{"title":"Machine learning models for discriminating clinically significant from clinically insignificant prostate cancer using bi-parametric magnetic resonance imaging.","authors":"Hakan Ayyıldız, Okan İnce, Esin Korkut, Merve Gülbiz Dağoğlu Kartal, Atadan Tunacı, Şükrü Mehmet Ertürk","doi":"10.4274/dir.2024.242856","DOIUrl":"https://doi.org/10.4274/dir.2024.242856","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to demonstrate the performance of machine learning algorithms to distinguish clinically significant prostate cancer (csPCa) from clinically insignificant prostate cancer (ciPCa) in prostate bi-parametric magnetic resonance imaging (MRI) using radiomics features.</p><p><strong>Methods: </strong>MRI images of patients who were diagnosed with cancer with histopathological confirmation following prostate MRI were collected retrospectively. Patients with a Gleason score of 3+3 were considered to have clinically ciPCa, and patients with a Gleason score of 3+4 and above were considered to have csPCa. Radiomics features were extracted from T2-weighted (T2W) images, apparent diffusion coefficient (ADC) images, and their corresponding Laplacian of Gaussian (LoG) filtered versions. Additionally, a third feature subset was created by combining the T2W and ADC images, enhancing the analysis with an integrated approach. Once the features were extracted, Pearson's correlation coefficient and selection were performed using wrapper-based sequential algorithms. The models were then built using support vector machine (SVM) and logistic regression (LR) machine learning algorithms. The models were validated using a five-fold cross-validation technique.</p><p><strong>Results: </strong>This study included 77 patients, 30 with ciPCA and 47 with csPCA. From each image, four images were extracted with LoG filtering, and 111 features were obtained from each image. After feature selection, 5 features were obtained from T2W images, 5 from ADC images, and 15 from the combined dataset. In the SVM model, area under the curve (AUC) values of 0.64 for T2W, 0.86 for ADC, and 0.86 for the combined dataset were obtained in the test set. In the LR model, AUC values of 0.79 for T2W, 0.86 for ADC, and 0.85 for the combined dataset were obtained.</p><p><strong>Conclusion: </strong>Machine learning models developed with radiomics can provide a decision support system to complement pathology results and help avoid invasive procedures such as re-biopsies or follow-up biopsies that are sometimes necessary today.</p><p><strong>Clinical significance: </strong>This study demonstrates that machine learning models using radiomics features derived from bi-parametric MRI can discriminate csPCa from clinically insignificant PCa. These findings suggest that radiomics-based machine learning models have the potential to reduce the need for re-biopsy in cases of indeterminate pathology, assist in diagnosing pathology-radiology discordance, and support treatment decision-making in the management of PCa.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benjamin D Simon, Kutsev Bengisu Ozyoruk, David G Gelikman, Stephanie A Harmon, Barış Türkbey
{"title":"The future of multimodal artificial intelligence models for integrating imaging and clinical metadata: a narrative review.","authors":"Benjamin D Simon, Kutsev Bengisu Ozyoruk, David G Gelikman, Stephanie A Harmon, Barış Türkbey","doi":"10.4274/dir.2024.242631","DOIUrl":"https://doi.org/10.4274/dir.2024.242631","url":null,"abstract":"<p><p>With the ongoing revolution of artificial intelligence (AI) in medicine, the impact of AI in radiology is more pronounced than ever. An increasing number of technical and clinical AI-focused studies are published each day. As these tools inevitably affect patient care and physician practices, it is crucial that radiologists become more familiar with the leading strategies and underlying principles of AI. Multimodal AI models can combine both imaging and clinical metadata and are quickly becoming a popular approach that is being integrated into the medical ecosystem. This narrative review covers major concepts of multimodal AI through the lens of recent literature. We discuss emerging frameworks, including graph neural networks, which allow for explicit learning from non-Euclidean relationships, and transformers, which allow for parallel computation that scales, highlighting existing literature and advocating for a focus on emerging architectures. We also identify key pitfalls in current studies, including issues with taxonomy, data scarcity, and bias. By informing radiologists and biomedical AI experts about existing practices and challenges, we hope to guide the next wave of imaging-based multimodal AI research.