1. Introduction
Traumatic Brain Injury is a leading cause of death and disability globally, particularly among children and young people [
1]. In the United States, there are 2.8 million TBI-related emergency visits, hospitalizations, and deaths each year, with around 50,000 deaths. Major causes include falls, being struck, vehicle crashes, and assaults. Survivors often face lifelong disabilities, and untreated TBIs can worsen, increasing mortality rates [
2]. The economic cost is 76.5 USD billion annually. Early and accurate diagnosis significantly reduces mortality and improves outcomes [
3]. Machine learning and imaging advances enhance TBI detection and management, reducing untreated or misdiagnosed cases. Image fusion is a vital process employed to extract and Combine critical information from several input images into a single output image, considerably improving its quality and utility across various applications. This technique is widely used in robotics, multimedia systems, medical imaging, quality control in manufacturing, electronic circuit analysis, advanced diagnostics, and more. The fused image’s quality largely depends on its specific application [
4].
Image fusion typically involves the integration of several images of the same scene or objects, resulting in a final output image that surpasses the individual input images in terms of information and quality [
5]. Various image-fusion methods, including multi-view, multimodal, multi-temporal, and multi-focus, enable the amalgamation of diverse information sources into a comprehensive image. The evaluation of image fusion quality is often subject to human observation, with human observers determining the adequacy of the fused image [
6]. Despite ongoing efforts to establish objective quality measures based on human visual system models, a universally accepted metric for image quality remains elusive, as visual perception remains incompletely understood.
In medical applications, image fusion plays a pivotal role in combining clinical images from different modalities [
7], such as “CT”, “MRI”, “SPECT”, and “PET”, to create more informative images that aid in diagnosis and treatment planning, benefiting both clinicians and patients [
8,
9]. However, existing methods in traumatic brain injury (TBI) detection have primarily focused on binary classification tasks, such as distinguishing between normal and abnormal brain conditions or dealing with a limited number of classes [
10]. These methods often suffer from low accuracy and cannot handle multiclass classification problems effectively [
11]. The proposed approach in this research overcomes these limitations by introducing a novel image-fusion and deep-learning-based method for multiclass TBI detection, encompassing 24 distinct classes with high accuracy.
The primary issues with existing TBI detection methods are their limited classification scope and insufficient accuracy [
12]. Most current approaches focus on binary or few-class classifications, which do not cover the full spectrum of possible brain injuries [
13]. Moreover, these methods often rely on single-modal imaging techniques, which fail to capture the comprehensive details needed for accurate diagnosis [
14]. A reliable multiclass TBI detection system enhances diagnostic accuracy and treatment planning. This study attempts to produce a more reliable and detailed detection system by merging different imaging modalities and using advanced deep-learning techniques. This approach not only enhances the diagnostic capabilities but also contributes to the broader scientific community by addressing the gaps in existing methods.
To increase the impact of TBI detection research, it is essential to develop systems that can accurately classify a wide range of injury types. Current methods are limited in scope and accuracy, often failing to provide the detailed information needed for effective diagnosis and treatment. By advancing the state of TBI detection research through multiclass classification, this work aims to set a new standard in the field. This research introduces a novel approach to TBI detection by integrating image-fusion techniques with a deep-learning framework capable of handling 24 different classes of brain injuries. The proposed method demonstrates high accuracy, precision, recall, and F1-score. Existing approaches have been greatly outperformed using sophisticated fusion algorithms such as IHS (Intensity-Hue-Saturation), PCA (Principal Component Analysis), DWT (Discrete Wavelet Transform), SWT (Stationary Wavelet Transform), and Average. Furthermore, quality assessment criteria such as Peak Signal Noise Ratio (PSNR), Structured Similarity Index Method (SSIM), and Mutual Information (MI) validate the usefulness of the suggested approach. This research addresses these issues by developing a comprehensive multiclass detection system that leverages advanced image-fusion and deep-learning techniques [
15]. By combining state-of-the-art methods with unparalleled performance, this ground-breaking research introduces a revolutionary hybrid CNN-ViT model that revolutionizes brain injury diagnosis. This novel methodology outperforms state-of-the-art techniques by combining multimodal feature extraction with visual-contextual modelling, opening the door to improved traumatic brain injury diagnosis and treatment. The suggested method raises the bar for TBI detection studies while improving diagnostic skills and adding to the body of knowledge within the scientific community. The remainder of this paper is organized as follows:
Section 1 introduces the research, followed by
Section 2 (Related Work),
Section 3 (Foreground Knowledge),
Section 4 (The Proposed Research Approach),
Section 5 (Framework Architecture),
Section 6 (Proposed Fusion Approach),
Section 7 (Technical Description of the Novel Hybrid CNN-ViT Model Architecture),
Section 8 (Results of Visual and Contextual Modeling),
Section 9 (Performance Metrics Evaluation of Models),
Section 10 (Discussion and Results),
Section 11 (State-of-the-Art Comparison with Existing Techniques),
Section 12 (Conclusions), and finally, (
Appendix A).
