Cheng Chi-Tung, Ooyang Chun-Hsiang, Liao Chien-Hung, Kang Shih-Ching
Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
Biomed J. 2025 Feb;48(1):100743. doi: 10.1016/j.bj.2024.100743. Epub 2024 Apr 26.
Diagnostic imaging is essential in modern trauma care for initial evaluation and identifying injuries requiring intervention. Deep learning (DL) has become mainstream in medical image analysis and has shown promising efficacy for classification, segmentation, and lesion detection. This narrative review provides the fundamental concepts for developing DL algorithms in trauma imaging and presents an overview of current progress in each modality. DL has been applied to detect free fluid on Focused Assessment with Sonography for Trauma (FAST), traumatic findings on chest and pelvic X-rays, and computed tomography (CT) scans, identify intracranial hemorrhage on head CT, detect vertebral fractures, and identify injuries to organs like the spleen, liver, and lungs on abdominal and chest CT. Future directions involve expanding dataset size and diversity through federated learning, enhancing model explainability and transparency to build clinician trust, and integrating multimodal data to provide more meaningful insights into traumatic injuries. Though some commercial artificial intelligence products are Food and Drug Administration-approved for clinical use in the trauma field, adoption remains limited, highlighting the need for multi-disciplinary teams to engineer practical, real-world solutions. Overall, DL shows immense potential to improve the efficiency and accuracy of trauma imaging, but thoughtful development and validation are critical to ensure these technologies positively impact patient care.
诊断成像在现代创伤护理中对于初始评估和识别需要干预的损伤至关重要。深度学习(DL)已成为医学图像分析的主流,并在分类、分割和病变检测方面显示出有前景的效果。这篇叙述性综述提供了在创伤成像中开发DL算法的基本概念,并概述了每种模态的当前进展。DL已被应用于在创伤重点超声评估(FAST)中检测游离液体、在胸部和骨盆X线片以及计算机断层扫描(CT)上检测创伤性发现、在头部CT上识别颅内出血、检测椎体骨折以及在腹部和胸部CT上识别脾脏、肝脏和肺部等器官的损伤。未来的方向包括通过联邦学习扩大数据集的规模和多样性、提高模型的可解释性和透明度以建立临床医生的信任,以及整合多模态数据以提供关于创伤性损伤更有意义的见解。尽管一些商业人工智能产品已获得美国食品药品监督管理局批准可用于创伤领域的临床应用,但其采用仍然有限,这凸显了需要多学科团队来设计切实可行的现实世界解决方案。总体而言,DL显示出提高创伤成像效率和准确性的巨大潜力,但经过深思熟虑的开发和验证对于确保这些技术对患者护理产生积极影响至关重要。