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cortical and subcortical structural changes in pediatric patients with infratentorial tumors.","authors":"Barış Genç, Kerim Aslan, Derya Bako, Semra Delibalta, Meltem Necibe Ceyhan Bilgici","doi":"10.4274/dir.2024.242652","DOIUrl":"10.4274/dir.2024.242652","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to detect supratentorial cortical and subcortical morphological changes in pediatric patients with infratentorial tumors.</p><p><strong>Methods: </strong>The study included 24 patients aged 4-18 years who were diagnosed with primary infratentorial tumors and 41 age- and gender-matched healthy controls. Synthetic magnetization-prepared rapid gradient echo images of brain magnetic resonance imaging were generated using deep learning algorithms applied to T2-axial images. The cortical thickness, surface area, volume, and local gyrification index (LGI), as well as subcortical gray matter volumes, were automatically calculated. Surface-based morphometry parameters for the patient and control groups were compared using the general linear model, and volumes between subcortical structures were compared using the t-test and Mann-Whitney U test.</p><p><strong>Results: </strong>In the patient group, cortical thinning was observed in the left supramarginal, and cortical thickening was observed in the left caudal middle frontal (CMF), left fusiform, left lateral orbitofrontal, left lingual gyrus, right CMF, right posterior cingulate, and right superior frontal (<i>P</i> < 0.050). The patient group showed a volume reduction in the pars triangularis, paracentral, precentral, and supramarginal gyri of the left hemisphere (<i>P</i> < 0.05). A decreased surface area was observed in the bilateral superior frontal and cingulate gyri (<i>P</i> < 0.05). The patient group exhibited a decreased LGI in the right precentral and superior temporal gyri, left supramarginal, and posterior cingulate gyri and showed an increased volume in the bilateral caudate nucleus and hippocampus, while a volume reduction was observed in the bilateral putamen, pallidum, and amygdala (<i>P</i> < 0.05). The ventricular volume and tumor volume showed a positive correlation with the cortical thickness in the bilateral CMF while demonstrating a negative correlation with areas exhibiting a decreased LGI (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Posterior fossa tumors lead to widespread morphological changes in cortical structures, with the most prominent pattern being hypogyria.</p><p><strong>Clinical significance: </strong>This study illuminates the neurological impacts of infratentorial tumors in children, providing a foundation for future therapeutic strategies aimed at mitigating these adverse cortical and subcortical changes and improving patient outcomes.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cemal Aydın Gündoğmuş, Hande Özen Atalay, Vugar Samadli, Levent Oğuzkurt
{"title":"Factors effecting the success of retrograde tibiopedal access and recanalization in infrapopliteal artery occlusions.","authors":"Cemal Aydın Gündoğmuş, Hande Özen Atalay, Vugar Samadli, Levent Oğuzkurt","doi":"10.4274/dir.2024.242833","DOIUrl":"https://doi.org/10.4274/dir.2024.242833","url":null,"abstract":"<p><strong>Purpose: </strong>Peripheral arterial disease (PAD) is increasingly prevalent, particularly among the aging population. Retrograde tibiopedal access (RTPA) has emerged as a useful endovascular treatment for PAD. However, there is limited research examining factors that influence the efficacy of RTPA. To investigate factors affecting the access, crossing, and recanalization success rates of RTPA for infrapopliteal PAD treatment.