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Practical applications of AI in body imaging.

Mervak BM, Fried JG, Neshewat J, Wasnik AP

pubmed logopapersJun 27 2025
Artificial intelligence (AI) algorithms and deep learning continue to change the landscape of radiology. New algorithms promise to enhance diagnostic accuracy, improve workflow efficiency, and automate repetitive tasks. This article provides a narrative review of the FDA-cleared AI algorithms which are commercially available in the United States as of late 2024 and targeted toward assessment of abdominopelvic organs and related diseases, evaluates potential advantages of using AI, and suggests future directions for the field.

Deep-Learning Based Contrast Boosting Improves Lesion Visualization and Image Quality: A Multi-Center Multi-Reader Study on Clinical Performance with Standard Contrast Enhanced MRI of Brain Tumors

Pasumarthi, S., Campbell Arnold, T., Colombo, S., Rudie, J. D., Andre, J. B., Elor, R., Gulaka, P., Shankaranarayanan, A., Erb, G., Zaharchuk, G.

medrxiv logopreprintJun 13 2025
BackgroundGadolinium-based Contrast Agents (GBCAs) are used in brain MRI exams to improve the visualization of pathology and improve the delineation of lesions. Higher doses of GBCAs can improve lesion sensitivity but involve substantial deviation from standard-of-care procedures and may have safety implications, particularly in the light of recent findings on gadolinium retention and deposition. PurposeTo evaluate the clinical performance of an FDA cleared deep-learning (DL) based contrast boosting algorithm in routine clinical brain MRI exams. MethodsA multi-center retrospective database of contrast-enhanced brain MRI images (obtained from April 2017 to December 2023) was used to evaluate a DL-based contrast boosting algorithm. Pre-contrast and standard post-contrast (SC) images were processed with the algorithm to obtain contrast boosted (CB) images. Quantitative performance of CB images in comparison to SC images was compared using contrast-to-noise ratio (CNR), lesion-to-brain ratio (LBR) and contrast enhancement percentage (CEP). Three board-certified radiologists reviewed CB and SC images side-by-side for qualitative evaluation and rated them on a 4-point Likert scale for lesion contrast enhancement, border delineation, internal morphology, overall image quality, presence of artefacts, and changes in vessel conspicuity. The presence, cause, and severity of any false lesions was recorded. CB results were compared to SC using Wilcoxon signed rank test for statistical significance. ResultsBrain MRI images from 110 patients (47 {+/-} 22 years; 52 Females, 47 Males, 11 N/A) were evaluated. CB images had superior quantitative performance than SC images in terms of CNR (+634%), LBR (+70%) and CEP (+150%). In the qualitative assessment CB images showed better lesion visualization (3.73 vs 3.16) and had better image quality (3.55 vs 3.07). Readers were able to rule out all false lesions on CB by using SC for comparison. ConclusionsDeep learning based contrast boosting improves lesion visualization and image quality without increasing contrast dosage. Key ResultsO_LIIn a retrospective study of 110 patients, deep-learning based contrast boosted (CB) images showed better lesion visualization than standard post-contrast (SC) brain MRI images (3.73 vs 3.16; mean reader scores [4-point Likert scale]) C_LIO_LICB images had better overall image quality than SC images (3.55 vs 3.07) C_LIO_LIContrast-to-noise ratio, Lesion-to-brain Ratio and Contrast Enhancement Percentage for CB images were significantly higher than SC images (+729%, +88% and +165%; p < 0.001) C_LI Summary StatementDeep-learning based contrast boosting achieves better lesion visualization and overall image quality and provides more contrast information, without increasing the contrast dosage in contrast-enhanced brain MR protocols.

Curriculum check, 2025-equipping radiology residents for AI challenges of tomorrow.

