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Ko HS, Attenberger U. Medical imaging in cancer cachexia. RADIOLOGIE (HEIDELBERG, GERMANY) 2024:10.1007/s00117-024-01346-5. [PMID: 38995346 DOI: 10.1007/s00117-024-01346-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/13/2024]
Abstract
Cancer cachexia, often referred to as "wasting syndrome," is characterized by fatigue, weakness, and involuntary weight loss. This syndrome is concomitant with progressive skeletal muscle atrophy with or without adipose tissue loss and is frequently accompanied by systemic inflammation. Understanding the complexities of cancer cachexia is crucial for early detection and intervention, and it is also paramount for enhancing patient outcomes. Medical imaging, comprising diverse imaging modalities, plays a pivotal role in this context, facilitating the diagnosis and surveillance assessment of both the disease extent and the body composition changes that offer valuable information and insights into disease progression. This article provides a comprehensive discourse of the pathophysiological mechanisms and clinical manifestations of cancer cachexia as well as the role of medical imaging in this setting. Particular emphasis is placed on contemporary multidisciplinary and translational research efforts for the development of diagnostic and treatment tools, aiming to mitigate the devastating consequences of cancer cachexia.
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Affiliation(s)
- Hyun Soo Ko
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany.
| | - Ulrike Attenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
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2
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Blankemeier L, Cohen JP, Kumar A, Van Veen D, Gardezi SJS, Paschali M, Chen Z, Delbrouck JB, Reis E, Truyts C, Bluethgen C, Jensen MEK, Ostmeier S, Varma M, Valanarasu JMJ, Fang Z, Huo Z, Nabulsi Z, Ardila D, Weng WH, Amaro E, Ahuja N, Fries J, Shah NH, Johnston A, Boutin RD, Wentland A, Langlotz CP, Hom J, Gatidis S, Chaudhari AS. Merlin: A Vision Language Foundation Model for 3D Computed Tomography. RESEARCH SQUARE 2024:rs.3.rs-4546309. [PMID: 38978576 PMCID: PMC11230513 DOI: 10.21203/rs.3.rs-4546309/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Over 85 million computed tomography (CT) scans are performed annually in the US, of which approximately one quarter focus on the abdomen. Given the current shortage of both general and specialized radiologists, there is a large impetus to use artificial intelligence to alleviate the burden of interpreting these complex imaging studies while simultaneously using the images to extract novel physiological insights. Prior state-of-the-art approaches for automated medical image interpretation leverage vision language models (VLMs) that utilize both the image and the corresponding textual radiology reports. However, current medical VLMs are generally limited to 2D images and short reports. To overcome these shortcomings for abdominal CT interpretation, we introduce Merlin - a 3D VLM that leverages both structured electronic health records (EHR) and unstructured radiology reports for pretraining without requiring additional manual annotations. We train Merlin using a high-quality clinical dataset of paired CT scans (6+ million images from 15,331 CTs), EHR diagnosis codes (1.8+ million codes), and radiology reports (6+ million tokens) for training. We comprehensively evaluate Merlin on 6 task types and 752 individual tasks. The non-adapted (off-the-shelf) tasks include zero-shot findings classification (31 findings), phenotype classification (692 phenotypes), and zero-shot cross-modal retrieval (image to findings and image to impressions), while model adapted tasks include 5-year chronic disease prediction (6 diseases), radiology report generation, and 3D semantic segmentation (20 organs). We perform internal validation on a test set of 5,137 CTs, and external validation on 7,000 clinical CTs and on two public CT datasets (VerSe, TotalSegmentator). Beyond these clinically-relevant evaluations, we assess the efficacy of various network architectures and training strategies to depict that Merlin has favorable performance to existing task-specific baselines. We derive data scaling laws to empirically assess training data needs for requisite downstream task performance. Furthermore, unlike conventional VLMs that require hundreds of GPUs for training, we perform all training on a single GPU. This computationally efficient design can help democratize foundation model training, especially for health systems with compute constraints. We plan to release our trained models, code, and dataset, pending manual removal of all protected health information.
