Displaying publications 1 - 20 of 25 in total

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  1. Suradi SH, Abdullah KA
    Curr Med Imaging, 2021 Jan 26.
    PMID: 33504312 DOI: 10.2174/1573405617666210127101101
    BACKGROUND: Digital mammograms with appropriate image enhancement techniques will improve breast cancer detection, and thus increase the survival rates. The objectives of this study were to systematically review and compare various image enhancement techniques in digital mammograms for breast cancer detection.

    METHODS: A literature search was conducted with the use of three online databases namely, Web of Science, Scopus, and ScienceDirect. Developed keywords strategy was used to include only the relevant articles. A Population Intervention Comparison Outcomes (PICO) strategy was used to develop the inclusion and exclusion criteria. Image quality was analyzed quantitatively based on peak signal-noise-ratio (PSNR), Mean Squared Error (MSE), Absolute Mean Brightness Error (AMBE), Entropy, and Contrast Improvement Index (CII) values.

    RESULTS: Nine studies with four types of image enhancement techniques were included in this study. Two studies used histogram-based, three studies used frequency-based, one study used fuzzy-based and three studies used filter-based. All studies reported PSNR values whilst only four studies reported MSE, AMBE, Entropy and CII values. Filter-based was the highest PSNR values of 78.93, among other types. For MSE, AMBE, Entropy, and CII values, the highest were frequency-based (7.79), fuzzy-based (93.76), filter-based (7.92), and frequency-based (6.54) respectively.

    CONCLUSION: In summary, image quality for each image enhancement technique is varied, especially for breast cancer detection. In this study, the frequency-based of Fast Discrete Curvelet Transform (FDCT) via the UnequiSpaced Fast Fourier Transform (USFFT) shows the most superior among other image enhancement techniques.

  2. Shoaib MA, Hossain MB, Hum YC, Chuah JH, Mohd Salim MI, Lai KW
    Curr Med Imaging, 2020;16(6):739-751.
    PMID: 32723246 DOI: 10.2174/1573405615666190903143330
    BACKGROUND: Ultrasound (US) imaging can be a convenient and reliable substitute for magnetic resonance imaging in the investigation or screening of articular cartilage injury. However, US images suffer from two main impediments, i.e., low contrast ratio and presence of speckle noise.

    AIMS: A variation of anisotropic diffusion is proposed that can reduce speckle noise without compromising the image quality of the edges and other important details.

    METHODS: For this technique, four gradient thresholds were adopted instead of one. A new diffusivity function that preserves the edge of the resultant image is also proposed. To automatically terminate the iterative procedures, the Mean Absolute Error as its stopping criterion was implemented.

    RESULTS: Numerical results obtained by simulations unanimously indicate that the proposed method outperforms conventional speckle reduction techniques. Nevertheless, this preliminary study has been conducted based on a small number of asymptomatic subjects.

    CONCLUSION: Future work must investigate the feasibility of this method in a large cohort and its clinical validity through testing subjects with a symptomatic cartilage injury.

  3. Chan WY, Hamid MTR, Gowdh NFM, Rahmat K, Yaakup NA, Chai CS
    Curr Med Imaging, 2021;17(6):677-685.
    PMID: 33390122 DOI: 10.2174/1573405616666201231103312
    BACKGROUND: Coronavirus disease 2019 (COVID-19) is highly contagious and has claimed more than one million lives, besides causing hardship and disruptions. The Fleischner Society has recommended chest X-ray (CXR) in detecting cases at high risk of disease progression, for triaging suspected patients with moderate-to-severe illness, and for eliminating false negatives in areas with high pre-test probability or limited resources. Although CXR is less sensitive than real-- time reverse transcription-polymerase chain reaction (RT-PCR) in detecting mild COVID-19, it is nevertheless useful because of equipment portability, low cost and practicality in serial assessments of disease progression among hospitalized patients.

    OBJECTIVE: This study aims to review the typical and relatively atypical CXR manifestations of COVID-19 pneumonia in a tertiary care hospital.