Venugopal VK, Kumar A, Tan MO, Szarf G

pubmed logopapersJun 9 2025
The exponential rise in the artificial intelligence (AI) tools for medical imaging is profoundly impacting the practice of radiology. With over 1000 FDA-cleared AI algorithms now approved for clinical use-many of them designed for radiologic tasks-the responsibility lies with training institutions to ensure that radiology residents are equipped not only to use AI systems, but to critically evaluate, monitor, respond to their output in a safe, ethical manner. This review proposes a comprehensive framework to integrate AI into radiology residency curricula, targeting both essential competencies required of all residents, optional advanced skills for those interested in research or AI development. Core educational strategies include structured didactic instruction, hands-on lab exposure to commercial AI tools, case-based discussions, simulation-based clinical pathways, teaching residents how to interpret model cards, regulatory documentation. Clinical examples such as stroke triage, Urinary tract calculi detection, AI-CAD in mammography, false-positive detection are used to anchor theory in practice. The article also addresses critical domains of AI governance: model transparency, ethical dilemmas, algorithmic bias, the role of residents in human-in-the-loop oversight systems. It outlines mentorship, faculty development strategies to build institutional readiness, proposes a roadmap to future-proof radiology education. This includes exposure to foundation models, vision-language systems, multi-agent workflows, global best practices in post-deployment AI monitoring. This pragmatic framework aims to serve as a guide for residency programs adapting to the next era of radiology practice.

Current utilization and impact of AI LVO detection tools in acute stroke triage: a multicenter survey analysis.

Darkhabani Z, Ezzeldin R, Delora A, Kass-Hout O, Alderazi Y, Nguyen TN, El-Ghanem M, Anwoju T, Ali Z, Ezzeldin M

pubmed logopapersJun 7 2025
Artificial intelligence (AI) tools for large vessel occlusion (LVO) detection are increasingly used in acute stroke triage to expedite diagnosis and intervention. However, variability in access and workflow integration limits their potential impact. This study assessed current usage patterns, access disparities, and integration levels across U.S. stroke programs. Cross-sectional, web-based survey of 97 multidisciplinary stroke care providers from diverse institutions. Descriptive statistics summarized demographics, AI tool usage, access, and integration. Two-proportion Z-tests assessed differences across institutional types. Most respondents (97.9%) reported AI tool use, primarily Viz AI and Rapid AI, but only 62.1% consistently used them for triage prior to radiologist interpretation. Just 37.5% reported formal protocol integration, and 43.6% had designated personnel for AI alert response. Access varied significantly across departments, and in only 61.7% of programs did all relevant team members have access. Formal implementation of the AI detection tools did not differ based on the certification (z = -0.2; <i>p</i> = 0.4) or whether the program was academic or community-based (z =-0.3; <i>p</i> = 0.3). AI-enabled LVO detection tools have the potential to improve stroke care and patient outcomes by expediting workflows and reducing treatment delays. This survey effectively evaluated current utilization of these tools and revealed widespread adoption alongside significant variability in access, integration, and workflow standardization. Larger, more diverse samples are needed to validate these findings across different hospital types, and further prospective research is essential to determine how formal integration of AI tools can enhance stroke care delivery, reduce disparities, and improve clinical outcomes.

Inconsistency of AI in intracranial aneurysm detection with varying dose and image reconstruction.

Goelz L, Laudani A, Genske U, Scheel M, Bohner G, Bauknecht HC, Mutze S, Hamm B, Jahnke P

pubmed logopapersJun 6 2025
Scanner-related changes in data quality are common in medical imaging, yet monitoring their impact on diagnostic AI performance remains challenging. In this study, we performed standardized consistency testing of an FDA-cleared and CE-marked AI for triage and notification of intracranial aneurysms across changes in image data quality caused by dose and image reconstruction. Our assessment was based on repeated examinations of a head CT phantom designed for AI evaluation, replicating a patient with three intracranial aneurysms in the anterior, middle and posterior circulation. We show that the AI maintains stable performance within the medium dose range but produces inconsistent results at reduced dose and, unexpectedly, at higher dose when filtered back projection is used. Data quality standards required for AI are stricter than those for neuroradiologists, who report higher aneurysm visibility rates and experience performance degradation only at substantially lower doses, with no decline at higher doses.

External validation and performance analysis of a deep learning-based model for the detection of intracranial hemorrhage.

Nada A, Sayed AA, Hamouda M, Tantawi M, Khan A, Alt A, Hassanein H, Sevim BC, Altes T, Gaballah A

