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Healthcare resource utilization for the management of neonatal head shape deformities: a propensity-matched analysis of AI-assisted and conventional approaches.

Shin J, Caron G, Stoltz P, Martin JE, Hersh DS, Bookland MJ

pubmed logopapersJun 1 2025
Overuse of radiography studies and underuse of conservative therapies for cranial deformities in neonates is a known inefficiency in pediatric craniofacial healthcare. This study sought to establish whether the introduction of artificial intelligence (AI)-generated craniometrics and craniometric interpretations into craniofacial clinical workflow improved resource utilization patterns in the initial evaluation and management of neonatal cranial deformities. A retrospective chart review of pediatric patients referred for head shape concerns between January 2019 and June 2023 was conducted. Patient demographics, final encounter diagnosis, review of an AI analysis, and provider orders were documented. Patients were divided based on whether an AI cranial deformity analysis was documented as reviewed during the index evaluation, then both groups were propensity matched. Rates of index-encounter radiology studies, physical therapy (PT), orthotic therapy, and craniofacial specialist follow-up evaluations were compared using logistic regression and ANOVA analyses. One thousand patient charts were reviewed (663 conventional encounters, 337 AI-assisted encounters). One-to-one propensity matching was performed between these groups. AI models were significantly more likely to be reviewed during telemedicine encounters and advanced practice provider (APP) visits (54.8% telemedicine vs 11.4% in-person, p < 0.0001; 12.3% physician vs 44.4% APP, p < 0.0001). All AI diagnoses of craniosynostosis versus benign deformities were congruent with final diagnoses. AI model review was associated with a significant increase in the use of orthotic therapies for neonatal cranial deformities (31.5% vs 38.6%, p = 0.0132) but not PT or specialist follow-up evaluations. Radiology ordering rates did not correlate with AI-interpreted data review. As neurosurgeons and pediatricians continue to work to limit neonatal radiation exposure and contain healthcare costs, AI-assisted clinical care could be a cheap and easily scalable diagnostic adjunct for reducing reliance on radiography and encouraging adherence to established clinical guidelines. In practice, however, providers appear to default to preexisting diagnostic biases and underweight AI-generated data and interpretations, ultimately negating any potential advantages offered by AI. AI engineers and specialty leadership should prioritize provider education and user interface optimization to improve future adoption of validated AI diagnostic tools.

Prediction Model and Nomogram for Amyloid Positivity Using Clinical and MRI Features in Individuals With Subjective Cognitive Decline.

Li Q, Cui L, Guan Y, Li Y, Xie F, Guo Q

pubmed logopapersJun 1 2025
There is an urgent need for the precise prediction of cerebral amyloidosis using noninvasive and accessible indicators to facilitate the early diagnosis of individuals with the preclinical stage of Alzheimer's disease (AD). Two hundred and four individuals with subjective cognitive decline (SCD) were enrolled in this study. All subjects completed neuropsychological assessments and underwent 18F-florbetapir PET, structural MRI, and functional MRI. A total of 315 features were extracted from the MRI, demographics, and neuropsychological scales and selected using the least absolute shrinkage and selection operator (LASSO). The logistic regression (LR) model, based on machine learning, was trained to classify SCD as either β-amyloid (Aβ) positive or negative. A nomogram was established using a multivariate LR model to predict the risk of Aβ+. The performance of the prediction model and nomogram was assessed with area under the curve (AUC) and calibration. The final model was based on the right rostral anterior cingulate thickness, the grey matter volume of the right inferior temporal, the ReHo of the left posterior cingulate gyrus and right superior temporal gyrus, as well as MoCA-B and AVLT-R. In the training set, the model achieved a good AUC of 0.78 for predicting Aβ+, with an accuracy of 0.72. The validation of the model also yielded a favorable discriminatory ability with an AUC of 0.88 and an accuracy of 0.83. We have established and validated a model based on cognitive, sMRI, and fMRI data that exhibits adequate discrimination. This model has the potential to predict amyloid status in the SCD group and provide a noninvasive, cost-effective way that might facilitate early screening, clinical diagnosis, and drug clinical trials.

Multivariate Classification of Adolescent Major Depressive Disorder Using Whole-brain Functional Connectivity.

