Periventricular-intraventricular haemorrhage (IVH) is the most prevalent type of neonatal intracranial haemorrhage. It is especially threatening to preterm infants, in whom it is associated with significant morbidity and mortality. Cranial ultrasound has become an important means of screening periventricular IVH in infants. The integration of artificial intelligence with neonatal ultrasound is promising for enhancing diagnostic accuracy, reducing physician workload, and consequently improving periventricular IVH outcomes. The study investigated whether deep learning-based analysis of the cranial ultrasound images of infants could detect and grade periventricular IVH. This multicentre observational study included 1,060 cases and healthy controls from two hospitals. The retrospective modelling dataset encompassed 773 participants from January 2020 to July 2023, while the prospective two-centre validation dataset included 287 participants from August 2023 to January 2024. The periventricular IVH net model, a deep learning model incorporating the convolutional block attention module mechanism, was developed. The model's effectiveness was assessed by randomly dividing the retrospective data into training and validation sets, followed by independent validation with the prospective two-centre data. To evaluate the model, we measured its recall, precision, accuracy, F1-score, and area under the curve (AUC). The regions of interest (ROI) that influenced the detection by the deep learning model were visualised in significance maps, and the t-distributed stochastic neighbour embedding (t-SNE) algorithm was used to visualise the clustering of model detection parameters. The final retrospective dataset included 773 participants (mean (standard deviation (SD)) gestational age, 32.7 (4.69) weeks; mean (SD) weight, 1,862.60 (855.49) g). For the retrospective data, the model's AUC was 0.99 (95% confidence interval (CI), 0.98-0.99), precision was 0.92 (0.89-0.95), recall was 0.93 (0.89-0.95), and F1-score was 0.93 (0.90-0.95). For the prospective two-centre validation data, the model's AUC was 0.961 (95% CI, 0.94-0.98) and accuracy was 0.89 (95% CI, 0.86-0.92). The two-centre prospective validation results of the periventricular IVH net model demonstrated its tremendous potential for paediatric clinical applications. Combining artificial intelligence with paediatric ultrasound can enhance the accuracy and efficiency of periventricular IVH diagnosis, especially in primary hospitals or community hospitals.

Diagnosing pulmonary tuberculosis (PTB) in children is challenging owing to paucibacillary disease, non-specific symptoms and signs and challenges in microbiological confirmation. Chest X-ray (CXR) interpretation is fundamental for diagnosis and classifying disease as severe or non-severe. In adults with PTB, there is substantial evidence showing the usefulness of artificial intelligence (AI) in CXR interpretation, but very limited data exist in children. A prospective two-stage study of children with presumed PTB in three sites (one in South Africa and two in Pakistan) will be conducted. In stage I, eligible children will be enrolled and comprehensively investigated for PTB. A CXR radiological reference standard (RRS) will be established by an expert panel of blinded radiologists. CXRs will be classified into those with findings consistent with PTB or not based on RRS. Cases will be classified as confirmed, unconfirmed or unlikely PTB according to National Institutes of Health definitions. Data from 300 confirmed and unconfirmed PTB cases and 250 unlikely PTB cases will be collected. An AI-CXR algorithm (qXR) will be used to process CXRs. The primary endpoint will be sensitivity and specificity of AI to detect confirmed and unconfirmed PTB cases (composite reference standard); a secondary endpoint will be evaluated for confirmed PTB cases (microbiological reference standard). In stage II, a multi-reader multi-case study using a cross-over design will be conducted with 16 readers and 350 CXRs to assess the usefulness of AI-assisted CXR interpretation for readers (clinicians and radiologists). The primary endpoint will be the difference in the area under the receiver operating characteristic curve of readers with and without AI assistance in correctly classifying CXRs as per RRS. The study has been approved by a local institutional ethics committee at each site. Results will be published in academic journals and presented at conferences. Data will be made available as an open-source database. PACTR202502517486411.

