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Wang A, Zou C, Yuan S, Fan N, Du P, Wang T, Zang L. Deep learning assisted segmentation of the lumbar intervertebral disc: a systematic review and meta-analysis. J Orthop Surg Res 2024; 19:496. [PMID: 39169382 DOI: 10.1186/s13018-024-05002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 08/16/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND In recent years, deep learning (DL) technology has been increasingly used for the diagnosis and treatment of lumbar intervertebral disc (IVD) degeneration. This study aims to evaluate the performance of DL technology for IVD segmentation in magnetic resonance (MR) images and explore improvement strategies. METHODS We developed a PRISMA systematic review protocol and systematically reviewed studies that used DL algorithm frameworks to perform IVD segmentation based on MR images published up to April 10, 2024. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess methodological quality, and the pooled dice similarity coefficient (DSC) score and Intersection over Union (IoU) were calculated to evaluate segmentation performance. RESULTS 45 studies were included in this systematic review, of which 16 provided complete segmentation performance data and were included in the quantitative meta-analysis. The results indicated that DL models showed satisfactory IVD segmentation performance, with a pooled DSC of 0.900 (95% confidence interval [CI]: 0.887-0.914) and IoU of 0.863 (95% CI: 0.730-0.995). However, the subgroup analysis did not show significant effects of factors on IVD segmentation performance, including network dimensionality, algorithm type, publication year, number of patients, scanning direction, data augmentation, and cross-validation. CONCLUSIONS This study highlights the potential of DL technology in IVD segmentation and its further applications. However, due to the heterogeneity in algorithm frameworks and result reporting of the included studies, the conclusions should be interpreted with caution. Future research should focus on training generalized models on large-scale datasets to enhance their clinical application.
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Affiliation(s)
- Aobo Wang
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Congying Zou
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Shuo Yuan
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Ning Fan
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Peng Du
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Tianyi Wang
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China
| | - Lei Zang
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China.
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Anish RJ, Nair A. Osteoporosis management-current and future perspectives - A systemic review. J Orthop 2024; 53:101-113. [PMID: 38495575 PMCID: PMC10940894 DOI: 10.1016/j.jor.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction Osteoporosis is a geriatric metabolic ailment distinguished by low bone mineral density (BMD) and strength with enhanced micro-architectural retrogression of the extracellular matrix, further increasing bone fragility risk. Osteoporotic fractures and associated complications become common in women and men after 55 and 65 years, respectively. The loss in BMD markedly enhances the risk of fracture, non-skeletal injury, and subsequent pain, adversely affecting the quality of life. Methods Data summarised in this review were sourced and summarised, including contributions from 2008 to 2023, online from scientific search engines, based on scientific inclusion and exclusion criteria. Results Biochemical serum markers such as BALP, collagen, osteocalcin, and cathepsin-K levels can reveal the osteoporotic status. DEXA scan techniques evaluate the whole body's BMD and bone mineral content (BMC), crucial in osteoporosis management. Anabolic and anti-osteoporotic agents are commonly used to enhance bone formation, minimize bone resorption, and regulate remodelling. The challenges and side effects of drug therapy can be overcome by combining the various drug moieties. Conclusion The current review discusses the management protocol for osteoporosis, ranging from lifestyle modification, including physical exercise, pharmaceutical approaches, drug delivery applications, and advanced therapeutic possibilities of AI and machine learning techniques to reduce osteoporosis complications and fracture risk.