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Affiliation(s)
- Louis Blankemeier
- Department of Electrical Engineering, Stanford University
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
| | - Joseph Paul Cohen
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
| | - Ashwin Kumar
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
| | - Dave Van Veen
- Department of Electrical Engineering, Stanford University
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
| | | | - Magdalini Paschali
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
| | - Zhihong Chen
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
| | - Jean-Benoit Delbrouck
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
| | - Eduardo Reis
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
| | - Cesar Truyts
- Department of Radiology, Hospital Israelita Albert Einstein
| | - Christian Bluethgen
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, University Hospital Zurich
| | - Malte Engmann Kjeldskov Jensen
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
| | - Sophie Ostmeier
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
| | - Maya Varma
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
- Department of Computer Science, Stanford University
| | - Jeya Maria Jose Valanarasu
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
- Department of Computer Science, Stanford University
| | | | - Zepeng Huo
- Department of Biomedical Data Science, Stanford University
| | - Zaid Nabulsi
- Department of Electrical Engineering, Stanford University
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
- Department of Radiology, University of Wisconsin-Madison
- Department of Radiology, Hospital Israelita Albert Einstein
- Department of Radiology, University Hospital Zurich
- Department of Computer Science, Stanford University
- Department of Biomedical Data Science, Stanford University
- Department of Medicine, Stanford University
| | - Diego Ardila
- Department of Electrical Engineering, Stanford University
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
- Department of Radiology, University of Wisconsin-Madison
- Department of Radiology, Hospital Israelita Albert Einstein
- Department of Radiology, University Hospital Zurich
- Department of Computer Science, Stanford University
- Department of Biomedical Data Science, Stanford University
- Department of Medicine, Stanford University
| | - Wei-Hung Weng
- Department of Electrical Engineering, Stanford University
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
- Department of Radiology, University of Wisconsin-Madison
- Department of Radiology, Hospital Israelita Albert Einstein
- Department of Radiology, University Hospital Zurich
- Department of Computer Science, Stanford University
- Department of Biomedical Data Science, Stanford University
- Department of Medicine, Stanford University
| | - Edson Amaro
- Department of Radiology, Hospital Israelita Albert Einstein
| | | | - Jason Fries
- Department of Computer Science, Stanford University
- Department of Biomedical Data Science, Stanford University
| | - Nigam H Shah
- Department of Radiology, Stanford University
- Department of Biomedical Data Science, Stanford University
| | | | | | | | - Curtis P Langlotz
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
| | - Jason Hom
- Department of Medicine, Stanford University
| | | | - Akshay S Chaudhari
- Stanford Center for Artificial Intelligence in Medicine and Imaging, Stanford University
- Department of Radiology, Stanford University
- Department of Biomedical Data Science, Stanford University
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Wu J, Lu Y, Dong S, Wu L, Shen X. Predicting COPD exacerbations based on quantitative CT analysis: an external validation study. Front Med (Lausanne) 2024; 11:1370917. [PMID: 38933101 PMCID: PMC11199769 DOI: 10.3389/fmed.2024.1370917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
Purpose Quantitative computed tomography (CT) analysis is an important method for diagnosis and severity evaluation of lung diseases. However, the association between CT-derived biomarkers and chronic obstructive pulmonary disease (COPD) exacerbations remains unclear. We aimed to investigate its potential in predicting COPD exacerbations. Methods Patients with COPD were consecutively enrolled, and their data were analyzed in this retrospective study. Body composition and thoracic abnormalities were analyzed from chest CT scans. Logistic regression analysis was performed to identify independent risk factors of exacerbation. Based on 2-year follow-up data, the deep learning system (DLS) was developed to predict future exacerbations. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic performance. Finally, the survival analysis was performed to further evaluate the potential of the DLS in risk stratification. Results A total of 1,150 eligible patients were included and followed up for 2 years. Multivariate analysis revealed that CT-derived high affected lung volume/total lung capacity (ALV/TLC) ratio, high visceral adipose tissue area (VAT), and low pectoralis muscle cross-sectional area (CSA) were independent risk factors causing COPD exacerbations. The DLS outperformed exacerbation history and the BMI, airflow obstruction, dyspnea, and exercise capacity (BODE) index, with an area under the ROC (AUC) value of 0.88 (95%CI, 0.82-0.92) in the internal cohort and 0.86 (95%CI, 0.81-0.89) in the external cohort. The DeLong test revealed significance between this system and conventional scores in the test cohorts (p < 0.05). In the survival analysis, patients with higher risk were susceptible to exacerbation events. Conclusion The DLS could allow accurate prediction of COPD exacerbations. The newly identified CT biomarkers (ALV/TLC ratio, VAT, and pectoralis muscle CSA) could potentially enable investigation into underlying mechanisms responsible for exacerbations.
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Affiliation(s)
- Ji Wu
- Department of General Surgery, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China
| | - Yao Lu
- Department of Anesthesia, Fifth People's Hospital of Wujiang District, Suzhou, China
| | - Sunbin Dong
- Department of General Medicine, Municipal Hospital, Suzhou, China
| | - Luyang Wu
- Department of General Medicine, Municipal Hospital, Suzhou, China
| | - Xiping Shen
- Department of General Surgery, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, China
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Zambrano Chaves JM, Lenchik L, Gallegos IO, Blankemeier L, Rubin DL, Willis MH, Chaudhari AS, Boutin RD. Abdominal CT metrics in 17,646 patients reveal associations between myopenia, myosteatosis, and medical phenotypes: a phenome-wide association study. EBioMedicine 2024; 103:105116. [PMID: 38636199 PMCID: PMC11031722 DOI: 10.1016/j.ebiom.2024.105116] [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: 11/21/2023] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Deep learning facilitates large-scale automated imaging evaluation of body composition. However, associations of body composition biomarkers with medical phenotypes have been underexplored. Phenome-wide association study (PheWAS) techniques search for medical phenotypes associated with biomarkers. A PheWAS integrating large-scale analysis of imaging biomarkers and electronic health record (EHR) data could discover previously unreported associations and validate expected associations. Here we use PheWAS methodology to determine the association of abdominal CT-based skeletal muscle metrics with medical phenotypes in a large North American cohort. METHODS An automated deep learning pipeline was used to measure skeletal muscle index (SMI; biomarker of myopenia) and skeletal muscle density (SMD; biomarker of myosteatosis) from abdominal CT scans of adults between 2012 and 2018. A PheWAS was performed with logistic regression using patient sex and age as covariates to assess for associations between CT-derived muscle metrics and 611 common EHR-derived medical phenotypes. PheWAS P values were considered significant at a Bonferroni corrected threshold (α = 0.05/1222). FINDINGS 17,646 adults (mean age, 56 years ± 19 [SD]; 57.5% women) were included. CT-derived SMI was significantly associated with 268 medical phenotypes; SMD with 340 medical phenotypes. Previously unreported associations with the highest magnitude of significance included higher SMI with decreased cardiac dysrhythmias (OR [95% CI], 0.59 [0.55-0.64]; P < 0.0001), decreased epilepsy (OR, 0.59 [0.50-0.70]; P < 0.0001), and increased elevated prostate-specific antigen (OR, 1.84 [1.47-2.31]; P < 0.0001), and higher SMD with decreased decubitus ulcers (OR, 0.36 [0.31-0.42]; P < 0.0001), sleep disorders (OR, 0.39 [0.32-0.47]; P < 0.0001), and osteomyelitis (OR, 0.43 [0.36-0.52]; P < 0.0001). INTERPRETATION PheWAS methodology reveals previously unreported associations between CT-derived biomarkers of myopenia and myosteatosis and EHR medical phenotypes. The high-throughput PheWAS technique applied on a population scale can generate research hypotheses related to myopenia and myosteatosis and can be adapted to research possible associations of other imaging biomarkers with hundreds of EHR medical phenotypes. FUNDING National Institutes of Health, Stanford AIMI-HAI pilot grant, Stanford Precision Health and Integrated Diagnostics, Stanford Cardiovascular Institute, Stanford Center for Digital Health, and Stanford Knight-Hennessy Scholars.
