Drew A. Torigian

Michael S. Yao, Allison Chae, Matthew T. MacLean et al.

Early diagnosis of Type 2 Diabetes Mellitus (T2DM) is crucial to enable timely therapeutic interventions and lifestyle modifications. As the time available for clinical office visits shortens and medical imaging data become more widely available, patient image data could be used to opportunistically identify patients for additional T2DM diagnostic workup by physicians. We investigated whether image-derived phenotypic data could be leveraged in tabular learning classifier models to predict T2DM risk in an automated fashion to flag high-risk patients without the need for additional blood laboratory measurements. In contrast to traditional binary classifiers, we leverage neural networks and decision tree models to represent patient data as 'SynthA1c' latent variables, which mimic blood hemoglobin A1c empirical lab measurements, that achieve sensitivities as high as 87.6%. To evaluate how SynthA1c models may generalize to other patient populations, we introduce a novel generalizable metric that uses vanilla data augmentation techniques to predict model performance on input out-of-domain covariates. We show that image-derived phenotypes and physical examination data together can accurately predict diabetes risk as a means of opportunistic risk stratification enabled by artificial intelligence and medical imaging. Our code is available at https://github.com/allisonjchae/DMT2RiskAssessment.

Yishu Wei, Adam E. Flanders, Errol Colak et al.

Multimodal large language models have demonstrated comparable performance to that of radiology trainees on multiple-choice board-style exams. However, to develop clinically useful multimodal LLM tools, high-quality benchmarks curated by domain experts are essential. To curate released and holdout datasets of 100 chest radiographic studies each and propose an artificial intelligence (AI)-assisted expert labeling procedure to allow radiologists to label studies more efficiently. A total of 13,735 deidentified chest radiographs and their corresponding reports from the MIDRC were used. GPT-4o extracted abnormal findings from the reports, which were then mapped to 12 benchmark labels with a locally hosted LLM (Phi-4-Reasoning). From these studies, 1,000 were sampled on the basis of the AI-suggested benchmark labels for expert review; the sampling algorithm ensured that the selected studies were clinically relevant and captured a range of difficulty levels. Seventeen chest radiologists participated, and they marked "Agree all", "Agree mostly" or "Disagree" to indicate their assessment of the correctness of the LLM suggested labels. Each chest radiograph was evaluated by three experts. Of these, at least two radiologists selected "Agree All" for 381 radiographs. From this set, 200 were selected, prioritizing those with less common or multiple finding labels, and divided into 100 released radiographs and 100 reserved as the holdout dataset. The holdout dataset is used exclusively by RSNA to independently evaluate different models. A benchmark of 200 chest radiographic studies with 12 benchmark labels was created and made publicly available https://imaging.rsna.org, with each chest radiograph verified by three radiologists. In addition, an AI-assisted labeling procedure was developed to help radiologists label at scale, minimize unnecessary omissions, and support a semicollaborative environment.

Ismail Irmakci, Syed Muhammad Anwar, Drew A. Torigian et al.

The diagnosis, prognosis, and treatment of patients with musculoskeletal (MSK) disorders require radiology imaging (using computed tomography, magnetic resonance imaging(MRI), and ultrasound) and their precise analysis by expert radiologists. Radiology scans can also help assessment of metabolic health, aging, and diabetes. This study presents how machinelearning, specifically deep learning methods, can be used for rapidand accurate image analysis of MRI scans, an unmet clinicalneed in MSK radiology. As a challenging example, we focus on automatic analysis of knee images from MRI scans and study machine learning classification of various abnormalities including meniscus and anterior cruciate ligament tears. Using widely used convolutional neural network (CNN) based architectures, we comparatively evaluated the knee abnormality classification performances of different neural network architectures under limited imaging data regime and compared single and multi-view imaging when classifying the abnormalities. Promising results indicated the potential use of multi-view deep learning based classification of MSK abnormalities in routine clinical assessment.

Aliasghar Mortazi, Naji Khosravan, Drew A. Torigian et al.

The performance of the state-of-the-art image segmentation methods heavily relies on the high-quality annotations, which are not easily affordable, particularly for medical data. To alleviate this limitation, in this study, we propose a weakly supervised image segmentation method based on a deep geodesic prior. We hypothesize that integration of this prior information can reduce the adverse effects of weak labels in segmentation accuracy. Our proposed algorithm is based on a prior information, extracted from an auto-encoder, trained to map objects geodesic maps to their corresponding binary maps. The obtained information is then used as an extra term in the loss function of the segmentor. In order to show efficacy of the proposed strategy, we have experimented segmentation of cardiac substructures with clean and two levels of noisy labels (L1, L2). Our experiments showed that the proposed algorithm boosted the performance of baseline deep learning-based segmentation for both clean and noisy labels by 4.4%, 4.6%(L1), and 6.3%(L2) in dice score, respectively. We also showed that the proposed method was more robust in the presence of high-level noise due to the existence of shape priors.