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Affiliation(s)
- Rajamohanan Jalaja Anish
- Department of Biochemistry, University of Kerala, Kariyavattom Campus, Trivandrum, 695581, India
| | - Aswathy Nair
- Department of Biochemistry, University of Kerala, Kariyavattom Campus, Trivandrum, 695581, India
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Chen Y, Esmaeilzadeh P. Generative AI in Medical Practice: In-Depth Exploration of Privacy and Security Challenges. J Med Internet Res 2024; 26:e53008. [PMID: 38457208 PMCID: PMC10960211 DOI: 10.2196/53008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/12/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024] Open
Abstract
As advances in artificial intelligence (AI) continue to transform and revolutionize the field of medicine, understanding the potential uses of generative AI in health care becomes increasingly important. Generative AI, including models such as generative adversarial networks and large language models, shows promise in transforming medical diagnostics, research, treatment planning, and patient care. However, these data-intensive systems pose new threats to protected health information. This Viewpoint paper aims to explore various categories of generative AI in health care, including medical diagnostics, drug discovery, virtual health assistants, medical research, and clinical decision support, while identifying security and privacy threats within each phase of the life cycle of such systems (ie, data collection, model development, and implementation phases). The objectives of this study were to analyze the current state of generative AI in health care, identify opportunities and privacy and security challenges posed by integrating these technologies into existing health care infrastructure, and propose strategies for mitigating security and privacy risks. This study highlights the importance of addressing the security and privacy threats associated with generative AI in health care to ensure the safe and effective use of these systems. The findings of this study can inform the development of future generative AI systems in health care and help health care organizations better understand the potential benefits and risks associated with these systems. By examining the use cases and benefits of generative AI across diverse domains within health care, this paper contributes to theoretical discussions surrounding AI ethics, security vulnerabilities, and data privacy regulations. In addition, this study provides practical insights for stakeholders looking to adopt generative AI solutions within their organizations.
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Affiliation(s)
- Yan Chen
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, United States
| | - Pouyan Esmaeilzadeh
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, United States
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Bharadwaj UU, Chin CT, Majumdar S. Practical Applications of Artificial Intelligence in Spine Imaging: A Review. Radiol Clin North Am 2024; 62:355-370. [PMID: 38272627 DOI: 10.1016/j.rcl.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Artificial intelligence (AI), a transformative technology with unprecedented potential in medical imaging, can be applied to various spinal pathologies. AI-based approaches may improve imaging efficiency, diagnostic accuracy, and interpretation, which is essential for positive patient outcomes. This review explores AI algorithms, techniques, and applications in spine imaging, highlighting diagnostic impact and challenges with future directions for integrating AI into spine imaging workflow.
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Affiliation(s)
- Upasana Upadhyay Bharadwaj
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 1700 4th Street, Byers Hall, Suite 203, Room 203D, San Francisco, CA 94158, USA
| | - Cynthia T Chin
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue, Box 0628, San Francisco, CA 94143, USA.
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 1700 4th Street, Byers Hall, Suite 203, Room 203D, San Francisco, CA 94158, USA
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Wagner DT, Tilmans L, Peng K, Niedermeier M, Rohl M, Ryan S, Yadav D, Takacs N, Garcia-Fraley K, Koso M, Dikici E, Prevedello LM, Nguyen XV. Artificial Intelligence in Neuroradiology: A Review of Current Topics and Competition Challenges. Diagnostics (Basel) 2023; 13:2670. [PMID: 37627929 PMCID: PMC10453240 DOI: 10.3390/diagnostics13162670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
There is an expanding body of literature that describes the application of deep learning and other machine learning and artificial intelligence methods with potential relevance to neuroradiology practice. In this article, we performed a literature review to identify recent developments on the topics of artificial intelligence in neuroradiology, with particular emphasis on large datasets and large-scale algorithm assessments, such as those used in imaging AI competition challenges. Numerous applications relevant to ischemic stroke, intracranial hemorrhage, brain tumors, demyelinating disease, and neurodegenerative/neurocognitive disorders were discussed. The potential applications of these methods to spinal fractures, scoliosis grading, head and neck oncology, and vascular imaging were also reviewed. The AI applications examined perform a variety of tasks, including localization, segmentation, longitudinal monitoring, diagnostic classification, and prognostication. While research on this topic is ongoing, several applications have been cleared for clinical use and have the potential to augment the accuracy or efficiency of neuroradiologists.
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Affiliation(s)
- Daniel T. Wagner
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA (L.M.P.)
| | - Luke Tilmans
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA (L.M.P.)
| | - Kevin Peng
- College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | | | - Matt Rohl
- College of Arts and Sciences, The Ohio State University, Columbus, OH 43210, USA
| | - Sean Ryan
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA (L.M.P.)
| | - Divya Yadav
- College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Noah Takacs
- College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Krystle Garcia-Fraley
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA (L.M.P.)
| | - Mensur Koso
- College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Engin Dikici
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA (L.M.P.)
| | - Luciano M. Prevedello
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA (L.M.P.)
| | - Xuan V. Nguyen
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA (L.M.P.)