    METHODS: The CXRs of 136 COVID-19 patients confirmed through real-time RT-PCR from March to May 2020 were reviewed. A literature search was performed using PubMed.

    RESULTS: A total of 54 patients had abnormal CXR whilst the others were normal. Typical CXR findings included pulmonary consolidation or ground-glass opacities in a multifocal, bilateral peripheral, or lower zone distribution, whereas atypical CXR features comprised cavitation and pleural effusion.

    CONCLUSION: Typical findings of COVID-19 infection in chest computed tomography studies can also be seen in CXR. The presence of atypical features associated with worse disease outcome. Recognition of these features on CXR will improve the accuracy and speed of diagnosing COVID-19 patients.

  4. Sanmugasiva V, Hamid MTR, Fadzli F, Ab Mumin N, Rahmat K
    Curr Med Imaging, 2021 Oct 04.
    PMID: 34607549 DOI: 10.2174/1573405617666211004114041
    INTRODUCTION: Metaplastic breast carcinoma is an uncommon malignancy that constitutes < 5% of all breast cancers. There are 5 subtypes which are spindle cell, squamous cell, carcinosarcoma, matrix-producing and metaplastic with osteoclastic giant cells. Spindle cell carcinoma represents approximately <0.3% of invasive breast carcinomas. It is typically a triple-negative cancer with distinct pathological characteristics, but relatively a non-conclusive imaging findings.

    CASE REPORT: An elderly lady presented with an enlarging painful left breast lump for 1 year. Palpable left breast lump noted on clinical examination. Mammography demonstrated a high density, oval lesion with a partially indistinct margin. Corresponding ultrasound showed a large irregular heterogeneous lesion with solid-cystic areas. Histopathology showed atypical spindle-shaped cells which stained positive for cytokeratins and negative for hormone and human epidermal growth factor receptors, which favours spindle cell metaplastic carcinoma. Left mastectomy and axillary dissection were performed, and the final diagnosis was consistent with metaplastic spindle cell carcinoma.

    CONCLUSION: Spindle cell carcinoma of the breast is a rare aggressive histological type of carcinoma which may present with benign features on imaging. Tissue diagnosis is essential for prompt diagnosis with multidisciplinary team discussion to guide management and improve patient's outcome.

  5. Nizar MHA, Chan CK, Khalil A, Yusof AKM, Lai KW
    Curr Med Imaging, 2020;16(5):584-591.
    PMID: 32484093 DOI: 10.2174/1573405615666190114151255
    BACKGROUND: Valvular heart disease is a serious disease leading to mortality and increasing medical care cost. The aortic valve is the most common valve affected by this disease. Doctors rely on echocardiogram for diagnosing and evaluating valvular heart disease. However, the images from echocardiogram are poor in comparison to Computerized Tomography and Magnetic Resonance Imaging scan. This study proposes the development of Convolutional Neural Networks (CNN) that can function optimally during a live echocardiographic examination for detection of the aortic valve. An automated detection system in an echocardiogram will improve the accuracy of medical diagnosis and can provide further medical analysis from the resulting detection.

    METHODS: Two detection architectures, Single Shot Multibox Detector (SSD) and Faster Regional based Convolutional Neural Network (R-CNN) with various feature extractors were trained on echocardiography images from 33 patients. Thereafter, the models were tested on 10 echocardiography videos.

    RESULTS: Faster R-CNN Inception v2 had shown the highest accuracy (98.6%) followed closely by SSD Mobilenet v2. In terms of speed, SSD Mobilenet v2 resulted in a loss of 46.81% in framesper- second (fps) during real-time detection but managed to perform better than the other neural network models. Additionally, SSD Mobilenet v2 used the least amount of Graphic Processing Unit (GPU) but the Central Processing Unit (CPU) usage was relatively similar throughout all models.

    CONCLUSION: Our findings provide a foundation for implementing a convolutional detection system to echocardiography for medical purposes.