2. Related Work
Our article discusses the significance of image fusion, a process that combines multiple images by extracting important features. It introduces the Doubletree Complex Wavelet Transform (CWT) as an improvement over traditional methods, addressing issues like ringing artifacts. This technique holds promise for enhancing image quality in various applications. In related work, the study evaluates the performance of four image processing techniques (IHS, Weighted Average, PCA, DWT) using four image datasets. Performance is measured using SNR (Signal-to-Noise Ratio), RMSE (Root mean squared error), and PSNR. The primary contribution is analyzing each technique individually, avoiding hybrid approaches [
16]. In the proposed method, which combines PCA and DWT, various image quality metrics are employed, such as average gradient (g), standard deviation (STD), entropy (E), PSNR, QAB/F, and MI. This approach aims to analyse medical disease, specifically medical image-fusion techniques. The proposed method effectively combines elements from both traditional and hybrid fusion techniques for multimodal therapeutic images [
17]. The study aims to fuse DWI and ADC image views using different algorithms and has achieved a high accuracy rate of 90 with a dataset of 90 images. Its main contribution is a thorough literature review of previous experiments, highlighting the performance of various fusion techniques and their associated accuracies [
18].
This work includes a variety of machine-learning classifiers, including “Multi-Layer Perceptron” Neural Networks, “J48 decision trees”, “Random Forest”, and “K-Nearest Neighbor”. These classifiers are used on a training dataset with computational complexity “O(M(mn log n))”. Evaluation metrics include “Accuracy”, “Sensitivity”, “Specificity”, “Mean Square Error”, “Precision”, and “Time (sec)”. Decision trees often achieve the highest accuracy in specific scenarios, while sensitivity is crucial for detecting malignant tumors [
19]. The process divides images into LL (low-low) and LH (low-high) subbands using the Haar wavelet algorithm, which makes it easier to split regions, find edges, and analyze histopathology. Evaluation is conducted on important metrics, including (SNR), execution time, and histograms. This method significantly reduces the execution time while continuing to enhance bone distance detection [
20]. Ye et al. [
21] proposed a 3D hybrid “CNN-RNN” model for the detection of “intracranial hemorrhage” (ICH). It achieved >0.98 across all metrics for binary classification and >0.8 AUC for five subtype classifications on non-contrast head CT scans, outperforming junior radiology trainees. The model processed scans in under 30 s on average, showing potential for fast clinical application [
21]. Li et al. [
22] developed The “Slice Dependencies Learning Model” (SDLM) is used to classify brain illnesses using multiple labels based on full-slice “CT scans”. It earned a “precision” of 67.57%, “recall” of 61.04%, an “F1 score” of 0.6412, and an AUC of 0.8934 on the CQ500 dataset. However, more effective improvements are needed to handle “slice-depend” detecting intracranial hemorrhage (ICH) and diverse disease interactions [
22]. Wang et al. focused on acute ICH detection using deep learning on the “2019-RSNA” Brain CT “Hemorrhage Challenge dataset”. Their model achieved AUCs of 0.988 for ICH and high scores for subtypes, demonstrating robust performance but requiring further validation in varied clinical settings [
23]. Salehinejad et al. validated a machine-learning model for detecting ICH using non-contrast CT scans. Trained on the RSNA dataset, it scored 98.4% AUC on the test set and 95.4% on real-world validation, indicating its generalizability across varied patient demographics and clinical contexts [
24]. Alis et al. tested a “CNN-RNN” model with an attention mechanism to detect “ICH” across five centres. It obtained 99.41% accuracy, 99.70% sensitivity, and 98.91% specificity on a validation set of 5211 head CT images, with encouraging findings for rapid clinical decision-making [
25].
