1
|
Rogers JL, Baker M. AI in practice: Opportunities, obstacles, and outlook. Nurse Pract 2025; 50:34-38. [PMID: 40420348 DOI: 10.1097/01.npr.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2025]
Abstract
ABSTRACT The integration of artificial intelligence (AI) into clinical practice represents a paradigm shift in healthcare delivery, with significant implications for NPs. This emerging technology offers a myriad of benefits, including enhanced practice efficiency, streamlined documentation processes, and potential reduction in healthcare expenditures. However, the implementation of AI is not without challenges. Ethical considerations, data privacy concerns, and lack of comprehensive training present significant hurdles that must be addressed. NPs are uniquely positioned to play a pivotal role in the judicious implementation of AI technologies, ensuring that the fundamental tenets of compassionate, patient-centered care are not compromised.
Collapse
|
2
|
Kocak B, Ponsiglione A, Romeo V, Ugga L, Huisman M, Cuocolo R. Radiology AI and sustainability paradox: environmental, economic, and social dimensions. Insights Imaging 2025; 16:88. [PMID: 40244301 PMCID: PMC12006592 DOI: 10.1186/s13244-025-01962-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2025] [Accepted: 03/26/2025] [Indexed: 04/18/2025] Open
Abstract
Artificial intelligence (AI) is transforming radiology by improving diagnostic accuracy, streamlining workflows, and enhancing operational efficiency. However, these advancements come with significant sustainability challenges across environmental, economic, and social dimensions. AI systems, particularly deep learning models, require substantial computational resources, leading to high energy consumption, increased carbon emissions, and hardware waste. Data storage and cloud computing further exacerbate the environmental impact. Economically, the high costs of implementing AI tools often outweigh the demonstrated clinical benefits, raising concerns about their long-term viability and equity in healthcare systems. Socially, AI risks perpetuating healthcare disparities through biases in algorithms and unequal access to technology. On the other hand, AI has the potential to improve sustainability in healthcare by reducing low-value imaging, optimizing resource allocation, and improving energy efficiency in radiology departments. This review addresses the sustainability paradox of AI from a radiological perspective, exploring its environmental footprint, economic feasibility, and social implications. Strategies to mitigate these challenges are also discussed, alongside a call for action and directions for future research. CRITICAL RELEVANCE STATEMENT: By adopting an informed and holistic approach, the radiology community can ensure that AI's benefits are realized responsibly, balancing innovation with sustainability. This effort is essential to align technological advancements with environmental preservation, economic sustainability, and social equity. KEY POINTS: AI has an ambivalent potential, capable of both exacerbating global sustainability issues and offering increased productivity and accessibility. Addressing AI sustainability requires a broad perspective accounting for environmental impact, economic feasibility, and social implications. By embracing the duality of AI, the radiology community can adopt informed strategies at individual, institutional, and collective levels to maximize its benefits while minimizing negative impacts.
Collapse
Affiliation(s)
- Burak Kocak
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Lorenzo Ugga
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Merel Huisman
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Renato Cuocolo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
| |
Collapse
|
3
|
Hanneman K, Szava-Kovats A, Burbridge B, Leswick D, Nadeau B, Islam O, Lee EJY, Harris A, Hamel C, Brown MJ. Canadian Association of Radiologists Statement on Environmental Sustainability in Medical Imaging. Can Assoc Radiol J 2025; 76:44-54. [PMID: 39080832 DOI: 10.1177/08465371241260013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024] Open
Abstract
Immediate and strategic action is needed to improve environmental sustainability and reduce the detrimental effects of climate change. Climate change is already adversely affecting the health of Canadians related to worsening air pollution and wildfire smoke, increasing frequency and intensity of extreme weather events, and expansion of vector-borne and infectious illnesses. On one hand, radiology contributes to the climate crisis by generating greenhouse gas emissions and waste during the production, manufacture, transportation, and use of medical imaging equipment and supplies. On the other hand, radiology departments are also susceptible to equipment and infrastructure damage from flooding, extreme temperatures, and power failures, as well as workforce shortages due to injury and illness, potentially disrupting radiology services and increasing costs. The Canadian Association of Radiologists' (CAR) advocacy for environmentally sustainable radiology in Canada encompasses both minimizing the detrimental effects that delivery of radiology services has on the environment and optimizing the resilience of radiology departments to increasing health needs and changing patterns of disease on imaging related to climate change. This statement provides specific recommendations and pathways to help guide radiologists, medical imaging leadership teams, industry partners, governments, and other key stakeholders to transition to environmentally sustainable, net-zero, and climate-resilient radiology organizations. Specific consideration is given to unique aspects of medical imaging in Canada. Finally, environmentally sustainable radiology programs, policies, and achievements in Canada are highlighted.
