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[Orthodontics in the CBCT era: 25 years later, what are the guidelines?].

Foucart JM, Papelard N, Bourriau J

pubmed logopapersMay 15 2025
CBCT has become an essential tool in orthodontics, although its use must remain judicious and evidence-based. This study provides an updated analysis of international recommendations concerning the use of CBCT in orthodontics, with a particular focus on clinical indications, radiation dose reduction, and recent technological advancements. A systematic review of guidelines published between 2015 and 2025 was conducted following the PRISMA methodology. Inclusion criteria comprised official directives from recognized scientific societies and clinical studies evaluating low dose protocols in orthodontics. The analysis of the 19 retained recommendations reveals a consensus regarding the primary indications for CBCT in orthodontics, particularly for impacted teeth, skeletal anomalies, periodontal and upper airways assessment. Dose optimization and the integration of artificial intelligence emerge as major advancements, enabling significant radiation reduction while preserving diagnostic accuracy. The development of low dose protocols and advanced reconstruction algorithms presents promising perspectives for safer and more efficient imaging, increasingly replacing conventional 2D radiographic techniques. However, an international harmonization of recommendations for these new imaging sequences is imperative to standardize clinical practices and enhance patient radioprotection.

Challenges in Implementing Artificial Intelligence in Breast Cancer Screening Programs: Systematic Review and Framework for Safe Adoption.

Goh S, Goh RSJ, Chong B, Ng QX, Koh GCH, Ngiam KY, Hartman M

pubmed logopapersMay 15 2025
Artificial intelligence (AI) studies show promise in enhancing accuracy and efficiency in mammographic screening programs worldwide. However, its integration into clinical workflows faces several challenges, including unintended errors, the need for professional training, and ethical concerns. Notably, specific frameworks for AI imaging in breast cancer screening are still lacking. This study aims to identify the challenges associated with implementing AI in breast screening programs and to apply the Consolidated Framework for Implementation Research (CFIR) to discuss a practical governance framework for AI in this context. Three electronic databases (PubMed, Embase, and MEDLINE) were searched using combinations of the keywords "artificial intelligence," "regulation," "governance," "breast cancer," and "screening." Original studies evaluating AI in breast cancer detection or discussing challenges related to AI implementation in this setting were eligible for review. Findings were narratively synthesized and subsequently mapped directly onto the constructs within the CFIR. A total of 1240 results were retrieved, with 20 original studies ultimately included in this systematic review. The majority (n=19) focused on AI-enhanced mammography, while 1 addressed AI-enhanced ultrasound for women with dense breasts. Most studies originated from the United States (n=5) and the United Kingdom (n=4), with publication years ranging from 2019 to 2023. The quality of papers was rated as moderate to high. The key challenges identified were reproducibility, evidentiary standards, technological concerns, trust issues, as well as ethical, legal, societal concerns, and postadoption uncertainty. By aligning these findings with the CFIR constructs, action plans targeting the main challenges were incorporated into the framework, facilitating a structured approach to addressing these issues. This systematic review identifies key challenges in implementing AI in breast cancer screening, emphasizing the need for consistency, robust evidentiary standards, technological advancements, user trust, ethical frameworks, legal safeguards, and societal benefits. These findings can serve as a blueprint for policy makers, clinicians, and AI developers to collaboratively advance AI adoption in breast cancer screening. PROSPERO CRD42024553889; https://tinyurl.com/mu4nwcxt.

CirnetamorNet: An ultrasonic temperature measurement network for microwave hyperthermia based on deep learning.

Cui F, Du Y, Qin L, Li B, Li C, Meng X

pubmed logopapersMay 9 2025
Microwave thermotherapy is a promising approach for cancer treatment, but accurate noninvasive temperature monitoring remains challenging. This study aims to achieve accurate temperature prediction during microwave thermotherapy by efficiently integrating multi-feature data, thereby improving the accuracy and reliability of noninvasive thermometry techniques. We proposed an enhanced recurrent neural network architecture, namely CirnetamorNet. The experimental data acquisition system is developed by using the material that simulates the characteristics of human tissue to construct the body model. Ultrasonic image data at different temperatures were collected, and 5 parameters with high temperature correlation were extracted from gray scale covariance matrix and Homodyned-K distribution. Using multi-feature data as input and temperature prediction as output, the CirnetamorNet model is constructed by multi-head attention mechanism. Model performance was evaluated by analyzing training losses, predicting mean square error and accuracy, and ablation experiments were performed to evaluate the contribution of each module. Compared with common models, the CirnetamorNet model performs well, with training losses as low as 1.4589 and mean square error of only 0.1856. Its temperature prediction accuracy of 0.3°C exceeds that of many advanced models. Ablation experiments show that the removal of any key module of the model will lead to performance degradation, which proves that the collaboration of all modules is significant for improving the performance of the model. The proposed CirnetamorNet model exhibits exceptional performance in noninvasive thermometry for microwave thermotherapy. It offers a novel approach to multi-feature data fusion in the medical field and holds significant practical application value.