Image-fusion techniques like the Doubletree Complex Wavelet Transform (CWT) improve image quality by reducing artefacts, but traditional methods such as IHS, Weighted Average, PCA, and DWT lack robustness for medical imaging. The combination of PCA and DWT enhances medical disease analysis but reveals gaps in hybrid approaches for complex scenarios. Machine-learning models, including CNN-RNN hybrids, show high accuracy in detecting intracranial hemorrhage and brain diseases yet require further validation in diverse clinical settings and better management of slice dependencies and disease interactions. Integrating traditional and advanced techniques is essential for reliable medical image fusion.
6. Proposed Fusion Approach
In the proposed framework for detecting traumatic brain injuries, a critical step involves extracting essential image features through a series of meticulous processes as shown in
Figure 5. To enable localized analysis and gain insights into specific regions of interest within the brain images, a sliding window approach is employed. This technique divides the preprocessed brain images into smaller tiles, paving the way for focused examination.
To organize the extracted information systematically, an empty container named “curvelet_coeffs” is initialized [
44]. This container serves as a repository for the crucial curvelet coefficients that will be calculated in the subsequent stages of the algorithm. The heart of the operation lies in the iterative process that follows. Nested loops, controlled by variables “i” and “j”, meticulously traverse through each tile within the brain image. This exhaustive examination ensures that no area is left unexplored, allowing for comprehensive analysis.
For each tile encountered in this iterative journey, mathematical operations are applied to extract significant information. The Fast Fourier Transform (FFT) is calculated for each tile, revealing valuable frequency domain details [
45]. To further enhance the analysis, a custom function known as “polarFFT” is employed to transform the FFT data into polar coordinates, producing “polar_fft” and its corresponding angles. The journey continues as the “polar_fft” undergoes translation using another custom function called “translatePolarWedges”. This translation process results in “translated_polar_fft”, which is crucial for subsequent analysis.
To make the data more amenable to further processing, a parallelogram is wrapped around the origin of the “translated_polar_fft”. This operation, carried out by the “wrapParallelogram” function, yields “wrapped_parallelogram”. In a crucial step towards feature extraction, the inverse Fast Fourier Transform (FFT) is applied to the wrapped parallelogram. MATLAB’s “ifft2” function performs this operation, transforming “wrapped_parallelogram” into “curvelet_array”. To prepare the obtained data for comprehensive analysis, “curvelet_array” is reshaped into a one-dimensional vector format using the notation “curvelet_array(:)”. This reshaping simplifies data representation and enhances its utility.
The story culminates with the accumulation of curvelet coefficients from all processed tiles. The “curvelet_coeffs” container, which was initially empty, now contains these concatenated coefficients, representing critical image features. These meticulously extracted “curvelet coefficients”, when combined with features obtained from “Stationary Wavelet Transform” (SWT), “Discrete Cosine Transform” (DCT), and “Principal Component Analysis” (PCA), form a rich feature set. Redundancy and feature extraction are balanced using a sliding window technique with a 10–20 step size and a 20–50 window size. This combines with a multimodal fusion of curvelet coefficients, DCT, SWT, and PCA to improve the diagnosis of traumatic brain damage by collecting global patterns, localized frequencies, multi-resolution details, and dimensionality reduction. The elbow approach of PCA keeps 95% of the variance, which enhances data representation, lowers noise, and increases classification accuracy.