</p><p><strong>Methods: </strong>A retrospective study was conducted on 720 patients who underwent endovascular treatment for PAD. Of these, 104 patients (mean age: 65.5 ± 16.2; 89 men) with 131 RTPA trials were included in the final evaluation. The disease and its duration, Rutherford score, smoking status, access site, and its occlusion status, access, crossing, and recanalization success were noted. Data were analyzed using Pearson's chi-square and Mann-Whitney U tests and multivariate logistic regression to evaluate the impact of various factors on success rates.</p><p><strong>Results: </strong>The access success rate was 82.6%, the crossing success rate was 95.4%, and the recanalization success rate was 74%. Access success was significantly higher when the dorsal pedal artery (DPA) was the access artery compared with the posterior tibial artery (91.3% vs. 74.2%, <i>P</i> = 0.009). Access success was notably lower in patients with thromboangiitis obliterans compared with patients with diabetes mellitus (DM) and non-DM atherosclerosis (68.6% vs. 90.3% and 80.3%, <i>P</i> = 0.019). Recanalization success was higher when the puncture site was non-occluded (76.7% vs. 53.5%, <i>P</i> = 0.023).</p><p><strong>Conclusion: </strong>The study suggests that RTPA is a generally effective and safe technique for infrapopliteal PAD treatment. The most favorable outcomes are observed in individuals with DM who have a non-occluded DPA at the puncture site. Recanalization success is only affected by the patency of the artery at the puncture site.</p><p><strong>Clinical significance: </strong>These findings offer targeted guidance for clinicians and highlight areas requiring further investigation.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yasin Celal Güneş, Turay Cesur, Eren Çamur, Leman Günbey Karabekmez
{"title":"Evaluating text and visual diagnostic capabilities of large language models on questions related to the Breast Imaging Reporting and Data System Atlas 5<sup>th</sup> edition.","authors":"Yasin Celal Güneş, Turay Cesur, Eren Çamur, Leman Günbey Karabekmez","doi":"10.4274/dir.2024.242876","DOIUrl":"https://doi.org/10.4274/dir.2024.242876","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the performance of large language models (LLMs) and multimodal LLMs in interpreting the Breast Imaging Reporting and Data System (BI-RADS) categories and providing clinical management recommendations for breast radiology in text-based and visual questions.</p><p><strong>Methods: </strong>This cross-sectional observational study involved two steps. In the first step, we compared ten LLMs (namely ChatGPT 4o, ChatGPT 4, ChatGPT 3.5, Google Gemini 1.5 Pro, Google Gemini 1.0, Microsoft Copilot, Perplexity, Claude 3.5 Sonnet, Claude 3 Opus, and Claude 3 Opus 200K), general radiologists, and a breast radiologist using 100 text-based multiple-choice questions (MCQs) related to the BI-RADS Atlas 5<sup>th</sup> edition. In the second step, we assessed the performance of five multimodal LLMs (ChatGPT 4o, ChatGPT 4V, Claude 3.5 Sonnet, Claude 3 Opus, and Google Gemini 1.5 Pro) in assigning BI-RADS categories and providing clinical management recommendations on 100 breast ultrasound images. The comparison of correct answers and accuracy by question types was analyzed using McNemar's and chi-squared tests. Management scores were analyzed using the Kruskal- Wallis and Wilcoxon tests.</p><p><strong>Results: </strong>Claude 3.5 Sonnet achieved the highest accuracy in text-based MCQs (90%), followed by ChatGPT 4o (89%), outperforming all other LLMs and general radiologists (78% and 76%) (<i>P</i> < 0.05), except for the Claude 3 Opus models and the breast radiologist (82%) (<i>P</i> > 0.05). Lower-performing LLMs included Google Gemini 1.0 (61%) and ChatGPT 3.5 (60%). Performance across different categories of showed no significant variation among LLMs or radiologists (<i>P</i> > 0.05). For breast ultrasound images, Claude 3.5 Sonnet achieved 59% accuracy, significantly higher than other multimodal LLMs (<i>P</i> < 0.05). Management recommendations were evaluated using a 3-point Likert scale, with Claude 3.5 Sonnet scoring the highest (mean: 2.12 ± 0.97) (<i>P</i> < 0.05). Accuracy varied significantly across BI-RADS categories, except Claude 3 Opus (<i>P</i> < 0.05). Gemini 1.5 Pro failed to answer any BI-RADS 5 questions correctly. Similarly, ChatGPT 4V failed to answer any BI-RADS 1 questions correctly, making them the least accurate in these categories (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Although LLMs such as Claude 3.5 Sonnet and ChatGPT 4o show promise in text-based BI-RADS assessments, their limitations in visual diagnostics suggest they should be used cautiously and under radiologists' supervision to avoid misdiagnoses.