  6. Qian J, Xie J, Lakshmipriya T, Gopinath SCB, Xu H
    Curr Med Imaging, 2020;16(5):534-544.
    PMID: 32484087 DOI: 10.2174/1573405615666190130164037
    Cardiovascular death is one of the leading causes worldwide; an accurate identification followed by diagnosing the cardiovascular disease increases the chance of a better recovery. Among different demonstrated strategies, imaging on cardiac infections yields a visible result and highly reliable compared to other analytical methods. Two-dimensional spot tracking imaging is the emerging new technology that has been used to study the function and structure of the heart and test the deformation and movement of the myocardium. Particularly, it helps to capture the images of each segment in different directions of myocardial strain values, such as valves of radial strain, longitudinal strain, and circumferential strain. In this overview, we discussed the imaging of infections in the heart by using the two-dimensional spot tracking.
  7. Kazemipoor M, Rezaeian M, Kazemipoor M, Hamzah S, Shandilya SK
    Curr Med Imaging, 2020;16(4):288-295.
    PMID: 32410532 DOI: 10.2174/1573405614666180905111814
    BACKGROUND: Physical characteristics including body size and configuration, are considered as one of the key influences on the optimum performance in athletes. Despite several analyzing methods for modeling the slimming estimation in terms of reduction in anthropometric indices, there are still weaknesses of these models such as being very demanding including time taken for analysis and accuracy.

    OBJECTIVES: This research proposes a novel approach for determining the slimming effect of a herbal composition as a natural medicine for weight loss.

    METHODS: To build an effective prediction model, a modern hybrid approach, merging adaptivenetwork- based fuzzy inference system and particle swarm optimization (ANFIS-PSO) was constructed for prediction of changes in anthropometric indices including waist circumference, waist to hip ratio, thigh circumference and mid-upper arm circumference, on female athletes after consumption of caraway extract during ninety days clinical trial.

    RESULTS: The outcomes showed that caraway extract intake was effective on lowering all anthropometric indices in female athletes after ninety days trial. The results of analysis by ANFIS-PSO was more accurate compared to SPSS. Also, the efficiency of the proposed approach was confirmed using the existing data.

    CONCLUSION: It is concluded that a development in predictive accuracy and simplification capability could be attained by hybrid adaptive neuro-fuzzy techniques as modern approaches in detecting changes in body characteristics. These developed techniques could be more useful and valid than other conventional analytical methods for clinical applications.

  8. Shehab M, Khader AT
    Curr Med Imaging, 2020;16(4):307-315.
    PMID: 32410534 DOI: 10.2174/1573405614666180905111128
    BACKGROUND: Cuckoo Search Algorithm (CSA) was introduced by Yang and Deb in 2009. It considers as one of the most successful in various fields compared with the metaheuristic algorithms. However, random selection is used in the original CSA which means there is no high chance for the best solution to select, also, losing the diversity.

    METHODS: In this paper, the Modified Cuckoo Search Algorithm (MCSA) is proposed to enhance the performance of CSA for unconstrained optimization problems. MCSA is focused on the default selection scheme of CSA (i.e. random selection) which is replaced with tournament selection. So, MCSA will increase the probability of better results and avoid the premature convergence. A set of benchmark functions is used to evaluate the performance of MCSA.

    RESULTS: The experimental results showed that the performance of MCSA outperformed standard CSA and the existing literature methods.

    CONCLUSION: The MCSA provides the diversity by using the tournament selection scheme because it gives the opportunity to all solutions to participate in the selection process.

  9. Abualigah LM, Hanandeh ES, Khader AT, Otair MA, Shandilya SK
    Curr Med Imaging, 2020;16(4):296-306.
    PMID: 32410533 DOI: 10.2174/1573405614666180903112541
    BACKGROUND: Considering the increasing volume of text document information on Internet pages, dealing with such a tremendous amount of knowledge becomes totally complex due to its large size. Text clustering is a common optimization problem used to manage a large amount of text information into a subset of comparable and coherent clusters.

    AIMS: This paper presents a novel local clustering technique, namely, β-hill climbing, to solve the problem of the text document clustering through modeling the β-hill climbing technique for partitioning the similar documents into the same cluster.