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Affiliation(s)
- Juan M Zambrano Chaves
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology, Stanford University, Stanford, CA, USA
| | - Leon Lenchik
- Department of Diagnostic Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Isabel O Gallegos
- Department of Computer Science, (IOG), Stanford University, Stanford, CA, USA
| | - Louis Blankemeier
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Daniel L Rubin
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology, Stanford University, Stanford, CA, USA
| | - Marc H Willis
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Akshay S Chaudhari
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology, Stanford University, Stanford, CA, USA
| | - Robert D Boutin
- Department of Radiology, Stanford University, Stanford, CA, USA.
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Linder N, Denecke T, Busse H. Body composition analysis by radiological imaging - methods, applications, and prospects. ROFO-FORTSCHR RONTG 2024. [PMID: 38569516 DOI: 10.1055/a-2263-1501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
BACKGROUND This review discusses the quantitative assessment of tissue composition in the human body (body composition, BC) using radiological methods. Such analyses are gaining importance, in particular, for oncological and metabolic problems. The aim is to present the different methods and definitions in this field to a radiological readership in order to facilitate application and dissemination of BC methods. The main focus is on radiological cross-sectional imaging. METHODS The review is based on a recent literature search in the US National Library of Medicine catalog (pubmed.gov) using appropriate search terms (body composition, obesity, sarcopenia, osteopenia in conjunction with imaging and radiology, respectively), as well as our own work and experience, particularly with MRI- and CT-based analyses of abdominal fat compartments and muscle groups. RESULTS AND CONCLUSION Key post-processing methods such as segmentation of tomographic datasets are now well established and used in numerous clinical disciplines, including bariatric surgery. Validated reference values are required for a reliable assessment of radiological measures, such as fatty liver or muscle. Artificial intelligence approaches (deep learning) already enable the automated segmentation of different tissues and compartments so that the extensive datasets can be processed in a time-efficient manner - in the case of so-called opportunistic screening, even retrospectively from diagnostic examinations. The availability of analysis tools and suitable datasets for AI training is considered a limitation. KEY POINTS · Radiological imaging methods are increasingly used to determine body composition (BC).. · BC parameters are usually quantitative and well reproducible.. · CT image data from routine clinical examinations can be used retrospectively for BC analysis.. · Prospectively, MRI examinations can be used to determine organ-specific BC parameters.. · Automated and in-depth analysis methods (deep learning or radiomics) appear to become important in the future.. CITATION FORMAT · Linder N, Denecke T, Busse H. Body composition analysis by radiological imaging - methods, applications, and prospects. Fortschr Röntgenstr 2024; DOI: 10.1055/a-2263-1501.
