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MRI-based Radiomics for Predicting Prostate Cancer Grade Groups: A Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies.

Lomer NB, Ashoobi MA, Ahmadzadeh AM, Sotoudeh H, Tabari A, Torigian DA

pubmed logopapersJun 1 2025
Prostate cancer (PCa) is the second most common cancer among men and a leading cause of cancer-related mortalities. Radiomics has shown promising performances in the classification of PCa grade group (GG) in several studies. Here, we aimed to systematically review and meta-analyze the performance of radiomics in predicting GG in PCa. Adhering to PRISMA-DTA guidelines, we included studies employing magnetic resonance imaging-derived radiomics for predicting GG, with histopathologic evaluations as the reference standard. Databases searched included Web of Sciences, PubMed, Scopus, and Embase. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) and METhodological RadiomICs Score (METRICS) tools were used for quality assessment. Pooled estimates for sensitivity, specificity, likelihood ratios, diagnostic odds ratio, and area under the curve (AUC) were calculated. Cochran's Q and I-squared tests assessed heterogeneity, while meta-regression, subgroup analysis, and sensitivity analysis addressed potential sources. Publication bias was evaluated using Deek's funnel plot, while clinical applicability was assessed with Fagan nomograms and likelihood ratio scattergrams. Data were extracted from 43 studies involving 9983 patients. Radiomics models demonstrated high accuracy in predicting GG. Patient-based analyses yielded AUCs of 0.93 for GG≥2, 0.91 for GG≥3, and 0.93 for GG≥4. Lesion-based analyses showed AUCs of 0.84 for GG≥2 and 0.89 for GG≥3. Significant heterogeneity was observed, and meta-regression identified sources of heterogeneity. Radiomics model showed moderate power to exclude and confirm the GG. Radiomics appears to be an accurate noninvasive tool for predicting PCa GG. It improves the performance of standard diagnostic methods, enhancing clinical decision-making.

Integration of Deep Learning and Sub-regional Radiomics Improves the Prediction of Pathological Complete Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients.

Wu X, Wang J, Chen C, Cai W, Guo Y, Guo K, Chen Y, Shi Y, Chen J, Lin X, Jiang X

pubmed logopapersJun 1 2025
The precise prediction of response to neoadjuvant chemoradiotherapy is crucial for tailoring perioperative treatment in patients diagnosed with locally advanced rectal cancer (LARC). This retrospective study aims to develop and validate a model that integrates deep learning and sub-regional radiomics from MRI imaging to predict pathological complete response (pCR) in patients with LARC. We retrospectively enrolled 768 eligible participants from three independent hospitals who had received neoadjuvant chemoradiotherapy followed by radical surgery. Pretreatment pelvic MRI scans (T2-weighted), were collected for annotation and feature extraction. The K-means approach was used to segment the tumor into sub-regions. Radiomics and deep learning features were extracted by the Pyradiomics and 3D ResNet50, respectively. The predictive models were developed using the radiomics, sub-regional radiomics, and deep learning features with the machine learning algorithm in training cohort, and then validated in the external tests. The models' performance was assessed using various metrics, including the area under the curve (AUC), decision curve analysis, Kaplan-Meier survival analysis. We constructed a combined model, named SRADL, which includes deep learning with sub-regional radiomics signatures, enabling precise prediction of pCR in LARC patients. SRADL had satisfactory performance for the prediction of pCR in the training cohort (AUC 0.925 [95% CI 0.894 to 0.948]), and in test 1 (AUC 0.915 [95% CI 0.869 to 0.949]) and in test 2 (AUC 0.902 [95% CI 0.846 to 0.945]). By employing optimal threshold of 0.486, the predicted pCR group had longer survival compared to predicted non-pCR group across three cohorts. SRADL also outperformed other single-modality prediction models. The novel SRADL, which integrates deep learning with sub-regional signatures, showed high accuracy and robustness in predicting pCR to neoadjuvant chemoradiotherapy using pretreatment MRI images, making it a promising tool for the personalized management of LARC.

Deep Learning Radiomics Nomogram Based on MRI for Differentiating between Borderline Ovarian Tumors and Stage I Ovarian Cancer: A Multicenter Study.

