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Boosting LLM-Assisted Diagnosis: 10-Minute LLM Tutorial Elevates Radiology Residents' Performance in Brain MRI Interpretation 促进 LLM 辅助诊断:10 分钟 LLM 教程提高放射科住院医师的脑 MRI 解释能力
Pub Date : 2024-07-05 DOI: 10.1101/2024.07.03.24309779
Su Hwan Kim, Severin Schramm, Jonas Wihl, Philipp Raffler, Marlene Tahedl, Julian Canisius, Ina Luiken, Lukas Endroes, Stefan Reischl, Alexander Marka, Robert Walter, Mathias Schillmaier, Claus Zimmer, Benedikt Wiestler, Dennis Martin Hedderich
PurposeTo evaluate the impact of a structured tutorial on the use of a large language model (LLM)-based search engine on radiology residents' performance in LLM-assisted brain MRI differential diagnosis. Materials & MethodsIn this retrospective study, nine radiology residents determined the three most likely differential diagnoses for three sets of ten brain MRI cases with a challenging yet definite diagnosis. Each set of cases was assessed 1) with the support of conventional internet search, 2) using an LLM-based search engine (© Perplexity AI) without prior training, or 3) with LLM assistance after a structured 10-minute tutorial on how to effectively use the tool for differential diagnosis. The tutorial content was based on the results of two studies on LLM-assisted radiological diagnosis and included a prompt template. Reader responses were rated using a binary and numeric scoring system. Reading times were tracked and confidence levels were recorded on a 5-point Likert scale. Binary and numeric scores were analyzed using chi-square tests and pairwise Mann-Whitney U tests each. Search engine logs were examined to quantify user interaction metrics, and to identify hallucinations and misinterpretations in LLM responses. ResultsRadiology residents achieved the highest accuracy when employing the LLM-based search engine following the tutorial, indicating the correct diagnosis among the top three differential diagnoses in 62.5% of cases (55/88). This was followed by the LLM-assisted workflow before the tutorial (44.8%; 39/87) and the conventional internet search workflow (32.2%; 28/87). The LLM tutorial led to significantly higher performance (binary scores: p = 0.042, numeric scores: p = 0.016) and confidence (p = 0.006) but resulted in no relevant differences in reading times. Hallucinations were found in 5.1% of LLM queries. ConclusionA structured 10-minute LLM tutorial increased performance and confidence levels in LLM-assisted brain MRI differential diagnosis among radiology residents.
目的 评估基于大语言模型(LLM)搜索引擎的结构化教程对放射科住院医师在 LLM 辅助下进行脑部 MRI 鉴别诊断的影响。材料& 方法在这项回顾性研究中,九名放射科住院医师为三组十个脑部 MRI 病例确定了三个最有可能的鉴别诊断,这些病例的诊断具有挑战性但又是明确的。每组病例的评估方式包括:1)在传统互联网搜索的支持下进行评估;2)使用基于 LLM 的搜索引擎(© Perplexity AI)进行评估,无需事先接受培训;或 3)在 LLM 的协助下,接受 10 分钟的结构化教程,了解如何有效使用该工具进行鉴别诊断。教程内容基于两项关于 LLM 辅助放射诊断的研究结果,并包含一个提示模板。使用二进制和数字评分系统对读者的回答进行评分。对阅读时间进行跟踪,并以 5 点李克特量表记录信心水平。二进制和数字评分分别采用卡方检验和成对曼-惠特尼U检验进行分析。对搜索引擎日志进行了检查,以量化用户交互指标,并识别 LLM 回复中的幻觉和误解。结果 放射科住院医师在按照教程使用基于 LLM 的搜索引擎时,准确率最高,62.5% 的病例(55/88)在前三个鉴别诊断中给出了正确诊断。其次是教程前的 LLM 辅助工作流程(44.8%;39/87)和传统的互联网搜索工作流程(32.2%;28/87)。LLM 辅导显著提高了成绩(二进制分数:p = 0.042,数字分数:p = 0.016)和信心(p = 0.006),但在阅读时间上没有相关差异。在 5.1% 的 LLM 查询中发现了幻觉。结论 10 分钟结构化 LLM 教程提高了放射学住院医师在 LLM 辅助脑 MRI 鉴别诊断中的表现和信心水平。
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引用次数: 0
Contrastive Self-supervised Learning for Neurodegenerative Disorder Classification 用于神经退行性疾病分类的对比式自我监督学习
Pub Date : 2024-07-04 DOI: 10.1101/2024.07.03.24309882
Vadym Gryshchuk, Devesh Singh, Stefan J. Teipel, Martin Dyrba
Neurodegenerative diseases such as Alzheimer's disease (AD) or frontotemporal lobar degeneration (FTLD) involve specific loss of brain volume, detectable in vivo using T1-weighted MRI scans. Supervised machine learning approaches classifying neurodegenerative diseases require diagnostic-labels for each sample. However, it can be difficult to obtain expert labels for a large amount of data. Self-supervised learning (SSL) offers an alternative for training machine learning models without data-labels. We investigated if the SSL models can applied to distinguish between different neurodegenerative disorders in an interpretable manner. Our method comprises a feature extractor and a downstream classification head. A deep convolutional neural network trained in a contrastive self-supervised way serves as the feature extractor, learning latent representation, while the classifier head is a single-layer perceptron. We used N=2694 T1-weighted MRI scans from four data cohorts: two ADNI datasets, AIBL and FTLDNI, including cognitively normal controls (CN), cases with prodromal and clinical AD, as well as FTLD cases differentiated into its sub-types. Our results showed that the feature extractor trained in a self-supervised way provides generalizable and robust representations for the downstream classification. For AD vs. CN, our model achieves 82% balanced accuracy on the test subset and 80% on an independent holdout dataset. Similarly, the behavioral variant of frontotemporal dementia (BV) vs. CN model attains an 88% balanced accuracy on the test subset. The average feature attribution heatmaps obtained by the Integrated Gradient method highlighted hallmark regions, i.e., temporal gray matter atrophy for AD, and insular atrophy for BV. In conclusion, our models perform comparably to state-of-the-art supervised deep learning approaches. This suggests that the SSL methodology can successfully make use of unannotated neuroimaging datasets as training data while remaining robust and interpretable.
阿尔茨海默病(AD)或额颞叶变性(FTLD)等神经退行性疾病会导致特定的脑容量损失,可通过 T1 加权磁共振成像扫描在体内检测到。对神经退行性疾病进行分类的有监督机器学习方法需要每个样本的诊断标签。然而,要获得大量数据的专家标签可能很困难。自我监督学习(SSL)提供了一种无需数据标签即可训练机器学习模型的替代方法。我们研究了 SSL 模型能否以可解释的方式用于区分不同的神经退行性疾病。我们的方法包括一个特征提取器和一个下游分类头。以对比自监督方式训练的深度卷积神经网络作为特征提取器,学习潜在表征,而分类器则是一个单层感知器。我们使用了来自四个数据队列的 N=2694 张 T1 加权 MRI 扫描图像:两个 ADNI 数据集(AIBL 和 FTLDNI),包括认知正常对照组(CN)、AD 前驱和临床病例,以及区分为不同亚型的 FTLD 病例。我们的研究结果表明,以自我监督方式训练的特征提取器为下游分类提供了通用且稳健的表征。对于 AD 与 CN,我们的模型在测试子集上达到了 82% 的平衡准确率,在独立的保留数据集上达到了 80%。同样,前额颞叶痴呆症(BV)的行为变异与 CN 模型在测试子集中的平衡准确率达到了 88%。综合梯度法获得的平均特征归因热图突出了标志性区域,即AD的颞灰质萎缩和BV的岛叶萎缩。总之,我们的模型与最先进的监督深度学习方法性能相当。这表明 SSL 方法可以成功地利用未标注的神经成像数据集作为训练数据,同时保持稳健性和可解释性。
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引用次数: 0
Altered dynamic functional connectivity in antagonistic state in first-episode, drug-naive patients with major depressive disorder. 初发、未服药的重度抑郁症患者在拮抗状态下的动态功能连接发生改变。
Pub Date : 2024-07-03 DOI: 10.1101/2024.07.02.24309338
Min Wang, Tao Chen, Zhongyi He, Lawrence Wing-Chi Chan, qinger guo, Shuyang Cai, Jingfeng Duan, Danbin Zhang, Xunda Wang, Yu Fang, Hong Yang
Major depressive disorder (MDD) is characterized by disrupted functional network connectivity (FNC), with unclear underlying dynamics. We investigated both static FNC (sFNC) and dynamic FNC (dFNC) on resting-state fMRI data from drug-naive first-episode MDD patients and healthy controls (HC). MDD patients exhibited lower sFNC within and between sensory and motor networks than HC. Four dFNC states were identified, including a globally-weakly-connected state, a cognitive-control-dominated state, a globally-positively-connected state, and an antagonistic state. The antagonistic state was marked by strong positive connections within the sensorimotor domain and their anti-correlations with the executive-motor control domain. Notably, MDD patients exhibited significantly longer time dwelling in the globally-weakly-connected state, at the cost of significantly shorter time dwelling in the antagonistic state. Further, only the mean dwell time of this antagonistic state was significantly anticorrelated to disease severity measures. Our study highlights the altered dynamics of the antagonistic state as a fundamental aspect of disrupted FNC in early MDD.
重度抑郁障碍(MDD)的特征是功能网络连接(FNC)紊乱,其潜在的动态变化尚不清楚。我们研究了静息态 FNC(sFNC)和动态 FNC(dFNC),研究对象是未服药的首发 MDD 患者和健康对照组(HC)的静息态 fMRI 数据。与健康对照组相比,MDD 患者在感觉和运动网络内部和之间表现出较低的 sFNC。研究发现了四种 dFNC 状态,包括全局弱连接状态、认知控制主导状态、全局正连接状态和拮抗状态。拮抗状态的特征是感觉运动领域内的强正向连接及其与执行-运动控制领域的反相关性。值得注意的是,MDD 患者在全局弱连接状态下的停留时间明显更长,而在拮抗状态下的停留时间则明显更短。此外,只有这种拮抗状态的平均停留时间与疾病严重程度显著反相关。我们的研究强调,拮抗状态的动态变化是早期 MDD FNC 紊乱的一个基本方面。
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引用次数: 0
Quantitative T1 and Effective Proton Density (PD*) mapping in children and adults at 7T from an MP2RAGE sequence optimised for uniform T1-weighted (UNI) and FLuid And White matter Suppression (FLAWS) contrasts 利用针对均匀 T1 加权 (UNI) 和流体与白质抑制 (FLAWS) 对比进行优化的 MP2RAGE 序列,在 7T 下绘制儿童和成人的定量 T1 和有效质子密度 (PD*) 图谱
Pub Date : 2024-07-01 DOI: 10.1101/2024.06.28.24307535
Ayşe Sıla Dokumacı, Katy Vecchiato, Raphael Tomi-Tricot, Michael Eyre, Philippa Bridgen, Pierluigi Di Cio, Chiara Casella, Tobias C. Wood, Jan Sedlacik, Tom Wilkinson, Sharon L. Giles, Joseph V. Hajnal, Jonathan O'Muircheartaigh, Shaihan J. Malik, David W. Carmichael
IntroductionQuantitative MRI is important for non-invasive tissue characterisation. In previous work we developed a clinically feasible multi-contrast protocol for T1-weighted imaging based on the MP2RAGE sequence that was optimised for both children and adults. It was demonstrated that a range of Fluid And White Matter Suppression (FLAWS) related contrasts could be produced while maintaining T1-weighted uniform image (UNI) quality, a challenge at higher field strengths. Here we introduce an approach to use these images to calculate effective proton density (PD*) and quantitative T1 relaxation maps especially for shorter repetition times (TRMP2RAGE) than those typically used previously.MethodsT1 and PD* were estimated from the analytical equations of the MP2RAGE signal derived for partial Fourier acquisitions. The sensitivity of the fitting results was evaluated with respect to the TRMP2RAGE and B1+ effects on both excitation flip angles and inversion efficiency and compared to vendor T1 maps which do not use B1+ information. Data acquired for a range of individuals (aged 10-54 years) at the shortest TRMP2RAGE (4000ms) were compared across white matter (WM), cortical grey matter, and deep grey matter regions. Results The T1 values were insensitive to the choice of different TRMP2RAGE. The results were similar to the vendor T1 maps if the B1+ effects on the excitation flip angle and inversion efficiency were not included in the fits. T1 values varied over development into adulthood, especially for the deep grey matter regions whereas only a very small difference was observed for WM T1. Effective PD maps were produced which did not show a significant difference between children and adults for the age range included. ConclusionWe produced PD* maps and improved the accuracy of T1 maps from an MP2RAGE protocol that is optimised for UNI and FLAWS-related contrasts in a single scan at 7T by incorporating the excitation flip angle and inversion efficiency related effects of B1+ in the fitting. This multi-parametric protocol made it possible to acquire high resolution images (0.65mm iso) in children and adults within a clinically feasible duration (7:18 min:s). The combination of analytical equations utilizing B1+ maps led to T1 fits that were consistent at different TRMP2RAGE values. Average WM T1 values of adults and children were very similar (1092ms vs 1117ms) while expected reductions in T1 with age were found for GM especially for deep GM.
导言定量磁共振成像对于无创组织特征描述非常重要。在之前的工作中,我们基于 MP2RAGE 序列开发了一种临床上可行的 T1 加权成像多对比度方案,并针对儿童和成人进行了优化。研究表明,在保持 T1 加权均匀图像(UNI)质量的同时,还能产生一系列与流体和白质抑制(FLAWS)相关的对比度,这在较高的场强下是一个挑战。在此,我们介绍了一种使用这些图像计算有效质子密度(PD*)和定量 T1 驰豫图的方法,尤其是在重复时间(TRMP2RAGE)比以前通常使用的重复时间更短的情况下。根据 TRMP2RAGE 和 B1+ 对激发翻转角度和反转效率的影响评估了拟合结果的灵敏度,并与不使用 B1+ 信息的供应商 T1 图谱进行了比较。比较了白质(WM)、皮质灰质和深灰质区域在最短 TRMP2RAGE(4000 毫秒)时获取的一系列个人(10-54 岁)数据。结果 T1 值对选择不同的 TRMP2RAGE 不敏感。如果在拟合时不考虑 B1+ 对激发翻转角和反转效率的影响,结果与供应商的 T1 图相似。从发育到成年,T1 值会发生变化,尤其是在深部灰质区域,而在 WM T1 方面只观察到很小的差异。绘制的有效 PD 图在所包含的年龄范围内未显示出儿童和成人之间的显著差异。结论通过在拟合中加入 B1+ 的激发翻转角和反转效率相关影响,我们在 7 T 的单次扫描中通过 MP2RAGE 方案生成了 PD* 地图,并提高了 T1 地图的准确性,该方案针对 UNI 和 FLAWS 相关对比进行了优化。这种多参数方案可以在临床可行的时间内(7:18 分:秒)获得儿童和成人的高分辨率图像(0.65 毫米等深线)。结合使用 B1+ 地图的分析方程,可得出不同 TRMP2RAGE 值下一致的 T1 拟合值。成人和儿童的平均 WM T1 值非常相似(1092ms vs 1117ms),而 GM,尤其是深部 GM 的 T1 值会随着年龄的增长而降低。
{"title":"Quantitative T1 and Effective Proton Density (PD*) mapping in children and adults at 7T from an MP2RAGE sequence optimised for uniform T1-weighted (UNI) and FLuid And White matter Suppression (FLAWS) contrasts","authors":"Ayşe Sıla Dokumacı, Katy Vecchiato, Raphael Tomi-Tricot, Michael Eyre, Philippa Bridgen, Pierluigi Di Cio, Chiara Casella, Tobias C. Wood, Jan Sedlacik, Tom Wilkinson, Sharon L. Giles, Joseph V. Hajnal, Jonathan O'Muircheartaigh, Shaihan J. Malik, David W. Carmichael","doi":"10.1101/2024.06.28.24307535","DOIUrl":"https://doi.org/10.1101/2024.06.28.24307535","url":null,"abstract":"<strong>Introduction</strong>\u0000Quantitative MRI is important for non-invasive tissue characterisation. In previous work we developed a clinically feasible multi-contrast protocol for T<sub>1</sub>-weighted imaging based on the MP2RAGE sequence that was optimised for both children and adults. It was demonstrated that a range of Fluid And White Matter Suppression (FLAWS) related contrasts could be produced while maintaining T<sub>1</sub>-weighted uniform image (UNI) quality, a challenge at higher field strengths. Here we introduce an approach to use these images to calculate effective proton density (PD<sup>*</sup>) and quantitative T<sub>1</sub> relaxation maps especially for shorter repetition times (TR<sub>MP2RAGE</sub>) than those typically used previously.\u0000<strong>Methods</strong>\u0000T<sub>1</sub> and PD<sup>*</sup> were estimated from the analytical equations of the MP2RAGE signal derived for partial Fourier acquisitions. The sensitivity of the fitting results was evaluated with respect to the TR<sub>MP2RAGE</sub> and B<sub>1</sub><sup>+</sup> effects on both excitation flip angles and inversion efficiency and compared to vendor T<sub>1</sub> maps which do not use B<sub>1</sub><sup>+</sup> information. Data acquired for a range of individuals (aged 10-54 years) at the shortest TR<sub>MP2RAGE</sub> (4000ms) were compared across white matter (WM), cortical grey matter, and deep grey matter regions. <strong>Results</strong> The T<sub>1</sub> values were insensitive to the choice of different TR<sub>MP2RAGE</sub>. The results were similar to the vendor T<sub>1</sub> maps if the B<sub>1</sub><sup>+</sup> effects on the excitation flip angle and inversion efficiency were not included in the fits. T<sub>1</sub> values varied over development into adulthood, especially for the deep grey matter regions whereas only a very small difference was observed for WM T<sub>1</sub>. Effective PD maps were produced which did not show a significant difference between children and adults for the age range included. <strong>Conclusion</strong>\u0000We produced PD<sup>*</sup> maps and improved the accuracy of T<sub>1</sub> maps from an MP2RAGE protocol that is optimised for UNI and FLAWS-related contrasts in a single scan at 7T by incorporating the excitation flip angle and inversion efficiency related effects of B<sub>1</sub><sup>+</sup> in the fitting. This multi-parametric protocol made it possible to acquire high resolution images (0.65mm iso) in children and adults within a clinically feasible duration (7:18 min:s). The combination of analytical equations utilizing B<sub>1</sub><sup>+</sup> maps led to T<sub>1</sub> fits that were consistent at different TR<sub>MP2RAGE</sub> values. Average WM T<sub>1</sub> values of adults and children were very similar (1092ms vs 1117ms) while expected reductions in T<sub>1</sub> with age were found for GM especially for deep GM.","PeriodicalId":501358,"journal":{"name":"medRxiv - Radiology and Imaging","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141503248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dosimetry of [64Cu]FBP8: a fibrin-binding PET probe 64Cu]FBP8 的剂量测定:纤维蛋白结合 PET 探针
Pub Date : 2024-06-28 DOI: 10.1101/2024.06.27.24309589
David Izquierdo-Garcia, Pauline Désogère, Anne L. Philip, David E. Sosnovik, Ciprian Catana, Peter Caravan
Purpose: This study presents the biodistribution, clearance and dosimetry estimates of [64Cu]FBP8 Binding Probe #8 ([64Cu]FBP8) in healthy subjects.Procedures: This prospective study included 8 healthy subjects to evaluate biodistribution, safety and dosimetry estimates of [64Cu]FBP8, a fibrin-binding positron emission tomography (PET) probe. All subjects underwent up to 3 sessions of PET/Magnetic Resonance Imaging (PET/MRI) 0-2 hours, 4h and 24h post injection. Dosimetry estimates were obtained using OLINDA 2.2 software.Results: Subjects were injected with ~400 MBq of [64Cu]FBP8. Subjects did not experience adverse effects due to the injection of the probe. [64Cu]FBP8 PET images demonstrated fast blood clearance (half-life = 67 min) and renal excretion of the probe, showing low background signal across the body. The organs with the higher doses were: the urinary bladder (0.075 vs. 0.091 mGy/MBq for males and females, respectively); the kidneys (0.050 vs. 0.056 mGy/MBq respectively); and the liver (0.027 vs. 0.035 mGy/MBq respectively). The combined mean effective dose for males and females was 0.016 ± 0.0029 mSv/MBq, lower than the widely used [18F]fluorodeoxyglucose ([18F]FDG, 0.020mSv/MBq).Conclusions: This study demonstrates the following properties of the [64Cu]FBP8 probe: low dosimetry estimates; fast blood clearance and renal excretion; low background signal; and whole-body acquisition within 20 minutes in a single session. These properties provide the basis for [64Cu]FBP8 to be an excellent candidate for whole-body non-invasive imaging of fibrin, an important driver/feature in many cardiovascular, oncological and neurological conditions.
目的:本研究介绍了[64Cu]FBP8 结合探针 #8 ([64Cu]FBP8)在健康受试者中的生物分布、清除率和剂量估算:这项前瞻性研究纳入了 8 名健康受试者,以评估[64Cu]FBP8(一种纤维蛋白结合正电子发射断层扫描(PET)探针)的生物分布、安全性和剂量估算。所有受试者都在注射后 0-2 小时、4 小时和 24 小时接受了最多 3 次 PET/磁共振成像(PET/MRI)检查。使用 OLINDA 2.2 软件进行剂量测定:受试者注射了约 400 MBq 的[64Cu]FBP8。受试者没有因注射探针而出现不良反应。[64Cu]FBP8正电子发射计算机断层图像显示,探针在血液中清除(半衰期=67分钟)和肾脏排泄速度快,全身背景信号低。剂量较高的器官是:膀胱(男性和女性分别为 0.075 和 0.091 mGy/MBq);肾脏(分别为 0.050 和 0.056 mGy/MBq);肝脏(分别为 0.027 和 0.035 mGy/MBq)。男性和女性的综合平均有效剂量为 0.016 ± 0.0029 mSv/MBq,低于广泛使用的[18F]氟脱氧葡萄糖([18F]FDG,0.020mSv/MBq):这项研究证明了[64Cu]FBP8探针的以下特性:低剂量估算;快速血液清除和肾脏排泄;低背景信号;单次治疗在20分钟内完成全身采集。这些特性为[64Cu]FBP8 成为纤维蛋白全身无创成像的优秀候选者奠定了基础,纤维蛋白是许多心血管、肿瘤和神经疾病的重要驱动因素/特征。
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引用次数: 0
Deep Learning-based Multiclass Segmentation in Aneurysmal Subarachnoid Hemorrhage 基于深度学习的动脉瘤性蛛网膜下腔出血多类分割技术
Pub Date : 2024-06-25 DOI: 10.1101/2024.06.24.24309431
Julia Kiewitz, Orhun Utku Aydin, Adam Hilbert, Marie Gultom, Anouar Nouri, Ahmed A Khalil, Peter Vajkoczy, Satoru Tanioka, Fujimaro Ishida, Nora F. Dengler, Dietmar Frey
Introduction Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition with a significant variability in patients’ outcomes. Radiographic scores used to assess the extent of SAH or other potentially outcome-relevant pathologies are limited by interrater variability and do not utilize all available information from the imaging. Image segmentation plays an important role in extracting relevant information from images by enabling precise identification and delineation of objects or regions of interest. Thus, segmentation offers the potential for automatization of score assessments and downstream outcome prediction using precise volumetric information. Our study aims to develop a deep learning model that enables automated multiclass segmentation of structures and pathologies relevant for aSAH outcome prediction.
导言 动脉瘤性蛛网膜下腔出血(aSAH)是一种危及生命的疾病,患者的预后差异很大。用于评估 SAH 或其他可能与预后相关的病变程度的影像评分受限于评定者之间的差异,而且无法利用影像中的所有可用信息。图像分割通过精确识别和划分感兴趣的对象或区域,在从图像中提取相关信息方面发挥着重要作用。因此,图像分割可利用精确的容积信息实现评分评估和下游结果预测的自动化。我们的研究旨在开发一种深度学习模型,该模型可对与急性脑梗死结果预测相关的结构和病理进行自动多类分割。
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引用次数: 0
Feasibility to virtually generate T2 fat-saturated breast MRI by convolutional neural networks 利用卷积神经网络虚拟生成 T2 脂肪饱和乳腺 MRI 的可行性
Pub Date : 2024-06-25 DOI: 10.1101/2024.06.25.24309404
Andrzej Liebert, Dominique Hadler, Hannes Schreiter, Chris Ehring, Luise Brock, Lorenz A. Kapsner, Jessica Eberle, Ramona Erber, Julius Emons, Frederik B. Laun, Michael Uder, Evelyn Wenkel, Sabine Ohlmeyer, Sebastian Bickelhaupt
Background: Breast magnetic resonance imaging (MRI) protocols often include T2-weighted fat-saturated (T2w-FS) sequences, which are vital for tissue characterization but significantly increase scan time. Purpose: This study aims to evaluate whether a 2D-U-Net neural network can generate virtual T2w-FS images from routine multiparametric breast MRI sequences.Materials and Methods: This IRB approved, retrospective study included n=914 breast MRI examinations performed between January 2017 and June 2020. The dataset was divided into training (n=665), validation (n=74), and test sets (n=175). The U-Net was trained on T1-weighted (T1w), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) sequences to generate virtual T2w-FS images (VirtuT2). Quantitative metrics and a qualitative multi-reader assessment by two radiologists were used to evaluate the VirtuT2 images.Results: VirtuT2 images demonstrated high structural similarity (SSIM=0.87) and peak signal-to-noise ratio (PSNR=24.90) compared to original T2w-FS images. High level of the frequency error norm (HFNE=0.87) indicates strong blurring presence in the VirtuT2 images, which was also confirmed in qualitative reading. Radiologists correctly identified VirtuT2 images with 92.3% and 94.2% accuracy, respectively. No significant difference in diagnostic image quality (DIQ) was noted for one reader (p=0.21), while the other reported significantly lower DIQ for VirtuT2 (p<=0.001). Moderate inter-reader agreement was observed for edema detection on T2w-FS images (ƙ=0.43), decreasing to fair on VirtuT2 images (ƙ=0.36). Conclusion: The 2D-U-Net can technically generate virtual T2w-FS images with high similarity to real T2w-FS images, though blurring remains a limitation. Further investigation of other architectures and using larger datasets are needed to improve clinical applicability.
背景:乳腺磁共振成像(MRI)方案通常包括 T2 加权脂肪饱和(T2w-FS)序列,这对组织特征描述至关重要,但会大大增加扫描时间。目的:本研究旨在评估 2D-U-Net 神经网络能否从常规多参数乳腺 MRI 序列生成虚拟 T2w-FS 图像:这项经 IRB 批准的回顾性研究纳入了 2017 年 1 月至 2020 年 6 月期间进行的 n=914 次乳腺 MRI 检查。数据集分为训练集(n=665)、验证集(n=74)和测试集(n=175)。U-Net 在 T1 加权(T1w)、弥散加权成像(DWI)和动态对比增强(DCE)序列上进行训练,以生成虚拟 T2w-FS 图像(VirtuT2)。两名放射科医生使用定量指标和多阅片器定性评估来评价 VirtuT2 图像:结果:与原始 T2w-FS 图像相比,VirtuT2 图像显示出较高的结构相似性(SSIM=0.87)和峰值信噪比(PSNR=24.90)。较高的频率误差标准(HFNE=0.87)表明 VirtuT2 图像存在较强的模糊现象,定性阅读也证实了这一点。放射医师识别 VirtuT2 图像的正确率分别为 92.3%和 94.2%。一位读者的诊断图像质量(DIQ)无明显差异(p=0.21),而另一位读者的 VirtuT2 诊断图像质量则明显较低(p<=0.001)。在 T2w-FS 图像的水肿检测方面,观察到读片者之间有中等程度的一致性(ƙ=0.43),而在 VirtuT2 图像上,一致性降至一般(ƙ=0.36)。结论2D-U-Net 可以在技术上生成与真实 T2w-FS 图像高度相似的虚拟 T2w-FS 图像,但模糊仍然是一个限制因素。要提高临床应用性,还需要进一步研究其他架构和使用更大的数据集。
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引用次数: 0
Fingerprint method applied to data from a phase III clinical trial 将指纹法应用于 III 期临床试验数据
Pub Date : 2024-06-25 DOI: 10.1101/2024.06.25.24309472
Lars Edenbrandt
Researchers in the RECOMIA network have been developing AI tools for the automated analysis of PET/CT studies in lymphoma patients. To enhance these AI tools, the CALGB 50303 dataset from The Cancer Imaging Archive was identified for inclusion in their project. Ensuring the quality of databases used for AI training is crucial, and one quality control (QC) measure involves the AI-based Fingerprint method to verify correct de-identification of clinical trial images. The study applied the Fingerprint method to PET/CT studies from 130 patients, successfully detecting an incorrectly de-identified study and identifying its correct trial identification number. This demonstrates the feasibility of using AI for QC in clinical trials. AI-based methods offer significant opportunities for enhancing QC, providing automated, consistent, and objective analyses that reduce the workload on human annotators. Integrating AI into QC processes promises to improve accuracy, consistency, and efficiency, thereby enhancing data integrity and the reliability of clinical trial results. This study underscores the importance of further developing AI-based QC methods in clinical trials.
RECOMIA 网络的研究人员一直在开发用于自动分析淋巴瘤患者 PET/CT 研究的人工智能工具。为了增强这些人工智能工具,癌症成像档案馆的 CALGB 50303 数据集被确定纳入他们的项目。确保用于人工智能训练的数据库的质量至关重要,其中一项质量控制(QC)措施涉及基于人工智能的指纹方法,以验证临床试验图像的去标识化是否正确。该研究将指纹法应用于 130 名患者的 PET/CT 研究,成功检测出了一个错误的去标识化研究,并确定了其正确的试验标识号。这证明了将人工智能用于临床试验质量控制的可行性。基于人工智能的方法为加强质量控制提供了重要机会,可提供自动、一致和客观的分析,减少人工标注者的工作量。将人工智能融入质量控制流程有望提高准确性、一致性和效率,从而增强数据完整性和临床试验结果的可靠性。这项研究强调了在临床试验中进一步开发基于人工智能的质量控制方法的重要性。
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引用次数: 0
Empowering Radiologists with ChatGPT-4o: Comparative Evaluation of Large Language Models and Radiologists in Cardiac Cases 通过 ChatGPT-4o 增强放射科医生的能力:心脏病例中大语言模型与放射医师的比较评估
Pub Date : 2024-06-25 DOI: 10.1101/2024.06.25.24309247
Turay Cesur, Yasin Celal Gunes, Eren Camur, Mustafa Dağlı
Purpose This study evaluated the diagnostic accuracy and differential diagnosis capabilities of 12 Large Language Models (LLMs), one cardiac radiologist, and three general radiologists in cardiac radiology. The impact of ChatGPT-4o assistance on radiologist performance was also investigated.