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Affiliation(s)
- Nicolas Linder
- Department of Diagnostic and Interventional Radiology, University of Leipzig Medical Center, Leipzig, Germany
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, Sankt Gallen, Switzerland
| | - Timm Denecke
- Department of Diagnostic and Interventional Radiology, University of Leipzig Medical Center, Leipzig, Germany
| | - Harald Busse
- Department of Diagnostic and Interventional Radiology, University of Leipzig Medical Center, Leipzig, Germany
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Lee MH, Zea R, Garrett JW, Summers RM, Pickhardt PJ. AI-generated CT body composition biomarkers associated with increased mortality risk in socioeconomically disadvantaged individuals. Abdom Radiol (NY) 2024; 49:1330-1340. [PMID: 38280049 DOI: 10.1007/s00261-023-04161-z] [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: 09/26/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 01/29/2024]
Abstract
PURPOSE To evaluate the relationship between socioeconomic disadvantage using national area deprivation index (ADI) and CT-based body composition measures derived from fully automated artificial intelligence (AI) tools to identify body composition measures associated with increased risk for all-cause mortality and adverse cardiovascular events. METHODS Fully automated AI body composition tools quantifying abdominal aortic calcium, abdominal fat (visceral [VAT], visceral-to-subcutaneous ratio [VSR]), and muscle attenuation (muscle HU) were applied to non-contrast CT examinations in adults undergoing screening CT colonography (CTC). Patients were partitioned into 5 socioeconomic groups based on the national ADI rank at the census block group level. Pearson correlation analysis was performed to determine the association between national ADI and body composition measures. One-way analysis of variance was used to compare means across groups. Odds ratios (ORs) were generated using high-risk, high specificity (90% specificity) body composition thresholds with the most disadvantaged groups being compared to the least disadvantaged group (ADI < 20). RESULTS 7785 asymptomatic adults (mean age, 57 years; 4361:3424 F:M) underwent screening CTC from April 2004-December 2016. ADI rank data were available in 7644 patients. Median ADI was 31 (IQR 22-43). Aortic calcium, VAT, and VSR had positive correlation with ADI and muscle attenuation had a negative correlation with ADI (all p < .001). Compared with the least disadvantaged group, mean differences for the most disadvantaged group (ADI > 80) were: Aortic calcium (Agatston) = 567, VAT = 27 cm2, VSR = 0.1, and muscle HU = -6 HU (all p < .05). Compared with the least disadvantaged group, the most disadvantaged group had significantly higher odds of having high-risk body composition measures: Aortic calcium OR = 3.8, VAT OR = 2.5, VSR OR = 2.0, and muscle HU OR = 3.1(all p < .001). CONCLUSION Fully automated CT body composition tools show that socioeconomic disadvantage is associated with high-risk body composition measures and can be used to identify individuals at increased risk for all-cause mortality and adverse cardiovascular events.
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Affiliation(s)
- Matthew H Lee
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Ave, Madison, WI, 53792, USA.
| | - Ryan Zea
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Ave, Madison, WI, 53792, USA
| | - John W Garrett
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Ave, Madison, WI, 53792, USA
| | - Ronald M Summers
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Perry J Pickhardt
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Ave, Madison, WI, 53792, USA
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Kim H. Performing a Research Study Using Open-Source Deep Learning Models. Korean J Radiol 2024; 25:217-219. [PMID: 38238013 PMCID: PMC10912490 DOI: 10.3348/kjr.2023.0869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/19/2023] [Accepted: 11/04/2023] [Indexed: 02/29/2024] Open
Affiliation(s)
- Hyungjin Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
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Chatterjee D, Shen TC, Mukherjee P, Lee S, Garrett JW, Zacharias N, Pickhardt PJ, Summers RM. Automated detection of incidental abdominal aortic aneurysms on computed tomography. Abdom Radiol (NY) 2024; 49:642-650. [PMID: 38091064 DOI: 10.1007/s00261-023-04119-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 02/01/2024]
Abstract
PURPOSE To detect and assess abdominal aortic aneurysms (AAAs) on CT in a large asymptomatic adult patient population using fully-automated deep learning software. MATERIALS AND METHODS The abdominal aorta was segmented using a fully-automated deep learning model trained on 66 manually-segmented abdominal CT scans from two datasets. The axial diameters of the segmented aorta were extracted to detect the presence of AAAs-maximum axial aortic diameter greater than 3 cm were labeled as AAA positive. The trained system was then externally-validated on CT colonography scans of 9172 asymptomatic outpatients (mean age, 57 years) referred for colorectal cancer screening. Using a previously-validated automated calcified atherosclerotic plaque detector, we correlated abdominal aortic Agatston and volume scores with the presence of AAA. RESULTS The deep learning software detected AAA on the external validation dataset with a sensitivity, specificity, and AUC of 96%, (95% CI 89%, 100%), 96% (96%, 97%), and 99% (98%, 99%) respectively. The Agatston and volume scores of reported AAA-positive cases were statistically significantly greater than those of reported AAA-negative cases (p < 0.0001). Using plaque alone as a AAA detector, at a threshold Agatston score of 2871, the sensitivity and specificity were 84% (73%, 94%) and 87% (86%, 87%), respectively. CONCLUSION Fully-automated detection and assessment of AAA on CT is feasible and accurate. There was a strong statistical association between the presence of AAA and the quantity of abdominal aortic calcified atherosclerotic plaque.
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Affiliation(s)
- Devina Chatterjee
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892-1182, USA
| | - Thomas C Shen
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892-1182, USA
| | - Pritam Mukherjee
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892-1182, USA
| | - Sungwon Lee
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892-1182, USA
| | - John W Garrett
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, USA
| | - Nicholas Zacharias
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, USA
| | - Perry J Pickhardt
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, USA
| | - Ronald M Summers
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, 20892-1182, USA.
- Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bldg. 10 Room 1C224D MSC 1182, Bethesda, MD, 20892-1182, USA.
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Chawla T, Hurrell C, Keough V, Lindquist CM, Mohammed MF, Samson C, Sugrue G, Walsh C. Canadian Association of Radiologists Practice Guidelines for Computed Tomography Colonography. Can Assoc Radiol J 2024; 75:54-68. [PMID: 37411043 DOI: 10.1177/08465371231182975] [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: 07/08/2023] Open
Abstract
Colon cancer is the third most common malignancy in Canada. Computed tomography colonography (CTC) provides a creditable and validated option for colon screening and assessment of known pathology in patients for whom conventional colonoscopy is contraindicated or where patients self-select to use imaging as their primary modality for initial colonic assessment. This updated guideline aims to provide a toolkit for both experienced imagers (and technologists) and for those considering launching this examination in their practice. There is guidance for reporting, optimal exam preparation, tips for problem solving to attain high quality examinations in challenging scenarios as well as suggestions for ongoing maintenance of competence. We also provide insight into the role of artificial intelligence and the utility of CTC in tumour staging of colorectal cancer. The appendices provide more detailed guidance into bowel preparation and reporting templates as well as useful information on polyp stratification and management strategies. Reading this guideline should equip the reader with the knowledge base to perform colonography but also provide an unbiased overview of its role in colon screening compared with other screening options.
