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Register a new userObjective task-based evaluation of artificial intelligence-based medical imaging methods: Framework, strategies and role of the physician
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Artificial intelligence (AI)-based methods are showing promise in multiple medical-imaging applications. Thus, there is substantial interest in clinical translation of these methods, requiring in turn, that they be evaluated rigorously. In this paper, our goal is to lay out a framework for objective task-based evaluation of AI methods. We will also provide a list of tools available in the literature to conduct this evaluation. Further, we outline the important role of physicians in conducting these evaluation studies. The examples in this paper will be proposed in the context of PET with a focus on neural-network-based methods. However, the framework is also applicable to evaluate other medical-imaging modalities and other types of AI methods.
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Artificial intelligence (AI) classification holds promise as a novel and affordable screening tool for clinical management of ocular diseases. Rural and underserved areas, which suffer from lack of access to experienced ophthalmologists may particularly benefit from this technology. Quantitative optical coherence tomography angiography (OCTA) imaging provides excellent capability to identify subtle vascular distortions, which are useful for classifying retinovascular diseases. However, application of AI for differentiation and classification of multiple eye diseases is not yet established. In this study, we demonstrate supervised machine learning based multi-task OCTA classification. We sought 1) to differentiate normal from diseased ocular conditions, 2) to differentiate different ocular disease conditions from each other, and 3) to stage the severity of each ocular condition. Quantitative OCTA features, including blood vessel tortuosity (BVT), blood vascular caliber (BVC), vessel perimeter index (VPI), blood vessel density (BVD), foveal avascular zone (FAZ) area (FAZ-A), and FAZ contour irregularity (FAZ-CI) were fully automatically extracted from the OCTA images. A stepwise backward elimination approach was employed to identify sensitive OCTA features and optimal-feature-combinations for the multi-task classification. For proof-of-concept demonstration, diabetic retinopathy (DR) and sickle cell retinopathy (SCR) were used to validate the supervised machine leaning classifier. The presented AI classification methodology is applicable and can be readily extended to other ocular diseases, holding promise to enable a mass-screening platform for clinical deployment and telemedicine.
Schizophrenia (SZ) is a mental disorder that typically emerges in late adolescence or early adulthood. It reduces the life expectancy of patients by 15 years. Abnormal behavior, perception of emotions, social relationships, and reality perception are among its most significant symptoms. Past studies have revealed the temporal and anterior lobes of hippocampus regions of brain get affected by SZ. Also, increased volume of cerebrospinal fluid (CSF) and decreased volume of white and gray matter can be observed due to this disease. The magnetic resonance imaging (MRI) is the popular neuroimaging technique used to explore structural/functional brain abnormalities in SZ disorder owing to its high spatial resolution. Various artificial intelligence (AI) techniques have been employed with advanced image/signal processing methods to obtain accurate diagnosis of SZ. This paper presents a comprehensive overview of studies conducted on automated diagnosis of SZ using MRI modalities. Main findings, various challenges, and future works in developing the automated SZ detection are described in this paper.
In SPECT, list-mode (LM) format allows storing data at higher precision compared to binned data. There is significant interest in investigating whether this higher precision translates to improved performance on clinical tasks. Towards this goal, in this study, we quantitatively investigated whether processing data in LM format, and in particular, the energy attribute of the detected photon, provides improved performance on the task of absolute quantification of region-of-interest (ROI) uptake in comparison to processing the data in binned format. We conducted this evaluation study using a DaTscan brain SPECT acquisition protocol, conducted in the context of imaging patients with Parkinsons disease. This study was conducted with a synthetic phantom. A signal-known exactly/background-known-statistically (SKE/BKS) setup was considered. An ordered-subset expectation-maximization algorithm was used to reconstruct images from data acquired in LM format, including the scatter-window data, and including the energy attribute of each LM event. Using a realistic 2-D SPECT system simulation, quantification tasks were performed on the reconstructed images. The results demonstrated improved quantification performance when LM data was used compared to binning the attributes in all the conducted evaluation studies. Overall, we observed that LM data, including the energy attribute, yielded improved performance on absolute quantification tasks compared to binned data.
Medical imaging is widely used in cancer diagnosis and treatment, and artificial intelligence (AI) has achieved tremendous success in various tasks of medical image analysis. This paper reviews AI-based tumor subregion analysis in medical imaging. We summarize the latest AI-based methods for tumor subregion analysis and their applications. Specifically, we categorize the AI-based methods by training strategy: supervised and unsupervised. A detailed review of each category is presented, highlighting important contributions and achievements. Specific challenges and potential AI applications in tumor subregion analysis are discussed.
Objective evaluation of new and improved methods for PET imaging requires access to images with ground truth, as can be obtained through simulation studies. However, for these studies to be clinically relevant, it is important that the simulated images are clinically realistic. In this study, we develop a stochastic and physics-based method to generate realistic oncological two-dimensional (2-D) PET images, where the ground-truth tumor properties are known. The developed method extends upon a previously proposed approach. The approach captures the observed variabilities in tumor properties from actual patient population. Further, we extend that approach to model intra-tumor heterogeneity using a lumpy object model. To quantitatively evaluate the clinical realism of the simulated images, we conducted a human-observer study. This was a two-alternative forced-choice (2AFC) study with trained readers (five PET physicians and one PET physicist). Our results showed that the readers had an average of ~ 50% accuracy in the 2AFC study. Further, the developed simulation method was able to generate wide varieties of clinically observed tumor types. These results provide evidence for the application of this method to 2-D PET imaging applications, and motivate development of this method to generate 3-D PET images.
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