    METHODS: The β parameter is the primary innovation in β-hill climbing technique. It has been introduced in order to perform a balance between local and global search. Local search methods are successfully applied to solve the problem of the text document clustering such as; k-medoid and kmean techniques.

    RESULTS: Experiments were conducted on eight benchmark standard text datasets with different characteristics taken from the Laboratory of Computational Intelligence (LABIC). The results proved that the proposed β-hill climbing achieved better results in comparison with the original hill climbing technique in solving the text clustering problem.

    CONCLUSION: The performance of the text clustering is useful by adding the β operator to the hill climbing.

  10. Mumin NA, Rahmat K, Hamid MTR, Ng WL, Chan WY, Cheah XY, et al.
    Curr Med Imaging, 2021;17(4):552-558.
    PMID: 33030134 DOI: 10.2174/1573405616666201007161119
    BACKGROUND: Primary breast angiosarcoma is a rare malignancy with non-specific clinical and radiological findings.

    CASE REPORT: A 30-year-old lady presented with left breast pain and lumpiness for over one year. She has had several breast ultrasounds (US) and was treated for acute mastitis and abscess. Subsequently, in view of the rapid growth of the lump and worsening pain, she was re-investigated with US, elastography, digital breast tomosynthesis (DBT) and MRI. MRI raised the suspicion of angiosarcoma. The diagnosis was confirmed after biopsy and she underwent mastectomy.

    DISCUSSION: Literature review on imaging findings of breast angiosarcoma, especially on MRI, is discussed. MRI features showed heterogeneous low signal intensity on T1 and high signal intensity on T2. Dynamic contrast enhancement (DCE) features included either early enhancement with or without washout in the delayed phase, and some reported central areas of non-enhancement.

    CONCLUSION: This case report emphasises on the importance of MRI in clinching the diagnosis of breast angiosarcoma, and hence, should be offered sooner to prevent diagnostic delay.

  11. Latif G, Iskandar DNFA, Alghazo J, Butt MM
    Curr Med Imaging, 2021;17(1):56-63.
    PMID: 32160848 DOI: 10.2174/1573405616666200311122429
    BACKGROUND: Detection of brain tumor is a complicated task, which requires specialized skills and interpretation techniques. Accurate brain tumor classification and segmentation from MR images provide an essential choice for medical treatments. Different objects within an MR image have similar size, shape, and density, which makes the tumor classification and segmentation even more complex.

    OBJECTIVE: Classification of the brain MR images into tumorous and non-tumorous using deep features and different classifiers to get higher accuracy.

    METHODS: In this study, a novel four-step process is proposed; pre-processing for image enhancement and compression, feature extraction using convolutional neural networks (CNN), classification using the multilayer perceptron and finally, tumor segmentation using enhanced fuzzy cmeans method.

    RESULTS: The system is tested on 65 cases in four modalities consisting of 40,300 MR Images obtained from the BRATS-2015 dataset. These include images of 26 Low-Grade Glioma (LGG) tumor cases and 39 High-Grade Glioma (HGG) tumor cases. The proposed CNN feature-based classification technique outperforms the existing methods by achieving an average accuracy of 98.77% and a noticeable improvement in the segmentation results are measured.

    CONCLUSION: The proposed method for brain MR image classification to detect Glioma Tumor detection can be adopted as it gives better results with high accuracies.

  12. Kreah MH, Misni MN, Mumin NA
    Curr Med Imaging, 2021 Oct 29.
    PMID: 34719375 DOI: 10.2174/1573405617666211029163214
    BACKGROUND: Kimura disease is a rare inflammatory condition classically manifested as painless subcutaneous nodules in the head and neck region and associated with regional cervical lymphadenopathy and salivary gland involvement.

    OBJECTIVE: The purpose of this report is to illustrate the diagnostic difficulty due to its rarity and non-specific clinical presentation.

