibility. Full article
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20 pages, 12866 KiB  
Article
Integrating Spatial Autocorrelation and Greenest Images for Dynamic Analysis Urban Heat Islands Based on Google Earth Engine
by Dandan Yan, Yuqing Zhang, Peng Song, Xiaofang Zhang, Yu Wang, Wenyan Zhu and Qinghui Du
Sustainability 2025, 17(15), 7155; https://doi.org/10.3390/su17157155 - 7 Aug 2025
Abstract
With rapid global urbanization development, impermeable surface increase, urban population growth, building area expansion, and rising energy consumption, the urban heat island (UHI) effect is becoming increasingly serious. However, the spatial distribution of the UHI cannot be accurately extracted. Therefore, we focused on [...] Read more.
With rapid global urbanization development, impermeable surface increase, urban population growth, building area expansion, and rising energy consumption, the urban heat island (UHI) effect is becoming increasingly serious. However, the spatial distribution of the UHI cannot be accurately extracted. Therefore, we focused on Luoyang City as the research area and combined the Getis-Ord-Gi* statistic and the greenest image to extract the UHI based on the Google Earth Engine using land surface temperature–spatial autocorrelation characteristics and seasonal changes in vegetation. As bare land considerably influenced the UHI extraction results, we combined the greenest image with the initial extraction results and applied the maximum normalized difference vegetation index threshold method to remove this effect on UHI distribution extraction, thereby achieving improved UHI extraction accuracy. Our results showed that the UHI of Luoyang continuously expanded outward, increasing from 361.69 km2 in 2000 to 912.58 km2 in 2023, with a continuous expansion rate of 22.95 km2/year. Furthermore, the urban area had a higher UHI area growth rate than the county area. Analysis indicates that the UHI effect in Luoyang has increased in parallel with the expansion of the building area. Intensive urban construction is a primary driver of this growth, directly exacerbating the UHI effect. Additionally, rising temperatures, population growth, and gross domestic product accumulation have collectively contributed to the ongoing expansion of this phenomenon. This study provides scientific guidance for future urban planning through the accurate extraction of the UHI effect, which promotes the development of sustainable human settlements. Full article
(This article belongs to the Special Issue Sustainable Future of Ecohydrology: Climate Change and Land Use)
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16 pages, 2818 KiB  
Article
Thermographic Evaluation of the Stifle Region in Dogs with a Rupture of the Cranial Cruciate Ligament
by Tudor Căsălean, Cristian Zaha, Larisa Schuszler, Roxana Dascălu, Bogdan Sicoe, Răzvan Cojocaru, Andrei Călugărița, Ciprian Rujescu, Janos Degi and Romeo Teodor Cristina
Animals 2025, 15(15), 2317; https://doi.org/10.3390/ani15152317 - 7 Aug 2025
Abstract
Background: Canine cranial cruciate ligament (CCL) rupture is a common orthopedic condition leading to stifle joint dysfunction, discomfort, and reduced mobility. Diagnosis typically involves radiography, computed tomography (CT), and magnetic resonance imaging (MRI). In this study, we conducted a retrospective analysis to evaluate [...] Read more.