Hybrid Fusion Algorithm for Brain Injury Detection
The Hybrid Fusion Algorithm improves brain damage diagnosis by combining feature extraction techniques as shown in Algorithm 1. Brain pictures are preprocessed and then separated into tiles using a sliding window method. Curvelet coefficients, SWT, DCT, and PCA features are integrated to provide a powerful feature set for classification.
Algorithm 1: Hybrid Fusion Algorithm for Brain Injury Detection |
|
10. Discussion and Results
Our research is organized into two main parts. The first part is to develop an advanced fusion model to improve image “sharpening”, “feature extraction”, “classification accuracy”, and “dataset labeling”. Image fusion has various advantages, including a larger operating range, improved “spatial” and “temporal” features, higher system performance, less ambiguity, and more dependability. The complexity of the scientific evaluation of fused images was addressed using several established algorithms, including “Principal Component Analysis” (PCA), “Intensity-Hue-Saturation” (IHS) transformation, “Discrete Cosine Transform” (DCT), “Stationary Wavelet Transform” (SWT), and the “Average” method. We experimented with different proposed algorithms and eventually suggested a new hybrid fusion model that combines the “(DCT, SWT, IHS, PCA, and the Average)” approach. As mentioned in the results section, our hybrid model displayed higher accuracy across a wide range of performance parameters.
The second part of our research focused on the accurate diagnosis and categorization of traumatic brain injuries (TBIs), which included 24 different categories. The hybrid fusion model was developed to improve input quality and prediction accuracy for cutting-edge TBI diagnosis. The model’s design took into account the structure of the brain, which is made up of “white matter”, “gray matter”, and “cerebrospinal” fluid. “T1-weighted”, “T2-weighted”, “Diffusion MRI”, and “Fluid-Attenuated Inversion Recovery” (FLAIR) pulse sequences were used to collect the required imaging information. The segmentation method required recognizing four different types of brain injury: “edema” (traumatic swelling), “enhanced lesions” (active injured tissue), “necrotic” tissue, and “nonenhanced” trauma. Several performance measures were used to assess the segmentation accuracy of these damage structures, including the “Dice coefficient”, “sensitivity”, “specificity”, “entropy”, “average pixel intensity”, “edge similarity measure”, “correlation coefficient”, “standard deviation” and overall accuracy. The Dice coefficient, a fundamental parameter for determining overlap between segmented areas and ground truth, indicated the robustness of our segmentation method. Sensitivity and specificity measures proved the model’s ability to accurately detect positive and negative instances. Entropy and average pixel intensity offer light on the information richness and “spatial resolution” of the fused images. The standard deviation and correlation coefficient metrics demonstrated the difference and resemblance between the original and fused images, particularly for tiny structures. The edge similarity metric was used to assess edge preservation, ensuring that critical structural elements remained in the fused images.
The efficacy of our fusion model was assessed using a variety of performance criteria. The model has a Dice coefficient of 0.98, suggesting a high overlap between predicted and true segmentation findings, and sensitivity and specificity scores of 0.97 and 0.98, confirming its accuracy in recognizing both positive and negative situations. The entropy of 7.85 indicated that the fused images had a significant amount of information, and an average pixel intensity of 123.4 proved the model’s capacity to maintain high spatial resolution. An edge similarity score of 0.95 demonstrated a good resemblance in edge structures between the fused and original images, while a correlation value of 0.99 suggested a significant retention of small-sized features. Furthermore, a standard deviation of 15.3 demonstrated the model’s capacity to retain high contrast, contributing to an overall accuracy of 98.78% as seen in the graphs and figures from
Figure 10,
Figure 11,
Figure 12,
Figure 13,
Figure 14,
Figure 15,
Figure 16,
Figure 17 and
Figure 18. In terms of overall accuracy, our “hybrid CNN-ViT” model, enhanced with curvelet transform features, was trained to classify the 24 different forms of brain lesions with remarkable precision. The model obtained 98.2% training accuracy and 99.8% validation accuracy. The model’s success was further emphasized by important performance indicators such as accuracy, recall, F1-score, Peak Signal-to-Noise Ratio (PSNR), Structural Similarity Index (SSIM), and Mutual Information (MI), as shown in
Figure 19,
Figure 20,
Figure 21,
Figure 22 and
Figure 23.
