Current Medical Imaging - Current Issue

Magnetic resonance imaging can differentiate Alzheimer-type dementia from dementia with Lewy bodies using voxel-based specific regional analysis systems for Alzheimer’s disease and arterial spin labeling, which reveal reduced blood flow from the posterior cingulate gyrus to the precuneus in Alzheimer-type dementia. However, the relationship between voxel-based specific regional analysis system scores and arterial spin labeling remains unclear. To investigate the relationship between brain atrophy scores and arterial spin labeling values in the posterior cingulate precuneus.

Participants with suspected dementia who underwent brain magnetic resonance imaging using a voxel-based regional analysis system were included. They were classified as follows: Group 1 (suspected Alzheimer-type dementia) had atrophy ≥2 in the volume of interest; Group 2 (suspected dementia with Lewy body) had atrophy <2 in the volume of interest and ≥0.2 in the gray and white matter of the dorsal brainstem; and Group 3 included those not meeting these criteria. Correlation values among atrophy within the volume of interest, percentage of atrophic areas, atrophy ratio, percentage of total brain atrophy, age, and maximum arterial spin labeling value at the posterior cingulate precuneus were evaluated.

Groups 1, 2, and 3 comprised 179, 143, and 197 patients, respectively. Arterial spin labeling values at the posterior cingulate precuneus were 77.0±24.4–77.3±25.2, 78.3±81.3–80.2±23.6, and 80.2±22.3–80.4±22.8 mL/min/100 g, respectively. Group 1 had a correlation coefficient between total brain atrophy and arterial spin labeling of –0.189 to–0.214 (P<0.01). Group 2 had a correlation coefficient between total brain atrophy and arterial spin labeling of –0.215 to –0.223 (P<0.01). Group 3 showed no significant correlations. No statistically significant difference was observed in ASL 1 and 2 values between the Alzheimer-type dementia and other groups (ASL 1: 74.5 mL/min/100 g vs. 78.8 mL/min/100 g, P=0.08; ASL 2: 74.8 mL/min/100 g vs. 79.2 mL/min/100 g, P=0.101). No statistically significant difference was observed in ASL 1 and 2 values between the Alzheimer-type dementia and DLB groups (ASL 1: 74.5 mL/min/100 g vs. 69.3. mL/min/100 g, P=0.093; ASL 2: 74.8 mL/min/100 g vs. 78.9 mL/min/100 g, P=0.258).

Reduced blood flow in the posterior cingulate gyrus and precuneus shows only a weak correlation with brain atrophy in both Alzheimer-type dementia and dementia with Lewy bodies. Therefore, it is not a reliable marker for differentiating Alzheimer-type dementia from dementia with Lewy bodies and other groups.

It is necessary to avoid using cerebral blood flow assessment alone when diagnosing dementia.

The synchronous occurrence of primary pure squamous cell carcinoma (SCC) and invasive ductal carcinoma (IDC) of the breast is rare. Accurate identification of synchronous primary malignancies is crucial because their prognosis and treatment differ significantly from recurrent diseases. Herein, we present an unusual case highlighting the synchronous development of primary SCC and IDC in the ipsilateral breast.

A 48-year-old woman presented with a palpable mass in her right breast. Preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) demonstrated an irregularly shaped mass with internal rim enhancement. Surgical resection confirmed IDC of nuclear grade 3 with a high proliferation index (Ki-67: 70%), and the patient underwent adjuvant chemotherapy without radiation. Five months postoperation, a chest computed tomography (CT) revealed a new round-shaped lesion with rim enhancement and relatively circumscribed margins near the previous operation site. Breast ultrasound additionally identified a complex cystic and solid mass with an echogenic rind and increased vascularity. Following total resection, a pure squamous cell carcinoma with prominent keratinization was confirmed.

Accurate and early diagnosis of synchronous multiple primary malignancies from recurrence of the primary tumor is critical for improving prognosis by establishing an appropriate treatment and follow-up plan. Recognizing complex cystic and solid masses with relatively circumscribed margins on radiological imaging can assist clinicians in identifying and managing rare cases where IDC and SCC coexist or appear sequentially within a short period.