Background: Canine cranial cruciate ligament (CCL) rupture is a common orthopedic condition leading to stifle joint dysfunction, discomfort, and reduced mobility. Diagnosis typically involves radiography, computed tomography (CT), and magnetic resonance imaging (MRI). In this study, we conducted a retrospective analysis to evaluate the use of infrared thermography in assessing local temperature and thermal patterns in dogs with acute-onset lameness due to CCL rupture compared to those with intact ligaments. Methods: The study involved 12 dogs with cranial cruciate ligament rupture and nine dogs with intact ligaments. The stifle area of all dogs was clipped and scanned using a FLIR E50 thermographic camera. Two regions of interest (ROI), designated El1 and Bx1, were analyzed with FLIR Tools software 5.X by comparing the average of the maximum and of the mean temperature values between the two groups. Results: Thermal imaging revealed differences between the two groups of dogs, which were further supported by significantly higher temperatures in the El1 (lateral aspect of the stifle joint) and Bx1 (cranial aspect of the stifle joint) areas in the study group compared to the control group using a comparative analysis—two-sample t-test. In the El1 area, the study group showed a temperature increase of 1.8 °C compared to the control group, while in the Bx1 area, the difference was 1.76 °C. Conclusions: Infrared thermography shows potential to differentiate dogs with acute-onset lameness due to CCL rupture from dogs with intact ligaments, but further studies are needed to assess its accuracy in distinguishing it from other stifle pathologies. Full article
(This article belongs to the Special Issue Infrared Thermography in Animals)
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16 pages, 713 KiB  
Systematic Review
Machine Learning Application in Different Imaging Modalities for Detection of Obstructive Coronary Artery Disease and Outcome Prediction: A Systematic Review and Meta-Analysis
by Peter McGranaghan, Doreen Schoeppenthau, Antonia Popp, Anshul Saxena, Sharat Kothakapu, Muni Rubens, Gabriel Jiménez, Pablo Gordillo, Emir Veledar, Alaa Abd El Al, Anja Hennemuth, Volkmar Falk and Alexander Meyer
Hearts 2025, 6(3), 21; https://doi.org/10.3390/hearts6030021 - 7 Aug 2025
Abstract
Background/Objectives: Invasive coronary angiography (ICA) is the gold standard for the diagnosis of coronary artery disease (CAD), with various non-invasive imaging modalities also available. Machine learning (ML) methods are increasingly applied to overcome the limitations of diagnostic imaging by improving accuracy and observer [...] Read more.
Background/Objectives: Invasive coronary angiography (ICA) is the gold standard for the diagnosis of coronary artery disease (CAD), with various non-invasive imaging modalities also available. Machine learning (ML) methods are increasingly applied to overcome the limitations of diagnostic imaging by improving accuracy and observer independent performance. Methods: This meta-analysis (PRISMA method) summarizes the evidence for ML-based analyses of coronary imaging data from ICA, coronary computed tomography angiography (CT), and nuclear stress perfusion imaging (SPECT) to predict clinical outcomes and performance for precise diagnosis. We searched for studies from Jan 2012–March 2023. Study-reported c index values and 95% confidence intervals were used. Subgroup analyses separated models by outcome. Combined effect sizes using a random-effects model, test for heterogeneity, and Egger’s test to assess publication bias were considered. Results: In total, 46 studies were included (total subjects = 192,561; events = 31,353), of which 27 had sufficient data. Imaging modalities used were CT (n = 34), ICA (n = 7) and SPECT (n = 5). The most frequent study outcome was detection of stenosis (n = 11). Classic deep neural networks (n = 12) and convolutional neural networks (n = 7) were the most used ML models. Studies aiming to diagnose CAD performed best (0.85; 95% CI: 82, 89); models aiming to predict clinical outcomes performed slightly lower (0.81; 95% CI: 78, 84). The combined c-index was 0.84 (95% CI: 0.81–0.86). Test of heterogeneity showed a high variation among studies (I2 = 97.2%). Egger’s test did not indicate publication bias (p = 0.485). Conclusions: The application of ML methods to diagnose CAD and predict clinical outcomes appears promising, although there is lack of standardization across studies. Full article
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20 pages, 6359 KiB  
Article
Symmetry in Explainable AI: A Morphometric Deep Learning Analysis for Skin Lesion Classification
by Rafael Fernandez, Angélica Guzmán-Ponce, Ruben Fernandez-Beltran and Ginés García-Mateos
Symmetry 2025, 17(8), 1264; https://doi.org/10.3390/sym17081264 - 7 Aug 2025
Abstract
Deep learning has achieved remarkable performance in skin lesion classification, but its lack of interpretability often remains a critical barrier to clinical adoption. In this study, we investigate the spatial properties of saliency-based model explanations, focusing on symmetry and other morphometric features. We [...] Read more.
