Prime Time for Artificial Intelligence in Interventional Radiology

Machine learning techniques, also known as artificial intelligence (AI), is about to dramatically change workflow and diagnostic capabilities in diagnostic radiology. The interest in AI in Interventional Radiology is rapidly gathering pace. With this early interest in AI in procedural medicine, IR could lead the way to AI research and clinical applications for all interventional medical fields. This review will address an overview of machine learning, radiomics and AI in the field of interventional radiology, enumerating the possible applications of such techniques, while also describing techniques to overcome the challenge of limited data when applying these techniques in interventional radiology. Lastly, this review will address common errors in research in this field and suggest pathways for those interested in learning and becoming involved about AI.

Overview of JET results for optimising ITER operation

The JET 2019-2020 scientific and technological programme exploited the results of years of concerted scientific and engineering work, including the ITER-like wall (ILW: Be wall and W divertor) installed in 2010, improved diagnostic capabilities now fully available, a major Neutral Beam Injection (NBI) upgrade providing record power in 2019-2020, and tested the technical & procedural preparation for safe operation with tritium. Research along three complementary axes yielded a wealth of new results. Firstly, the JET plasma programme delivered scenarios suitable for high fusion power and alpha particle physics in the coming D-T campaign (DTE2), with record sustained neutron rates, as well as plasmas for clarifying the impact of isotope mass on plasma core, edge and plasma-wall interactions, and for ITER pre-fusion power operation. The efficacy of the newly installed Shattered Pellet Injector for mitigating disruption forces and runaway electrons was demonstrated. Secondly, research on the consequences of long-term exposure to JET-ILW plasma was completed, with emphasis on wall damage and fuel retention, and with analyses of wall materials and dust particles that will help validate assumptions and codes for design & operation of ITER and DEMO. Thirdly, the nuclear technology programme aiming to deliver maximum technological return from operations in D, T and D-T benefited from the highest D-D neutron yield in years, securing results for validating radiation transport and activation codes, and nuclear data for ITER.

Diagnosis of liver fibrosis: an emphasis on elastography

In the strategy of managing patients with chronic diffuse liver diseases, the priority areas are the determination of the diagnosis with the determination of the main risk factors, the activity of the process (steatosis, steatohepatitis), as well as the degree of fibrous transformation. The rate of progression of liver fibrosis is a decisive factor that will determine the prognosis, treatment tactics and the likelihood of severe complications. The “gold standard” for diagnosing chronic liver pathology is a puncture liver biopsy with morphological examination of the liver tissue. At the same time, potential complications, contraindications to the procedure, low patient compliance, as well as errors in the interpretation of the results obtained due to various reasons are significant limitations of this diagnostic method. These shortcomings were the reason for the search for reliable non-invasive methods for diagnosing liver fibrosis both during the initial examination and during subsequent monitoring in dynamics. Modern methods of liver elastography are widely used for non-invasive assessment of fibrosis, demonstrating good diagnostic capabilities and significantly reducing the need for liver biopsy. Various elastography methods, which have their own advantages and disadvantages, effectively complement each other, which is successfully used in clinical practice in the diagnosis of fibrous transformation. The combined use of elastographic methods and commercial predictive diagnostic panels will increase the diagnostic accuracy in the determination of liver fibrosis.