Li Z, Shen Y, Zhang M, Li X, Wu B

pubmed logopapersJun 1 2025
Adolescent major depressive disorder (MDD) is a serious mental health condition that has been linked to abnormal functional connectivity (FC) patterns within the brain. However, whether FC could be used as a potential biomarker for diagnosis of adolescent MDD is still unclear. The aim of our study was to investigate the potential diagnostic value of whole-brain FC in adolescent MDD. Resting-state functional magnetic resonance imaging data were obtained from 94 adolescents with MDD and 78 healthy adolescents. The whole brain was segmented into 90 regions of interest (ROIs) using the automated anatomical labeling atlas. FC was assessed by calculating the Pearson correlation coefficient of the average time series between each pair of ROIs. A multivariate pattern analysis was employed to classify patients from controls using the whole-brain FC as input features. The linear support vector machine classifier achieved an accuracy of 69.18% using the optimal functional connection features. The consensus functional connections were mainly located within and between large-scale brain networks. The top 10 nodes with the highest weight in the classification model were mainly located in the default mode, salience, auditory, and sensorimotor networks. Our findings highlighted the importance of functional network connectivity in the neurobiology of adolescent MDD, and suggested the possibility of altered FC and high-weight regions as complementary diagnostic markers in adolescents with depression.

Multimodal Neuroimaging Based Alzheimer's Disease Diagnosis Using Evolutionary RVFL Classifier.

Goel T, Sharma R, Tanveer M, Suganthan PN, Maji K, Pilli R

pubmed logopapersJun 1 2025
Alzheimer's disease (AD) is one of the most known causes of dementia which can be characterized by continuous deterioration in the cognitive skills of elderly people. It is a non-reversible disorder that can only be cured if detected early, which is known as mild cognitive impairment (MCI). The most common biomarkers to diagnose AD are structural atrophy and accumulation of plaques and tangles, which can be detected using magnetic resonance imaging (MRI) and positron emission tomography (PET) scans. Therefore, the present paper proposes wavelet transform-based multimodality fusion of MRI and PET scans to incorporate structural and metabolic information for the early detection of this life-taking neurodegenerative disease. Further, the deep learning model, ResNet-50, extracts the fused images' features. The random vector functional link (RVFL) with only one hidden layer is used to classify the extracted features. The weights and biases of the original RVFL network are being optimized by using an evolutionary algorithm to get optimum accuracy. All the experiments and comparisons are performed over the publicly available Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset to demonstrate the suggested algorithm's efficacy.

Neuroimaging and machine learning in eating disorders: a systematic review.

Monaco F, Vignapiano A, Di Gruttola B, Landi S, Panarello E, Malvone R, Palermo S, Marenna A, Collantoni E, Celia G, Di Stefano V, Meneguzzo P, D'Angelo M, Corrivetti G, Steardo L

pubmed logopapersJun 1 2025
Eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), are complex psychiatric conditions with high morbidity and mortality. Neuroimaging and machine learning (ML) represent promising approaches to improve diagnosis, understand pathophysiological mechanisms, and predict treatment response. This systematic review aimed to evaluate the application of ML techniques to neuroimaging data in EDs. Following PRISMA guidelines (PROSPERO registration: CRD42024628157), we systematically searched PubMed and APA PsycINFO for studies published between 2014 and 2024. Inclusion criteria encompassed human studies using neuroimaging and ML methods applied to AN, BN, or BED. Data extraction focused on study design, imaging modalities, ML techniques, and performance metrics. Quality was assessed using the GRADE framework and the ROBINS-I tool. Out of 185 records screened, 5 studies met the inclusion criteria. Most applied support vector machines (SVMs) or other supervised ML models to structural MRI or diffusion tensor imaging data. Cortical thickness alterations in AN and diffusion-based metrics effectively distinguished ED subtypes. However, all studies were observational, heterogeneous, and at moderate to serious risk of bias. Sample sizes were small, and external validation was lacking. ML applied to neuroimaging shows potential for improving ED characterization and outcome prediction. Nevertheless, methodological limitations restrict generalizability. Future research should focus on larger, multicenter, and multimodal studies to enhance clinical applicability. Level IV, multiple observational studies with methodological heterogeneity and moderate to serious risk of bias.

Evolution of Cortical Lesions and Function-Specific Cognitive Decline in People With Multiple Sclerosis.