</p><p><strong>Clinical significance: </strong>This study demonstrates that while LLMs exhibit strong capabilities in text-based BI-RADS assessments, their visual diagnostic abilities are currently limited, necessitating further development and cautious application in clinical practice.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juan Li, Cuili Niu, Ling Zhang, Yanmin Mu, Xiuyin Gui
{"title":"Association of body composition and systemic inflammation for patients with locally advanced cervical cancer following concurrent chemoradiotherapy","authors":"Juan Li, Cuili Niu, Ling Zhang, Yanmin Mu, Xiuyin Gui","doi":"10.4274/dir.2024.242751","DOIUrl":"10.4274/dir.2024.242751","url":null,"abstract":"<p><strong>Purpose: </strong>Systemic inflammation and body composition are associated with survival outcomes of cancer patients. This study aimed to examine the combined prognostic value of systemic inflammatory markers and body composition parameters in patients with locally advanced cervical cancer (LACC).</p><p><strong>Methods: </strong>Patients who underwent concurrent chemoradiotherapy (CCRT) for LACC at a tertiary referral teaching hospital between January 2010 and January 2018 were enrolled. A predictive model was established based on systemic immune-inflammation index (SII) and computer tomography-derived visceral fat-to-muscle ratio (vFMR). Overall survival (OS) and progression-free survival (PFS) were assessed using the Kaplan-Meier method and Cox regression models. The model performance was assessed using discrimination, calibration, and clinical usefulness.</p><p><strong>Results: </strong>In total, 212 patients were enrolled. The SII and vFMR were closely related, and both independently predicted survival (<i>P</i> < 0.05). A predictive model was established based on the above biomarkers and included three subgroups: high-risk [both high SII (>828) and high vFMR (>1.1)], middle-risk (either high SII or high vFMR), and low-risk (neither high SII nor high vFMR). The 3-year OS (PFS) rates for low-, middle-, and high-risk patients were 90.5% (86.0%), 73.9% (58.4%), and 46.8% (36.1%), respectively (<i>P</i> < 0.05). This model demonstrated satisfactory predictive accuracy (area under the curve values for predicting 3-year OS and PFS were 0.704 and 0.718, respectively), good fit (Hosmer-Lemeshow tests: <i>P</i> > 0.05), and clinical usefulness.</p><p><strong>Conclusion: </strong>Systemic inflammatory markers combined with body composition parameters could independently predict the prognosis of patients with LACC, highlighting the utilization of commonly collected indicators in decision-making processes.</p><p><strong>Clinical significance: </strong>The SII and vFMR, as well as their composite indices, were promising prognostic factors in patients with LACC who received definitive CCRT. Future studies are needed to explore novel therapies to improve the outcomes in high-risk patients.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Onur Taydaş, Emre Ünal, Devrim Akıncı, Mehmet Şeker, Osman Melih Topçuoğlu, Okan Akhan, Türkmen Turan Çiftçi
{"title":"Percutaneous nephrostomy in infants: a 20-year single-center experience","authors":"Onur Taydaş, Emre Ünal, Devrim Akıncı, Mehmet Şeker, Osman Melih Topçuoğlu, Okan Akhan, Türkmen Turan Çiftçi","doi":"10.4274/dir.2023.232276","DOIUrl":"10.4274/dir.2023.232276","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the safety and efficacy of the imaging-guided percutaneous nephrostomy (PCN) procedure in infants.</p><p><strong>Methods: </strong>A total of 75 (50 boys; 66.7%) patients with a mean age of 121 days (range, 1-351 days) who underwent PCN over a period of 20 years were included in this retrospective study. For each patient, PCN indications, catheter size, the mean duration of catheterization, complications, and the procedure performed following nephrostomy were recorded. Technical success was determined based on the successful placement of the nephrostomy catheter within the pelvicalyceal system. Clinical success was defined as the complete resolution of hydronephrosis and improvement in renal function tests during follow-up. In patients with urinary leakage, technical and clinical success was determined based on the resolution of leakage.