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Affiliation(s)
- Tanya Chawla
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Casey Hurrell
- Canadian Association of Radiologists, Ottawa, Ontario, Canada
| | - Valerie Keough
- Department of Diagnostic Radiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Chris M Lindquist
- Department of Radiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mohammed F Mohammed
- Abdominal Radiology Section, Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Caroline Samson
- Département de Radiologie, Radio-oncologie et Médecine Nucléaire, Université de Montréal, Montreal, Quebec, Canada
| | - Gavin Sugrue
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Cynthia Walsh
- Department of Radiology, Radiation Oncology and Medical Physics, University of Ottawa, Ottawa, Ontario, Canada
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Samim A, Spijkers S, Moeskops P, Littooij AS, de Jong PA, Veldhuis WB, de Vos BD, van Santen HM, Nievelstein RAJ. Pediatric body composition based on automatic segmentation of computed tomography scans: a pilot study. Pediatr Radiol 2023; 53:2492-2501. [PMID: 37640800 PMCID: PMC10635977 DOI: 10.1007/s00247-023-05739-x] [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: 04/24/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Body composition during childhood may predispose to negative health outcomes later in life. Automatic segmentation may assist in quantifying pediatric body composition in children. OBJECTIVE To evaluate automatic segmentation for body composition on pediatric computed tomography (CT) scans and to provide normative data on muscle and fat areas throughout childhood using automatic segmentation. MATERIALS AND METHODS In this pilot study, 537 children (ages 1-17 years) who underwent abdominal CT after high-energy trauma at a Dutch tertiary center (2002-2019) were retrospectively identified. Of these, the CT images of 493 children (66% boys) were used to establish normative data. Muscle (psoas, paraspinal and abdominal wall) and fat (subcutaneous and visceral) areas were measured at the third lumbar vertebral (L3) level by automatic segmentation. A representative subset of 52 scans was also manually segmented to evaluate the performance of automatic segmentation. RESULTS For manually-segmented versus automatically-segmented areas (52 scans), mean Dice coefficients were high for muscle (0.87-0.90) and subcutaneous fat (0.88), but lower for visceral fat (0.60). In the control group, muscle area was comparable for both sexes until the age of 13 years, whereafter, boys developed relatively more muscle. From a young age, boys were more prone to visceral fat storage than girls. Overall, boys had significantly higher visceral-to-subcutaneous fat ratios (median 1.1 vs. 0.6, P<0.01) and girls higher fat-to-muscle ratios (median 1.0 vs. 0.7, P<0.01). CONCLUSION Automatic segmentation of L3-level muscle and fat areas allows for accurate quantification of pediatric body composition. Using automatic segmentation, the development in muscle and fat distribution during childhood (in otherwise healthy) Dutch children was demonstrated.
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Affiliation(s)
- Atia Samim
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
| | - Suzanne Spijkers
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Pim Moeskops
- Quantib-U, Utrecht, The Netherlands
- Image Sciences Institute, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Annemieke S Littooij
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Pim A de Jong
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Wouter B Veldhuis
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Quantib-U, Utrecht, The Netherlands
| | - Bob D de Vos
- Quantib-U, Utrecht, The Netherlands
- Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers - location AMC, Amsterdam, The Netherlands
| | - Hanneke M van Santen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rutger A J Nievelstein
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Wilhelmina Children's Hospital, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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11
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Xu K, Khan MS, Li TZ, Gao R, Terry JG, Huo Y, Lasko TA, Carr JJ, Maldonado F, Landman BA, Sandler KL. AI Body Composition in Lung Cancer Screening: Added Value Beyond Lung Cancer Detection. Radiology 2023; 308:e222937. [PMID: 37489991 PMCID: PMC10374937 DOI: 10.1148/radiol.222937] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 07/26/2023]
Abstract
Background An artificial intelligence (AI) algorithm has been developed for fully automated body composition assessment of lung cancer screening noncontrast low-dose CT of the chest (LDCT) scans, but the utility of these measurements in disease risk prediction models has not been assessed. Purpose To evaluate the added value of CT-based AI-derived body composition measurements in risk prediction of lung cancer incidence, lung cancer death, cardiovascular disease (CVD) death, and all-cause mortality in the National Lung Screening Trial (NLST). Materials and Methods In this secondary analysis of the NLST, body composition measurements, including area and attenuation attributes of skeletal muscle and subcutaneous adipose tissue, were derived from baseline LDCT examinations by using a previously developed AI algorithm. The added value of these measurements was assessed with sex- and cause-specific Cox proportional hazards models with and without the AI-derived body composition measurements for predicting lung cancer incidence, lung cancer death, CVD death, and all-cause mortality. Models were adjusted for confounding variables including age; body mass index; quantitative emphysema; coronary artery calcification; history of diabetes, heart disease, hypertension, and stroke; and other PLCOM2012 lung cancer risk factors. Goodness-of-fit improvements were assessed with the likelihood ratio test. Results Among 20 768 included participants (median age, 61 years [IQR, 57-65 years]; 12 317 men), 865 were diagnosed with lung cancer and 4180 died during follow-up. Including the AI-derived body composition measurements improved risk prediction for lung cancer death (male participants: χ2 = 23.09, P < .001; female participants: χ2 = 15.04, P = .002), CVD death (males: χ2 = 69.94, P < .001; females: χ2 = 16.60, P < .001), and all-cause mortality (males: χ2 = 248.13, P < .001; females: χ2 = 94.54, P < .001), but not for lung cancer incidence (male participants: χ2 = 2.53, P = .11; female participants: χ2 = 1.73, P = .19). Conclusion The body composition measurements automatically derived from baseline low-dose CT examinations added predictive value for lung cancer death, CVD death, and all-cause death, but not for lung cancer incidence in the NLST. Clinical trial registration no. NCT00047385 © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Fintelmann in this issue.
