Supracondylar humerus fractures in children are among the most common elbow fractures in pediatrics. However, their diagnosis can be particularly challenging due to the anatomical characteristics and imaging features of the pediatric skeleton. In recent years, convolutional neural networks (CNNs) have achieved notable success in medical image analysis, though their performance typically relies on large-scale, high-quality labeled datasets. Unfortunately, labeled samples for pediatric supracondylar fractures are scarce and difficult to obtain. To address this issue, this paper introduces a deep learning-based multi-scale patch residual network (MPR) for the automatic detection and localization of subtle pediatric supracondylar fractures. The MPR framework combines a CNN for automatic feature extraction with a multi-scale generative adversarial network to model skeletal integrity using healthy samples. By leveraging healthy images to learn the normal skeletal distribution, the approach reduces the dependency on labeled fracture data and effectively addresses the challenges posed by limited pediatric datasets. Datasets from two different hospitals were used, with data augmentation techniques applied during both training and validation. On an independent test set, the proposed model achieves an accuracy of 90.5%, with 89% sensitivity, 92% specificity, and an F1 score of 0.906-outperforming the diagnostic accuracy of emergency medicine physicians and approaching that of pediatric radiologists. Furthermore, the model demonstrates a fast inference speed of 1.1 s per sheet, underscoring its substantial potential for clinical application.

Thyroid cancer is the most prevalent malignant tumour in the endocrine system, with its incidence steadily rising in recent years. Current central processing units (CPUs) and graphics processing units (GPUs) face significant challenges in terms of processing speed, energy consumption, cost, and scalability in the identification of thyroid nodules, making them inadequate for the demands of future green, efficient, and accessible healthcare. To overcome these limitations, this study proposes an efficient quantized inference method using a field-programmable gate array (FPGA). We employ the YOLOv4-tiny neural network model, enhancing software performance with the K-means + + optimization algorithm and improving hardware performance through techniques such as 8-bit weight quantization, batch normalization, and convolutional layer fusion. The study is based on the ZYNQ7020 FPGA platform. Experimental results demonstrate an average accuracy of 81.44% on the Tn3k dataset and 81.20% on the internal test set from a Chinese tertiary hospital. The power consumption of the FPGA platform, CPU (Intel Core i5-10200 H), and GPU (NVIDIA RTX 4090) were 3.119 watts, 45 watts, and 68 watts, respectively, with energy efficiency ratios of 5.45, 0.31, and 5.56. This indicates that the FPGA's energy efficiency is 17.6 times that of the CPU and 0.98 times that of the GPU. These results show that the FPGA not only significantly outperforms the CPU in speed but also consumes far less power than the GPU. Moreover, using mid-to-low-end FPGAs yields performance comparable to that of commercial-grade GPUs. This technology presents a novel solution for medical imaging diagnostics, with the potential to significantly enhance the speed, accuracy, and environmental sustainability of ultrasound image analysis, thereby supporting the future development of medical care.

Artificial intelligence (AI) has been proposed to assist radiologists in reporting multiparametric magnetic resonance imaging (mpMRI) of the prostate. We evaluate the diagnostic performance of radiologists with different levels of experience when reporting mpMRI with the support of available AI-based software (Quantib Prostate). This is a single-center study (NCT06298305) involving 110 patients. Those with a positive mpMRI (PI-RADS ≥ 3) underwent targeted plus systematic biopsy (TBx plus SBx), while those with a negative mpMRI but a high clinical suspicion of prostate cancer (PCa) underwent SBx. Three readers with different levels of experience, identified as R1, R2, and R3 reviewed all mpMRI. Inter-reader agreement among the three readers with or without the assistance of Quantib Prostate as well as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for the detection of clinically significant PCa (csPCa) were assessed. 102 patients underwent prostate biopsy and the csPCa detection rate was 47%. Using Quantib Prostate resulted in an increased number of lesions identified for R3 (101 vs. 127). Inter-reader agreement slightly increased when using Quantib Prostate from 0.37 to 0.41 without vs. with Quantib Prostate, respectively. PPV, NPV and diagnostic accuracy (measured by the area under the curve [AUC]) of R3 improved (0.51 vs. 0.55, 0.65 vs.0.82 and 0.56 vs. 0.62, respectively). Conversely, no changes were observed for R1 and R2. Using Quantib Prostate did not enhance the detection rate of csPCa for readers with some experience in prostate imaging. However, for an inexperienced reader, this AI-based software is demonstrated to improve the performance. Name of registry: clinicaltrials.gov. NCT06298305. Date of registration: 2022-09.