Dynamic changes in adenomyotic lesions in animal models have been difficult to observe and evaluate in vivo on a regular basis. Therefore, this study aims to investigate the feasibility of establishing a rat model of adenomyosis through autologous endometrial implantation and to assess the value of magnetic resonance imaging (MRI) for noninvasive evaluation of the model.

Forty rats were randomly divided into two groups (20 rats in the control group, 20 rats in the model group). A rat adenomyosis model was constructed through autologous endometrial implantation. Three months after the modeling surgery, the rats underwent MRI examination, including T2-weighted axial imaging and T1-weighted axial imaging. The thickness of the uterine myometrium and junctional zone was measured. Following the MRI, the rat uterus was sliced for hematoxylin-eosin (HE) staining.

In the model group, lesions of adenomyosis were successfully established in all surviving rats. The myometrium of the rat uterus showed uneven thickening accompanied by scattered spotty T2 hypersignal. The junctional zone appeared as a low-signal band between the endometrium with high signal and the myometrium. The average thicknesses of both the myometrium and the junctional zone were significantly greater in the model group compared to the control group, with the differences reaching statistical significance.

Ectopic endometrium can lead to hyperplasia of the peripheral muscle cells in the myometrium, which is manifested on T2-weighted images as localized thickening and hypo-intensity of the myometrium interspersed with punctiform hyperintensity. Histologically, regions of low signal intensity refer to hyperplasia of smooth muscle, while bright foci on T2-weighted images correspond to ectopic endometrial tissue and cystic dilation of glands. This study proved the noninvasive evaluation of a rat adenomyosis model and described the junctional zone in rats using MRI techniques. Histological examination using HE staining confirmed a higher nuclear-to-cytoplasmic ratio and a more compact cell arrangement in the junctional zone region of rats compared to the outer myometrium, which could explain its hypointensity.

MRI is a valuable method for evaluating the rat adenomyosis model non-invasively. Furthermore, the successful visualization of the junctional zone in the rat uterus using MRI may have potential applications in further evaluating the progression of adenomyosis.

The association between ABO and Rh blood groups and diseases is an intriguing topic that continues to be studied, but their potential influence on mandibular asymmetry has not been explored. Temporomandibular joint (TMJ) disorders are multifactorial, and subtle anatomical variations may be linked to genetic predispositions. Our study aims to investigate the relationship between ABO and Rh blood groups and mandibular condylar and ramal asymmetries in a healthy adult Turkish population.

This study included 149 adult patients (67 males, 82 females) who had no history of systemic diseases, craniofacial deformities, or TMJ-related complaints. Asymmetry was assessed in panoramic radiographic images using a formula developed in a previous study. The chi-square and Kruskal-Wallis tests were used to analyze differences among ABO groups while the Mann-Whitney U test was used for Rh groups.

No significant difference was found in terms of gender distribution, Rh factor or age between ABO or Rh groups. However, there was a significant difference in condylar asymmetry index (CAI) between ABO groups (p 0.05). Pairwise comparisons revealed that individuals with AB blood type exhibited significantly higher CAI values compared to those with B blood type. No statistically significant differences in asymmetry indices were observed between Rh groups.

The findings of our study indicate the existence of a significant relationship between blood groups and asymmetry indices in a healthy population. The significant differences in condylar asymmetry between AB and B blood groups indicate a possible association between blood type and mandibular anatomical variations, rather than a causal relationship. Further studies are needed to confirm these findings and to understand the underlying mechanisms of the relationship between blood groups and mandibular asymmetry.

The evaluation of the left atrial (LA) by imaging is becoming increasingly essential due to its significant role in numerous diseases. This study aimed to analyze and summarize research on LA imaging in the past 20 years through bibliometric analysis and offer insights into future research prospects.