    CASE PRESENTATION: We present a case of Kimura disease with bilateral eyelid swelling, parotid involvement, and cervical lymphadenopathy in a young boy. Computed Tomography (CT) showed ill-defined enhancing masses in both upper eyelids with lacrimal gland infiltration, multiple nodular lesions in both parotid glands, and bilateral enlargement of cervical nodes. After several multidisciplinary discussions and trials of medications, Kimura's disease was finally confirmed by histology examination.

    CONCLUSION: In conclusion, a rare disease such as Kimura must be considered earlier if the patient is not responding to the treatment.

  13. Latif G, Alghazo J, Sibai FN, Iskandar DNFA, Khan AH
    Curr Med Imaging, 2021;17(8):917-930.
    PMID: 33397241 DOI: 10.2174/1573405616666210104111218
    BACKGROUND: Variations of image segmentation techniques, particularly those used for Brain MRI segmentation, vary in complexity from basic standard Fuzzy C-means (FCM) to more complex and enhanced FCM techniques.

    OBJECTIVE: In this paper, a comprehensive review is presented on all thirteen variations of FCM segmentation techniques. In the review process, the concentration is on the use of FCM segmentation techniques for brain tumors. Brain tumor segmentation is a vital step in the process of automatically diagnosing brain tumors. Unlike segmentation of other types of images, brain tumor segmentation is a very challenging task due to the variations in brain anatomy. The low contrast of brain images further complicates this process. Early diagnosis of brain tumors is indeed beneficial to patients, doctors, and medical providers.

    RESULTS: FCM segmentation works on images obtained from magnetic resonance imaging (MRI) scanners, requiring minor modifications to hospital operations to early diagnose tumors as most, if not all, hospitals rely on MRI machines for brain imaging.

    CONCLUSION: In this paper, we critically review and summarize FCM based techniques for brain MRI segmentation.

  14. Hassan H, Othman MF, Razak HRA
    Curr Med Imaging, 2021;17(11):1271-1275.
    PMID: 33593263 DOI: 10.2174/1573405617666210216091202
    Bone metastases are a common source of malignancy in the skeleton and occur much more often than primary bone cancer. Several works were being performed to identify early markers for bone metastasis and novel drug targets to improve patients' quality of life. As some concerns exist with the [18F]sodiumfluoridein positron emission tomography (PET) bone imaging, there has been an increase in the number of targeted radiopharmaceutical markers for bone metastases imaging in its competitor, 68Ga. Since 18F properties are superior to those of 68Ga, there is a distinct motivation for developing 18F radiopharmaceuticals for bone metastases imaging.
  15. Latif G, Al Falanezi Pmu Edu saAnezi FY, Iskandar DNFA, Bashar A, Alghazo J
    Curr Med Imaging, 2022 Jan 17.
    PMID: 35040408 DOI: 10.2174/1573405618666220117151726
    BACKGROUND: The task of identifying a tumor in the brain is a complex problem that requires sophisticated skills and inference mechanisms to accurately locate the tumor region. The complex nature of the brain tissue makes the problem of locating, segmenting, and ultimately classifying Magnetic Resonance (MR) images a complex problem. The aim of this review paper is to consolidate the details of the most relevant and recent approaches proposed in this domain for the binary and multi-class classification of brain tumors using brain MR images.

    OBJECTIVE: In this review paper, a detailed summary of the latest techniques used for brain MR image feature extraction and classification is presented. A lot of research papers have been published recently with various techniques proposed for identifying an efficient method for the correct recognition and diagnosis of brain MR images. The review paper allows researchers in the field to familiarize themselves with the latest developments and be able to propose novel techniques that have not yet been explored in this research domain. In addition, the review paper will facilitate researchers, who are new to machine learning algorithms for brain tumor recognition, to understand the basics of the field and pave the way for them to be able to contribute to this vital field of medical research.

    RESULTS: In this paper, the review is performed for all recently proposed methods for both feature extraction and classification. It also identifies the combination of feature extraction methods and classification methods that when combined would be the most efficient technique for the recognition and diagnosis of brain tumor from MR images. In addition, the paper presents the performance metrics particularly the recognition accuracy, of selected research published between 2017- 2021.