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Waldenberg C, Brisby H, Hebelka H, Lagerstrand KM. Associations between Vertebral Localized Contrast Changes and Adjacent Annular Fissures in Patients with Low Back Pain: A Radiomics Approach. J Clin Med 2023; 12:4891. [PMID: 37568293 PMCID: PMC10420134 DOI: 10.3390/jcm12154891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 08/13/2023] Open
Abstract
Low back pain (LBP) is multifactorial and associated with various spinal tissue changes, including intervertebral disc fissures, vertebral pathology, and damaged endplates. However, current radiological markers lack specificity and individualized diagnostic capability, and the interactions between the various markers are not fully clear. Radiomics, a data-driven analysis of radiological images, offers a promising approach to improve evaluation and deepen the understanding of spinal changes related to LBP. This study investigated possible associations between vertebral changes and annular fissures using radiomics. A dataset of 61 LBP patients who underwent conventional magnetic resonance imaging followed by discography was analyzed. Radiomics features were extracted from segmented vertebrae and carefully reduced to identify the most relevant features associated with annular fissures. The results revealed three important texture features that display concentrated high-intensity gray levels, extensive regions with elevated gray levels, and localized areas with reduced gray levels within the vertebrae. These features highlight patterns within vertebrae that conventional classification systems cannot reflect on distinguishing between vertebrae adjacent to an intervertebral disc with or without an annular fissure. As such, the present study reveals associations that contribute to the understanding of pathophysiology and may provide improved diagnostics of LBP.
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Affiliation(s)
- Christian Waldenberg
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden;
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (H.B.); (H.H.)
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Helena Brisby
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (H.B.); (H.H.)
- Department of Orthopaedics, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Hanna Hebelka
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (H.B.); (H.H.)
- Department of Radiology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Kerstin Magdalena Lagerstrand
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden;
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden; (H.B.); (H.H.)
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
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Yagi M, Yamanouchi K, Fujita N, Funao H, Ebata S. Revolutionizing Spinal Care: Current Applications and Future Directions of Artificial Intelligence and Machine Learning. J Clin Med 2023; 12:4188. [PMID: 37445222 DOI: 10.3390/jcm12134188] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Artificial intelligence (AI) and machine learning (ML) are rapidly becoming integral components of modern healthcare, offering new avenues for diagnosis, treatment, and outcome prediction. This review explores their current applications and potential future in the field of spinal care. From enhancing imaging techniques to predicting patient outcomes, AI and ML are revolutionizing the way we approach spinal diseases. AI and ML have significantly improved spinal imaging by augmenting detection and classification capabilities, thereby boosting diagnostic accuracy. Predictive models have also been developed to guide treatment plans and foresee patient outcomes, driving a shift towards more personalized care. Looking towards the future, we envision AI and ML further ingraining themselves in spinal care with the development of algorithms capable of deciphering complex spinal pathologies to aid decision making. Despite the promise these technologies hold, their integration into clinical practice is not without challenges. Data quality, integration hurdles, data security, and ethical considerations are some of the key areas that need to be addressed for their successful and responsible implementation. In conclusion, AI and ML represent potent tools for transforming spinal care. Thoughtful and balanced integration of these technologies, guided by ethical considerations, can lead to significant advancements, ushering in an era of more personalized, effective, and efficient healthcare.
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Affiliation(s)
- Mitsuru Yagi
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita 286-8686, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare and Narita Hospital, Narita 286-8520, Japan
| | - Kento Yamanouchi
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita 286-8686, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare and Narita Hospital, Narita 286-8520, Japan
| | - Naruhito Fujita
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita 286-8686, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare and Narita Hospital, Narita 286-8520, Japan
| | - Haruki Funao
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita 286-8686, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare and Narita Hospital, Narita 286-8520, Japan
| | - Shigeto Ebata
- Department of Orthopaedic Surgery, International University of Health and Welfare and Narita Hospital, Narita 286-8520, Japan
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