The Web of Science (WOS) core collection database was retrieved for literature in LA imaging research from 2004 to 2023. Subsequently, the literature was processed and visualized by the VOSviewer and CiteSpace. VOSviewer was used to create cooperation networks for countries/regions and institutions. CiteSpace was used to analyze burst keywords in citation analysis.

A total of 3664 articles published in this field between January 2004 and December 2023 were analyzed. The number of published articles is increasing year by year. The USA contributed the most articles (1072). Hugh Calkins (44) was the most productive author with the highest publications.

Over the past 20 years, research on LA imaging has grown rapidly. The results of the present study provide insights into the field’s status and indicate the research hotspots. In recent years, research on left atrial appendage occlusion (LAAO) and LA strain has been notably focused, which is expected to remain a prominent topic in future research.

The sphenoid sinus is an important access point for trans-sphenoidal surgeries, but variations in its pneumatization may complicate surgical safety. Deep learning can be used to identify these anatomical variations.

We developed a convolutional neural network (CNN) model for the automated prediction of sphenoid sinus pneumatization patterns in computed tomography (CT) scans. This model was tested on mid-sagittal CT images. Two radiologists labeled all CT images into four pneumatization patterns: Conchal (type I), presellar (type II), sellar (type III), and postsellar (type IV). We then augmented the training set to address the limited size and imbalanced nature of the data.

The initial dataset included 249 CT images, divided into training (n = 174) and test (n = 75) datasets. The training dataset was augmented to 378 images. Following augmentation, the overall diagnostic accuracy of the model improved from 76.71% to 84%, with an area under the curve (AUC) of 0.84, indicating very good diagnostic performance. Subgroup analysis showed excellent results for type IV, with the highest AUC of 0.93, perfect sensitivity (100%), and an F1-score of 0.94. The model also performed robustly for type I, achieving an accuracy of 97.33% and high specificity (99%). These metrics highlight the model's potential for reliable clinical application.

The proposed CNN model demonstrates very good diagnostic accuracy in identifying various sphenoid sinus pneumatization patterns, particularly excelling in type IV, which is crucial for endoscopic sinus surgery due to its higher risk of surgical complications. By assisting radiologists and surgeons, this model enhances the safety of transsphenoidal surgery, highlighting its value, novelty, and applicability in clinical settings.

Rheumatoid arthritis (RA) is a systemic autoimmune disorder primarily characterized by joint degradation, with consequential cardiovascular ramifications significantly impacting patient mortality rates.

We systematically searched for full-text English-language journal articles from 1973 to 2025 in the PubMed and Web of Science databases. Utilizing keywords such as “Rheumatoid Arthritis,” “Autoimmune Diseases,” “Pathophysiology,” “Heart,” “Cardiac,” and “Echocardiography” to narrow the search results. Articles related to the evaluation of heart diseases in rheumatoid arthritis by echocardiography were included, while those with insufficient data or low data quality were excluded. Study quality was assessed using the CASP Quantitative Checklist (2018 version), and data were synthesized through thematic content analysis.

We included 52 studies in this review after the primary analysis. The results show that traditional echocardiography can identify organic changes in the heart and ventricular function impairment of patients with rheumatoid arthritis. New ultrasound techniques, such as speckle tracking and pressure-strain loops, can detect ventricular function impairment earlier than traditional echocardiography.

Echocardiography provides complementary diagnostic information for rheumatoid arthritis cardiac involvement through structural and functional assessment, yet limitations remain. Future work should establish multimodal ultrasound frameworks and develop AI-driven analytical platforms to enhance early detection and precision management.

The continuous progress of ultrasound technology has significantly improved the accuracy of assessing cardiac damage in patients with rheumatoid arthritis, and it has become an essential examination method for screening heart diseases in such patients, providing strong support for early diagnosis.

Unlike its well-established role in lung cancer staging, positron emission tomography /computed tomography (PET/CT)'s role in guiding lung biopsies remains unclear and underutilized, despite its potential to distinguish metabolically active regions from areas of necrosis or fibrosis within lesions.