Magnetic resonance imaging (MRI) is a cornerstone of neuroimaging, providing unparalleled soft-tissue contrast. However, its clinical utility is often limited by long acquisition times, which contribute to motion artifacts, patient discomfort, and increased costs. Although traditional acceleration techniques, such as parallel imaging and compressed sensing help reduce scan times, they may reduce signal-to-noise ratio (SNR) and introduce artifacts. The advent of deep learning-based image reconstruction (DLBIR) may help in several ways to reduce scan times while preserving or improving image quality. Various DLBIR techniques are currently available through different vendors, with claimed reductions in gradient times up to 85% while maintaining or enhancing lesion conspicuity, improved noise suppression and diagnostic accuracy. The evolution of DLBIR from 2D to 3D acquisitions, coupled with advancements in self-supervised learning, further expands its capabilities and clinical applicability. Despite these advancements, challenges persist in generalizability across scanners and imaging conditions, susceptibility to artifacts and potential alterations in pathology representation. Additionally, limited data on training, underlying algorithms and clinical validation of these vendor-specific closed-source algorithms pose barriers to end-user trust and widespread adoption. This review explores the current applications of DLBIR in neuroimaging, vendor-driven implementations, and emerging trends that may impact accelerated MRI acquisitions.ABBREVIATIONS: PI＝ parallel imaging; CS＝ compressed sensing; DLBIR = deep learning-based image reconstruction; AI= artificial intelligence; DR =. Deep resolve; ACS = Artificial-intelligence-assisted compressed sensing.

Incorrectly placed endotracheal tubes (ETTs) can lead to serious clinical harm. Studies have demonstrated the potential for artificial intelligence (AI)-led algorithms to detect ETT placement on chest X-Ray (CXR) images, however their effect on clinician accuracy remains unexplored. This study measured the impact of an AI-assisted ETT detection algorithm on the ability of clinical staff to correctly identify ETT misplacement on CXR images. Four hundred CXRs of intubated adult patients were retrospectively sourced from the John Radcliffe Hospital (Oxford) and two other UK NHS hospitals. Images were de-identified and selected from a range of clinical settings, including the intensive care unit (ICU) and emergency department (ED). Each image was independently reported by a panel of thoracic radiologists, whose consensus classification of ETT placement (correct, too low [distal], or too high [proximal]) served as the reference standard for the study. Correct ETT position was defined as the tip located 3-7 cm above the carina, in line with established guidelines. Eighteen clinical readers of varying seniority from six clinical specialties were recruited across four NHS hospitals. Readers viewed the dataset using an online platform and recorded a blinded classification of ETT position for each image. After a four-week washout period, this was repeated with assistance from an AI-assisted image interpretation tool. Reader accuracy, reported confidence, and timings were measured during each study phase. 14,400 image interpretations were undertaken. Pooled accuracy for tube placement classification improved from 73.6 to 77.4% (p = 0.002). Accuracy for identification of critically misplaced tubes increased from 79.3 to 89.0% (p = 0.001). Reader confidence improved with AI assistance, with no change in mean interpretation time at 36 s per image. Use of assistive AI technology improved accuracy and confidence in interpreting ETT placement on CXR, especially for identification of critically misplaced tubes. AI assistance may potentially provide a useful adjunct to support clinicians in identifying misplaced ETTs on CXR.

Three-dimensional magnetic resonance vessel wall imaging (3D MR-VWI) is critical for characterizing cerebrovascular pathologies, yet its clinical adoption is hindered by labor-intensive postprocessing. We developed VWI Assistant, a multi-sequence integrated deep learning platform trained on multicenter data (study cohorts 1981 patients and imaging datasets) to automate artery segmentation and reconstruction. The framework demonstrated robust performance across diverse patient populations, imaging protocols, and scanner manufacturers, achieving 92.9% qualified rate comparable to expert manual delineation. VWI Assistant reduced processing time by over 90% (10-12 min per case) compared to manual methods (p < 0.001) and improved inter-/intra-reader agreement. Real-world deployment (n = 1099 patients) demonstrated rapid clinical adoption, with utilization rates increasing from 10.8% to 100.0% within 12 months. By streamlining 3D MR-VWI workflows, VWI Assistant addresses scalability challenges in vascular imaging, offering a practical tool for routine use and large-scale research, significantly improving workflow efficiency while reducing labor and time costs.