Collapse
Affiliation(s)
- Kate Hanneman
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
- University Medical Imaging Toronto, Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada
| | | | - Brent Burbridge
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada
| | - David Leswick
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada
| | - Brandon Nadeau
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Omar Islam
- Department of Diagnostic Radiology, Queen's University, Kingston, ON, Canada
| | - Emil J Y Lee
- Department of Medical Imaging, Fraser Health Authority, Vancouver, BC, Canada
| | - Alison Harris
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Candyce Hamel
- Canadian Association of Radiologists, Ottawa, ON, Canada
| | - Maura J Brown
- Diagnostic Imaging, BC Cancer, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
4
|
Hanneman K, Picano E, Campbell-Washburn AE, Zhang Q, Browne L, Kozor R, Battey T, Omary R, Saldiva P, Ng M, Rockall A, Law M, Kim H, Lee YJ, Mills R, Ntusi N, Bucciarelli-Ducci C, Markl M. Society for Cardiovascular Magnetic Resonance recommendations toward environmentally sustainable cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2025:101840. [PMID: 39884945 DOI: 10.1016/j.jocmr.2025.101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2025] [Accepted: 01/13/2025] [Indexed: 02/01/2025] Open
Abstract
Delivery of health care, including medical imaging, generates substantial global greenhouse gas emissions. The cardiovascular magnetic resonance (CMR) community has an opportunity to decrease our carbon footprint, mitigate the effects of the climate crisis, and develop resiliency to current and future impacts of climate change. The goal of this document is to review and recommend actions and strategies to allow for CMR operation with improved sustainability, including efficient CMR protocols and CMR imaging workflow strategies for reducing greenhouse gas emissions, energy, and waste, and to decrease reliance on finite resources, including helium and waterbody contamination by gadolinium-based contrast agents. The article also highlights the potential of artificial intelligence and new hardware concepts, such as low-helium and low-field CMR, in achieving these aims. Specific actions include powering down magnetic resonance imaging scanners overnight and when not in use, reducing low-value CMR, and implementing efficient, non-contrast, and abbreviated CMR protocols when feasible. Data on estimated energy and greenhouse gas savings are provided where it is available, and areas of future research are highlighted.
Collapse
Affiliation(s)
- Kate Hanneman
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Eugenio Picano
- University Clinical Center of Serbia, Cardiology Division, University of Belgrade, Serbia
| | - Adrienne E Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Qiang Zhang
- RDM Division of Cardiovascular Medicine & NDPH Big Data Institute, University of Oxford, Oxford, UK
| | - Lorna Browne
- Dept of Radiology, Division of Pediatric Radiology, Children's Hospital Colorado, University of Colorado School of Medicine, USA
| | - Rebecca Kozor
- University of Sydney and Royal North Shore Hospital, Sydney, Australia
| | - Thomas Battey
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Reed Omary
- Departments of Radiology & Biomedical Engineering, Vanderbilt University, Nashville TN, USA; Greenwell Project, Nashville, TN, USA
| | - Paulo Saldiva
- Department of Pathology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Ming Ng
- Department of Diagnostic Radiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - Andrea Rockall
- Dept of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK
| | - Meng Law
- Departments of Neuroscience, Electrical and Computer Systems Engineering, Monash University, Australia; Department of Radiology, Alfred Health, Melbourne, Australia
| | - Helen Kim
- Department of Radiology, University of Washington, WA, USA
| | - Yoo Jin Lee
- Department of Radiology and Biomedical Engineering, UCSF, San Francisco, California, USA
| | - Rebecca Mills
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, UK
| | - Ntobeko Ntusi
- Groote Schuur Hospital, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Chiara Bucciarelli-Ducci
- Royal Brompton and Harefield Hospitals, Guys' & St Thomas NHS Trust, London, United Kingdom; School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College University, London, UK
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, Illinois, USA.