Wang X, Quan T, Chu X, Gao M, Zhang Y, Chen Y, Bai G, Chen S, Wei M

pubmed logopapersJun 1 2025
To develop and validate a deep learning radiomics nomogram (DLRN) based on T2-weighted MRI to distinguish between borderline ovarian tumors (BOTs) and stage I epithelial ovarian cancer (EOC) preoperatively. This retrospective multicenter study enrolled 279 patients from three centers, divided into a training set (n = 207) and an external test set (n = 72). The intra- and peritumoral radiomics analysis was employed to develop a combined radiomics model. A deep learning model was constructed based on the largest orthogonal slices of the tumor volume, and a clinical model was constructed using independent clinical predictors. The DLRN was then constructed by integrating deep learning, intra- and peritumoral radiomics, and clinical predictors. For comparison, an original radiomics model based solely on tumor volume (excluding the peritumoral area) was also constructed. All models were validated through 10-fold cross-validation and external testing, and their predictive performance was evaluated by the area under the receiver operating characteristic curve (AUC). The DLRN demonstrated superior performance across the 10-fold cross-validation, with the highest AUC of 0.825±0.082. On the external test set, the DLRN significantly outperformed the clinical model and the original radiomics model (AUC = 0.819 vs. 0.708 and 0.670, P = 0.047 and 0.015, respectively). Furthermore, the combined radiomics model performed significantly better than the original radiomics model (AUC = 0.778 vs. 0.670, P = 0.043). The DLRN exhibited promising performance in distinguishing BOTs from stage I EOC preoperatively, thus potentially assisting clinical decision-making.

ChatGPT-4o's Performance in Brain Tumor Diagnosis and MRI Findings: A Comparative Analysis with Radiologists.

Ozenbas C, Engin D, Altinok T, Akcay E, Aktas U, Tabanli A

pubmed logopapersJun 1 2025
To evaluate the accuracy of ChatGPT-4o in identifying magnetic resonance imaging (MRI) findings and diagnosing brain tumors by comparing its performance with that of experienced radiologists. This retrospective study included 46 patients with pathologically confirmed brain tumors who underwent preoperative MRI between January 2021 and October 2024. Two experienced radiologists and ChatGPT 4o independently evaluated the anonymized MRI images. Eight questions focusing on MRI sequences, lesion characteristics, and diagnoses were answered. ChatGPT-4o's responses were compared to those of the radiologists and the pathology outcomes. Statistical analyses were performed, which included accuracy, sensitivity, specificity, and the McNemar test, with p<0.05 considered to indicate a statistically significant difference. ChatGPT-4o successfully identified 44 of the 46 (95.7%) lesions; it achieved 88.3% accuracy in identifying MRI sequences, 81% in perilesional edema, 79.5% in signal characteristics, and 82.2% in contrast enhancement. However, its accuracy in localizing lesions was 53.6% and that in distinguishing extra-axial from intra-axial lesions was 26.3%. As such, ChatGPT-4o achieved success rates of 56.8% and 29.5% for differential diagnoses and most likely diagnoses when compared to 93.2-90.9% and 70.5-65.9% for radiologists, respectively (p<0.005). ChatGPT-4o demonstrated high accuracy in identifying certain MRI features but underperformed in diagnostic tasks in comparison with the radiologists. Despite its current limitations, future updates and advancements have the potential to enable large language models to facilitate diagnosis and offer a reliable second opinion to radiologists.

Deep learning-based acceleration of high-resolution compressed sense MR imaging of the hip.

Marka AW, Meurer F, Twardy V, Graf M, Ebrahimi Ardjomand S, Weiss K, Makowski MR, Gersing AS, Karampinos DC, Neumann J, Woertler K, Banke IJ, Foreman SC

pubmed logopapersJun 1 2025
To evaluate a Compressed Sense Artificial Intelligence framework (CSAI) incorporating parallel imaging, compressed sense (CS), and deep learning for high-resolution MRI of the hip, comparing it with standard-resolution CS imaging. Thirty-two patients with femoroacetabular impingement syndrome underwent 3 T MRI scans. Coronal and sagittal intermediate-weighted TSE sequences with fat saturation were acquired using CS (0.6 ×0.8 mm resolution) and CSAI (0.3 ×0.4 mm resolution) protocols in comparable acquisition times (7:49 vs. 8:07 minutes for both planes). Two readers systematically assessed the depiction of the acetabular and femoral cartilage (in five cartilage zones), labrum, ligamentum capitis femoris, and bone using a five-point Likert scale. Diagnostic confidence and abnormality detection were recorded and analyzed using the Wilcoxon signed-rank test. CSAI significantly improved the cartilage depiction across most cartilage zones compared to CS. Overall Likert scores were 4.0 ± 0.2 (CS) vs 4.2 ± 0.6 (CSAI) for reader 1 and 4.0 ± 0.2 (CS) vs 4.3 ± 0.6 (CSAI) for reader 2 (p ≤ 0.001). Diagnostic confidence increased from 3.5 ± 0.7 and 3.9 ± 0.6 (CS) to 4.0 ± 0.6 and 4.1 ± 0.7 (CSAI) for readers 1 and 2, respectively (p ≤ 0.001). More cartilage lesions were detected with CSAI, with significant improvements in diagnostic confidence in certain cartilage zones such as femoral zone C and D for both readers. Labrum and ligamentum capitis femoris depiction remained similar, while bone depiction was rated lower. No abnormalities detected in CS were missed in CSAI. CSAI provides high-resolution hip MR images with enhanced cartilage depiction without extending acquisition times, potentially enabling more precise hip cartilage assessment.