Deep learning has achieved remarkable performance in skin lesion classification, but its lack of interpretability often remains a critical barrier to clinical adoption. In this study, we investigate the spatial properties of saliency-based model explanations, focusing on symmetry and other morphometric features. We benchmark five deep learning architectures (ResNet-50, EfficientNetV2-S, ConvNeXt-Tiny, Swin-Tiny, and MaxViT-Tiny) on a nine-class skin lesion dataset from the International Skin Imaging Collaboration (ISIC) archive, generating saliency maps with Grad-CAM++ and LayerCAM. The best-performing model, Swin-Tiny, achieved an accuracy of 78.2% and a macro-F1 score of 71.2%. Our morphometric analysis reveals statistically significant differences in the explanation maps between correct and incorrect predictions. Notably, the transformer-based models exhibit highly significant differences (p<0.001) in metrics related to attentional focus (Entropy and Gini), indicating that their correct predictions are associated with more concentrated saliency maps. In contrast, convolutional models show less consistent differences, and only at a standard significance level (p<0.05). These findings suggest that the quantitative morphometric properties of saliency maps could serve as valuable indicators of predictive reliability in medical AI. Full article
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20 pages, 740 KiB  
Article
Virtual Non-Contrast Reconstructions Derived from Dual-Energy CTA Scans in Peripheral Arterial Disease: Comparison with True Non-Contrast Images and Impact on Radiation Dose
by Fanni Éva Szablics, Ákos Bérczi, Judit Csőre, Sarolta Borzsák, András Szentiványi, Máté Kiss, Georgina Juhász, Dóra Papp, Ferenc Imre Suhai and Csaba Csobay-Novák
J. Clin. Med. 2025, 14(15), 5571; https://doi.org/10.3390/jcm14155571 - 7 Aug 2025
Abstract
Background/Objectives: Virtual non-contrast (VNC) images derived from dual-energy CTA (DE-CTA) could potentially replace true non-contrast (TNC) scans while reducing radiation exposure. This study evaluated the image quality of VNC compared to TNC for assessing native arteries and bypass grafts in patients with [...] Read more.
Background/Objectives: Virtual non-contrast (VNC) images derived from dual-energy CTA (DE-CTA) could potentially replace true non-contrast (TNC) scans while reducing radiation exposure. This study evaluated the image quality of VNC compared to TNC for assessing native arteries and bypass grafts in patients with peripheral arterial disease (PAD). Methods: We retrospectively analyzed 175 patients (111 men, 64 women, mean age: 69.3 ± 9.5 years) with PAD who underwent lower extremity DE-CTA. Mean attenuation and image noise values of TNC and VNC images were measured in native arteries and bypass grafts at six arterial levels, from the aorta to the popliteal arteries, using circular regions of interest (ROI). Signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) were calculated. Three independent radiologists evaluated the subjective image quality of VNC images compared to baseline TNC scans for overall quality (4-point Likert scale), and for residual contrast medium (CM), calcium subtractions, and bypass graft visualization (3-point Likert scales). Radiation dose parameters (DLP, CTDIvol) were recorded to estimate effective dose values (ED) and the potential radiation dose reduction. Differences between TNC and VNC measurements and radiation dose parameters were compared using a paired t-test. Interobserver agreement was assessed with Gwet’s AC2. Results: VNC attenuation and noise values were significantly lower across all native arterial levels (p < 0.05, mean difference: 4.7 HU–10.8 HU) and generally lower at all bypass regions (mean difference: 2.2 HU–13.8 HU). Mean image quality scores were 3.03 (overall quality), 2.99 (residual contrast), 2.04 (subtracted calcifications), and 3.0 (graft visualization). Inter-reader agreement was excellent for each assessment (AC2 ≥ 0.81). The estimated radiation dose reduction was 36.8% (p < 0.0001). Conclusions: VNC reconstructions demonstrated comparable image quality to TNC in a PAD assessment and offer substantial radiation dose reduction, supporting their potential as a promising alternative in clinical practice. Further prospective studies and optimization of reconstruction algorithms remain essential to confirm diagnostic accuracy and address remaining technical limitations. Full article
(This article belongs to the Section Vascular Medicine)
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15 pages, 1304 KiB  
Review
Calcific Aortic Valve Stenosis: A Focal Disease in Older and Complex Patients—What Could Be the Best Time for an Appropriate Interventional Treatment?
by Annamaria Mazzone, Augusto Esposito, Ilenia Foffa and Sergio Berti
J. Clin. Med. 2025, 14(15), 5560; https://doi.org/10.3390/jcm14155560 - 7 Aug 2025
Abstract
Calcific aortic stenosis (CAS) is a newly emerging pandemic in elderly individuals due to the aging of the population in the world. Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve Replacement (TAVR) are the cornerstone of the management of severe aortic stenosis [...] Read more.