| |
Collapse
|
5
|
Savage CH, Kanhere A, Parekh V, Langlotz CP, Joshi A, Huang H, Doo FX, Atzen S. Open-Source Large Language Models in Radiology: A Review and Tutorial for Practical Research and Clinical Deployment. Radiology 2025; 314:e241073. [PMID: 39873598 PMCID: PMC11783163 DOI: 10.1148/radiol.241073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/17/2024] [Accepted: 07/24/2024] [Indexed: 01/30/2025]
Abstract
Integrating large language models (LLMs) into health care holds substantial potential to enhance clinical workflows and care delivery. However, LLMs also pose serious risks if integration is not thoughtfully executed, with complex challenges spanning accuracy, accessibility, privacy, and regulation. Proprietary commercial LLMs (eg, GPT-4 [OpenAI], Claude 3 Sonnet and Claude 3 Opus [Anthropic], Gemini [Google]) have received much attention from researchers in the medical domain, including radiology. Interestingly, open-source LLMs (eg, Llama 3 and LLaVA-Med) have received comparatively little attention. Yet, open-source LLMs hold several key advantages over proprietary LLMs for medical institutions, hospitals, and individual researchers. The wider adoption of open-source LLMs has been slower, perhaps in part due to the lack of familiarity, accessible computational infrastructure, and community-built tools to streamline their local implementation and customize them for specific use cases. Thus, this article provides a tutorial for the implementation of open-source LLMs in radiology, including examples of commonly used tools for text generation and techniques for troubleshooting issues with prompt engineering, retrieval-augmented generation, and fine-tuning. Implementation-ready code for each tool is provided at https://github.com/UM2ii/Open-Source-LLM-Tools-for-Radiology. In addition, this article compares the benefits and drawbacks of open-source and proprietary LLMs, discusses the differentiating characteristics of popular open-source LLMs, and highlights recent advancements that may affect their adoption.
Collapse
Affiliation(s)
- Cody H. Savage
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Diagnostic Radiology and Nuclear Medicine, University of
Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201 (C.H.S., A.K.,
V.P., F.X.D.); Departments of Radiology, Medicine, and Biomedical Data Science,
Stanford University, Palo Alto, Calif (C.P.L.); Department of Computer Science
and Electrical Engineering, College of Engineering and Information Technology,
University of Maryland, Baltimore County, Baltimore, Md (A.J.); Department of
Computer Science, University of Maryland, College Park, College Park, Md (H.H.);
and University of Maryland Institute for Health Computing, University of
Maryland, North Bethesda, Md (H.H., F.X.D.)
| | - Adway Kanhere
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Diagnostic Radiology and Nuclear Medicine, University of
Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201 (C.H.S., A.K.,
V.P., F.X.D.); Departments of Radiology, Medicine, and Biomedical Data Science,
Stanford University, Palo Alto, Calif (C.P.L.); Department of Computer Science
and Electrical Engineering, College of Engineering and Information Technology,
University of Maryland, Baltimore County, Baltimore, Md (A.J.); Department of
Computer Science, University of Maryland, College Park, College Park, Md (H.H.);
and University of Maryland Institute for Health Computing, University of
Maryland, North Bethesda, Md (H.H., F.X.D.)
| | - Vishwa Parekh
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Diagnostic Radiology and Nuclear Medicine, University of
Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201 (C.H.S., A.K.,
V.P., F.X.D.); Departments of Radiology, Medicine, and Biomedical Data Science,
Stanford University, Palo Alto, Calif (C.P.L.); Department of Computer Science
and Electrical Engineering, College of Engineering and Information Technology,
University of Maryland, Baltimore County, Baltimore, Md (A.J.); Department of
Computer Science, University of Maryland, College Park, College Park, Md (H.H.);
and University of Maryland Institute for Health Computing, University of
Maryland, North Bethesda, Md (H.H., F.X.D.)