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Affiliation(s)
- Kaiwen Xu
- From the Department of Computer Science (K.X., Y.H., T.A.L., B.A.L.),
Department of Biomedical Engineering (T.Z.L., B.A.L.), School of Medicine
(T.Z.L.), and Department of Electrical and Computer Engineering (Y.H., B.A.L.),
Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN 37235; University of
Missouri–Kansas City, Kansas City, Mo (M.S.K.); Saint Luke’s Mid
America Heart Institute, Kansas City, Mo (M.S.K.); Siemens Healthineers,
Princeton, NJ (R.G.); Department of Radiology (J.G.T., J.J.C., B.A.L., K.L.S.),
Department of Biomedical Informatics (T.A.L., J.J.C., B.A.L.), Division of
Cardiovascular Medicine (J.J.C.), Division of Allergy, Pulmonary and Critical
Care Medicine (F.M.), Vanderbilt University Institute of Imaging Science
(B.A.L.), Vanderbilt Brain Institute (B.A.L.), Department of Psychiatry and
Behavioral Sciences (B.A.L.), Department of Neurology (B.A.L.), and Vanderbilt
Memory & Alzheimer’s Center (B.A.L.), Vanderbilt University
Medical Center, Nashville, Tenn
| | - Mirza S. Khan
- From the Department of Computer Science (K.X., Y.H., T.A.L., B.A.L.),
Department of Biomedical Engineering (T.Z.L., B.A.L.), School of Medicine
(T.Z.L.), and Department of Electrical and Computer Engineering (Y.H., B.A.L.),
Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN 37235; University of
Missouri–Kansas City, Kansas City, Mo (M.S.K.); Saint Luke’s Mid
America Heart Institute, Kansas City, Mo (M.S.K.); Siemens Healthineers,
Princeton, NJ (R.G.); Department of Radiology (J.G.T., J.J.C., B.A.L., K.L.S.),
Department of Biomedical Informatics (T.A.L., J.J.C., B.A.L.), Division of
Cardiovascular Medicine (J.J.C.), Division of Allergy, Pulmonary and Critical
Care Medicine (F.M.), Vanderbilt University Institute of Imaging Science
(B.A.L.), Vanderbilt Brain Institute (B.A.L.), Department of Psychiatry and
Behavioral Sciences (B.A.L.), Department of Neurology (B.A.L.), and Vanderbilt
Memory & Alzheimer’s Center (B.A.L.), Vanderbilt University
Medical Center, Nashville, Tenn
| | - Thomas Z. Li
- From the Department of Computer Science (K.X., Y.H., T.A.L., B.A.L.),
Department of Biomedical Engineering (T.Z.L., B.A.L.), School of Medicine
(T.Z.L.), and Department of Electrical and Computer Engineering (Y.H., B.A.L.),
Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN 37235; University of
Missouri–Kansas City, Kansas City, Mo (M.S.K.); Saint Luke’s Mid
America Heart Institute, Kansas City, Mo (M.S.K.); Siemens Healthineers,
Princeton, NJ (R.G.); Department of Radiology (J.G.T., J.J.C., B.A.L., K.L.S.),
Department of Biomedical Informatics (T.A.L., J.J.C., B.A.L.), Division of
Cardiovascular Medicine (J.J.C.), Division of Allergy, Pulmonary and Critical
Care Medicine (F.M.), Vanderbilt University Institute of Imaging Science
(B.A.L.), Vanderbilt Brain Institute (B.A.L.), Department of Psychiatry and
Behavioral Sciences (B.A.L.), Department of Neurology (B.A.L.), and Vanderbilt
Memory & Alzheimer’s Center (B.A.L.), Vanderbilt University
Medical Center, Nashville, Tenn
| | - Riqiang Gao
- From the Department of Computer Science (K.X., Y.H., T.A.L., B.A.L.),
Department of Biomedical Engineering (T.Z.L., B.A.L.), School of Medicine
(T.Z.L.), and Department of Electrical and Computer Engineering (Y.H., B.A.L.),
Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN 37235; University of
Missouri–Kansas City, Kansas City, Mo (M.S.K.); Saint Luke’s Mid
America Heart Institute, Kansas City, Mo (M.S.K.); Siemens Healthineers,
Princeton, NJ (R.G.); Department of Radiology (J.G.T., J.J.C., B.A.L., K.L.S.),
Department of Biomedical Informatics (T.A.L., J.J.C., B.A.L.), Division of
Cardiovascular Medicine (J.J.C.), Division of Allergy, Pulmonary and Critical
Care Medicine (F.M.), Vanderbilt University Institute of Imaging Science
(B.A.L.), Vanderbilt Brain Institute (B.A.L.), Department of Psychiatry and
Behavioral Sciences (B.A.L.), Department of Neurology (B.A.L.), and Vanderbilt
Memory & Alzheimer’s Center (B.A.L.), Vanderbilt University
Medical Center, Nashville, Tenn
| | - James G. Terry
- From the Department of Computer Science (K.X., Y.H., T.A.L., B.A.L.),
Department of Biomedical Engineering (T.Z.L., B.A.L.), School of Medicine
(T.Z.L.), and Department of Electrical and Computer Engineering (Y.H., B.A.L.),
Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN 37235; University of
Missouri–Kansas City, Kansas City, Mo (M.S.K.); Saint Luke’s Mid
America Heart Institute, Kansas City, Mo (M.S.K.); Siemens Healthineers,
Princeton, NJ (R.G.); Department of Radiology (J.G.T., J.J.C., B.A.L., K.L.S.),
Department of Biomedical Informatics (T.A.L., J.J.C., B.A.L.), Division of
Cardiovascular Medicine (J.J.C.), Division of Allergy, Pulmonary and Critical
Care Medicine (F.M.), Vanderbilt University Institute of Imaging Science
(B.A.L.), Vanderbilt Brain Institute (B.A.L.), Department of Psychiatry and
Behavioral Sciences (B.A.L.), Department of Neurology (B.A.L.), and Vanderbilt
Memory & Alzheimer’s Center (B.A.L.), Vanderbilt University
Medical Center, Nashville, Tenn
| | - Yuankai Huo
- From the Department of Computer Science (K.X., Y.H., T.A.L., B.A.L.),
Department of Biomedical Engineering (T.Z.L., B.A.L.), School of Medicine
(T.Z.L.), and Department of Electrical and Computer Engineering (Y.H., B.A.L.),
Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN 37235; University of
Missouri–Kansas City, Kansas City, Mo (M.S.K.); Saint Luke’s Mid
America Heart Institute, Kansas City, Mo (M.S.K.); Siemens Healthineers,
Princeton, NJ (R.G.); Department of Radiology (J.G.T., J.J.C., B.A.L., K.L.S.),
Department of Biomedical Informatics (T.A.L., J.J.C., B.A.L.), Division of
Cardiovascular Medicine (J.J.C.), Division of Allergy, Pulmonary and Critical
Care Medicine (F.M.), Vanderbilt University Institute of Imaging Science
(B.A.L.), Vanderbilt Brain Institute (B.A.L.), Department of Psychiatry and
Behavioral Sciences (B.A.L.), Department of Neurology (B.A.L.), and Vanderbilt
Memory & Alzheimer’s Center (B.A.L.), Vanderbilt University
Medical Center, Nashville, Tenn
| | - Thomas A. Lasko
- From the Department of Computer Science (K.X., Y.H., T.A.L., B.A.L.),
Department of Biomedical Engineering (T.Z.L., B.A.L.), School of Medicine
(T.Z.L.), and Department of Electrical and Computer Engineering (Y.H., B.A.L.),
Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN 37235; University of
Missouri–Kansas City, Kansas City, Mo (M.S.K.); Saint Luke’s Mid
America Heart Institute, Kansas City, Mo (M.S.K.); Siemens Healthineers,
Princeton, NJ (R.G.); Department of Radiology (J.G.T., J.J.C., B.A.L., K.L.S.),
Department of Biomedical Informatics (T.A.L., J.J.C., B.A.L.), Division of
Cardiovascular Medicine (J.J.C.), Division of Allergy, Pulmonary and Critical
Care Medicine (F.M.), Vanderbilt University Institute of Imaging Science
(B.A.L.), Vanderbilt Brain Institute (B.A.L.), Department of Psychiatry and
Behavioral Sciences (B.A.L.), Department of Neurology (B.A.L.), and Vanderbilt
Memory & Alzheimer’s Center (B.A.L.), Vanderbilt University
Medical Center, Nashville, Tenn
| | - John Jeffrey Carr
- From the Department of Computer Science (K.X., Y.H., T.A.L., B.A.L.),
Department of Biomedical Engineering (T.Z.L., B.A.L.), School of Medicine
(T.Z.L.), and Department of Electrical and Computer Engineering (Y.H., B.A.L.),
Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN 37235; University of
Missouri–Kansas City, Kansas City, Mo (M.S.K.); Saint Luke’s Mid
America Heart Institute, Kansas City, Mo (M.S.K.); Siemens Healthineers,
Princeton, NJ (R.G.); Department of Radiology (J.G.T., J.J.C., B.A.L., K.L.S.),
Department of Biomedical Informatics (T.A.L., J.J.C., B.A.L.), Division of
Cardiovascular Medicine (J.J.C.), Division of Allergy, Pulmonary and Critical
Care Medicine (F.M.), Vanderbilt University Institute of Imaging Science
(B.A.L.), Vanderbilt Brain Institute (B.A.L.), Department of Psychiatry and
Behavioral Sciences (B.A.L.), Department of Neurology (B.A.L.), and Vanderbilt
Memory & Alzheimer’s Center (B.A.L.), Vanderbilt University
Medical Center, Nashville, Tenn
| | - Fabien Maldonado
- From the Department of Computer Science (K.X., Y.H., T.A.L., B.A.L.),
Department of Biomedical Engineering (T.Z.L., B.A.L.), School of Medicine
(T.Z.L.), and Department of Electrical and Computer Engineering (Y.H., B.A.L.),
Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN 37235; University of
Missouri–Kansas City, Kansas City, Mo (M.S.K.); Saint Luke’s Mid
America Heart Institute, Kansas City, Mo (M.S.K.); Siemens Healthineers,
