Radiology-Artificial Intelligence最新文献

Purpose To apply conformal prediction to a deep learning (DL) model for intracranial hemorrhage (ICH) detection and evaluate model performance in detection as well as model accuracy in identifying challenging cases. Materials and Methods This was a retrospective (November-December 2017) study of 491 noncontrast head CT volumes from the CQ500 dataset, in which three senior radiologists annotated sections containing ICH. The dataset was split into definite and challenging (uncertain) subsets, in which challenging images were defined as those in which there was disagreement among readers. A DL model was trained on patients from the definite data (training dataset) to perform ICH localization and classification into five classes. To develop an uncertainty-aware DL model, 1546 sections of the definite data (calibration dataset) were used for Mondrian conformal prediction (MCP). The uncertainty-aware DL model was tested on 8401 definite and challenging sections to assess its ability to identify challenging sections. The difference in predictive performance (P value) and ability to identify challenging sections (accuracy) were reported. Results The study included 146 patients (mean age, 45.7 years ± 9.9 [SD]; 76 [52.1%] men, 70 [47.9%] women). After the MCP procedure, the model achieved an F1 score of 0.919 for localization and classification. Additionally, it correctly identified patients with challenging cases with 95.3% (143 of 150) accuracy. It did not incorrectly label any definite sections as challenging. Conclusion The uncertainty-aware MCP-augmented DL model achieved high performance in ICH detection and high accuracy in identifying challenging sections, suggesting its usefulness in automated ICH detection and potential to increase trustworthiness of DL models in radiology. Keywords: CT, Head and Neck, Brain, Brain Stem, Hemorrhage, Feature Detection, Diagnosis, Supervised Learning Supplemental material is available for this article. © RSNA, 2025 See also commentary by Ngum and Filippi in this issue.

Purpose To evaluate the performance of eight lung cancer prediction models on patient cohorts with screening-detected, incidentally detected, and bronchoscopically biopsied pulmonary nodules. Materials and Methods This study retrospectively evaluated promising predictive models for lung cancer prediction in three clinical settings: lung cancer screening with low-dose CT, incidentally detected pulmonary nodules, and nodules deemed suspicious enough to warrant a biopsy. The area under the receiver operating characteristic curve of eight validated models, including logistic regressions on clinical variables and radiologist nodule characterizations, artificial intelligence (AI) on chest CT scans, longitudinal imaging AI, and multimodal approaches for prediction of lung cancer risk was assessed in nine cohorts (n = 898, 896, 882, 219, 364, 117, 131, 115, 373) from multiple institutions. Each model was implemented from their published literature, and each cohort was curated from primary data sources collected over periods from 2002 to 2021. Results No single predictive model emerged as the highest-performing model across all cohorts, but certain models performed better in specific clinical contexts. Single-time-point chest CT AI performed well for screening-detected nodules but did not generalize well to other clinical settings. Longitudinal imaging and multimodal models demonstrated comparatively good performance on incidentally detected nodules. When applied to biopsied nodules, all models showed low performance. Conclusion Eight lung cancer prediction models failed to generalize well across clinical settings and sites outside of their training distributions. Keywords: Diagnosis, Classification, Application Domain, Lung Supplemental material is available for this article. © RSNA, 2025 See also commentary by Shao and Niu in this issue.

Purpose To evaluate the performance of Physics-Informed Autoencoder (PIA), a self-supervised deep learning model, in measuring tissue-based biomarkers for prostate cancer (PCa) using hybrid multidimensional MRI. Materials and Methods This retrospective study introduces PIA, an emerging self-supervised deep learning model that integrates a three-compartment diffusion-relaxation model with hybrid multidimensional MRI. PIA was trained to encode the biophysical model into a deep neural network to predict measurements of tissue-specific biomarkers for PCa without extensive training data requirements. Comprehensive in silico and in vivo experiments, using histopathology measurements as the reference standard, were conducted to validate the model's efficacy in comparison to the traditional nonlinear least squares (NLLS) algorithm. PIA's robustness to noise was tested in in silico experiments with varying signal-to-noise ratio (SNR) conditions, and in vivo performance for estimating volume fractions was evaluated in 21 patients (mean age, 60 years ± 6.6 [SD]; all male) with PCa (71 regions of interest). Evaluation metrics included the intraclass correlation coefficient (ICC) and Pearson correlation coefficient. Results PIA predicted the reference standard tissue parameters with high accuracy, outperforming conventional NLLS methods, especially under noisy conditions (r_s = 0.80 vs 0.65, P < .001 for epithelium volume at SNR of 20:1). In in vivo validation, PIA's noninvasive volume fraction estimates matched quantitative histology (ICC, 0.94, 0.85, and 0.92 for epithelium, stroma, and lumen compartments, respectively; P < .001 for all). PIA's measurements strongly correlated with PCa aggressiveness (r = 0.75, P < .001). Furthermore, PIA ran 10 000 faster than NLLS (0.18 second vs 40 minutes per image). Conclusion PIA provided accurate prostate tissue biomarker measurements from MRI data with better robustness to noise and computational efficiency compared with the NLLS algorithm. The results demonstrate the potential of PIA as an accurate, noninvasive, and explainable artificial intelligence method for PCa detection. Keywords: Prostate, Stacked Auto-Encoders, Tissue Characterization, MR-Diffusion-weighted Imaging Supplemental material is available for this article. ©RSNA, 2025 See also commentary by Adams and Bressem in this issue.