A key cardiac magnetic resonance (CMR) challenge is breath-holding duration, difficult for cardiac patients. To evaluate whether artificial intelligence-assisted compressed sensing CINE (AI-CS-CINE) reduces image acquisition time of CMR compared to conventional CINE (C-CINE). Cardio-oncology patients (<i>n</i> = 60) and healthy volunteers (<i>n</i> = 29) underwent sequential C-CINE and AI-CS-CINE with a 1.5-T scanner. Acquisition time, visual image quality assessment, and biventricular metrics (end-diastolic volume, end-systolic volume, stroke volume, ejection fraction, left ventricular mass, and wall thickness) were analyzed and compared between C-CINE and AI-CS-CINE with Bland-Altman analysis, and calculation of intraclass coefficient (ICC). In 89 participants (58.5 ± 16.8 years, 42 males, 47 females), total AI-CS-CINE acquisition and reconstruction time (37 seconds) was 84% faster than C-CINE (238 seconds). C-CINE required repeats in 23% (20/89) of cases (approximately 8 minutes lost), while AI-CS-CINE only needed one repeat (1%; 2 seconds lost). AI-CS-CINE had slightly lower contrast but preserved structural clarity. Bland-Altman plots and ICC (0.73 ≤ <i>r</i> ≤ 0.98) showed strong agreement for left ventricle (LV) and right ventricle (RV) metrics, including those in the cardiac amyloidosis subgroup (<i>n</i> = 31). AI-CS-CINE enabled faster, easier imaging in patients with claustrophobia, dyspnea, arrhythmias, or restlessness. Motion-artifacted C-CINE images were reliably interpreted from AI-CS-CINE. AI-CS-CINE accelerated CMR image acquisition and reconstruction, preserved anatomical detail, and diminished impact of patient-related motion. Quantitative AI-CS-CINE metrics agreed closely with C-CINE in cardio-oncology patients, including the cardiac amyloidosis cohort, as well as healthy volunteers regardless of left and right ventricular size and function. AI-CS-CINE significantly enhanced CMR workflow, particularly in challenging cases. The strong analytical concordance underscores reliability and robustness of AI-CS-CINE as a valuable tool.

Lung cancer is the leading cause of cancer-related mortality worldwide, largely due to late-stage diagnosis. Low-dose computed tomography (LDCT) screening has emerged as a powerful tool for early detection, enabling diagnosis at curable stages and reducing lung cancer mortality. Despite strong evidence, LDCT screening uptake remains suboptimal globally. This review synthesizes current evidence supporting LDCT screening, highlights ongoing global implementation efforts, and discusses key insights from the 1st AGILE conference. Lung cancer screening is gaining global momentum, with many countries advancing plans for national LDCT programs. Expanding eligibility through risk-based models and targeting high-risk never- and light-smokers are emerging strategies to improve efficiency and equity. Technological advancements, including AI-assisted interpretation and image-based biomarkers, are addressing concerns around false positives, overdiagnosis, and workforce burden. Integrating cardiac and smoking-related disease assessment within LDCT screening offers added preventive health benefits. To maximize global impact, screening strategies must be tailored to local health systems and populations. Efforts should focus on increasing awareness, standardizing protocols, optimizing screening intervals, and strengthening multidisciplinary care pathways. International collaboration and shared infrastructure can accelerate progress and ensure sustainability. LDCT screening represents a cost-effective opportunity to reduce lung cancer mortality and premature deaths.

BackgroundNon-contrast computed tomography (NCCT) is the first image for stroke assessment, but its sensitivity for detecting large vessel occlusion (LVO) is limited. Artificial intelligence (AI) algorithms may contribute to a faster LVO diagnosis using only NCCT. This study evaluates the performance and the potential diagnostic time saving of Methinks LVO AI algorithm in a U.S. multi-facility stroke network.MethodsThis retrospective pilot study reviewed NCCT and computed tomography angiography (CTA) images between 2015 and 2023. The Methinks AI algorithm, designed to detect LVOs in the internal carotid artery and middle cerebral artery, was tested for sensitivity, specificity, and predictive values. A neuroradiologist reviewed cases to establish a gold standard. To evaluate potential time saving in workflow, time gaps between NCCT and CTA were analyzed and stratified into four groups in true positive cases: Group 1 (<10 min), Group 2 (10-30 min), Group 3 (30-60 min), and Group 4 (>60 min).ResultsFrom a total of 1155 stroke codes, 608 NCCT exams were analyzed. Methinks LVO demonstrated 75% sensitivity and 83% specificity, identifying 146 out of 194 confirmed LVO cases correctly. The PPV of the algorithm was 72%. The NPV was 83% (considering 'other occlusion', 'stenosis' and 'posteriors' as negatives), and 73% considered the same conditions as positives. Among the true positive cases, we found 112 patients Group 1, 32 patients in Group 2, 15 patients in Group 3, 3 patients in Group 4.ConclusionThe Methinks AI algorithm shows promise for improving LVO detection from NCCT, especially in resource limited settings. However, its sensitivity remains lower than CTA-based systems, suggesting the need for further refinement.