Princeton, NJ (R.G.); Department of Radiology (J.G.T., J.J.C., B.A.L., K.L.S.),
Department of Biomedical Informatics (T.A.L., J.J.C., B.A.L.), Division of
Cardiovascular Medicine (J.J.C.), Division of Allergy, Pulmonary and Critical
Care Medicine (F.M.), Vanderbilt University Institute of Imaging Science
(B.A.L.), Vanderbilt Brain Institute (B.A.L.), Department of Psychiatry and
Behavioral Sciences (B.A.L.), Department of Neurology (B.A.L.), and Vanderbilt
Memory & Alzheimer’s Center (B.A.L.), Vanderbilt University
Medical Center, Nashville, Tenn
| | - Bennett A. Landman
- From the Department of Computer Science (K.X., Y.H., T.A.L., B.A.L.),
Department of Biomedical Engineering (T.Z.L., B.A.L.), School of Medicine
(T.Z.L.), and Department of Electrical and Computer Engineering (Y.H., B.A.L.),
Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN 37235; University of
Missouri–Kansas City, Kansas City, Mo (M.S.K.); Saint Luke’s Mid
America Heart Institute, Kansas City, Mo (M.S.K.); Siemens Healthineers,
Princeton, NJ (R.G.); Department of Radiology (J.G.T., J.J.C., B.A.L., K.L.S.),
Department of Biomedical Informatics (T.A.L., J.J.C., B.A.L.), Division of
Cardiovascular Medicine (J.J.C.), Division of Allergy, Pulmonary and Critical
Care Medicine (F.M.), Vanderbilt University Institute of Imaging Science
(B.A.L.), Vanderbilt Brain Institute (B.A.L.), Department of Psychiatry and
Behavioral Sciences (B.A.L.), Department of Neurology (B.A.L.), and Vanderbilt
Memory & Alzheimer’s Center (B.A.L.), Vanderbilt University
Medical Center, Nashville, Tenn
| | - Kim L. Sandler
- From the Department of Computer Science (K.X., Y.H., T.A.L., B.A.L.),
Department of Biomedical Engineering (T.Z.L., B.A.L.), School of Medicine
(T.Z.L.), and Department of Electrical and Computer Engineering (Y.H., B.A.L.),
Vanderbilt University, 2301 Vanderbilt Pl, Nashville, TN 37235; University of
Missouri–Kansas City, Kansas City, Mo (M.S.K.); Saint Luke’s Mid
America Heart Institute, Kansas City, Mo (M.S.K.); Siemens Healthineers,
Princeton, NJ (R.G.); Department of Radiology (J.G.T., J.J.C., B.A.L., K.L.S.),
Department of Biomedical Informatics (T.A.L., J.J.C., B.A.L.), Division of
Cardiovascular Medicine (J.J.C.), Division of Allergy, Pulmonary and Critical
Care Medicine (F.M.), Vanderbilt University Institute of Imaging Science
(B.A.L.), Vanderbilt Brain Institute (B.A.L.), Department of Psychiatry and
Behavioral Sciences (B.A.L.), Department of Neurology (B.A.L.), and Vanderbilt
Memory & Alzheimer’s Center (B.A.L.), Vanderbilt University
Medical Center, Nashville, Tenn
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12
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Tong A, Magudia K. One Step Forward in Opportunistic Screening for Body Composition. Radiology 2023; 307:e231003. [PMID: 37191482 DOI: 10.1148/radiol.231003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- Angela Tong
- From the NYU Grossman School of Medicine, 660 1st Ave, 3rd Floor, New York, NY 10016 (A.T.); and Duke University School of Medicine, Durham, NC (K.M.)
| | - Kirti Magudia
- From the NYU Grossman School of Medicine, 660 1st Ave, 3rd Floor, New York, NY 10016 (A.T.); and Duke University School of Medicine, Durham, NC (K.M.)
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13
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Rajpurkar P, Lungren MP. The Current and Future State of AI Interpretation of Medical Images. N Engl J Med 2023; 388:1981-1990. [PMID: 37224199 DOI: 10.1056/nejmra2301725] [Citation(s) in RCA: 80] [Impact Index Per Article: 80.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Pranav Rajpurkar
- From the Department of Biomedical Informatics, Harvard Medical School, Boston (P.R.); the Center for Artificial Intelligence in Medicine and Imaging, Stanford University, Stanford, and the Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco - both in California (M.P.L.); and Microsoft, Redmond, Washington (M.P.L.)
| | - Matthew P Lungren
- From the Department of Biomedical Informatics, Harvard Medical School, Boston (P.R.); the Center for Artificial Intelligence in Medicine and Imaging, Stanford University, Stanford, and the Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco - both in California (M.P.L.); and Microsoft, Redmond, Washington (M.P.L.)
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