Krijnen EA, Jelgerhuis J, Van Dam M, Bouman PM, Barkhof F, Klawiter EC, Hulst HE, Strijbis EMM, Schoonheim MM

pubmed logopapersJun 1 2025
Cortical lesions in multiple sclerosis (MS) severely affect cognition, but their longitudinal evolution and impact on specific cognitive functions remain understudied. This study investigates the evolution of function-specific cognitive functioning over 10 years in people with MS and assesses the influence of cortical lesion load and formation on these trajectories. In this prospectively collected study, people with MS underwent 3T MRI (T1 and fluid-attenuated inversion recovery) at 3 study visits between 2008 and 2022. Cognitive functioning was evaluated based on neuropsychological assessment reflecting 7 cognitive functions: attention; executive functioning (EF); information processing speed (IPS); verbal fluency; and verbal, visuospatial, and working memory. Cortical lesions were manually identified on artificial intelligence-generated double-inversion recovery images. Linear mixed models were constructed to assess the temporal evolution between cortical lesion load and function-specific cognitive decline. In addition, analyses were stratified by MS disease stage: early and late relapsing-remitting MS (cutoff disease duration at 15 years) and progressive MS. The study included 223 people with MS (mean age, 47.8 ± 11.1 years; 153 women) and 62 healthy controls. All completed 5-year follow-up, and 37 healthy controls and 94 with MS completed 10-year follow-up. At baseline, people with MS exhibited worse functioning of IPS and working memory. Over 10 years, cognitive decline was most severe in attention, verbal memory, and EF. At baseline, people with MS had a median cortical lesion count of 7 (range 0-73), which was related to subsequent decline in attention (B[95% CI] = -0.22 [-0.40 to -0.03]) and verbal fluency (B[95% CI] = -0.23[-0.37 to -0.09]). Over time, cortical lesions increased by a median count of 4 (range -2 to 71), particularly in late and progressive disease, and was related to decline in verbal fluency (B [95% CI] = -0.33 [-0.51 to -0.15]). The associations between (change in) cortical lesion load and cognitive decline were not modified by MS disease stage. Cognition worsened over 10 years, particularly affecting attention, verbal memory, and EF, while preexisting impairments were worst in other functions such as IPS. Worse baseline cognitive functioning was related to baseline cortical lesions, whereas baseline cortical lesions and cortical lesion formation were related to cognitive decline in functions less affected at baseline. Accumulating cortical damage leads to spreading of cognitive impairments toward additional functions.

MSLesSeg: baseline and benchmarking of a new Multiple Sclerosis Lesion Segmentation dataset.

Guarnera F, Rondinella A, Crispino E, Russo G, Di Lorenzo C, Maimone D, Pappalardo F, Battiato S

pubmed logopapersMay 31 2025
This paper presents MSLesSeg, a new, publicly accessible MRI dataset designed to advance research in Multiple Sclerosis (MS) lesion segmentation. The dataset comprises 115 scans of 75 patients including T1, T2 and FLAIR sequences, along with supplementary clinical data collected across different sources. Expert-validated annotations provide high-quality lesion segmentation labels, establishing a reliable human-labeled dataset for benchmarking. Part of the dataset was shared with expert scientists with the aim to compare the last automatic AI-based image segmentation solutions with an expert-biased handmade segmentation. In addition, an AI-based lesion segmentation of MSLesSeg was developed and technically validated against the last state-of-the-art methods. The dataset, the detailed analysis of researcher contributions, and the baseline results presented here mark a significant milestone for advancing automated MS lesion segmentation research.

Deep-learning based multi-modal models for brain age, cognition and amyloid pathology prediction.

Wang C, Zhang W, Ni M, Wang Q, Liu C, Dai L, Zhang M, Shen Y, Gao F

pubmed logopapersMay 31 2025
Magnetic resonance imaging (MRI), combined with artificial intelligence techniques, has improved our understanding of brain structural change and enabled the estimation of brain age. Neurodegenerative disorders, such as Alzheimer's disease (AD), have been linked to accelerated brain aging. In this study, we aimed to develop a deep-learning framework that processes and integrates MRI images to more accurately predict brain age, cognitive function, and amyloid pathology. In this study, we aimed to develop a deep-learning framework that processes and integrates MRI images to more accurately predict brain age, cognitive function, and amyloid pathology.We collected over 10,000 T1-weighted MRI scans from more than 7,000 individuals across six cohorts. We designed a multi-modal deep-learning framework that employs 3D convolutional neural networks to analyze MRI and additional neural networks to evaluate demographic data. Our initial model focused on predicting brain age, serving as a foundational model from which we developed separate models for cognition function and amyloid plaque prediction through transfer learning. The brain age prediction model achieved the mean absolute error (MAE) for cognitive normal population in the ADNI (test) datasets of 3.302 years. The gap between predicted brain age and chronological age significantly increases while cognition declines. The cognition prediction model exhibited a root mean square error (RMSE) of 0.334 for the Clinical Dementia Rating (CDR) regression task, achieving an area under the curve (AUC) of approximately 0.95 in identifying ing dementia patients. Dementia related brain regions, such as the medial temporal lobe, were identified by our model. Finally, amyloid plaque prediction model was trained to predict amyloid plaque, and achieved an AUC about 0.8 for dementia patients. These findings indicate that the present predictive models can identify subtle changes in brain structure, enabling precise estimates of brain age, cognitive status, and amyloid pathology. Such models could facilitate the use of MRI as a non-invasive diagnostic tool for neurodegenerative diseases, including AD.

