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Rogue AI: Cautionary Cases in Neuroradiology and What We Can Learn From Them.

作者信息

Young Austin, Tan Kevin, Tariq Faiq, Jin Michael X, Bluestone Avraham Y

机构信息

Department of Radiology, Stony Brook University Hospital, Stony Brook, USA.

出版信息

Cureus. 2024 Mar 17;16(3):e56317. doi: 10.7759/cureus.56317. eCollection 2024 Mar.


DOI:10.7759/cureus.56317
PMID:38628986
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11019475/
Abstract

Introduction In recent years, artificial intelligence (AI) in medical imaging has undergone unprecedented innovation and advancement, sparking a revolutionary transformation in healthcare. The field of radiology is particularly implicated, as clinical radiologists are expected to interpret an ever-increasing number of complex cases in record time. Machine learning software purchased by our institution is expected to help our radiologists come to a more prompt diagnosis by delivering point-of-care quantitative analysis of suspicious findings and streamlining clinical workflow. This paper explores AI's impact on neuroradiology, an area accounting for a substantial portion of recent radiology studies. We present a case series evaluating an AI software's performance in detecting neurovascular findings, highlighting five cases where AI interpretations differed from radiologists' assessments. Our study underscores common pitfalls of AI in the context of CT head angiograms, aiming to guide future AI algorithms.  Methods We conducted a retrospective case series study at Stony Brook University Hospital, a large medical center in Stony Brook, New York, spanning from October 1, 2021 to December 31, 2021, analyzing 140 randomly sampled CT angiograms using AI software. This software assessed various neurovascular parameters, and AI findings were compared with neuroradiologists' interpretations. Five cases with divergent interpretations were selected for detailed analysis. Results Five representative cases in which AI findings were discordant with radiologists' interpretations are presented with diagnoses including diffuse anoxic ischemic injury, cortical laminar necrosis, colloid cyst, right superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass, and subacute bilateral subdural hematomas. Discussion The errors identified in our case series expose AI's limitations in radiology. Our case series reveals that AI's incorrect interpretations can stem from complexities in pathology, challenges in distinguishing densities, inability to identify artifacts, identifying post-surgical changes in normal anatomy, sensitivity limitations, and insufficient pattern recognition. AI's potential for improvement lies in refining its algorithms to effectively recognize and differentiate pathologies. Incorporating more diverse training datasets, multimodal data, deep-reinforcement learning, clinical context, and real-time learning capabilities are some ways to improve AI's performance in the field of radiology. Conclusion Overall, it is apparent that AI applications in radiology have much room for improvement before becoming more widely integrated into clinical workflows. While AI demonstrates remarkable potential to aid in diagnosis and streamline workflows, our case series highlights common pitfalls that underscore the need for continuous improvement. By refining algorithms, incorporating diverse datasets, embracing multimodal information, and leveraging innovative machine learning strategies, AI's diagnostic accuracy can be significantly improved.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258a/11019475/dac4d67de854/cureus-0016-00000056317-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258a/11019475/c9397eb28ebe/cureus-0016-00000056317-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258a/11019475/0b53fa86135a/cureus-0016-00000056317-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258a/11019475/a096eba52fb8/cureus-0016-00000056317-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258a/11019475/7bf92acd9f85/cureus-0016-00000056317-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258a/11019475/dac4d67de854/cureus-0016-00000056317-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258a/11019475/c9397eb28ebe/cureus-0016-00000056317-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258a/11019475/0b53fa86135a/cureus-0016-00000056317-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258a/11019475/a096eba52fb8/cureus-0016-00000056317-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258a/11019475/7bf92acd9f85/cureus-0016-00000056317-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/258a/11019475/dac4d67de854/cureus-0016-00000056317-i05.jpg

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引用本文的文献

[1]
Artificial Intelligence in Radiology: Augmentation, Not Replacement.

Cureus. 2025-6-17

[2]
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Eur Radiol. 2025-7-9

[3]
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本文引用的文献

[1]
Sources of bias in artificial intelligence that perpetuate healthcare disparities-A global review.

PLOS Digit Health. 2022-3-31

[2]
Multi-task deep learning for medical image computing and analysis: A review.

Comput Biol Med. 2023-2

[3]
Artificial intelligence-based methods for fusion of electronic health records and imaging data.

Sci Rep. 2022-10-26

[4]
The Need for Medical Artificial Intelligence That Incorporates Prior Images.

Radiology. 2022-8

[5]
Training Strategies for Radiology Deep Learning Models in Data-limited Scenarios.

Radiol Artif Intell. 2021-10-6

[6]
Are We Overdoing It? Changes in Diagnostic Imaging Workload during the Years 2010-2020 including the Impact of the SARS-CoV-2 Pandemic.

Healthcare (Basel). 2021-11-16

[7]
Deep Learning-based Image Segmentation on Multimodal Medical Imaging.

IEEE Trans Radiat Plasma Med Sci. 2019-3

[8]
Deep reinforcement learning in medical imaging: A literature review.

Med Image Anal. 2021-10

[9]
Workload of diagnostic radiologists in the foreseeable future based on recent scientific advances: growth expectations and role of artificial intelligence.

Insights Imaging. 2021-6-29

[10]
Continuous Learning AI in Radiology: Implementation Principles and Early Applications.

Radiology. 2020-8-25

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