| | - Curtis P. Langlotz
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Diagnostic Radiology and Nuclear Medicine, University of
Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201 (C.H.S., A.K.,
V.P., F.X.D.); Departments of Radiology, Medicine, and Biomedical Data Science,
Stanford University, Palo Alto, Calif (C.P.L.); Department of Computer Science
and Electrical Engineering, College of Engineering and Information Technology,
University of Maryland, Baltimore County, Baltimore, Md (A.J.); Department of
Computer Science, University of Maryland, College Park, College Park, Md (H.H.);
and University of Maryland Institute for Health Computing, University of
Maryland, North Bethesda, Md (H.H., F.X.D.)
| | - Anupam Joshi
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Diagnostic Radiology and Nuclear Medicine, University of
Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201 (C.H.S., A.K.,
V.P., F.X.D.); Departments of Radiology, Medicine, and Biomedical Data Science,
Stanford University, Palo Alto, Calif (C.P.L.); Department of Computer Science
and Electrical Engineering, College of Engineering and Information Technology,
University of Maryland, Baltimore County, Baltimore, Md (A.J.); Department of
Computer Science, University of Maryland, College Park, College Park, Md (H.H.);
and University of Maryland Institute for Health Computing, University of
Maryland, North Bethesda, Md (H.H., F.X.D.)
| | - Heng Huang
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Diagnostic Radiology and Nuclear Medicine, University of
Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201 (C.H.S., A.K.,
V.P., F.X.D.); Departments of Radiology, Medicine, and Biomedical Data Science,
Stanford University, Palo Alto, Calif (C.P.L.); Department of Computer Science
and Electrical Engineering, College of Engineering and Information Technology,
University of Maryland, Baltimore County, Baltimore, Md (A.J.); Department of
Computer Science, University of Maryland, College Park, College Park, Md (H.H.);
and University of Maryland Institute for Health Computing, University of
Maryland, North Bethesda, Md (H.H., F.X.D.)
| | - Florence X. Doo
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Diagnostic Radiology and Nuclear Medicine, University of
Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201 (C.H.S., A.K.,
V.P., F.X.D.); Departments of Radiology, Medicine, and Biomedical Data Science,
Stanford University, Palo Alto, Calif (C.P.L.); Department of Computer Science
and Electrical Engineering, College of Engineering and Information Technology,
University of Maryland, Baltimore County, Baltimore, Md (A.J.); Department of
Computer Science, University of Maryland, College Park, College Park, Md (H.H.);
and University of Maryland Institute for Health Computing, University of
Maryland, North Bethesda, Md (H.H., F.X.D.)
| | - Sarah Atzen
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Diagnostic Radiology and Nuclear Medicine, University of
Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201 (C.H.S., A.K.,
V.P., F.X.D.); Departments of Radiology, Medicine, and Biomedical Data Science,
Stanford University, Palo Alto, Calif (C.P.L.); Department of Computer Science
and Electrical Engineering, College of Engineering and Information Technology,
University of Maryland, Baltimore County, Baltimore, Md (A.J.); Department of
Computer Science, University of Maryland, College Park, College Park, Md (H.H.);
and University of Maryland Institute for Health Computing, University of
Maryland, North Bethesda, Md (H.H., F.X.D.)
| |
Collapse
|
6
|
Jackson A, Hirsch B. Changing the workflow - Artificial intelligence in radiologic sciences. J Med Imaging Radiat Sci 2024; 55:101710. [PMID: 38986297 DOI: 10.1016/j.jmir.2024.101710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/09/2024] [Accepted: 06/12/2024] [Indexed: 07/12/2024]
Affiliation(s)
- Ashley Jackson
- Medical Dosimetry Intern, School of Health Sciences, Southern Illinois University Carbondale, Carbondale, Illinois, United States
| | - Brandon Hirsch
- School of Health Sciences, Southern Illinois University Carbondale, Carbondale, Illinois, United States.