  16. Rahimi A, Khalil A, Faisal A, Lai KW
    Curr Med Imaging, 2021;18(1):61-66.
    PMID: 34433403 DOI: 10.2174/1573405617666210825155659
    BACKGROUND: Early diagnosis of liver cancer may increase life expectancy. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) play a vital role in diagnosing liver cancer. Together, both modalities offer significant individual and specific diagnosis data to physicians; however, they lack the integration of both types of information. To address this concern, a registration process has to be utilized for the purpose, as multimodal details are crucial in providing the physician with complete information.

    OBJECTIVE: The aim was to present a model of CT-MRI registration used to diagnose liver cancer, specifically for improving the quality of the liver images and provide all the required information for earlier detection of the tumors. This method should concurrently address the issues of imaging procedures for liver cancer to fasten the detection of the tumor from both modalities.

    METHODS: In this work, a registration scheme for fusing the CT and MRI liver images is studied. A feature point-based method with normalized cross-correlation has been utilized to aid in the diagnosis of liver cancer and provide multimodal information to physicians. Data on ten patients from an online database were obtained. For each dataset, three planar views from both modalities were interpolated and registered using feature point-based methods. The registration of algorithms was carried out by MATLAB (vR2019b, Mathworks, Natick, USA) on an Intel (R) Core (TM) i5-5200U CPU @ 2.20 GHz computer. The accuracy of the registered image is being validated qualitatively and quantitatively.

    RESULTS: The results show that an accurate registration is obtained with minimal distance errors by which CT and MRI were accurately registered based on the validation of the experts. The RMSE ranges from 0.02 to 1.01 for translation, which is equivalent in magnitude to approximately 0 to 5 pixels for CT and registered image resolution.

    CONCLUSION: The CT-MRI registration scheme can provide complementary information on liver cancer to physicians, thus improving the diagnosis and treatment planning process.

  17. Yong CW, Lai KW, Murphy BP, Hum YC
    Curr Med Imaging, 2021;17(8):981-987.
    PMID: 33319690 DOI: 10.2174/1573405616666201214122409
    BACKGROUND: Osteoarthritis (OA) is a common degenerative joint inflammation that may lead to disability. Although OA is not lethal, this disease will remarkably affect patient's mobility and their daily lives. Detecting OA at an early stage allows for early intervention and may slow down disease progression.

    INTRODUCTION: Magnetic resonance imaging is a useful technique to visualize soft tissues within the knee joint. Cartilage delineation in magnetic resonance (MR) images helps in understanding the disease progressions. Convolutional neural networks (CNNs) have shown promising results in computer vision tasks, and various encoder-decoder-based segmentation neural networks are introduced in the last few years. However, the performances of such networks are unknown in the context of cartilage delineation.

    METHODS: This study trained and compared 10 encoder-decoder-based CNNs in performing cartilage delineation from knee MR images. The knee MR images are obtained from the Osteoarthritis Initiative (OAI). The benchmarking process is to compare various CNNs based on physical specifications and segmentation performances.

    RESULTS: LadderNet has the least trainable parameters with the model size of 5 MB. UNetVanilla crowned the best performances by having 0.8369, 0.9108, and 0.9097 on JSC, DSC, and MCC.

    CONCLUSION: UNetVanilla can be served as a benchmark for cartilage delineation in knee MR images, while LadderNet served as an alternative if there are hardware limitations during production.

  18. Murat H, Awang Kechik MM, Chew MT, Kamal I, Abdul Karim MK
    Curr Med Imaging, 2024 Apr 09.
    PMID: 38616750 DOI: 10.2174/0115734056282004240403042345
    BACKGROUND: PET scan stands as a valuable diagnostic tool in nuclear medicine, enabling the observation of metabolic and physiological changes at a molecular level. However, PET scans have a number of drawbacks, such as poor spatial resolution, noisy images, scattered radiation, artifacts, and radiation exposure. These challenges demonstrate the need for optimization in image processing techniques.