To develop an early budget impact analysis of and inform future research on the national adoption of a commercially available AI application to support clinicians reviewing radiographs for suspected fractures across NHS emergency departments in England. A decision tree framework was coded to assess a change in outcomes for suspected fractures in adults when AI fracture detection was integrated into clinical workflow over a 1-year time horizon. Standard of care was the comparator scenario and the ground truth reference cases were characterised by radiology report findings. The effect of AI on assisting ED clinicians when detecting fractures was sourced from US literature. Data on resource use conditioned on the correct identification of a fracture in the ED was extracted from a London NHS trust. Sensitivity analysis was conducted to account for the influence of parameter uncertainty on results. In one year, an estimated 658,564 radiographs were performed in emergency departments across England for suspected wrist, ankle or hip fractures. The number of patients returning to the ED with a missed fracture was reduced by 21,674 cases and a reduction of 20, 916 unnecessary referrals to fracture clinics. The cost of current practice was estimated at £66,646,542 and £63,012,150 with the integration of AI. Overall, generating a return on investment of £3,634,392 to the NHS. The adoption of AI in EDs across England has the potential to generate cost savings. However, additional evidence on radiograph review accuracy and subsequent resource use is required to further demonstrate this.

Brain tumours continue to be a primary cause of worldwide death, highlighting the critical need for effective and accurate diagnostic tools. This article presents MK-YOLOv8, an innovative lightweight deep learning framework developed for the real-time detection and categorization of brain tumours from MRI images. Based on the YOLOv8 architecture, the proposed model incorporates Ghost Convolution, the C3Ghost module, and the SPPELAN module to improve feature extraction and substantially decrease computational complexity. An x-small object detection layer has been added, supporting precise detection of small and x-small tumours, which is crucial for early diagnosis. Trained on the Figshare Brain Tumour (FBT) dataset comprising (3,064) MRI images, MK-YOLOv8 achieved a mean Average Precision (mAP) of 99.1% at IoU (0.50) and 88.4% at IoU (0.50-0.95), outperforming YOLOv8 (98% and 78.8%, respectively). Glioma recall improved by 26%, underscoring the enhanced sensitivity to challenging tumour types. With a computational footprint of only 96.9 GFLOPs (representing 37.5% of YOYOLOv8x'sFLOPs) and utilizing 12.6 million parameters, a mere 18.5% of YOYOLOv8's parameters, MK-YOLOv8 delivers high efficiency with reduced resource demands. Also, it trained on the Br35H dataset (801 images) to guarantee the model's robustness and generalization; it achieved a mAP of 98.6% at IoU (0.50). The suggested model operates at 62 frames per second (FPS) and is suited for real-time clinical processes. These developments establish MK-YOLOv8 as an innovative framework, overcoming challenges in tiny tumour identification and providing a generalizable, adaptable, and precise detection approach for brain tumour diagnostics in clinical settings.

Tricuspid regurgitation jet velocity (TRJV) on echocardiography is used for screening patients with suspected pulmonary hypertension (PH). Artificial intelligence (AI) tools, such as the US2.AI, have been developed for automated evaluation of echocardiograms and can yield measurements that aid PH detection. This study evaluated the performance and utility of the US2.AI in a consecutive cohort of patients with suspected PH. 1031 patients who had been investigated for suspected PH between 2009-2021 were retrospectively identified from the ASPIRE registry. All patients had undergone echocardiography and right heart catheterisation (RHC). Based on RHC results, 771 (75%) patients with a mean pulmonary arterial pressure >20 mmHg were classified as having a diagnosis of PH (as per the 2022 European guidelines). Echocardiograms were evaluated manually and by the US2.AI tool to yield TRJV measurements. The AI tool demonstrated high interpretation yield, successfully measuring TRJV in 87% of echocardiograms. Manually and automatically derived TRJV values showed excellent agreement (intraclass correlation coefficient 0.94, 95% CI 0.94-0.95) with minimal bias (Bland-Altman analysis). Automated TRJV measurements showed equally high diagnostic accuracy for PH as manual measurements (area under the curve 0.88, 95% CI 0.84-0.90 <i>versus</i> 0.88, 95% CI 0.86-0.91). Automated TRJV measurements on echocardiography were similar to manual measurements, with similarly high and noninferior diagnostic accuracy for PH. These findings demonstrate that automated measurement of TRJV on echocardiography is feasible, accurate and reliable and support the implementation of AI-based approaches to echocardiogram evaluation and diagnostic imaging for PH.