Cystic fibrosis (CF) is a prevalent autosomal recessive disorder, with lung complications being the primary cause of morbidity and mortality. In paediatric patients, structural lung changes begin early, necessitating prompt detection to guide treatment and delay disease progression. This study evaluates ultra-low-dose CT (ULDCT) versus chest x-rays  (CXR) for children with CF (CwCF) lung disease assessment. ULDCT uses AI-enhanced deep-learning iterative reconstruction to achieve radiation doses comparable to a CXR. This prospective study recruited radiographers and radiologists to assess the image quality (IQ) of ten paired ULDCT and CXR images of CwCF from a single centre. Statistical analyses, including the Wilcoxon Signed Rank test and visual grading characteristic (VGC) analysis, compared diagnostic confidence and anatomical detail. Seventy-five participants were enrolled, 25 radiologists and 50 radiographers. The majority (88%) preferred ULDCT over CXR for monitoring CF lung disease due to higher perceived confidence (p ≤ 0.001) and better IQ ratings (p ≤ 0.05), especially among radiologists (area under the VGC curve and its 95% CI was 0.63 (asymmetric 95% CI: 0.51-0.73; p ≤ 0.05). While ULDCT showed no significant differences in anatomical visualisation compared to CXR, the overall IQ for lung pathology assessment was rated superior. ULDCT offers superior IQ over CXR in CwCF, with similar radiation doses. It also enhances diagnostic confidence, supporting its use as a viable CXR alternative. Standardising CT protocols to optimise IQ and minimise radiation is essential to improve disease monitoring in this vulnerable group. Question How does chest X-ray (CXR) IQ in children compare to ULDCT at similar radiation doses for assessing CF-related lung disease? Findings ULDCT offers superior IQ over CXR in CwCF. Participants preferred ULDCT due to higher perceived confidence levels and superior IQ. Clinical relevance ULDCT can enhance diagnosis in CwCF while maintaining comparable radiation doses. ULDCT also enhances diagnostic confidence, supporting its use as a viable CXR alternative.

Assessing dimensions of available bone throughout hundreds of cone-beam computed tomography cross-sectional images of the edentulous area is time-consuming, focus-demanding, and prone to variability and mistakes. This study aims for a clinically applicable artificial intelligence-based automation system for available bone quantity assessment and providing possible surgical and nonsurgical treatment options in a real-time manner. YOLOv8-seg, a single-stage convolutional neural network detector, has been used to segment mandibular alveolar bone and the inferior alveolar canal from cross-sectional images of a custom dataset. Measurements from the segmented mask of the bone and canal have been calculated mathematically and compared with manual measurements from 2 different operators, and the time for the measurement task has been compared. Classification of bone dimension with 25 treatment options has been automatically suggested by the system and validated with a team of specialists. The YOLOv8 model achieved significantly accurate improvements in segmenting anatomical structures with a precision of 0.951, recall of 0.915, mAP50 of 0.952, Intersection over Union of 0.871, and dice similarity coefficient of 0.911. The efficiency ratio of that segmentation performed by the artificial intelligence-based system is 2001 times faster in comparison to the human subject. A statistically significant difference in the measurements from the system to operators in height and time is recorded. The system's recommendations matched the clinicians' assessments in 94% of cases (83/88). Cohen κ of 0.89 indicated near-perfect agreement. The YOLOv8 model is an effective tool, providing high accuracy in segmenting dental structures with balanced computational requirements, and even with the challenges presented, the system can be clinically applicable with future improvements, providing less time-consuming and, most importantly, specialist-level accurate implant planning reports.