Department of Radiology, Division of Pediatric Radiology, Stanford University School of Medicine, 1201 Welch Rd, Stanford, CA 94305.
Department of Radiology, Integrative Biomedical Imaging Informatics (IBIIS), Stanford University School of Medicine, Stanford University, Stanford, CA.
AJR Am J Roentgenol. 2024 Aug;223(2):e2431076. doi: 10.2214/AJR.24.31076. Epub 2024 May 23.
Artificial intelligence (AI) is transforming the medical imaging of adult patients. However, its utilization in pediatric oncology imaging remains constrained, in part due to the inherent scarcity of data associated with childhood cancers. Pediatric cancers are rare, and imaging technologies are evolving rapidly, leading to insufficient data of a particular type to effectively train these algorithms. The small market size of pediatric patients compared with adult patients could also contribute to this challenge, as market size is a driver of commercialization. This review provides an overview of the current state of AI applications for pediatric cancer imaging, including applications for medical image acquisition, processing, reconstruction, segmentation, diagnosis, staging, and treatment response monitoring. Although current developments are promising, impediments due to the diverse anatomies of growing children and nonstandardized imaging protocols have led to limited clinical translation thus far. Opportunities include leveraging reconstruction algorithms to achieve accelerated low-dose imaging and automating the generation of metric-based staging and treatment monitoring scores. Transfer learning of adult-based AI models to pediatric cancers, multiinstitutional data sharing, and ethical data privacy practices for pediatric patients with rare cancers will be keys to unlocking the full potential of AI for clinical translation and improving outcomes for these young patients.
人工智能(AI)正在改变成人患者的医学影像诊断方式。然而,其在儿科肿瘤影像中的应用仍然受到限制,部分原因是与儿童癌症相关的数据本来就稀缺。儿科癌症较为罕见,而且成像技术发展迅速,导致某种特定类型的数据不足以有效训练这些算法。与成人患者相比,儿科患者的市场规模较小,这也是一个挑战,因为市场规模是商业化的驱动因素。本综述概述了 AI 在儿科癌症影像中的应用现状,包括在医学图像采集、处理、重建、分割、诊断、分期和治疗反应监测方面的应用。尽管目前的发展前景广阔,但由于儿童不断生长的身体结构和非标准化的成像方案,限制了其临床转化。目前的机会包括利用重建算法实现加速低剂量成像,并实现基于指标的分期和治疗监测评分的自动化生成。将基于成人的 AI 模型转移学习应用于儿科癌症、多机构数据共享,以及针对罕见癌症的儿科患者的伦理数据隐私实践,将是充分挖掘 AI 临床转化潜力和改善这些年轻患者预后的关键。