Deep learning-driven modality imputation and subregion segmentation to enhance high-grade glioma grading.

Yu J, Liu Q, Xu C, Zhou Q, Xu J, Zhu L, Chen C, Zhou Y, Xiao B, Zheng L, Zhou X, Zhang F, Ye Y, Mi H, Zhang D, Yang L, Wu Z, Wang J, Chen M, Zhou Z, Wang H, Wang VY, Wang E, Xu D

pubmed logopapersMay 30 2025
This study aims to develop a deep learning framework that leverages modality imputation and subregion segmentation to improve grading accuracy in high-grade gliomas. A retrospective analysis was conducted using data from 1,251 patients in the BraTS2021 dataset as the main cohort and 181 clinical cases collected from a medical center between April 2013 and June 2018 (51 years ± 17; 104 males) as the external test set. We propose a PatchGAN-based modality imputation network with an Aggregated Residual Transformer (ART) module combining Transformer self-attention and CNN feature extraction via residual links, paired with a U-Net variant for segmentation. Generative accuracy used PSNR and SSIM for modality conversions, while segmentation performance was measured with DSC and HD95 across necrotic core (NCR), edema (ED), and enhancing tumor (ET) regions. Senior radiologists conducted a comprehensive Likert-based assessment, with diagnostic accuracy evaluated by AUC. Statistical analysis was performed using the Wilcoxon signed-rank test and the DeLong test. The best source-target modality pairs for imputation were T1 to T1ce and T1ce to T2 (p < 0.001). In subregion segmentation, the overall DSC was 0.878 and HD95 was 19.491, with the ET region showing the highest segmentation accuracy (DSC: 0.877, HD95: 12.149). Clinical validation revealed an improvement in grading accuracy by the senior radiologist, with the AUC increasing from 0.718 to 0.913 (P < 0.001) when using the combined imputation and segmentation models. The proposed deep learning framework improves high-grade glioma grading by modality imputation and segmentation, aiding the senior radiologist and offering potential to advance clinical decision-making.

Imaging-based machine learning to evaluate the severity of ischemic stroke in the middle cerebral artery territory.

Xie G, Gao J, Liu J, Zhou X, Zhao Z, Tang W, Zhang Y, Zhang L, Li K

pubmed logopapersMay 30 2025
This study aims to develop an imaging-based machine learning model for evaluating the severity of ischemic stroke in the middle cerebral artery (MCA) territory. This retrospective study included 173 patients diagnosed with acute ischemic stroke (AIS) in the MCA territory from two centers, with 114 in the training set and 59 in the test set. In the training set, spearman correlation coefficient and multiple linear regression were utilized to analyze the correlation between the CT imaging features of patients prior to treatment and the national institutes of health stroke scale (NIHSS) score. Subsequently, an optimal machine learning algorithm was determined by comparing seven different algorithms. This algorithm was then used to construct a imaging-based prediction model for stroke severity (severe and non-severe). Finally, the model was validated in the test set. After conducting correlation analysis, CT imaging features such as infarction side, basal ganglia area involvement, dense MCA sign, and infarction volume were found to be independently associated with NIHSS score (P < 0.05). The Logistic Regression algorithm was determined to be the optimal method for constructing the prediction model for stroke severity. The area under the receiver operating characteristic curve of the model in both the training set and test set were 0.815 (95% CI: 0.736-0.893) and 0.780 (95% CI: 0.646-0.914), respectively, with accuracies of 0.772 and 0.814. Imaging-based machine learning model can effectively evaluate the severity (severe or non-severe) of ischemic stroke in the MCA territory. Not applicable.
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