| |
Collapse
|
7
|
Kulkarni P, Kanhere A, Siegel EL, Yi PH, Parekh VS. ISLE: An Intelligent Streaming Framework for High-Throughput AI Inference in Medical Imaging. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:3250-3263. [PMID: 38937343 PMCID: PMC11612124 DOI: 10.1007/s10278-024-01173-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/29/2024]
Abstract
As the adoption of artificial intelligence (AI) systems in radiology grows, the increase in demand for greater bandwidth and computational resources can lead to greater infrastructural costs for healthcare providers and AI vendors. To that end, we developed ISLE, an intelligent streaming framework to address inefficiencies in current imaging infrastructures. Our framework draws inspiration from video-on-demand platforms to intelligently stream medical images to AI vendors at an optimal resolution for inference from a single high-resolution copy using progressive encoding. We hypothesize that ISLE can dramatically reduce the bandwidth and computational requirements for AI inference, while increasing throughput (i.e., the number of scans processed by the AI system per second). We evaluate our framework by streaming chest X-rays for classification and abdomen CT scans for liver and spleen segmentation and comparing them with the original versions of each dataset. For classification, our results show that ISLE reduced data transmission and decoding time by at least 92% and 88%, respectively, while increasing throughput by more than 3.72 × . For both segmentation tasks, ISLE reduced data transmission and decoding time by at least 82% and 88%, respectively, while increasing throughput by more than 2.9 × . In all three tasks, the ISLE streamed data had no impact on the AI system's diagnostic performance (all P > 0.05). Therefore, our results indicate that our framework can address inefficiencies in current imaging infrastructures by improving data and computational efficiency of AI deployments in the clinical environment without impacting clinical decision-making using AI systems.
Collapse
Affiliation(s)
- Pranav Kulkarni
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Intelligent Imaging (UM2ii) Center, University of Maryland School of Medicine, 100 N Greene St, Baltimore, MD, 21201, USA
| | - Adway Kanhere
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Intelligent Imaging (UM2ii) Center, University of Maryland School of Medicine, 100 N Greene St, Baltimore, MD, 21201, USA
| | - Eliot L Siegel
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Intelligent Imaging (UM2ii) Center, University of Maryland School of Medicine, 100 N Greene St, Baltimore, MD, 21201, USA
| | - Paul H Yi
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Intelligent Imaging (UM2ii) Center, University of Maryland School of Medicine, 100 N Greene St, Baltimore, MD, 21201, USA
| | - Vishwa S Parekh
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Intelligent Imaging (UM2ii) Center, University of Maryland School of Medicine, 100 N Greene St, Baltimore, MD, 21201, USA.
| |
Collapse
|
8
|
Hirata K, Matsui Y, Yamada A, Fujioka T, Yanagawa M, Nakaura T, Ito R, Ueda D, Fujita S, Tatsugami F, Fushimi Y, Tsuboyama T, Kamagata K, Nozaki T, Fujima N, Kawamura M, Naganawa S. Generative AI and large language models in nuclear medicine: current status and future prospects. Ann Nucl Med 2024; 38:853-864. [PMID: 39320419 DOI: 10.1007/s12149-024-01981-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Accepted: 09/13/2024] [Indexed: 09/26/2024]
Abstract
This review explores the potential applications of Large Language Models (LLMs) in nuclear medicine, especially nuclear medicine examinations such as PET and SPECT, reviewing recent advancements in both fields. Despite the rapid adoption of LLMs in various medical specialties, their integration into nuclear medicine has not yet been sufficiently explored. We first discuss the latest developments in nuclear medicine, including new radiopharmaceuticals, imaging techniques, and clinical applications. We then analyze how LLMs are being utilized in radiology, particularly in report generation, image interpretation, and medical education. We highlight the potential of LLMs to enhance nuclear medicine practices, such as improving report structuring, assisting in diagnosis, and facilitating research. However, challenges remain, including the need for improved reliability, explainability, and bias reduction in LLMs. The review also addresses the ethical considerations and potential limitations of AI in healthcare. In conclusion, LLMs have significant potential to transform existing frameworks in nuclear medicine, making it a critical area for future research and development.