This study aims to assess the diagnostic efficacy of PET/CT-aided versus conventional CT-guided lung biopsy by comparing the incidences of non-diagnostic results, false results, and complications.

Studies comparing PET/CT-aided and conventional CT-guided lung biopsy were identified through an intensive search of PubMed, Embase, and the Cochrane Library. Data on nondiagnostic results, false results, and complications were extracted. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model.

Seven studies involving 1,661 procedures were included. PET/CT-aided lung biopsy significantly reduced nondiagnostic results compared to conventional CT-guided biopsy (2.8% vs. 9.1%; pooled RR: 0.38, 95% CI: 0.20–0.70, P = 0.002). False results were also significantly fewer in the PET/CT-aided group (6.5% vs. 17.0%; pooled RR: 0.48, 95% CI: 0.35–0.65, P < 0.001). There was no statistically significant difference in overall complication rates (28.1% vs. 32.5%; pooled RR: 0.92, 95% CI: 0.77–1.10, P = 0.352), while PET/CT-aided biopsy showed a slight tendency toward fewer major complications (0.9% vs. 1.7%; pooled RR: 0.67, 95% CI: 0.30–1.44, P = 0.303).

PET/CT-aided CT-guided lung biopsy offers advantages over conventional CT-guided lung biopsy by significantly reducing nondiagnostic and false results, without significant differences in the risk of complications.

This study evaluated the impact of Low-Intensity Pulsed Ultrasound (LIPUS) on bone radio density in patients undergoing orthodontic treatment with clear aligners, aiming to enhance bone remodeling and improve treatment stability.

This retrospective study included 68 participants divided into two groups: 34 treated with LIPUS and 34 in a control group. Bone radio density was measured using Hounsfield units from CBCT scans before and after treatment. Statistical analyses included Mann-Whitney U tests and paired t-tests.

The average age was 29.85 ± 14.85 years in the control group and 36.29 ± 12.78 years in the LIPUS group. Bone radio density in the upper arch of the LIPUS group significantly increased from 444.6 HU to 751.3 HU (p < 0.001), while the control group showed a slight decrease in the upper arch (657.4 HU to 650.5 HU, p = 0.86). In the lower arch, a similar trend was observed in the LIPUS group, with an increase from 767.7 HU to 823.4 HU (p = 0.17), though not statistically significant. There were no significant differences in post-treatment ABO DI scores between groups, suggesting equivalent effectiveness in achieving orthodontic outcomes.

LIPUS with clear aligners seems promising in enhancing bone radio density, indicating an improved bone remodeling effect. This highlights LIPUS's potential as a beneficial adjunct in orthodontic treatments.

Primary pituitary melanocytoma, an exceedingly rare tumor, may resemble pituitary adenoma with apoplexy owing to its heterogeneous melanin concentration and possible hemorrhagic events. An accurate diagnosis of melanocytoma is, therefore, essential.

We present a case of a 31-year-old female patient who exhibited a progressively worsening headache that commenced one month prior. MRI showed a significantly enlarged sella turcica with a gourd-shaped lesion that had a mixture of short T1 and T2 signals. In conjunction with the MRI findings, CT scans, both non-contrast and contrast-enhanced, revealed a circular, dense region in the sellar area, exhibiting heightened enhancement post-contrast administration. Subsequently, this patient was scheduled for endoscopic transnasal skull base tumor resection and skull base reconstruction. Later, histopathological assessment showed red-S-100 (+), red-melanin A (+), red-KI-67 (+5%), red-melanoma (+), P53 (+), red-P53 (+) and Ki-67 (+) and suggested an intermediate-grade melanocytoma, positioning this lesion between benign and malignant on the spectrum of melanocytic neoplasms.

This case report evaluated the presentation, key imaging findings, and histopathological features that help differentiate primary melanocytoma from other tumors and discussed key management and prognostic considerations following diagnosis.

Due to differences in subjective experience and professional level among doctors, as well as inconsistent diagnostic criteria, there are issues with the accuracy and reliability of single imaging diagnosis results for knee joint injuries.

