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放射学的未来展望:负责任成像的人工智能(AIRI)。

Future Perspectives in Radiology: Artificial Intelligence for Responsible Imaging (AIRI).

作者信息

Olayeye Kunmilayo, Owens-Charles Christina Regine, Choudhari Jashkumar, Parikh Esha, Liang Zhengrong Jerome

机构信息

Foundation, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.

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

出版信息

Cureus. 2025 Mar 5;17(3):e80095. doi: 10.7759/cureus.80095. eCollection 2025 Mar.

Abstract

Artificial intelligence (AI) has transformed the healthcare industry. In the field of radiology, AI has shown great promise in medical imaging, as it can enhance imaging accuracy, reduce diagnostic errors, and optimize workflow. However, the overuse and misuse of imaging is still a major ongoing problem, generating unnecessary costs, radiation exposure to patients, and delays in diagnosis. To address these challenges, we propose AI for responsible imaging (AIRI), a multimodal AI system to aid clinicians in making informed imaging decisions. AIRI is envisioned as a medical resource that would benefit the clinician, the radiologist, and, most importantly, the patient.  For clinicians, AIRI would process clinical data, such as labs, vitals, patient history and physical exam findings, and evidence-based appropriateness criteria, to determine if a medical image is clinically indicated based on the algorithmic likelihood that the imaging would provide necessary information for diagnosis. When imaging is indicated, AIRI would help the clinician determine logistic details such as what modality would give the most information for the radiologist to read, ordering details such as whether the use of contrast is indicated or not, and also how to best prepare the patient for what to expect to improve compliance and reduce the need for repeat scans. By assisting the non-radiologist clinician with these technical imaging decisions, AIRI has the potential to reduce unnecessary scans, minimize radiation exposure, and decrease healthcare costs. For radiologists, AIRI with radiomic integration could provide preliminary interpretations for low-priority images or frequently seen cases, allowing them to focus more on high-acuity and complex cases. With radiomics, AIRI could detect subtle abnormalities and imaging patterns that may be overlooked by the human eye and interpret images distorted by artifacts, allowing for more diagnostic information to be retrieved from a single scan and reducing the need for a repeat. Additionally, AIRI is envisioned to help the radiologist triage cases and implement a fatigue detection protocol to help prevent burnout. AIRI for the radiologist would streamline workflow, improve diagnostic accuracy, reduce repeat scans, and alleviate the radiologist's workload. For the patient, all of the applications mentioned above would work to reduce exposure to excess and unneeded radiation and help reduce healthcare costs and time spent in the diagnostic stage. AIRI, with AI chatbot integration, may improve the patient experience by supplementing the physician's explanation of imaging procedures and results, easing scan-related anxieties, giving personalized prep guidance, and finding imaging facilities with the most affordable imaging studies. AIRI is a shift toward more responsible usage of medical imaging. In this editorial, we expand upon AIRI's design, implementation, and its potential to mitigate areas of medical overuse in the field of radiology, as well as the existing benefits of AI in the medical industry and why we believe AIRI would be a promising addition in the field of medical innovation. Appropriate use of imaging is essential because it alleviates costs by scaling back imaging services without compromising diagnostic integrity. We elaborate on this concept, early use cases, and the potential for AIRI to change the landscape of radiology and healthcare for clinicians, radiologists, and patients.

摘要

人工智能(AI)已经改变了医疗行业。在放射学领域,AI在医学成像方面展现出了巨大的潜力,因为它可以提高成像准确性、减少诊断错误并优化工作流程。然而,成像的过度使用和滥用仍然是一个持续存在的主要问题,会产生不必要的成本、使患者受到辐射暴露并导致诊断延误。为应对这些挑战,我们提出了用于负责任成像的AI(AIRI),这是一个多模态AI系统,旨在帮助临床医生做出明智的成像决策。AIRI被设想为一种医疗资源,将使临床医生、放射科医生,最重要的是患者受益。对于临床医生来说,AIRI将处理临床数据,如实验室检查结果、生命体征、患者病史和体格检查结果,以及基于证据的适当性标准,以根据成像为诊断提供必要信息的算法可能性来确定医学影像是否具有临床指征。当成像具有指征时,AIRI将帮助临床医生确定后勤细节,例如哪种成像方式能为放射科医生提供最多可供解读的信息、检查医嘱细节,如是否需要使用造影剂,以及如何最好地让患者做好准备以提高依从性并减少重复扫描的需求。通过协助非放射科临床医生做出这些技术成像决策,AIRI有潜力减少不必要的扫描、将辐射暴露降至最低并降低医疗成本。对于放射科医生来说,集成了放射组学的AIRI可以为低优先级图像或常见病例提供初步解读,使他们能够将更多精力集中在高急症和复杂病例上。借助放射组学,AIRI可以检测出肉眼可能忽略的细微异常和成像模式,并解读因伪影而失真的图像,从而从单次扫描中获取更多诊断信息并减少重复检查的需求。此外,AIRI被设想为帮助放射科医生进行病例分类并实施疲劳检测方案以防止职业倦怠。针对放射科医生的AIRI将简化工作流程、提高诊断准确性、减少重复扫描并减轻放射科医生的工作量。对于患者而言,上述所有应用都将有助于减少过度和不必要的辐射暴露,并有助于降低医疗成本以及诊断阶段所花费的时间。集成了AI聊天机器人的AIRI可以通过补充医生对成像程序和结果的解释、缓解与扫描相关的焦虑、提供个性化的准备指导以及找到提供最实惠成像检查的机构来改善患者体验。AIRI是朝着更负责任地使用医学成像迈出的一步。在这篇社论中,我们详细阐述了AIRI的设计、实施及其在减轻放射学领域医疗过度使用方面的潜力,以及AI在医疗行业中的现有益处,以及我们认为AIRI在医疗创新领域将是一个有前景的补充的原因。合理使用成像至关重要,因为它通过缩减成像服务来降低成本,同时又不损害诊断完整性。我们详细阐述了这一概念、早期应用案例以及AIRI改变放射学和医疗保健格局以造福临床医生、放射科医生和患者的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91ee/11970708/ff8c5ee31014/cureus-0017-00000080095-i01.jpg

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