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机器学习与人工智能在肺栓塞放射学检测中的进展

Advancements in Machine Learning and Artificial Intelligence in the Radiological Detection of Pulmonary Embolism.

作者信息

Mohanarajan Maneeshaa, Salunke Prachi P, Arif Ali, Iglesias Gonzalez Paola Melissa, Ospina David, Benavides Dario S, Amudha Chaithanya, Raman Kumareson K, Siddiqui Humza F

机构信息

Integrated Urgent Care, London Ambulance Service, London, GBR.

Medicine and Surgery, Tver State Medical University, Tver, RUS.

出版信息

Cureus. 2025 Jan 29;17(1):e78217. doi: 10.7759/cureus.78217. eCollection 2025 Jan.

Abstract

Pulmonary embolism (PE) is a clinically challenging diagnosis that varies from silent to life-threatening symptoms. Timely diagnosis of the condition is subject to clinical assessment, D-dimer testing and radiological imaging. Computed tomography pulmonary angiogram (CTPA) is considered the gold standard imaging modality, although some cases can be missed due to reader dependency, resulting in adverse patient outcomes. Hence, it is crucial to implement faster and precise diagnostic strategies to help clinicians diagnose and treat PE patients promptly and mitigate morbidity and mortality. Machine learning (ML) and artificial intelligence (AI) are the newly emerging tools in the medical field, including in radiological imaging, potentially improving diagnostic efficacy. Our review of the studies showed that computer-aided design (CAD) and AI tools displayed similar to superior sensitivity and specificity in identifying PE on CTPA as compared to radiologists. Several tools demonstrated the potential in identifying minor PE on radiological scans showing promising ability to aid clinicians in reducing missed cases substantially. However, it is imperative to design sophisticated tools and conduct large clinical trials to integrate AI use in everyday clinical setting and establish guidelines for its ethical applicability. ML and AI can also potentially help physicians in formulating individualized management strategies to enhance patient outcomes.

摘要

肺栓塞(PE)是一种临床诊断具有挑战性的疾病,其症状从无症状到危及生命不等。该疾病的及时诊断取决于临床评估、D - 二聚体检测和影像学检查。计算机断层扫描肺动脉造影(CTPA)被认为是金标准成像方式,尽管由于依赖阅片者,一些病例可能会被漏诊,从而导致不良的患者结局。因此,实施更快、更精确的诊断策略以帮助临床医生及时诊断和治疗PE患者,并降低发病率和死亡率至关重要。机器学习(ML)和人工智能(AI)是医学领域新出现的工具,包括在放射影像学中,有可能提高诊断效率。我们对研究的综述表明,与放射科医生相比,计算机辅助设计(CAD)和AI工具在CTPA上识别PE时表现出相似或更高的敏感性和特异性。一些工具在识别放射学扫描中的微小PE方面显示出潜力,显示出有希望的能力,可大幅帮助临床医生减少漏诊病例。然而,必须设计复杂的工具并进行大型临床试验,以将AI应用整合到日常临床环境中,并建立其伦理适用性指南。ML和AI还有可能帮助医生制定个性化的管理策略,以改善患者结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43ec/11872007/d475e1ea615a/cureus-0017-00000078217-i01.jpg

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