Cross-site Validation of AI Segmentation and Harmonization in Breast MRI.

Huang Y, Leotta NJ, Hirsch L, Gullo RL, Hughes M, Reiner J, Saphier NB, Myers KS, Panigrahi B, Ambinder E, Di Carlo P, Grimm LJ, Lowell D, Yoon S, Ghate SV, Parra LC, Sutton EJ

pubmed logopapersJun 1 2025
This work aims to perform a cross-site validation of automated segmentation for breast cancers in MRI and to compare the performance to radiologists. A three-dimensional (3D) U-Net was trained to segment cancers in dynamic contrast-enhanced axial MRIs using a large dataset from Site 1 (n = 15,266; 449 malignant and 14,817 benign). Performance was validated on site-specific test data from this and two additional sites, and common publicly available testing data. Four radiologists from each of the three clinical sites provided two-dimensional (2D) segmentations as ground truth. Segmentation performance did not differ between the network and radiologists on the test data from Sites 1 and 2 or the common public data (median Dice score Site 1, network 0.86 vs. radiologist 0.85, n = 114; Site 2, 0.91 vs. 0.91, n = 50; common: 0.93 vs. 0.90). For Site 3, an affine input layer was fine-tuned using segmentation labels, resulting in comparable performance between the network and radiologist (0.88 vs. 0.89, n = 42). Radiologist performance differed on the common test data, and the network numerically outperformed 11 of the 12 radiologists (median Dice: 0.85-0.94, n = 20). In conclusion, a deep network with a novel supervised harmonization technique matches radiologists' performance in MRI tumor segmentation across clinical sites. We make code and weights publicly available to promote reproducible AI in radiology.

Deep Learning Classification of Ischemic Stroke Territory on Diffusion-Weighted MRI: Added Value of Augmenting the Input with Image Transformations.

Koska IO, Selver A, Gelal F, Uluc ME, Çetinoğlu YK, Yurttutan N, Serindere M, Dicle O

pubmed logopapersJun 1 2025
Our primary aim with this study was to build a patient-level classifier for stroke territory in DWI using AI to facilitate fast triage of stroke to a dedicated stroke center. A retrospective collection of DWI images of 271 and 122 consecutive acute ischemic stroke patients from two centers was carried out. Pretrained MobileNetV2 and EfficientNetB0 architectures were used to classify territorial subtypes as middle cerebral artery, posterior circulation, or watershed infarcts along with normal slices. Various input combinations using edge maps, thresholding, and hard attention versions were explored. The effect of augmenting the three-channel inputs of pre-trained models on classification performance was analyzed. ROC analyses and confusion matrix-derived performance metrics of the models were reported. Of the 271 patients included in this study, 151 (55.7%) were male and 120 (44.3%) were female. One hundred twenty-nine patients had MCA (47.6%), 65 patients had posterior circulation (24%), and 77 patients had watershed (28.0%) infarcts for center 1. Of the 122 patients from center 2, 78 (64%) were male and 44 (34%) were female. Fifty-two patients (43%) had MCA, 51 patients had posterior circulation (42%), and 19 (15%) patients had watershed infarcts. The Mobile-Crop model had the best performance with 0.95 accuracy and a 0.91 mean f1 score for slice-wise classification and 0.88 accuracy on external test sets, along with a 0.92 mean AUC. In conclusion, modified pre-trained models may be augmented with the transformation of images to provide a more accurate classification of affected territory by stroke in DWI.

MR Image Fusion-Based Parotid Gland Tumor Detection.