Artificial intelligence (AI) systems have been implemented to improve the diagnostic yield and operators' skills within endoscopy. Similar AI systems are now emerging in bronchoscopy. Our objective was to identify and describe AI systems in bronchoscopy. A systematic review was performed using MEDLINE, Embase and Scopus databases, focusing on two terms: bronchoscopy and AI. All studies had to evaluate their AI against human ratings. The methodological quality of each study was assessed using the Medical Education Research Study Quality Instrument (MERSQI). 1196 studies were identified, with 20 passing the eligibility criteria. The studies could be divided into three categories: nine studies in airway anatomy and navigation, seven studies in computer-aided detection and classification of nodules in endobronchial ultrasound, and four studies in rapid on-site evaluation. 16 were assessment studies, with 12 showing equal performance and four showing superior performance of AI compared with human ratings. Four studies within airway anatomy implemented their AI, all favouring AI guidance to no AI guidance. The methodological quality of the studies was moderate (mean MERSQI 12.9 points, out of a maximum 18 points). 20 studies developed AI systems, with only four examining the implementation of their AI. The four studies were all within airway navigation and favoured AI to no AI in a simulated setting. Future implementation studies are warranted to test for the clinical effect of AI systems within bronchoscopy.

This narrative review outlines the current applications and considerations of artificial intelligence (AI) for diagnosis, management, and prognosis in rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), and psoriatic arthritis (PsA). Advances in AI, mainly in machine learning and deep learning, have significantly influenced medical research and clinical practice over the past decades by offering precisions in data understanding and treatment approaches. AI applications have enhanced risk prediction models, early diagnosis, and better management in RA. Predictive models have guided treatment decisions such as-response to methotrexate and biologics-while wearable devices and electronic health records (EHR) improve disease activity monitoring. In addition, AI applications are reported as promising for the early identification of extra-articular involvements, prediction, detection, and assessment of comorbidities. In axSpA, AI-driven models using imaging techniques such as sacroiliac radiography, magnetic resonance imaging, and computed tomography have increased diagnostic accuracy, especially for early inflammatory changes. Predictive algorithms help stratify and predict disease outcomes, while clinical decision support systems integrate clinical and imaging data for optimized management. For PsA, AI has also allowed for early detection among psoriasis patients using genetic markers, immune profiling, and EHR-based natural language processing systems. Overall, AI models may predict diagnosis, disease severity, treatment response, and comorbidities to improve care in patients with RA, axSpA, and PsA. As a rapidly developing and improving area, AI has the potential to change our current perspective of medical practice by offering better diagnostic evaluation and treatments and improved patient follow-up. Multimodal AI, focusing on collaboration, reliability, transparency, and patient-centered innovation, looks like the future of medical practice. However, data quality, model interpretability, and ethical considerations must be addressed to ensure reliable and equitable applications in clinical practice.

Interval breast cancers (IBCs) are detected between regular mammographic screenings after an initially negative result. Studies have shown that the prognosis of IBCs is similar to that of unscreened symptomatic cancers and is hence a surrogate used to assess the effectiveness of screening programs. This systematic review consolidates the current literature available on strategies to reduce the rates of IBC. Following PRISMA guidelines, three databases were searched from inception till October 29, 2023 to identify papers, which reported IBC rates. Key search terms included "interval breast cancer", "mammogram", "tomosynthesis" and "screening". A total of 32 articles were included. Fourteen studies discussed the use of digital breast tomosynthesis (DBT) as an alternative screening modality to mammograms. Six studies discussed the use of artificial intelligence (AI) on mammograms, five studies discussed the use of supplemental modalities including ultrasonography (US) in addition to mammograms, five studies discussed varying screening intervals and two studies discussed tamoxifen use. The trajectory of IBCs can be altered by early detection when they are more amenable to treatment, through advanced screening techniques, adjusting inter-screening intervals and modifiable risk factors. The goal is to create a screening protocol that is economically effective and accessible to various populations.

Advancements in medical imaging technology have facilitated the acquisition of high-quality brain images through computed tomography (CT) or magnetic resonance imaging (MRI), enabling professional brain specialists to diagnose brain tumors more effectively. However, manual diagnosis is time-consuming, which has led to the growing importance of automatic detection and classification through brain imaging. Conventional object detection models for brain tumor detection face limitations in brain tumor detection owing to the significant differences between medical images and natural scene images, as well as challenges such as complex backgrounds, noise interference, and blurred boundaries between cancerous and normal tissues. This study investigates the application of deep learning to brain tumor detection, analyzing the effect of three factors, the number of model parameters, input data batch size, and the use of anchor boxes, on detection performance. Experimental results reveal that an excessive number of model parameters or the use of anchor boxes may reduce detection accuracy. However, increasing the number of brain tumor samples improves detection performance. This study, introduces a backbone network built using RepConv and RepC3, along with FGConcat feature map splicing module to optimize the brain tumor detection model. The experimental results show that the proposed RepConv-RepC3-FGConcat Network (RRFNet) can learn underlying semantic information about brain tumors during training stage, while maintaining a low number of parameters during inference, which improves the speed of brain tumor detection. Compared with YOLOv8, RRFNet achieved a higher accuracy in brain tumor detection, with a mAP value of 79.2%. This optimized approach enhances both accuracy and efficiency, which is essential in clinical settings where time and precision are critical.