Abstract

Radiology historically has been a leader of digital transformation in healthcare. The introduction of digital imaging systems, picture archiving and communication systems (PACS), and teleradiology transformed radiology services over the past 30 years. Radiology is again at the crossroad for the next generation of transformation, possibly evolving as a one-stop integrated diagnostic service. Artificial intelligence and machine learning promise to offer radiology new powerful new digital tools to facilitate the next transformation. The radiology community has been developing computer-aided diagnosis (CAD) tools based on machine learning (ML) over the past 20 years. Among various AI techniques, deep-learning convolutional neural networks (CNN) and its variants have been widely used in medical image pattern recognition. Since the 1990s, many CAD tools and products have been developed. However, clinical adoption has been slow due to a lack of substantial clinical advantages, difficulties integrating into existing workflow, and uncertain business models. This paper proposes three pathways for AI's role in radiology beyond current CNN based capabilities 1) improve the performance of CAD, 2) improve the productivity of radiology service by AI-assisted workflow, and 3) develop radiomics that integrate the data from radiology, pathology, and genomics to facilitate the emergence of a new integrated diagnostic service.

Highlights

  • Radiology was one of the first specialty in healthcare to adopt digital technology

  • We argue that a refocusing of artificial intelligence (AI) onto different aspects of the radiology workflow and medical error reduction will generated more demand and adoption by radiology community. (Dikici et al, 2020; Montagnon et al, 2020)

  • Screening mammography is an ideal application for computer aided detection (CADe) because it has to review many cases by a limited number of radiologists trained in mammography

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Summary

Artificial Intelligence for the Future Radiology Diagnostic Service

Reviewed by: Salva Mena-Mollá, University of Valencia, Spain Mohammad Shahid, Children’s National Hospital, United States. The introduction of digital imaging systems, picture archiving and communication systems (PACS), and teleradiology transformed radiology services over the past 30 years. Radiology is again at the crossroad for the generation of transformation, possibly evolving as a one-stop integrated diagnostic service. The radiology community has been developing computer-aided diagnosis (CAD) tools based on machine learning (ML) over the past 20 years. This paper proposes three pathways for AI’s role in radiology beyond current CNN based capabilities 1) improve the performance of CAD, 2) improve the productivity of radiology service by AI-assisted workflow, and 3) develop radiomics that integrate the data from radiology, pathology, and genomics to facilitate the emergence of a new integrated diagnostic service

INTRODUCTION
Operational Description of Radiology Service
CADe in Screening Mammography for Cancer Detection
CADe Use to Screen Diabetic Retinopathy to Prevent Blindness
Limitation of Current Generic CNN
Improving CNN for Medical Imaging
Open Source CNN
Availability of Data and Realistic Mix of Data
Data Labeling
Future of Radiology Service and Radiomics
CONCLUSION
Findings
AUTHOR CONTRIBUTIONS
Full Text
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