Purpose To develop and evaluate a deep learning-based prognostic model for predicting survival in locoregionally advanced nasopharyngeal carcinoma (LA-NPC) using serial MRI before and after induction chemotherapy (IC). Materials and Methods This multicenter retrospective study included 1039 patients with LA-NPC (779 male and 260 female patients; mean age, 44 years ± 11 [SD]) diagnosed between December 2011 and January 2016. A radiomics-clinical prognostic model (model RC) was developed using pre- and post-IC MRI acquisitions and other clinical factors using graph convolutional neural networks. The concordance index (C-index) was used to evaluate model performance in predicting disease-free survival (DFS). The survival benefits of concurrent chemoradiation therapy (CCRT) were analyzed in model-defined risk groups. Results The C-indexes of model RC for predicting DFS were significantly higher than those of TNM staging in the internal (0.79 vs 0.53) and external (0.79 vs 0.62, both P < .001) testing cohorts. The 5-year DFS for the model RC-defined low-risk group was significantly better than that of the high-risk group (90.6% vs 58.9%, P < .001). In high-risk patients, those who underwent CCRT had a higher 5-year DFS rate than those who did not (58.7% vs 28.6%, P = .03). There was no evidence of a difference in 5-year DFS rate in low-risk patients who did or did not undergo CCRT (91.9% vs 81.3%, P = .19). Conclusion Serial MRI before and after IC can effectively help predict survival in LA-NPC. The radiomics-clinical prognostic model developed using a graph convolutional network-based deep learning method showed good risk discrimination capabilities and may facilitate risk-adapted therapy. Keywords: Nasopharyngeal Carcinoma, Deep Learning, Induction Chemotherapy, Serial MRI, MR Imaging, Radiomics, Prognosis, Radiation Therapy/Oncology, Head/Neck Supplemental material is available for this article. © RSNA, 2025.

Purpose To evaluate the change in digital breast tomosynthesis artificial intelligence (DBT-AI) case scores over sequential screenings. Materials and Methods This retrospective review included 21 108 female patients (mean age ± SD, 58.1 years ± 11.5) with 31 741 DBT screening examinations performed at a single site from February 3, 2020, to September 12, 2022. Among 7000 patients with two or more DBT-AI screenings, 1799 had a 1-year follow-up and were included in the analysis. DBT-AI case scores and differences in case score over time were determined. Case scores ranged from 0 to 100. For each screening outcome (true positive [TP], false positive [FP], true negative [TN], false negative [FN]), mean and median case score change was calculated. Results The highest average case score was seen in TP examinations (average, 75; range, 7-100; n = 41), and the lowest average case score was seen in TN examinations (average, 34; range, 0-100; n = 1640). The largest positive case score change was seen in TP examinations (mean case score change, 21.1; median case score change, 17). FN examinations included mammographically occult cancers diagnosed following supplemental screening and those found at symptomatic diagnostic imaging. Differences between TP and TN mean case score change (P < .001) and between TP and FP mean case score change (P = .02) were statistically significant. Conclusion Using the combination of DBT AI case score with change in case score over time may help radiologists make recall decisions in DBT screening. All studies with high case score and/or case score changes should be carefully scrutinized to maximize screening performance. Keywords: Mammography, Breast, Computer Aided Diagnosis (CAD) Supplemental material is available for this article. © RSNA, 2025.

Purpose To evaluate the performance of the winning machine learning models from the 2023 RSNA Abdominal Trauma Detection AI Challenge. Materials and Methods The competition was hosted on Kaggle and took place between July 26 and October 15, 2023. The multicenter competition dataset consisted of 4274 abdominal trauma CT scans, in which solid organs (liver, spleen, and kidneys) were annotated as healthy, low-grade, or high-grade injury. Studies were labeled as positive or negative for the presence of bowel and mesenteric injury and active extravasation. In this study, performances of the eight award-winning models were retrospectively assessed and compared using various metrics, including the area under the receiver operating characteristic curve (AUC), for each injury category. The reported mean values of these metrics were calculated by averaging the performance across all models for each specified injury type. Results The models exhibited strong performance in detecting solid organ injuries, particularly high-grade injuries. For binary detection of injuries, the models demonstrated mean AUC values of 0.92 (range, 0.90-0.94) for liver, 0.91 (range, 0.87-0.93) for splenic, and 0.94 (range, 0.93-0.95) for kidney injuries. The models achieved mean AUC values of 0.98 (range, 0.96-0.98) for high-grade liver, 0.98 (range, 0.97-0.99) for high-grade splenic, and 0.98 (range, 0.97-0.98) for high-grade kidney injuries. For the detection of bowel and mesenteric injuries and active extravasation, the models demonstrated mean AUC values of 0.85 (range, 0.74-0.93) and 0.85 (range, 0.79-0.89), respectively. Conclusion The award-winning models from the artificial intelligence challenge demonstrated strong performance in the detection of traumatic abdominal injuries on CT scans, particularly high-grade injuries. These models may serve as a performance baseline for future investigations and algorithms. Keywords: Abdominal Trauma, CT, American Association for the Surgery of Trauma, Machine Learning, Artificial Intelligence Supplemental material is available for this article. © RSNA, 2024.