Cultura

RISE-MAR: Radiologist-Integrated Self-Evolution for Generalizable Metal Artifact Reduction in CT Imaging

VOLUME 22, 2025

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Saud Muhammad Alshammari, Alaa Saud Alanazi, Hamdan Ahmed Hamdan Alshehri, Asmaa Alahmadi, Amer Altarjami, Nasser Almohsen, Nawaf Othman Ahmed Alyahyawi, Abdulaziz Muhammad alharbi
Muhannad Alahmade, Amjad Majed Alharbi, Hatun Eid Albishi, Ahmed Theyab Alsahli, Abdullah Mahmoud Alsenani, Abdulrahman Bassam Alhazmi, Ammar Hani Alhejaili

Abstract

This study introduces RISE-MAR (Radiologist-Integrated Self-Evolution for Metal Artifact Reduction), a novel framework that addresses the persistent challenge of metal artifacts in computed tomography (CT) imaging. Unlike previous approaches that rely solely on mathematical optimization or deep learning, RISE-MAR explicitly integrates radiologist expertise into a self-evolving system through an innovative feedback loop. Our dual-domain architecture combines a transformer-based image branch with a specialized sinogram network, enforcing physical consistency while capturing long-range dependencies essential for complex artifact patterns. The key innovation lies in our confidence-guided pseudo-labeling mechanism that selectively identifies high-confidence regions for self-training, refined by radiologist feedback that ensures clinical relevance. Experimental results demonstrate RISE-MAR's superior performance across synthetic and clinical datasets, with significant improvements in both quantitative metrics (PSNR: 36.2 dB, SSIM: 0.923) and clinical relevance scores (4.2/5) compared to state-of-the-art methods. Most notably, RISE-MAR shows remarkable generalization capability across different implant types and anatomical regions, effectively bridging the domain gap between training environments and clinical applications. Our work establishes a new paradigm for developing medical image enhancement techniques that leverage the complementary strengths of computational methods and clinical expertise.

Keywords : .
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty