BJR artificial intelligence最新文献

This review examines the use of large language models (LLMs) in cancer, analysing articles sourced from PubMed, Embase, and Ovid Medline, published between 2017 and 2024. Our search strategy included terms related to LLMs, cancer research, risks, safeguards, and ethical issues, focusing on studies that utilized text-based data. 59 articles were included in the review, categorized into 3 segments: quantitative studies on LLMs, chatbot-focused studies, and qualitative discussions on LLMs on cancer. Quantitative studies highlight LLMs' advanced capabilities in natural language processing (NLP), while chatbot-focused articles demonstrate their potential in clinical support and data management. Qualitative research underscores the broader implications of LLMs, including the risks and ethical considerations. Our findings suggest that LLMs, notably ChatGPT, have potential in data analysis, patient interaction, and personalized treatment in cancer care. However, the review identifies critical risks, including data biases and ethical challenges. We emphasize the need for regulatory oversight, targeted model development, and continuous evaluation. In conclusion, integrating LLMs in cancer research offers promising prospects but necessitates a balanced approach focusing on accuracy, ethical integrity, and data privacy. This review underscores the need for further study, encouraging responsible exploration and application of artificial intelligence in oncology.

Our opinion piece pays homage to the evolution of medical practices, tracing back to the era of Hippocrates, through significant historical milestones, and drawing parallels with the principles underpinning foundational artificial intelligence (AI) models. It emphasizes the shared ethos of both domains: a commitment to comprehensive care that values diverse data integration and individualized patient treatment. The excitement surrounding foundation models in medical imaging is understandable. However, a critical and cautious approach is crucial before widespread adoption. By addressing the present 4 major limitations (ie, data bias and generalizability, interpretability of AI models, data scarcity and diversity, and computational resources and infrastructure) and fostering a culture of rigorous research, we can unlock the true potential of these models and revolutionize medical care. This critique (opinion) paper highlights the need for a more measured approach in the field of foundation AI models for medicine in general and for medical imaging in particular. It emphasizes the importance of tackling core challenges before rushing toward clinical applications. By focusing on robust methodologies and addressing limitations, researchers can ensure the development of truly impactful and trustworthy models for the betterment of healthcare.

Innovation in medical imaging artificial intelligence (AI)/machine learning (ML) demands extensive data collection, algorithmic advancements, and rigorous performance assessments encompassing aspects such as generalizability, uncertainty, bias, fairness, trustworthiness, and interpretability. Achieving widespread integration of AI/ML algorithms into diverse clinical tasks will demand a steadfast commitment to overcoming issues in model design, development, and performance assessment. The complexities of AI/ML clinical translation present substantial challenges, requiring engagement with relevant stakeholders, assessment of cost-effectiveness for user and patient benefit, timely dissemination of information relevant to robust functioning throughout the AI/ML lifecycle, consideration of regulatory compliance, and feedback loops for real-world performance evidence. This commentary addresses several hurdles for the development and adoption of AI/ML technologies in medical imaging. Comprehensive attention to these underlying and often subtle factors is critical not only for tackling the challenges but also for exploring novel opportunities for the advancement of AI in radiology.

Objectives: Auto-segmentation promises greater speed and lower inter-reader variability than manual segmentations in radiation oncology clinical practice. This study aims to implement and evaluate the accuracy of the auto-segmentation algorithm, "Masked Image modeling using the vision Transformers (SMIT)," for neck nodal metastases on longitudinal T₂-weighted (T₂w) MR images in oropharyngeal squamous cell carcinoma (OPSCC) patients.

Methods: This prospective clinical trial study included 123 human papillomaviruses (HPV-positive [+]) related OSPCC patients who received concurrent chemoradiotherapy. T₂w MR images were acquired on 3 T at pre-treatment (Tx), week 0, and intra-Tx weeks (1-3). Manual delineations of metastatic neck nodes from 123 OPSCC patients were used for the SMIT auto-segmentation, and total tumor volumes were calculated. Standard statistical analyses compared contour volumes from SMIT vs manual segmentation (Wilcoxon signed-rank test [WSRT]), and Spearman's rank correlation coefficients (ρ) were computed. Segmentation accuracy was evaluated on the test data set using the dice similarity coefficient (DSC) metric value. P-values <0.05 were considered significant.

Results: No significant difference in manual and SMIT delineated tumor volume at pre-Tx (8.68 ± 7.15 vs 8.38 ± 7.01 cm³, P = 0.26 [WSRT]), and the Bland-Altman method established the limits of agreement as -1.71 to 2.31 cm³, with a mean difference of 0.30 cm³. SMIT model and manually delineated tumor volume estimates were highly correlated (ρ = 0.84-0.96, P < 0.001). The mean DSC metric values were 0.86, 0.85, 0.77, and 0.79 at the pre-Tx and intra-Tx weeks (1-3), respectively.

Conclusions: The SMIT algorithm provides sufficient segmentation accuracy for oncological applications in HPV+ OPSCC.

Advances in knowledge: First evaluation of auto-segmentation with SMIT using longitudinal T₂w MRI in HPV+ OPSCC.

The adoption of artificial intelligence (AI) tools in medicine poses challenges to existing clinical workflows. This commentary discusses the necessity of context-specific quality assurance (QA), emphasizing the need for robust QA measures with quality control (QC) procedures that encompass (1) acceptance testing (AT) before clinical use, (2) continuous QC monitoring, and (3) adequate user training. The discussion also covers essential components of AT and QA, illustrated with real-world examples. We also highlight what we see as the shared responsibility of manufacturers or vendors, regulators, healthcare systems, medical physicists, and clinicians to enact appropriate testing and oversight to ensure a safe and equitable transformation of medicine through AI.