Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA; Research Department, Jacksonville University, Jacksonville, Florida, USA.
Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida, USA.
World Neurosurg. 2024 Aug;188:e59-e63. doi: 10.1016/j.wneu.2024.05.015. Epub 2024 May 10.
To evaluate variability in aneurysm detection and the potential of artificial intelligence (AI) software as a screening tool by comparing conventional computed tomography angiography (CTA) images (standard care) with AI software.
Neuroradiologists reviewed 770 CTA images and reported the presence or absence of saccular aneurysms. Subsequently, the images were analyzed by AI software. If the software suspected an aneurysm, it flagged the corresponding image. In cases where there was a mismatch between the radiologist's report and the AI findings, an expert neurosurgeon evaluated CTA images providing a definitive conclusion on the presence or absence of an aneurysm.
AI software flagged 33 cases as potential aneurysms; 16 cases were positively identified as aneurysms by radiologists, and 17 were dismissed. A total of 737 cases were considered negative by AI software, while in the same group, radiologists identified aneurysms in 28 CTA images. Compared with the radiologist's report, AI performance had a sensitivity of 36%, specificity of 97.6%, and negative predictive value of 96.2%. There were 45 mismatch cases between AI and radiologists. AI flagged 17 images as showing an aneurysm that was unreported by radiologists; the expert neurosurgeon confirmed that 7 of the 17 images showed an aneurysm. In 28 images considered negative by AI, radiologists indicated aneurysms; 17 of those confirmed by the neurosurgeon.
AI has the potential to increase the diagnosis of unruptured intracranial aneurysms. However, it must be used as an adjacent tool within the standard of care due to limited applicability in real-world settings.
通过比较传统计算机断层血管造影（CTA）图像（标准护理）和人工智能（AI）软件，评估动脉瘤检测的变异性和 AI 软件作为筛查工具的潜力。
神经放射科医生回顾了 770 张 CTA 图像，并报告了囊状动脉瘤的存在或不存在。随后，AI 软件对图像进行了分析。如果软件怀疑存在动脉瘤，它会标记相应的图像。如果放射科医生的报告与 AI 的发现不匹配，则由专家神经外科医生评估 CTA 图像，对动脉瘤的存在与否做出明确结论。
AI 软件标记了 33 个病例为潜在动脉瘤；16 个病例被放射科医生确认为动脉瘤，17 个病例被排除。AI 软件总共将 737 个病例判断为阴性，而在同一组中，放射科医生在 28 个 CTA 图像中发现了动脉瘤。与放射科医生的报告相比，AI 性能的敏感度为 36%，特异性为 97.6%，阴性预测值为 96.2%。AI 和放射科医生之间有 45 个不匹配的病例。AI 标记了 17 个图像为动脉瘤，但放射科医生未报告；神经外科医生确认这 17 个图像中有 7 个显示了动脉瘤。在 AI 认为阴性的 28 个图像中，放射科医生指出了动脉瘤；其中 17 个经神经外科医生确认。
AI 有可能增加未破裂颅内动脉瘤的诊断。然而，由于在实际环境中的适用性有限，它必须作为标准护理中的辅助工具使用。