Collapse
Affiliation(s)
- Kenji Hirata
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Yusuke Matsui
- Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Kita-Ku, Okayama, Japan
| | - Akira Yamada
- Medical Data Science Course, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Tomoyuki Fujioka
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, Bunkyo-Ku, Tokyo, Japan
| | - Masahiro Yanagawa
- Department of Radiology, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Kumamoto University Graduate School of Medicine, Chuo-Ku, Kumamoto, Japan
| | - Rintaro Ito
- Department of Radiology, Nagoya University Graduate School of Medicine, Showa-Ku, Nagoya, Japan
| | - Daiju Ueda
- Department of Artificial Intelligence, Graduate School of Medicine, Osaka Metropolitan University, Abeno-Ku, Osaka, Japan
| | - Shohei Fujita
- Department of Radiology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Fuminari Tatsugami
- Department of Diagnostic Radiology, Hiroshima University, Minami-Ku, Hiroshima, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Sakyoku, Kyoto, Japan
| | - Takahiro Tsuboyama
- Department of Radiology, Kobe University Graduate School of Medicine, Chuo-Ku, Kobe, Japan
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Bunkyo-Ku, Tokyo, Japan
| | - Taiki Nozaki
- Department of Radiology, Keio University School of Medicine, Shinjuku-Ku, Tokyo, Japan
| | - Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Kita-Ku, Sapporo, Japan
| | - Mariko Kawamura
- Department of Radiology, Nagoya University Graduate School of Medicine, Showa-Ku, Nagoya, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Showa-Ku, Nagoya, Japan
| |
Collapse
|
9
|
Ramwala OA, Lowry KP, Cross NM, Hsu W, Austin CC, Mooney SD, Lee CI. Establishing a Validation Infrastructure for Imaging-Based Artificial Intelligence Algorithms Before Clinical Implementation. J Am Coll Radiol 2024; 21:1569-1574. [PMID: 38789066 PMCID: PMC11486600 DOI: 10.1016/j.jacr.2024.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/05/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024]
Abstract
With promising artificial intelligence (AI) algorithms receiving FDA clearance, the potential impact of these models on clinical outcomes must be evaluated locally before their integration into routine workflows. Robust validation infrastructures are pivotal to inspecting the accuracy and generalizability of these deep learning algorithms to ensure both patient safety and health equity. Protected health information concerns, intellectual property rights, and diverse requirements of models impede the development of rigorous external validation infrastructures. The authors propose various suggestions for addressing the challenges associated with the development of efficient, customizable, and cost-effective infrastructures for the external validation of AI models at large medical centers and institutions. The authors present comprehensive steps to establish an AI inferencing infrastructure outside clinical systems to examine the local performance of AI algorithms before health practice or systemwide implementation and promote an evidence-based approach for adopting AI models that can enhance radiology workflows and improve patient outcomes.
Collapse
Affiliation(s)
- Ojas A Ramwala
- Department of Biomedical Informatics and Medical Education, University of Washington School of Medicine, Seattle, Washington
| | - Kathryn P Lowry
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington
| | - Nathan M Cross
- Vice Chair of Informatics, Department of Radiology, University of Washington School of Medicine, Seattle, Washington
| | - William Hsu
- Department of Radiological Sciences, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; Department of Bioengineering, University of California, Los Angeles, Samueli School of Engineering, Los Angeles, California; Deputy Editor, Radiology: Artificial Intelligence
| | | | - Sean D Mooney
- Director, Center for Information Technology, National Institutes of Health, Bethesda, Maryland
| | - Christoph I Lee
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington; Director, Northwest Screening and Cancer Outcomes Research Enterprise, University of Washington; Deputy Editor, JACR.