    OBJECTIVES: Our objective is to identify the evolving trends and impacts of publication in this field, as well as the most productive and influential countries, institutions, authors, themes, and articles.

    METHODS: A bibliometric study was conducted using a comprehensive query string such as "positron emission tomography" AND "image processing" AND optimization to retrieve 1,783 publications from 1981 to 2022 found in the Scopus database related to this field of study.

    RESULTS: The findings revealed that the most influential country, institution, and authors are from the USA, and the most prevalent theme is TOF PET image reconstruction.

    CONCLUSION: The increasing trend in publication in the field of optimization of image processing in PET scans would address the challenges in PET scan by reducing radiation exposure, faster scanning speed, as well as enhancing lesion identification.

  19. Herman, Kumar YJ, Wee SY, Perhakaran VK
    Curr Med Imaging, 2024 May 08.
    PMID: 38721794 DOI: 10.2174/0115734056295157240418043624
    INTRODUCTION: In developing Computer-Aided Diagnosis (CAD), a Convolutional Neural Network (CNN) has been commonly used as a Deep Learning (DL) model. Although it is still early, DL has excellent potential in implementing computers in medical diagnosis.

    METHODS: This study reviews the use of DL for Anterior Cruciate Ligament (ACL) tear diagnosis. A comprehensive search was performed in PubMed, Embase, and Web of Science databases from 2018 to 2024. The included study criteria used MRI images to evaluate ACL tears, and the diagnosis of ACL tears was performed using the DL model. We summarized the paper by reporting their model accuracy, model comparison with arthroscopy, and explainable.

    RESULTS: AI implementation in tabular format; we conclude that many medical professionals believe that arthroscopic diagnosis is the most reliable method for diagnosing ACL tears. However, due to its intrusive treatment, CAD is projected to be able to produce similar outcomes from MRI scan results. To gain the trust of physicians and meet the demand for reliable knee injury detection systems, an algorithm for CAD should also meet several criteria, such as being transparent, interpretable, explainable, and easy to use. Therefore, future works should consider creating an Explainable DL model for ACL tear diagnosis. It is also essential to evaluate the performance of this Explainable DL model compared to the gold standard of arthroscopy diagnosis.

    CONCLUSION: There are issues regarding the need for Explainable DL in CAD to increase confidence in its result while also highlighting the importance of the involvement of medical practitioners in system design. There is no funding for this work.

  20. Adibah Yusof NA, Abdul Karim MK, Asikin NM, Paiman S, Awang Kechik MM, Abdul Rahman MA, et al.
    Curr Med Imaging, 2023;19(10):1105-1113.
    PMID: 35975862 DOI: 10.2174/1573405618666220816160544
    BACKGROUND: For almost three decades, computed tomography (CT) has been extensively used in medical diagnosis, which led researchers to conduct linking of CT dose exposure with image quality.

    METHODS: In this study, a systematic review and a meta-analysis study were conducted on CT phantom for resolution study especially based on the low contrast detectability (LCD). Furthermore, the association between the CT parameter such as tube voltage and the type of reconstruction algorithm, the amount of phantom scanning affecting the image quality and the exposure dose were also investigated in this study. We utilize PubMed, ScienceDirect, Google Scholar and Scopus databases to search related published articles from the year 2011 until 2020. The notable keywords comprise "computed tomography", "CT phantom", and "low contrast detectability". Of 52 articles, 20 articles are within the inclusion criteria in this systematic review.

    RESULTS: The dichotomous outcomes were chosen to represent the results in terms of risk ratio as per meta-analysis study. Notably, the noise in iterative reconstruction (IR) reduced by 24%, 33% and 36% with the use of smooth, medium and sharp filters, respectively. Furthermore, adaptive iterative dose reduction (AIDR 3D) improved image quality and the visibility of smaller less dense objects compared to filtered back-projection. Most of the researchers used 120 kVp tube voltage to scan phantom for quality assurance study.

    CONCLUSION: Hence, optimizing primary factors such as tube potential reduces the dose exposure significantly, and the optimized IR technique could substantially reduce the radiation dose while maintaining the image quality.

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