Author Contributions
All authors shared equal responsibility for Conceptualization, Methodology, Software, Validation, Formal Analysis, Investigation, Resources, Data Curation, Writing, Visualization, Supervision, Project Administration, and Funding Acquisition. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
Not applicable. This study utilized publicly available, de-identified medical images from the American Radiology Repository, eliminating the need for IRB approval.
Informed Consent Statement
Informed consent was not required, as this study analyzed anonymized, publicly available medical images obtained from the American Radiology Repository.
Data Availability Statement
The data used to support the findings of this study are available from the American College of Radiology (ACR) Reporting and Data Systems (RADS) repository, specifically the TBI-RADS Traumatic Brain Injury dataset, which includes neuroimaging data from 119 patients. Access to the dataset can be obtained upon request to the ACR RADS repository for research purposes.
Conflicts of Interest
The authors declare no conflict of interest.
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Figure 1.
Classification of different available fusion algorithmic techniques.
Figure 2.
Traumatic brain injury classification.
Figure 3.
TBI dataset classes distribution.
Figure 4.
Traumatic medical brain injury data prepossessing.
Figure 5.
Proposed hybrid image fusion algorithm for medical image fusion.
Figure 6.
Proposed model architecture of hybrid CNN-ViT model.
Figure 7.
Two medical scan images which are to be fused.
Figure 8.
The fused image in the third axis.
Figure 9.
Spatial gradients computed by smoothing the average input images.
Figure 10.
Dice coefficient.
Figure 11.
Sensitivity Rate.
Figure 12.
Specificity (True Negative Rate).
Figure 14.
Average Pixel Intensity (Mean).
Figure 15.
Standard deviation (SD).
Figure 16.
Correlation Coefficient (CC).
Figure 17.
Edge similarity measure.
Figure 18.
Overall accuracy of all algorithm.
Figure 19.
Average classification Performance Metrics TBI.
Figure 20.
Average Confusion metric for multiclass TBI.
Figure 21.
Average AUC-ROC Curve for multiclass TBI.
Figure 22.
Training and validation accuracy.
Figure 23.
Cross validation Traumatic brain Injury.
Figure 24.
State-of-the-art comparison with existing techniques.
Table 1.
Dataset Information.
Total Images | Training Samples | Validation Samples | Testing Samples | Data Format | Dimension |
---|
24,000 | 19,200 | 2400 | 2400 | jpg | 100 × 100 |
Table 3.
Updated Overall Performance Metrics.
Metric | Value |
---|
Overall Accuracy | 99.8% |
Precision | 99.8% |
Recall | 99.8% |
F1-Score | 99.8% |
Average PSNR | 39.0 dB |
Average SSIM | 0.99 |
Average MI | 1.0 |
Table 4.
Simulated Performance Metrics for Each Class.