pubmed logopapersJun 1 2025
PurposeWe aimed to investigate the external validation and performance of an FDA-approved deep learning model in labeling intracranial hemorrhage (ICH) cases on a real-world heterogeneous clinical dataset. Furthermore, we delved deeper into evaluating how patients' risk factors influenced the model's performance and gathered feedback on satisfaction from radiologists of varying ranks.MethodsThis prospective IRB approved study included 5600 non-contrast CT scans of the head in various clinical settings, that is, emergency, inpatient, and outpatient units. The patients' risk factors were collected and tested for impacting the performance of DL model utilizing univariate and multivariate regression analyses. The performance of DL model was contrasted to the radiologists' interpretation to determine the presence or absence of ICH with subsequent classification into subcategories of ICH. Key metrics, including accuracy, sensitivity, specificity, positive predictive value, and negative predictive value, were calculated. Receiver operating characteristics curve, along with the area under the curve, were determined. Additionally, a questionnaire was conducted with radiologists of varying ranks to assess their experience with the model.ResultsThe model exhibited outstanding performance, achieving a high sensitivity of 89% and specificity of 96%. Additional performance metrics, including positive predictive value (82%), negative predictive value (97%), and overall accuracy (94%), underscore its robust capabilities. The area under the ROC curve further demonstrated the model's efficacy, reaching 0.954. Multivariate logistic regression revealed statistical significance for age, sex, history of trauma, operative intervention, HTN, and smoking.ConclusionOur study highlights the satisfactory performance of the DL model on a diverse real-world dataset, garnering positive feedback from radiology trainees.

Artificial Intelligence in Vascular Neurology: Applications, Challenges, and a Review of AI Tools for Stroke Imaging, Clinical Decision Making, and Outcome Prediction Models.

Alqadi MM, Vidal SGM

pubmed logopapersMay 9 2025
Artificial intelligence (AI) promises to compress stroke treatment timelines, yet its clinical return on investment remains uncertain. We interrogate state‑of‑the‑art AI platforms across imaging, workflow orchestration, and outcome prediction to clarify value drivers and execution risks. Convolutional, recurrent, and transformer architectures now trigger large‑vessel‑occlusion alerts, delineate ischemic core in seconds, and forecast 90‑day function. Commercial deployments-RapidAI, Viz.ai, Aidoc-report double‑digit reductions in door‑to‑needle metrics and expanded thrombectomy eligibility. However, dataset bias, opaque reasoning, and limited external validation constrain scalability. Hybrid image‑plus‑clinical models elevate predictive accuracy but intensify data‑governance demands. AI can operationalize precision stroke care, but enterprise‑grade adoption requires federated data pipelines, explainable‑AI dashboards, and fit‑for‑purpose regulation. Prospective multicenter trials and continuous lifecycle surveillance are mandatory to convert algorithmic promise into reproducible, equitable patient benefit.

Automated Emergent Large Vessel Occlusion Detection Using Viz.ai Software and Its Impact on Stroke Workflow Metrics and Patient Outcomes in Stroke Centers: A Systematic Review and Meta-analysis.

Sarhan K, Azzam AY, Moawad MHED, Serag I, Abbas A, Sarhan AE

pubmed logopapersMay 8 2025
The implementation of artificial intelligence (AI), particularly Viz.ai software in stroke care, has emerged as a promising tool to enhance the detection of large vessel occlusion (LVO) and to improve stroke workflow metrics and patient outcomes. The aim of this systematic review and meta-analysis is to evaluate the impact of Viz.ai on stroke workflow efficiency in hospitals and on patients' outcomes. Following the PRISMA guidelines, we conducted a comprehensive search on electronic databases, including PubMed, Web of Science, and Scopus databases, to obtain relevant studies until 25 October 2024. Our primary outcomes were door-to-groin puncture (DTG) time, CT scan-to-start of endovascular treatment (EVT) time, CT scan-to-recanalization time, and door-in-door-out time. Secondary outcomes included symptomatic intracranial hemorrhage (ICH), any ICH, mortality, mRS score < 2 at 90 days, and length of hospital stay. A total of 12 studies involving 15,595 patients were included in our analysis. The pooled analysis demonstrated that the implementation of the Viz.ai algorithm was associated with lesser CT scan to EVT time (SMD -0.71, 95% CI [-0.98, -0.44], p < 0.001) and DTG time (SMD -0.50, 95% CI [-0.66, -0.35], p < 0.001) as well as CT to recanalization time (SMD -0.55, 95% CI [-0.76, -0.33], p < 0.001). Additionally, patients in the post-AI group had significantly lower door-in door-out time than the pre-AI group (SMD -0.49, 95% CI [-0.71, -0.28], p < 0.001). Despite the workflow metrics improvement, our analysis did not reveal statistically significant differences in patient clinical outcomes (p > 0.05). Our results suggest that the integration of the Viz.ai platform in stroke care holds significant potential for reducing EVT delays in patients with LVO and optimizing stroke flow metrics in comprehensive stroke centers. Further studies are required to validate its efficacy in improving clinical outcomes in patients with LVO.
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