To address these issues, magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) are adopted in this article for ensemble learning, and deep learning (DL) is combined for automatic analysis.

By steps such as image enhancement, noise elimination, and tissue segmentation, the quality of image data is improved, and then convolutional neural networks (CNN) are used to automatically identify and classify injury types. The experimental results show that the DL model exhibits high sensitivity and specificity in the diagnosis of different types of injuries, such as anterior cruciate ligament tear, meniscus injury, cartilage injury, and fracture.

The diagnostic accuracy of anterior cruciate ligament tear exceeds 90%, and the highest diagnostic accuracy of cartilage injury reaches 95.80%. In addition, compared with traditional manual image interpretation, the DL model has significant advantages in time efficiency, with a significant reduction in average interpretation time per case. The diagnostic consistency experiment shows that the DL model has high consistency with doctors’ diagnosis results, with an overall error rate of less than 2%.

The model has high accuracy and strong generalization ability when dealing with different types of joint injuries. These data indicate that combining multiple imaging technologies and the DL algorithm can effectively improve the accuracy and efficiency of diagnosing sports injuries of knee joints.

This study aimed to retrospectively analyze the curative effect and influencing factors of lauromacrogol in the treatment of symptomatic hepatic cysts of <10 cm.

In this study, a total of 51 patients with symptomatic hepatic cysts (maximum diameter ranging from 5 cm to 10 cm) were included. Polycystic Liver Disease Questionnaire (PLD-Q) was used to evaluate the symptoms of patients prior to treatment. The patients were followed up at 1, 3, 6, and 12 months after treatment. At the 12-month follow-up, patients were asked to fill out the PLD-Q to assess their symptoms. The improvement rate of patients' symptoms was evaluated using a 5-point Likert scale (worse, 1; slight difference, 2; roughly the same, 3; good, and 4; better, 5. Volume reduction rate (VRR) was calculated by measuring the volume of the cyst cavity via ultrasound. Treatment success at the 12-month follow-up was determined using two criteria: symptom improvement and changes in cyst volume. Symptom improvement was assessed using a Likert Scale, with a score greater than 3 points indicating significant improvement. Additionally, a volume reduction rate (VRR) of 50% or more in cyst size (VRR ≥ 50%) was considered an effective treatment outcome. The relationship between the clinical factors and the ultrasonographic manifestations of hepatic cysts, including the initial maximum diameter of the cyst (measured using ultrasound before operation), the initial volume of the cyst, and the formation of septa after sclerosis of the cyst, was analyzed.

All patients completed at least 12 months of follow-up. After a 12-month follow-up, the effective and ineffective rates were 96.1% (49/51) and 3.9% (2/51), respectively. The logistic regression univariate analysis showed significant differences in the initial cyst volume (p = 0.001), the initial maximum diameter of the cyst (p = 0.005), and the interval formation after cyst sclerosis (p = <0.001) between VRR ≥ 50% and VRR < 50%. Logistic regression analysis demonstrated that septa formation after cyst sclerosis was an independent factor related to treatment failure, with an odds ratio of 3.246 (95% confidence interval, 0.784–4.148).

Lauromacrogol is an effective method for hepatic cyst treatment. Septa formation after cyst sclerosis is an independent factor related to ineffective treatment.

The standard treatment for hydrocephalus is often the placement of a ventriculoperitoneal shunt (VPS), especially in patients with myelomeningocele (MMC). This case report aimed to enrich the existing knowledge by presenting a rare instance of asymptomatic anal extrusion of a VPS catheter in an infant, along with a review of the relevant literature.

A 2-month-old male infant with myelomeningocele (MMC) and hydrocephalus presented with asymptomatic anal extrusion of his ventriculoperitoneal shunt (VPS) catheter, discovered by his mother. Emergency imaging revealed distal catheter migration through the rectosigmoid junction. Surgical management included (1) laparoscopic-assisted catheter removal with bowel repair using Vicryl sutures, (2) intraoperative external ventricular drain (EVD) placement, and (3) 14-day antibiotic prophylaxis. Cerebrospinal fluid analysis remained normal throughout the treatment. Following three weeks of infection monitoring, contralateral VPS replacement was performed successfully, with postoperative imaging confirming optimal shunt function and resolved hydrocephalus. This case highlighted the importance of caregiver vigilance in identifying this rare but serious complication, even in asymptomatic patients (Fig. 1).