目的 本研究评估了 12 个大型语言模型 (LLM)、一名心脏放射科医生和三名普通放射科医生在心脏放射学方面的诊断准确性和鉴别诊断能力。此外,还研究了 ChatGPT-4o 辅助工具对放射科医生工作表现的影响。
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引用次数: 0
High-dimensional causal mediation analysis by partial sum statistic and sample splitting strategy in imaging genetics application 部分和统计和样本分割策略的高维因果中介分析在影像遗传学中的应用
Pub Date : 2024-06-24 DOI: 10.1101/2024.06.23.24309362
Hung-Ching Chang, Yusi Fang, Michael T. Gorczyca, Kayhan Batmanghelich, George C. Tseng
Causal mediation analysis provides a systematic approach to explore the causal role of one or more mediators in the association between exposure and outcome. In omics or imaging data analysis, mediators are often high-dimensional, which brings new statistical challenges. Existing methods either violate causal assumptions or fail in interpretable variable selection. Additionally, mediators are often highly correlated, presenting difficulties in selecting and prioritizing top mediators. To address these issues, we develop a framework using Partial Sum Statistic and Sample Splitting Strategy, namely PS5, for high-dimensional causal mediation analysis. The method provides a powerful global mediation test satisfying causal assumptions, followed by an algorithm to select and prioritize active mediators with quantification of individual mediation contributions. We demonstrate its accurate type I error control, superior statistical power, reduced bias in mediation effect estimation, and accurate mediator selection using extensive simulations of varying levels of effect size, signal sparsity, and mediator correlations. Finally, we apply PS5 to an imaging genetics dataset of chronic obstructive pulmonary disease (COPD) patients (N=8,897) in the COPDGene study to examine the causal mediation role of lung images (p=5,810) in the associations between polygenic risk score and lung function and between smoking exposure and lung function, respectively. Both causal mediation analyses successfully estimate the global indirect effect and detect mediating image regions. Collectively, we find a region in the lower lobe of the right lung with a strong and concordant mediation effect for both genetic and environmental exposures. This suggests that targeted treatment toward this region might mitigate the severity of COPD due to genetic and smoking effects.
因果中介分析提供了一种系统方法,用于探索一个或多个中介因素在暴露与结果之间的关联中的因果作用。在omics或成像数据分析中,中介因子通常是高维的,这给统计带来了新的挑战。现有的方法要么违反因果假设,要么在可解释的变量选择上失败。此外,中介因子往往高度相关,这给选择和优先考虑顶级中介因子带来了困难。为了解决这些问题,我们开发了一种使用偏和统计和样本分割策略(即 PS5)进行高维因果中介分析的框架。该方法提供了一个满足因果假设的强大的全局中介检验,随后提供了一种算法来选择和优先考虑活跃的中介,并量化单个中介的贡献。我们通过对不同水平的效应大小、信号稀疏性和中介相关性进行大量模拟,证明了该方法具有准确的 I 类误差控制、出色的统计能力、降低中介效应估计偏差以及准确的中介选择。最后,我们将 PS5 应用于 COPDGene 研究中慢性阻塞性肺病(COPD)患者(N=8897)的影像遗传学数据集,分别研究了肺部影像(p=5810)在多基因风险评分与肺功能之间以及吸烟暴露与肺功能之间的因果中介作用。这两项因果中介分析都成功地估算出了整体间接效应,并发现了中介图像区域。总之,我们发现右肺下叶的一个区域对遗传和环境暴露具有强烈且一致的中介效应。这表明,针对该区域的针对性治疗可能会减轻慢性阻塞性肺病因遗传和吸烟影响而导致的严重程度。
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引用次数: 0
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medRxiv - Radiology and Imaging
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