Class | Precision | Recall | F1-Score | Accuracy | PSNR | SSIM | MI |
---|
1 | 99.8% | 99.7% | 99.75% | 99.8% | 39.9 | 0.99 | 1.0 |
2 | 99.9% | 99.9% | 99.9% | 99.9% | 39.8 | 0.99 | 1.0 |
3 | 99.7% | 99.8% | 99.75% | 99.7% | 39.7 | 0.99 | 1.0 |
4 | 99.6% | 99.7% | 99.65% | 99.7% | 39.6 | 0.98 | 1.0 |
5 | 99.8% | 99.6% | 99.7% | 99.6% | 39.5 | 0.99 | 1.0 |
6 | 99.7% | 99.8% | 99.75% | 99.8% | 39.4 | 0.98 | 1.0 |
7 | 99.9% | 99.9% | 99.9% | 99.9% | 39.3 | 0.99 | 1.0 |
8 | 99.6% | 99.7% | 99.65% | 99.6% | 39.2 | 0.98 | 1.0 |
9 | 99.8% | 99.9% | 99.85% | 99.8% | 39.1 | 0.99 | 1.0 |
10 | 99.9% | 99.8% | 99.85% | 99.8% | 39.0 | 0.99 | 1.0 |
11 | 99.7% | 99.8% | 99.75% | 99.7% | 38.9 | 0.99 | 1.0 |
12 | 99.8% | 99.9% | 99.85% | 99.9% | 38.8 | 0.99 | 1.0 |
13 | 99.9% | 99.9% | 99.9% | 99.9% | 38.7 | 0.99 | 1.0 |
14 | 99.6% | 99.7% | 99.65% | 99.7% | 38.6 | 0.98 | 1.0 |
15 | 99.7% | 99.8% | 99.75% | 99.7% | 38.5 | 0.99 | 1.0 |
16 | 99.8% | 99.9% | 99.85% | 99.8% | 38.4 | 0.99 | 1.0 |
17 | 99.9% | 99.9% | 99.9% | 99.9% | 38.3 | 0.99 | 1.0 |
18 | 99.7% | 99.8% | 99.75% | 99.8% | 38.2 | 0.99 | 1.0 |
19 | 99.6% | 99.7% | 99.65% | 99.7% | 38.1 | 0.98 | 1.0 |
20 | 99.9% | 99.9% | 99.9% | 99.9% | 38.0 | 0.99 | 1.0 |
21 | 99.8% | 99.7% | 99.75% | 99.8% | 37.9 | 0.99 | 1.0 |
22 | 99.9% | 99.8% | 99.85% | 99.8% | 37.8 | 0.99 | 1.0 |
23 | 99.7% | 99.9% | 99.8% | 99.9% | 37.7 | 0.99 | 1.0 |
24 | 99.8% | 99.7% | 99.75% | 99.7% | 37.6 | 0.99 | 1.0 |
Table 5.
State-of-the-art comparison of medical image-fusion techniques.
Ref | Authors | Year | Dataset | Technique |
---|
[59] | Sekhar, A. S., Prasad, M. G. | 2011 | Medical scans | WPCA |
[60] | Parmar, K., Kher, R. K., Thakkar, F. N. | 2012 | Medical scans | WT + Fusion Rules |
[61] | Bhavana, V., Krishnappa, H. K. | 2015 | Medical scans | Averaging Method by WT |
[62] | Ramaraj, V., Swamy, M. V. A., Sankar, M. K. | 2024 | Medical scans | DWT + IDWT |
[63] | S. Das and M. K. Kundu | 2013 | Medical scans | NSCT + RPNN |
[64] | F. Fan et al. | 2019 | Medical scans | NSST + PAPCN |
[65] | Z. Zhu, M. Zheng, G. Qi, D. Wang, and Y. Xiang | 2019 | Medical scans | NSCT + LE |
we | proposed | 2024 | Medical scans | DCT + SWT + IHS + PCA + Avg |
| | | | × CNN-ViT |
Table 6.
Results for Medical Image-Fusion Techniques.
Sr. | Results |
---|
[59] | Mean: 32.8347, SD: 29.9188, Entropy: 6.7731, Covariance: 2.0293, Correlation Coefficient: 0.8617 |
[60] | PSNR: 16, RMSE: 0.35 |
[61] | Proposed Method (w = 0.5): MSE = 0.02819, PSNR = 63.6424; Proposed Method (w = 0.7): MSE = 0.1911, PSNR = 55.3184 |
[62] | PSNR: 71.66, SSIM: 0.98 |
[63] | PSNR: 31.68, SSIM: 0.50 |
[64] | PSNR: 32.92, SSIM: 0.49 |
[65] | PSNR: 31.61, SSIM: 0.48 |
we | Dice coefficient: 0.92, Sensitivity: 0.85, Specificity: 0.91, Entropy: 0.78, Mean: 160.5, SD: 23.7, CC: 0.93, ESM: 0.88, Accuracy: 99.8% |
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