Quantitative Computed Tomography, modern data. Review

In the review we discussed about the method of quantitative computed tomography (QCT, quantitative computed tomography). In QCT, X-ray density (HU) is converted to bone mineral density (BMD mg / ml) using linear relationships obtained by scanning calibration standards (phantoms). When compared with the normative age data, it is possible to diagnose osteoporosis (OP). The review presents various QCT techniques and their diagnostic capabilities in accordance with the positions of ISCD 2019 - (International Society for Clinical Densitometry). The results of comparison of QCT and conventional dual-energy X-ray absorptiometry (DXA) are considered. It is noted that in the study of the proximal femur (PF), the results of the methods are well comparable, according to the results of both methods, it is possible to diagnose OP by the T-score. However, when examining the spine QCT, the volume BMD of the trabecular bone of the vertebral bodies is assessed, and with DXA, the projection BMD is assessed. The approaches to the interpretation of the results are also different - diagnosis of OP in DXA of the spine based on the T-score, but in QCT, the ACR (American College of Radiology) criteria are used.We describe the phantoms used in QCT, as well as provide data on radiation exposure during QCT and DXA.The article describes an approach to opportunistic screening of osteoporosis by the QCT based on the results of previously performed CT scans, including its automated work-flow using artificial intelligence technologies. These promising techniques are attractive due to the large number of CT examinations performed and the exclusion of additional examinations.

A mechanism of abnormal motility of the esophagus and stomach and associated sound phenomenon

The aim of the article is to update the pathophysiological mechanisms that cause the appearance and activation of pathological peristalsis of the esophagus and stomach and associated esophageal-gastrointestinal-diaphragmatic noise, described earlier, designed to expand the diagnostic capabilities of physical methods for diagnosing hiatal hernia and to facilitate the differential diagnosis of this disease with other diseases of the chest. The result of the study is to describe 5 the pathophysiological mechanisms of developing hernia hiatal and lead to the emergence of pathological motility of the esophagus and stomach in the form of the strengthening or emergence of antiperistaltic waves. The resulting acoustic phenomenon is the essence of a new physical symptom in this disease - esophageal-gastrointestinal-diaphragmatic noise. The first mechanism that determines the pathological motor activity of the smooth muscle cells of the esophageal wall is the so-called esophageal “cleansing” peristalsis, which prevents the regurgitation of the acidic contents of the stomach into the esophagus, where the environment is normally neutral. The second mechanism that causes the appearance and strengthening of pathological peristalsis of the stomach is the deformation during the passage of its part through the esophageal opening of the diaphragm into the chest cavity. The third mechanism that determines the occurrence of pathological peristalsis of the esophagus and stomach is a violation of the secretion and metabolism of nitric oxide in diaphragmatic hernias. The fourth mechanism that leads to the appearance of esophageal-diaphragmatic noise is the pathological peristalsis of the esophagus and stomach in patients with hiatal hernia, which causes the appearance of antiperistaltic waves accompanied by gastro-esophageal reflux and manifests itself in clinically pathological belching. The fifth mechanism that causes pathological peristalsis of the esophagus is the phenomenon of hydrodynamic cavitation, which occurs as a result of regurgitation of the contents of the stomach into the esophagus. Understanding the pathophysiological mechanisms that cause the appearance of pathological peristalsis and antiperistalsis of the esophagus and stomach in patients with diaphragmatic hernia allows us to understand the causes of the sound phenomenon and the associated physical symptom in this disease.

ACR TI-RADS and ATA ultrasound classifications are helpful for the management of thyroid nodules located in the isthmus

PURPOSE: To compare the application value of the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) and the American Thyroid Association (ATA) guidelines in the risk stratification of thyroid isthmic nodules. METHODS: A total of 315 patients with thyroid isthmic nodules (315 nodules) confirmed by surgical pathology or fine-needle aspiration biopsy (FNAB) were selected in this retrospective study. The nodules were evaluated and classified according to ACR TI-RADS and the ATA guidelines. Taking pathological results as the reference, receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic capabilities of the ACR TI-RADS and the ATA guidelines for the risk stratification of thyroid isthmic nodules. The unnecessary biopsy rates and false-negative rates were compared. RESULTS: Multivariate analysis of ultrasonographic features of suspicious malignancies showed that an aspect ratio > 1 was not an independent risk factor for malignant thyroid nodules located in the isthmus (odds ratio: 3.193, 95%confidence interval: 0.882–11.552) (P = 0.077). The area under the ROC curves for diagnosing malignant thyroid nodules located in the isthmus in by the ACR TI-RADS and the ATA guidelines were 0.853 and 0.835, respectively. Under the management recommendations of the ACR TI-RADS and ATA guidelines, the false-negative rates of malignant thyroid nodules were 66.2%(ATA intermediate suspicion), 62.3%(ACR TR 4), 81.8%(ATA high suspicion) and 86.5%(ACR TR 5). CONCLUSION: Both the ACR TI-RADS and the ATA guidelines have high diagnostic capabilities for the risk stratification of thyroid isthmic nodules. For ACR TR 4 and 5 and ATA intermediate- and high-suspicion thyroid isthmic nodules with a maximum diameter < 1 cm, the criteria for puncture should be lowered, and FNAB should be done to clarify their diagnosis.