Calcific aortic stenosis (CAS) is a newly emerging pandemic in elderly individuals due to the aging of the population in the world. Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve Replacement (TAVR) are the cornerstone of the management of severe aortic stenosis accompanied by one or more symptoms. Moreover, an appropriate interventional treatment of CAS, in elderly patients, is a very complex decision for heart teams, to avoid bad outcomes such as operative mortality, cardiovascular and all-cause death, hospitalization for heart failure, worsening of quality of life. In fact, CAS in the elderly is not only a focal valve disease, but a very complex clinical picture with different risk factors and etiologies, differing underlying pathophysiology, large phenotypic heterogeneity in a context of subjective biological, phenotypic and functional aging until frailty and disability. In this review, we analyzed separately and in a more integrated manner, the natural and prognostic histories of the progression of aortic stenosis, the phenotypes of myocardial damage and heart failure, within the metrics and aging trajectory. The aim is to suggest, during the clinical timing of valve disease, the best interval time for an appropriate and effective interventional treatment in each older patient, beyond subjective symptoms by integration of clinical, geriatric, chemical, and advanced imaging biomarkers. Full article
(This article belongs to the Section Cardiology)
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17 pages, 5085 KiB  
Article
A Segmentation Network with Two Distinct Attention Modules for the Segmentation of Multiple Renal Structures in Ultrasound Images
by Youhe Zuo, Jing Li and Jing Tian
Diagnostics 2025, 15(15), 1978; https://doi.org/10.3390/diagnostics15151978 - 7 Aug 2025
Abstract
Background/Objectives: Ultrasound imaging is widely employed to assess kidney health and diagnose renal diseases. Accurate segmentation of renal structures in ultrasound images plays a critical role in the diagnosis and treatment of related kidney diseases. However, challenges such as speckle noise and [...] Read more.
Background/Objectives: Ultrasound imaging is widely employed to assess kidney health and diagnose renal diseases. Accurate segmentation of renal structures in ultrasound images plays a critical role in the diagnosis and treatment of related kidney diseases. However, challenges such as speckle noise and low contrast still hinder precise segmentation. Methods: In this work, we propose an encoder–decoder architecture, named MAT-UNet, which incorporates two distinct attention mechanisms to enhance segmentation accuracy. Specifically, the multi-convolution pixel-wise attention module utilizes the pixel-wise attention to enable the network to focus more effectively on important features at each stage. Furthermore, the triple-branch multi-head self-attention mechanism leverages the different convolution layers to obtain diverse receptive fields, capture global contextual information, compensate for the local receptive field limitations of convolution operations, and boost the segmentation performance. We evaluate the segmentation performance of the proposed MAT-UNet using the Open Kidney US Data Set (OKUD). Results: For renal capsule segmentation, MAT-UNet achieves a Dice Similarity Coefficient (DSC) of 93.83%, a 95% Hausdorff Distance (HD95) of 32.02 mm, an Average Surface Distance (ASD) of 9.80 mm, and an Intersection over Union (IOU) of 88.74%. Additionally, MAT-UNet achieves a DSC of 84.34%, HD95 of 35.79 mm, ASD of 11.17 mm, and IOU of 74.26% for central echo complex segmentation; a DSC of 66.34%, HD95 of 82.54 mm, ASD of 19.52 mm, and IOU of 51.78% for renal medulla segmentation; and a DSC of 58.93%, HD95 of 107.02 mm, ASD of 21.69 mm, and IOU of 43.61% for renal cortex segmentation. Conclusions: The experimental results demonstrate that our proposed MAT-UNet achieves superior performance in multiple renal structure segmentation in ultrasound images. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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