Multistage Diffusion Model With Phase Error Correction for Fast PET Imaging.

Gao Y, Huang Z, Xie X, Zhao W, Yang Q, Yang X, Yang Y, Zheng H, Liang D, Liu J, Chen R, Hu Z

pubmed logopapersMay 7 2025
Fast PET imaging is clinically important for reducing motion artifacts and improving patient comfort. While recent diffusion-based deep learning methods have shown promise, they often fail to capture the true PET degradation process, suffer from accumulated inference errors, introduce artifacts, and require extensive reconstruction iterations. To address these challenges, we propose a novel multistage diffusion framework tailored for fast PET imaging. At the coarse level, we design a multistage structure to approximate the temporal non-linear PET degradation process in a data-driven manner, using paired PET images collected under different acquisition duration. A Phase Error Correction Network (PECNet) ensures consistency across stages by correcting accumulated deviations. At the fine level, we introduce a deterministic cold diffusion mechanism, which simulates intra-stage degradation through interpolation between known acquisition durations-significantly reducing reconstruction iterations to as few as 10. Evaluations on [<sup>68</sup>Ga]FAPI and [<sup>18</sup>F]FDG PET datasets demonstrate the superiority of our approach, achieving peak PSNRs of 36.2 dB and 39.0 dB, respectively, with average SSIMs over 0.97. Our framework offers high-fidelity PET imaging with fewer iterations, making it practical for accelerated clinical imaging.

Prompt Engineering for Large Language Models in Interventional Radiology.

Dietrich N, Bradbury NC, Loh C

pubmed logopapersMay 7 2025
Prompt engineering plays a crucial role in optimizing artificial intelligence (AI) and large language model (LLM) outputs by refining input structure, a key factor in medical applications where precision and reliability are paramount. This Clinical Perspective provides an overview of prompt engineering techniques and their relevance to interventional radiology (IR). It explores key strategies, including zero-shot, one- or few-shot, chain-of-thought, tree-of-thought, self-consistency, and directional stimulus prompting, demonstrating their application in IR-specific contexts. Practical examples illustrate how these techniques can be effectively structured for workplace and clinical use. Additionally, the article discusses best practices for designing effective prompts and addresses challenges in the clinical use of generative AI, including data privacy and regulatory concerns. It concludes with an outlook on the future of generative AI in IR, highlighting advances including retrieval-augmented generation, domain-specific LLMs, and multimodal models.

The added value of artificial intelligence using Quantib Prostate for the detection of prostate cancer at multiparametric magnetic resonance imaging.

Russo T, Quarta L, Pellegrino F, Cosenza M, Camisassa E, Lavalle S, Apostolo G, Zaurito P, Scuderi S, Barletta F, Marzorati C, Stabile A, Montorsi F, De Cobelli F, Brembilla G, Gandaglia G, Briganti A

pubmed logopapersMay 7 2025
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.

New Targets for Imaging in Nuclear Medicine.

Brink A, Paez D, Estrada Lobato E, Delgado Bolton RC, Knoll P, Korde A, Calapaquí Terán AK, Haidar M, Giammarile F

pubmed logopapersMay 6 2025
Nuclear medicine is rapidly evolving with new molecular imaging targets and advanced computational tools that promise to enhance diagnostic precision and personalized therapy. Recent years have seen a surge in novel PET and SPECT tracers, such as those targeting prostate-specific membrane antigen (PSMA) in prostate cancer, fibroblast activation protein (FAP) in tumor stroma, and tau protein in neurodegenerative disease. These tracers enable more specific visualization of disease processes compared to traditional agents, fitting into a broader shift toward precision imaging in oncology and neurology. In parallel, artificial intelligence (AI) and machine learning techniques are being integrated into tracer development and image analysis. AI-driven methods can accelerate radiopharmaceutical discovery, optimize pharmacokinetic properties, and assist in interpreting complex imaging datasets. This editorial provides an expanded overview of emerging imaging targets and techniques, including theranostic applications that pair diagnosis with radionuclide therapy, and examines how AI is augmenting nuclear medicine. We discuss the implications of these advancements within the field's historical trajectory and address the regulatory, manufacturing, and clinical challenges that must be navigated. Innovations in molecular targeting and AI are poised to transform nuclear medicine practice, enabling more personalized diagnostics and radiotheranostic strategies in the era of precision healthcare.
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