Although anal extrusion of a VPS catheter is an uncommon but serious complication, primarily seen in pediatric patients, it can lead to life-threatening infections if untreated. Prompt surgical intervention along with broad-spectrum antibiotic therapy is critical. This report highlights the need for recognizing classic symptoms of intestinal perforation and catheter migration in pediatric patients.

This study aimed to detect the performance of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for assessing primary biliary cholangitis (PBC).

Seventy-five patients with PBC were included in this prospective study. Shear wave elastography (SWE) and Gd-EOB-DTPA-enhanced MRI were conducted, and then the signal intensity ratio (SIR) and contrast enhancement index (CEI) in different phases, including portal venous phase (PVP), equilibrium phase (EP), and hepatobiliary phase (HBP), were calculated. Afterward, the results were compared with Child-Pugh grading and non-invasive liver fibrosis models using the Kruskal-Wallis H test or Chi-squared test. The area under the curve (AUC) was applied to evaluate the diagnostic performance of SIRHBP, CEIHBP, and SWE across different Child-Pugh grades.

SWE (p0.001), SIR HBP (p0.001), CEIHBP (p0.001), APRI (p=0.002), and FIB-4(p0.001) showed significant differences in different Child-Pugh grades. Statistically significant differences were found in SIRHBP (p=0.005), CEIHBP (p=0.010), and FIB-4 (p=0.001) of different SWE levels. For the diagnosis of Child-Pugh C, the AUC of SWE, SIRHBP, and CEIHBP were 0.889, 0.778, and 0.761, respectively. Correspondingly, the sensitivity was 75.0%, 64.4%, and 54.2%, and the specificity was 94.9%, 100%, and 100%, respectively. For the diagnosis of Child-Pugh B+C, the AUC of SWE, SIRHBP, and CEIHBP were 0.919, 0.809, and 0.814, respectively.

Our study confirmed that Gd-EOB-DTPA-enhanced MRI is an effective and objective method for assessing liver function in patients with PBC.

SIRHBP and CEIHBP could be regarded as a novel imaging biomarker to evaluate liver function. Gd-EOB-DTPA-enhanced MRI and SWE outperformed serum-based models in sensitivity and specificity, strengthening the value of imaging in clinical decision-making.

The aim of this study is to assess the identification of incidental myocardial infarction on non-electrocardiogram-gated computed tomographic scans of the chest and its prognostic significance.

The increased utilization and abundance of thoracic computed tomographic (CT) scans have provided a substrate for potential screening purposes.

The objective of this study was to evaluate the detection of incidental myocardial infarction on routine non-gated thoracic CT performed for non-cardiac reasons and its associated major cardiovascular events and survival.

We retrospectively assessed routine non-gated thoracic CT scans of all consecutive individuals aged 18 or above who underwent thoracic CT scans as outpatients at the University of California Davis from January 2015 to December 2015. We evaluated the presence and location of incidental MI on non-gated thoracic CT and compared major adverse cardiac events (MACE) and overall survival in CT-positive infarct individuals with a CT-negative infarct control group.

We reviewed routine thoracic CT scans of 1157 individuals and identified 12 individuals with incidental MI. The mean age of individuals with infarction was 71.4 ± 14.1 years, and 50% were female. All individuals with incidental MI had coronary calcification. Individuals with incidental MI had a higher rate of MACE endpoint (92% vs. 28%, p=0.0001), number of MACE events (1.1 vs. 0.3, p<0.001), and lower overall survival (median survival of 67 months vs. not reached, p=0.023) compared with age and sex-matched controls without incidental MI.

