Artificial Intelligence to Automatically Assess Scan Quality in Hip Ultrasound

Overcoming barriers in the use of artificial intelligence in point of care ultrasound

Point-of-care ultrasound is a portable, low-cost imaging technology focused on answering specific clinical questions in real time. Artificial intelligence amplifies its capabilities by aiding clinicians in the acquisition and interpretation of the images; however, there are growing concerns on its effectiveness and trustworthiness. Here, we address key issues such as population bias, explainability and training of artificial intelligence in this field and propose approaches to ensure clinical effectiveness.

Automated scan quality evaluation for DDH using transfer learning: Development of a novel ensemble system

BACKGROUND

Developmental Dysplasia of the Hip (DDH) is a relatively common hip joint disorders in infants, affecting one to three per a thousand births. If found early, it can be treated preemptively by simple non-invasive methods. But if not, then several surgical procedures may be required that can cause high economic burden. The accuracy of diagnosis using ultrasound (US) images heavily relies on locating anatomical landmarks on the image. However, there is an intra-observer/inter-observer variability in determining the exact location of the landmarks. In this study, an automated scan quality assessment system of pelvic US image by evaluating quality of five landmarks using transfer learning models was proposed.

METHODS

US images from 1,891 subjects were obtained at two hospitals in the Republic of Korea (henceforth Korea). Also, an ensemble system was developed using transfer learning models to automatically evaluate the scan quality by scoring five anatomical landmarks. Gradient-weighted class activation mapping was used for verifying whether models that reflect the geographical features of the images had been properly trained. Considering the applicability in the real-time environment, this study proposes an alternative sequence method (ASM) that has been discovered to have improved the lapse of scan quality assessment.

RESULTS

All the selected models achieved kappa values of 0.6 or higher, indicating substantial agreement, and the AUC score for classifying standard images based on the total score was 0.89. The activation map of the trained models properly reflected the structural features of the image. The time lapse for standard image classification was 0.35 second per image in full sequence method, and that of the three versions - ASM-1, ASM-2, ASM-3 - were 0.27, 0.22, and 0.20, respectively.

The diagnostic value of artificial intelligence-assisted imaging for developmental dysplasia of the hip: a systematic review and meta-analysis

OBJECTIVE

To clarify the efficacy of artificial intelligence (AI)-assisted imaging in the diagnosis of developmental dysplasia of the hip (DDH) through a meta-analysis.

METHODS

Relevant literature on AI for early DDH diagnosis was searched in PubMed, Web of Science, Embase, and The Cochrane Library databases until April 4, 2024. The Quality Assessment of Diagnostic Accuracy Studies tool was used to assess the quality of included studies. Revman5.4 and StataSE-64 software were used to calculate the combined sensitivity, specificity, AUC value, and DOC value of AI-assisted imaging for DDH diagnosis.

RESULTS

The meta-analysis included 13 studies (6 prospective and 7 retrospective) with 28 AI models and a total of 10,673 samples. The summary sensitivity, specificity, AUC value, and DOC value were 99.0% (95% CI: 97.0-100.0%), 94.0% (95% CI: 89.0-96.0%), 99.0% (95% CI: 98.0-100.0%), and 1342 (95% CI: 469-3842), respectively.

CONCLUSION

AI-assisted imaging demonstrates high diagnostic efficacy for DDH detection, improving the accuracy of early DDH imaging examination. More prospective studies are needed to further confirm the value of AI-assisted imaging for early DDH diagnosis.

Artificial intelligence and point-of-care ultrasound: Benefits, limitations, and implications for the future

The utilization of artificial intelligence (AI) in medical imaging has become a rapidly growing field as a means to address contemporary demands and challenges of healthcare. Among the emerging applications of AI is point-of-care ultrasound (POCUS), in which the combination of these two technologies has garnered recent attention in research and clinical settings. In this Controversies paper, we will discuss the benefits, limitations, and future considerations of AI in POCUS for patients, clinicians, and healthcare systems.