Sunnetci KM, Kaba E, Celiker FB, Alkan A

pubmed logopapersJun 1 2025
The differentiation of benign and malignant parotid gland tumors is of major significance as it directly affects the treatment process. In addition, it is also a vital task in terms of early and accurate diagnosis of parotid gland tumors and the determination of treatment planning accordingly. As in other diseases, the differentiation of tumor types involves several challenging, time-consuming, and laborious processes. In the study, Magnetic Resonance (MR) images of 114 patients with parotid gland tumors are used for training and testing purposes by Image Fusion (IF). After the Apparent Diffusion Coefficient (ADC), Contrast-enhanced T1-w (T1C-w), and T2-w sequences are cropped, IF (ADC, T1C-w), IF (ADC, T2-w), IF (T1C-w, T2-w), and IF (ADC, T1C-w, T2-w) datasets are obtained for different combinations of these sequences using a two-dimensional Discrete Wavelet Transform (DWT)-based fusion technique. For each of these four datasets, ResNet18, GoogLeNet, and DenseNet-201 architectures are trained separately, and thus, 12 models are obtained in the study. A Graphical User Interface (GUI) application that contains the most successful of these trained architectures for each data is also designed to support the users. The designed GUI application not only allows the fusing of different sequence images but also predicts whether the label of the fused image is benign or malignant. The results show that the DenseNet-201 models for IF (ADC, T1C-w), IF (ADC, T2-w), and IF (ADC, T1C-w, T2-w) are better than the others, with accuracies of 95.45%, 95.96%, and 92.93%, respectively. It is also noted in the study that the most successful model for IF (T1C-w, T2-w) is ResNet18, and its accuracy is equal to 94.95%.

Deep Learning Approaches for Brain Tumor Detection and Classification Using MRI Images (2020 to 2024): A Systematic Review.

Bouhafra S, El Bahi H

pubmed logopapersJun 1 2025
Brain tumor is a type of disease caused by uncontrolled cell proliferation in the brain leading to serious health issues such as memory loss and motor impairment. Therefore, early diagnosis of brain tumors plays a crucial role to extend the survival of patients. However, given the busy nature of the work of radiologists and aiming to reduce the likelihood of false diagnoses, advancing technologies including computer-aided diagnosis and artificial intelligence have shown an important role in assisting radiologists. In recent years, a number of deep learning-based methods have been applied for brain tumor detection and classification using MRI images and achieved promising results. The main objective of this paper is to present a detailed review of the previous researches in this field. In addition, This work summarizes the existing limitations and significant highlights. The study systematically reviews 60 articles researches published between 2020 and January 2024, extensively covering methods such as transfer learning, autoencoders, transformers, and attention mechanisms. The key findings formulated in this paper provide an analytic comparison and future directions. The review aims to provide a comprehensive understanding of automatic techniques that may be useful for professionals and academic communities working on brain tumor classification and detection.

Leveraging Ensemble Models and Follow-up Data for Accurate Prediction of mRS Scores from Radiomic Features of DSC-PWI Images.

Yassin MM, Zaman A, Lu J, Yang H, Cao A, Hassan H, Han T, Miao X, Shi Y, Guo Y, Luo Y, Kang Y

pubmed logopapersJun 1 2025
Predicting long-term clinical outcomes based on the early DSC PWI MRI scan is valuable for prognostication, resource management, clinical trials, and patient expectations. Current methods require subjective decisions about which imaging features to assess and may require time-consuming postprocessing. This study's goal was to predict multilabel 90-day modified Rankin Scale (mRS) score in acute ischemic stroke patients by combining ensemble models and different configurations of radiomic features generated from Dynamic susceptibility contrast perfusion-weighted imaging. In Follow-up studies, a total of 70 acute ischemic stroke (AIS) patients underwent magnetic resonance imaging within 24 hours poststroke and had a follow-up scan. In the single study, 150 DSC PWI Image scans for AIS patients. The DRF are extracted from DSC-PWI Scans. Then Lasso algorithm is applied for feature selection, then new features are generated from initial and follow-up scans. Then we applied different ensemble models to classify between three classes normal outcome (0, 1 mRS score), moderate outcome (2,3,4 mRS score), and severe outcome (5,6 mRS score). ANOVA and post-hoc Tukey HSD tests confirmed significant differences in model style performance across various studies and classification techniques. Stacking models consistently on average outperformed others, achieving an Accuracy of 0.68 ± 0.15, Precision of 0.68 ± 0.17, Recall of 0.65 ± 0.14, and F1 score of 0.63 ± 0.15 in the follow-up time study. Techniques like Bo_Smote showed significantly higher recall and F1 scores, highlighting their robustness and effectiveness in handling imbalanced data. Ensemble models, particularly Bagging and Stacking, demonstrated superior performance, achieving nearly 0.93 in Accuracy, 0.95 in Precision, 0.94 in Recall, and 0.94 in F1 metrics in follow-up conditions, significantly outperforming single models. Ensemble models based on radiomics generated from combining Initial and follow-up scans can be used to predict multilabel 90-day stroke outcomes with reduced subjectivity and user burden.
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