Although small in number relative to the total number of individuals evaluated, subjects with incidental MI on routine non-gated thoracic CT scans have worse cardiovascular outcomes and survival compared with controls without infarction. This study highlights the potential opportunistic screening utility of routine thoracic CTs, which could lead to improved risk stratification and intervention.

Electrical Impedance Tomography (EIT) is widely used for bedside ventilation monitoring but is limited in reconstructing cardiac-related signals due to the dominance of lung impedance changes. This study aims to reconstruct heart-related impedance imaging from lung EIT using a novel semi-Siamese U-Net architecture.

A deep learning model was developed with a shared encoder and two decoders designed to segment lung and heart regions independently. The model was trained and validated on FEM-based EIT simulations and tested on real human EIT data. A weighted binary cross-entropy loss was applied to emphasize cardiac-related learning.

The model achieved a Dice coefficient >0.99 and MAE <0.1% on simulation data. It successfully separated lung and heart regions on human EIT frames without additional fine-tuning, demonstrating strong generalization capacity.

These findings reveal that the semi-Siamese U-Net can overcome signal dominance and improve cardiac-related EIT reconstruction. However, promising results are currently limited to qualitative evaluation of real data and simulation-based training.

The proposed method offers a potential pathway for simultaneous lung-heart monitoring in ICU settings. Future work will focus on clinical validation and real-time implementation.

To address the low efficiency of diagnosing pulmonary nodules using computed tomography (CT) images and the difficulty in obtaining the key signs of malignant pulmonary nodules, a ghost convolution residual network incorporating hybrid normalization (GCHN-net) is proposed.

Firstly, a three-dimensional ghost convolution with a small kernel is embedded in the GCHN-net. Secondly, we designed a hybrid normalized-activation module (TMNAM) that can handle the rich and complex features of lung nodules in both the deep and shallow layers of the network, and incorporating two different normalization methods. This allows the network to comprehensively learn the intricate relationships underlying the intrinsic features of lung nodules and enhances its capacity to classify the properties of unknown nodules. Additionally, to enhance the accuracy and detail of the category activation map, GradCAM++ is integrated into the third layer of the GCHN-net. This integration enables the visualization of specific regions within three-dimensional lung nodules that the model focuses on during its predictions.

The accuracy of the GCHN-net on the Lung Nodule Analysis 16 (LUNA16) dataset was 90.22%, with an F1-score of 88.31% and a G-mean of 90.48%.

Compared with existing methods, the proposed method can greatly improve the classification of pulmonary nodules and can effectively assist doctors in diagnosing patients with pulmonary nodules.

Recently, deep learning (DL) algorithms use Arithmetic Units (AU) in CPU/GPU hardware for processing images/data. AU operates in fixed precision and limits the representation of weights and activations in DL. The problem leads to quantization errors, which reduce accuracy during cancer cell segmentation.

In this study, arithmetic multiplication in convolution layers is replaced with Vedic multiplication in the proposed DnCNN algorithm. Next, Vedic multiplication-based convolution layers in the DnCNN architecture are optimized using POA (Pelican Optimization Algorithm), and the resulting POA-DnCNN is implemented on an FPGA device for breast cancer detection, segmentation, and classification of benign and malignant breast lesions.

In the convolution layer of DnCNN, floating-point operations are performed through the Hybrid-Vedic (HV) multiplier called ‘CUTIN,’ which is the combination of Urdhva Tryambakam and Nikhilam Sutra with the upasutra ‘Anurupyena.’ Larger image sizes increase processor size and gate count.

The proposed HV-FPGA-based breast cancer detection system, employing Vedic multiplication in the convolution layers of DnCNN and hyperparameters optimized by POA, detects stages of breast cancer with an accuracy of 96.3%, precision of 94.54%, specificity of 92.37%, F-score of 93.56%, IoU of 94.78%, and DSC of 95.45%, outperforming existing methods.

The proposed CUTIN multiplier uses a CSA (carry save adder) with simplified sum-carry generation logic (CSCGL), achieving lower area-delay, high speed, and improved precision.