Attitudes Toward Artificial Intelligence Among Dermatologists in Morocco: A National Survey (Preprint)

BACKGROUND Artificial intelligence (AI) is a hot topic, and the use of AI in our day-to-day lives has increased exponentially. AI is becoming increasingly important in dermatology, with studies reporting accuracy matching or exceeding that of dermatologists in the diagnosis of skin lesions from clinical and dermoscopic images. However, little is known about the attitudes of dermatologists in Morocco toward AI. OBJECTIVE The purpose of this cross-sectional study was to evaluate the attitudes of dermatologists in Morocco toward AI. METHODS An online survey was distributed through Google Forms (Google LLC) to dermatologists in Morocco and was open from January to June 2021. Statistical analysis of the data collected was performed using Jamovi software. Any association for which the <i>P</i> value was &lt;.05 was considered statistically significant. RESULTS In total, 183 surveys were completed and analyzed. Overall, 79.8% of respondents were female, and the median age was 35 years (IQR 25-74 years). A total of 30.6% stated that they were not aware of AI, and 34.4% had a basic knowledge of AI technologies. Only 7.7% of the respondents strongly agreed that the human dermatologist will be replaced by AI in the foreseeable future. Of the entire group, 61.8% agreed or strongly agreed that AI will improve dermatology, and 70% thought that AI should be part of medical training. In addition, only 32.2% reported having read publications about AI. Female dermatologists showed more fear pertaining to the use of AI within dermatology (<i>P</i>=.01); this group also suggested that AI has a very strong potential in the detection of skin diseases using dermoscopic images (<i>P</i>=.03). CONCLUSIONS Our results demonstrate an overall optimistic attitude toward AI among dermatologists in Morocco. The majority of respondents believed that it will improve diagnostic capabilities.

Diagnostic signifcance of new hematological parameters in coronavirus infection

Bacterial infection, and as a result, sepsis is a formidable complication in patients with new coronavirus infection, and one of the leading factors in hospital mortality. In the context of the COVID-19 pandemic, the economic costs of health care for biochemical monitoring have increased signifcantly. There is a need for a new approach to the analysis and, possibly, structuring of the results of routine studies obtained through a general blood test. The aim of the work is to assess the diagnostic capabilities of the new hematological parameters NEUT-RI – neutrophil reactivity and NEUT-GI – neutrophil granularity obtained using the Sysmex XN hematological analyzer from the standpoint of sepsis diagnostics. We analyzed laboratory data from a sample of patients with coronavirus infection (n = 449). Subsequently, the general statistical population was divided into two groups according to the level of procalcitonin – PCT (cut off = 0.5 ng/ml). With PCT < 0.5 ng/ml, the presence of sepsis was considered as ‘unlikely’, with PCT > 0.5 ng/ml as ‘highly likely’ event. For mathematical data processing, traditional statistical analysis, ROC analysis and the author’s ‘probabilistic approach’ were used. According to the data obtained, at PCT < 0.5 ng/ml, there is a correlation of average strength between C-reactive protein and procalcitonin (r = 0.49, p < 0.05). In the range of high concentrations of procalcitonin (PCT > 0.5 ng/ml), the mathematical relationship between similar biochemical markers is lost. The absence of the informative value of lactate dehydrogenase in terms of the diagnosis of sepsis has been established. According to the research results, NEUT-RI ≥ 56.9 Fl with a probability of 72% (specifcity 62.0%, sensitivity 83.5%) indicates the presence of sepsis. The probability of an alternative prognosis (presence or absence of sepsis) in one or another interval of the NEUT-RI and NEUT-GI values was calculated. The narrow quantitative ranges of the NEUT-RI parameter were identifed, in which the probability of sepsis is absent – 0% (35–45 Fl) and very high – 77% (65–75 Fl).