</p><p><strong>Results: </strong>The technical success rate was 100%, and no procedure-related mortality was observed. In 11 patients (14.7%), bilateral PCN was performed. The most frequent indication of PCN was ureteropelvic junction obstruction (n = 41, 54.7%). Procedure-related major complications were encountered in two patients (methemoglobinemia and respiratory arrest caused by the local anesthetic agent in one patient and the development of urinoma caused by urinary leakage from the puncture site in the other). Mild urinary leakage was the only minor complication that occurred and only in one patient. Catheter-related complications were managed through replacement or revision surgery in 16 patients (21.3%).</p><p><strong>Conclusion: </strong>Imaging-guided PCN is a feasible and effective procedure with high technical success and low major complication rates, and it is useful for protecting kidney function in infants.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10024131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of gelatin sponge to seal the biliary tract after percutaneous transhepatic biliary drainage in patients with liver transplants.","authors":"Ali Özgen","doi":"10.4274/dir.2023.232344","DOIUrl":"10.4274/dir.2023.232344","url":null,"abstract":"<p><p>Percutaneous transhepatic biliary drainage (PTBD) is commonly used in the treatment of malign and benign biliary pathologies. Certain complications after PTBD may occur, such as biliary fistula, biliary leakage, bilioma, and hematoma. The purpose of this study was to evaluate the safety and effectiveness of using a sterile gelatin sponge to seal the biliary tract after PTBD in patients with liver transplants to prevent complications. A total of 131 biliary drainages were introduced in 97 patients, and a sterile gelatin sponge was used to seal the biliary tract after removal of the biliary drainage catheter. The patients were immediately examined for complications using ultrasound and then followed up clinically unless imaging was required. Five fluid collections within the liver with a diameter <2 cm, consistent with hematoma or bilioma, were resolved spontaneously. No hematoma or bilioma required treatment, and no biliary leakage or fistula was detected. No compli¬cations related to the use of the sponge were observed. The use of a sterile gelatin sponge is a safe and effec-tive method for sealing the biliary tract to prevent complications after PTBD in patients with liver transplants.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hye Soo Cho, Eui Jin Hwang, Jaeyoun Yi, Boorym Choi, Chang Min Park
{"title":"Artificial intelligence system for identification of overlooked lung metastasis in abdominopelvic computed tomography scans of patients with malignancy.","authors":"Hye Soo Cho, Eui Jin Hwang, Jaeyoun Yi, Boorym Choi, Chang Min Park","doi":"10.4274/dir.2024.242835","DOIUrl":"https://doi.org/10.4274/dir.2024.242835","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate whether an artificial intelligence (AI) system can identify basal lung metastatic nodules examined using abdominopelvic computed tomography (CT) that were initially overlooked by radiologists.</p><p><strong>Methods: </strong>We retrospectively included abdominopelvic CT images with the following inclusion criteria: a) CT images from patients with solid organ malignancies between March 1 and March 31, 2019, in a single institution; and b) abdominal CT images interpreted as negative for basal lung metastases. Reference standards for diagnosis of lung metastases were confirmed by reviewing medical records and subsequent CT images. An AI system that could automatically detect lung nodules on CT images was applied retrospectively. A radiologist reviewed the AI detection results to classify them as lesions with the possibility of metastasis or clearly benign. The performance of the initial AI results and the radiologist's review of the AI results were evaluated using patient-level and lesion-level sensitivities, false-positive rates, and the number of false-positive lesions per patient.