Felipe Kitamura

Edward H. Lee, Brendan Kelly, Emre Altinmakas et al.

While it is well known that population differences from genetics, sex, race, and environmental factors contribute to disease, AI studies in medicine have largely focused on locoregional patient cohorts with less diverse data sources. Such limitation stems from barriers to large-scale data share and ethical concerns over data privacy. Federated learning (FL) is one potential pathway for AI development that enables learning across hospitals without data share. In this study, we show the results of various FL strategies on one of the largest and most diverse COVID-19 chest CT datasets: 21 participating hospitals across five continents that comprise >10,000 patients with >1 million images. We also propose an FL strategy that leverages synthetically generated data to overcome class and size imbalances. We also describe the sources of data heterogeneity in the context of FL, and show how even among the correctly labeled populations, disparities can arise due to these biases.

Tyler J. Richards, Adam E. Flanders, Errol Colak et al.

The Radiological Society of North America (RSNA) Lumbar Degenerative Imaging Spine Classification (LumbarDISC) dataset is the largest publicly available dataset of adult MRI lumbar spine examinations annotated for degenerative changes. The dataset includes 2,697 patients with a total of 8,593 image series from 8 institutions across 6 countries and 5 continents. The dataset is available for free for non-commercial use via Kaggle and RSNA Medical Imaging Resource of AI (MIRA). The dataset was created for the RSNA 2024 Lumbar Spine Degenerative Classification competition where competitors developed deep learning models to grade degenerative changes in the lumbar spine. The degree of spinal canal, subarticular recess, and neural foraminal stenosis was graded at each intervertebral disc level in the lumbar spine. The images were annotated by expert volunteer neuroradiologists and musculoskeletal radiologists from the RSNA, American Society of Neuroradiology, and the American Society of Spine Radiology. This dataset aims to facilitate research and development in machine learning and lumbar spine imaging to lead to improved patient care and clinical efficiency.

Bastien Le Guellec, Kokou Adambounou, Lisa C Adams et al.

Rationale and Objectives: To develop and validate PARROT (Polyglottal Annotated Radiology Reports for Open Testing), a large, multicentric, open-access dataset of fictional radiology reports spanning multiple languages for testing natural language processing applications in radiology. Materials and Methods: From May to September 2024, radiologists were invited to contribute fictional radiology reports following their standard reporting practices. Contributors provided at least 20 reports with associated metadata including anatomical region, imaging modality, clinical context, and for non-English reports, English translations. All reports were assigned ICD-10 codes. A human vs. AI report differentiation study was conducted with 154 participants (radiologists, healthcare professionals, and non-healthcare professionals) assessing whether reports were human-authored or AI-generated. Results: The dataset comprises 2,658 radiology reports from 76 authors across 21 countries and 13 languages. Reports cover multiple imaging modalities (CT: 36.1%, MRI: 22.8%, radiography: 19.0%, ultrasound: 16.8%) and anatomical regions, with chest (19.9%), abdomen (18.6%), head (17.3%), and pelvis (14.1%) being most prevalent. In the differentiation study, participants achieved 53.9% accuracy (95% CI: 50.7%-57.1%) in distinguishing between human and AI-generated reports, with radiologists performing significantly better (56.9%, 95% CI: 53.3%-60.6%, p<0.05) than other groups. Conclusion: PARROT represents the largest open multilingual radiology report dataset, enabling development and validation of natural language processing applications across linguistic, geographic, and clinical boundaries without privacy constraints.

Farhad Maleki, Linda Moy, Reza Forghani et al.

Deep learning techniques hold immense promise for advancing medical image analysis, particularly in tasks like image segmentation, where precise annotation of regions or volumes of interest within medical images is crucial but manually laborious and prone to interobserver and intraobserver biases. As such, deep learning approaches could provide automated solutions for such applications. However, the potential of these techniques is often undermined by challenges in reproducibility and generalizability, which are key barriers to their clinical adoption. This paper introduces the RIDGE checklist, a comprehensive framework designed to assess the Reproducibility, Integrity, Dependability, Generalizability, and Efficiency of deep learning-based medical image segmentation models. The RIDGE checklist is not just a tool for evaluation but also a guideline for researchers striving to improve the quality and transparency of their work. By adhering to the principles outlined in the RIDGE checklist, researchers can ensure that their developed segmentation models are robust, scientifically valid, and applicable in a clinical setting.

Timothy L. Kline, Felipe Kitamura, Ian Pan et al.

With the recent advances in A.I. methodologies and their application to medical imaging, there has been an explosion of related research programs utilizing these techniques to produce state-of-the-art classification performance. Ultimately, these research programs culminate in submission of their work for consideration in peer reviewed journals. To date, the criteria for acceptance vs. rejection is often subjective; however, reproducible science requires reproducible review. The Machine Learning Education Sub-Committee of SIIM has identified a knowledge gap and a serious need to establish guidelines for reviewing these studies. Although there have been several recent papers with this goal, this present work is written from the machine learning practitioners standpoint. In this series, the committee will address the best practices to be followed in an A.I.-based study and present the required sections in terms of examples and discussion of what should be included to make the studies cohesive, reproducible, accurate, and self-contained. This first entry in the series focuses on the task of image classification. Elements such as dataset curation, data pre-processing steps, defining an appropriate reference standard, data partitioning, model architecture and training are discussed. The sections are presented as they would be detailed in a typical manuscript, with content describing the necessary information that should be included to make sure the study is of sufficient quality to be considered for publication. The goal of this series is to provide resources to not only help improve the review process for A.I.-based medical imaging papers, but to facilitate a standard for the information that is presented within all components of the research study. We hope to provide quantitative metrics in what otherwise may be a qualitative review process.

Holger R. Roth, Ken Chang, Praveer Singh et al.

Building robust deep learning-based models requires large quantities of diverse training data. In this study, we investigate the use of federated learning (FL) to build medical imaging classification models in a real-world collaborative setting. Seven clinical institutions from across the world joined this FL effort to train a model for breast density classification based on Breast Imaging, Reporting & Data System (BI-RADS). We show that despite substantial differences among the datasets from all sites (mammography system, class distribution, and data set size) and without centralizing data, we can successfully train AI models in federation. The results show that models trained using FL perform 6.3% on average better than their counterparts trained on an institute's local data alone. Furthermore, we show a 45.8% relative improvement in the models' generalizability when evaluated on the other participating sites' testing data.