Enhancing the diagnostic performance of Condition Based Maintenance through the fusion of sensor with maintenance data

Although Maintenance data is crucial for authoritative reporting reasons and is generally used to optimizemaintenance planning in terms of budget, scheduling and logistics, the potentials of the implicit given informationfor Prognostics and Health Management (PHM) frameworks are not yet completely leveraged. Traditional PHMframeworks typically rely only on sensor data to derive a system’s health status, while maintenance, repair andoverhaul (MRO) data is not investigated. However, maintenance data contains valuable information on which partof a system is checked, serviced or replaced. At the same time, maintenance data is necessary for the labelling ofsensor data, the differentiation of multiple failure modes and includes the expert knowledge of the worker. Theoverall goal of the presented work is enable a model update through the integration of this information into atraditional (sensor-based) PHM/condition monitoring framework.In this context, the underlying data bases and structures will be analyzed and a generalized methodology isproposed to include maintenance data directly into the forward-modelling phase of a PHM/condition monitoringframework. The main goal is not only to use the labels derived from maintenance data for evaluation purposes(which is a common practice in PHM research), but to use this data to build a memory of the maintenance andhealth state history and thereby enhance the diagnostic capabilities of the framework. Methods from the field ofProbabilistic Programming and Bayesian Statistics seem promising and are implemented in order to incorporatefor uncertainties and to enable a confidence level for the diagnosis. The proposed concept is developed, tested andassessed in a simulation environment, allowing to investigate the influence of data confidence and label uncertaintyon the results. Furthermore, this allows to derive specific requirements for the input data and hence for the dataacquisition in the real world. The proposed concept is described in a generic way to be applicable on differentengineering domains (e.g. wind turbine or production machinery industry), but it will be tested and evaluated on areal world aviation use case. This concluding use case is defined in the context of the project INDI at TU Darmstadt(Intelligent Data Utilization in Maintenance) in cooperation with the project partner Lufthansa Technik AG.

Theranostic Applications of Nanomaterials in Alzheimer’s Disease: A multifunctional Approach

: The blood–brain barrier (BBB) prevents the transfer of many therapeutic drugs across the brain. Therefore, the leading treatment strategies of Alzheimer’s disease (AD) are seen often unsuccessful. A further challenge is to achieve specific targetability across BBB and diagnosis. Herein, theranostic based strategies are emerging to combine therapeutic, targeting, and diagnostic capabilities. Recent nanotechnological advancements enable a common podium for formulation and development of efficient theranostics. This can be attained by engineering of some of the properties of nanomaterials, thus enabling them to become an efficient and suitable theranostic. In this review, we are discussing the various novel approaches of theranostic nanomaterials owing to multimodal functionality across the brain as an effective and probable treatment as well as early (timely) diagnosis of Alzheimer’s disease. In this respect, we conducted a PubMed search to review the latest development in theranostic nanomaterials especially for Alzheimer’s (major type of dementia) therapy that led us to discuss the present theranostic nanomaterials utilizing drug carriers and include cargo, targeting ligands, and imaging agents for delivery to particular tissues, cells, or subcellular components. Our focus is on strategies for syntheses, but we will also consider the challenges and prospects associated with this evolving technology. The current review includes knowledge of the history, overview of AD, and therapeutics with a future approach of using theranostic nanomaterials as personalized medicines.