</p><p><strong>Results: </strong>A total of 878 patients (580 men; mean age, 63 years) were included, with overlooked basal lung metastases confirmed in 13 patients (1.5%). The AI exhibited an area under the receiver operating characteristic curve value of 0.911 for the identification of overlooked basal lung metastases. Patient- and lesion-level sensitivities of the AI system ranged from 69.2% to 92.3% and 46.2% to 92.3%, respectively. After a radiologist reviewed the AI results, the sensitivity remained unchanged. The false-positive rate and number of false-positive lesions per patient ranged from 5.8% to 27.6% and 0.1% to 0.5%, respectively. Radiologist reviews significantly reduced the false-positive rate (2.4%-12.6%; all <i>P</i> values < 0.001) and the number of false-positive lesions detected per patient (0.03-0.20, respectively).</p><p><strong>Conclusion: </strong>The AI system could accurately identify basal lung metastases detected in abdominopelvic CT images that were overlooked by radiologists, suggesting its potential as a tool for radiologist interpretation.</p><p><strong>Clinical significance: </strong>The AI system can identify missed basal lung lesions in abdominopelvic CT scans in patients with malignancy, providing feedback to radiologists, which can reduce the risk of missing basal lung metastasis.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Meta-research on reporting guidelines for artificial intelligence: are authors and reviewers encouraged enough in radiology, nuclear medicine, and medical imaging journals?","authors":"Burak Koçak, Ali Keleş, Fadime Köse","doi":"10.4274/dir.2024.232604","DOIUrl":"10.4274/dir.2024.232604","url":null,"abstract":"<p><strong>Purpose: </strong>To determine how radiology, nuclear medicine, and medical imaging journals encourage and mandate the use of reporting guidelines for artificial intelligence (AI) in their author and reviewer instructions.</p><p><strong>Methods: </strong>The primary source of journal information and associated citation data used was the Journal Citation Reports (June 2023 release for 2022 citation data; Clarivate Analytics, UK). The first- and second-quartile journals indexed in the Science Citation Index Expanded and the Emerging Sources Citation Index were included. The author and reviewer instructions were evaluated by two independent readers, followed by an additional reader for consensus, with the assistance of automatic annotation. Encouragement and submission requirements were systematically analyzed. The reporting guidelines were grouped as AI-specific, related to modeling, and unrelated to modeling.</p><p><strong>Results: </strong>Out of 102 journals, 98 were included in this study, and all of them had author instructions. Only five journals (5%) encouraged the authors to follow AI-specific reporting guidelines. Among these, three required a filled-out checklist. Reviewer instructions were found in 16 journals (16%), among which one journal (6%) encouraged the reviewers to follow AI-specific reporting guidelines without submission requirements. The proportions of author and reviewer encouragement for AI-specific reporting guidelines were statistically significantly lower compared with those for other types of guidelines (<i>P</i> < 0.05 for all).</p><p><strong>Conclusion: </strong>The findings indicate that AI-specific guidelines are not commonly encouraged and mandated (i.e., requiring a filled-out checklist) by these journals, compared with guidelines related to modeling and unrelated to modeling, leaving vast space for improvement. This meta-research study hopes to contribute to the awareness of the imaging community for AI reporting guidelines and ignite large-scale group efforts by all stakeholders, making AI research less wasteful.</p><p><strong>Clinical significance: </strong>This meta-research highlights the need for improved encouragement of AI-specific guidelines in radiology, nuclear medicine, and medical imaging journals. This can potentially foster greater awareness among the AI community and motivate various stakeholders to collaborate to promote more efficient and responsible AI research reporting practices.</p>","PeriodicalId":11341,"journal":{"name":"Diagnostic and interventional radiology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}