| |
Collapse
|
10
|
Doo FX, Savani D, Kanhere A, Carlos RC, Joshi A, Yi PH, Parekh VS, Atzen S. Optimal Large Language Model Characteristics to Balance Accuracy and Energy Use for Sustainable Medical Applications. Radiology 2024; 312:e240320. [PMID: 39189909 PMCID: PMC11366671 DOI: 10.1148/radiol.240320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 08/28/2024]
Abstract
Background Large language models (LLMs) for medical applications use unknown amounts of energy, which contribute to the overall carbon footprint of the health care system. Purpose To investigate the tradeoffs between accuracy and energy use when using different LLM types and sizes for medical applications. Materials and Methods This retrospective study evaluated five different billion (B)-parameter sizes of two open-source LLMs (Meta's Llama 2, a general-purpose model, and LMSYS Org's Vicuna 1.5, a specialized fine-tuned model) using chest radiograph reports from the National Library of Medicine's Indiana University Chest X-ray Collection. Reports with missing demographic information and missing or blank files were excluded. Models were run on local compute clusters with visual computing graphic processing units. A single-task prompt explained clinical terminology and instructed each model to confirm the presence or absence of each of the 13 CheXpert disease labels. Energy use (in kilowatt-hours) was measured using an open-source tool. Accuracy was assessed with 13 CheXpert reference standard labels for diagnostic findings on chest radiographs, where overall accuracy was the mean of individual accuracies of all 13 labels. Efficiency ratios (accuracy per kilowatt-hour) were calculated for each model type and size. Results A total of 3665 chest radiograph reports were evaluated. The Vicuna 1.5 7B and 13B models had higher efficiency ratios (737.28 and 331.40, respectively) and higher overall labeling accuracy (93.83% [3438.69 of 3665 reports] and 93.65% [3432.38 of 3665 reports], respectively) than that of the Llama 2 models (7B: efficiency ratio of 13.39, accuracy of 7.91% [289.76 of 3665 reports]; 13B: efficiency ratio of 40.90, accuracy of 74.08% [2715.15 of 3665 reports]; 70B: efficiency ratio of 22.30, accuracy of 92.70% [3397.38 of 3665 reports]). Vicuna 1.5 7B had the highest efficiency ratio (737.28 vs 13.39 for Llama 2 7B). The larger Llama 2 70B model used more than seven times the energy of its 7B counterpart (4.16 kWh vs 0.59 kWh) with low overall accuracy, resulting in an efficiency ratio of only 22.30. Conclusion Smaller fine-tuned LLMs were more sustainable than larger general-purpose LLMs, using less energy without compromising accuracy, highlighting the importance of LLM selection for medical applications. © RSNA, 2024 Supplemental material is available for this article.
Collapse
Affiliation(s)
| | | | - Adway Kanhere
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Radiology and Nuclear Medicine, University of Maryland
School of Medicine, 22 S Greene St, Baltimore, MD 21201 (F.X.D., D.S., A.K.,
P.H.Y., V.S.P.); Department of Radiology, University of Michigan, Ann Arbor,
Mich (R.C.C.); and Department of Computer Science and Electrical Engineering,
University of Maryland Baltimore County, Baltimore, Md (A.J.)
| | - Ruth C. Carlos
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Radiology and Nuclear Medicine, University of Maryland
School of Medicine, 22 S Greene St, Baltimore, MD 21201 (F.X.D., D.S., A.K.,
P.H.Y., V.S.P.); Department of Radiology, University of Michigan, Ann Arbor,
Mich (R.C.C.); and Department of Computer Science and Electrical Engineering,
University of Maryland Baltimore County, Baltimore, Md (A.J.)
| | - Anupam Joshi
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Radiology and Nuclear Medicine, University of Maryland
School of Medicine, 22 S Greene St, Baltimore, MD 21201 (F.X.D., D.S., A.K.,
P.H.Y., V.S.P.); Department of Radiology, University of Michigan, Ann Arbor,
Mich (R.C.C.); and Department of Computer Science and Electrical Engineering,
University of Maryland Baltimore County, Baltimore, Md (A.J.)
| | - Paul H. Yi
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Radiology and Nuclear Medicine, University of Maryland
School of Medicine, 22 S Greene St, Baltimore, MD 21201 (F.X.D., D.S., A.K.,
P.H.Y., V.S.P.); Department of Radiology, University of Michigan, Ann Arbor,
Mich (R.C.C.); and Department of Computer Science and Electrical Engineering,
University of Maryland Baltimore County, Baltimore, Md (A.J.)
| | - Vishwa S. Parekh
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Radiology and Nuclear Medicine, University of Maryland
School of Medicine, 22 S Greene St, Baltimore, MD 21201 (F.X.D., D.S., A.K.,
P.H.Y., V.S.P.); Department of Radiology, University of Michigan, Ann Arbor,
Mich (R.C.C.); and Department of Computer Science and Electrical Engineering,
University of Maryland Baltimore County, Baltimore, Md (A.J.)
| | - Sarah Atzen
- From the University of Maryland Medical Intelligent Imaging (UM2ii)
Center, Department of Radiology and Nuclear Medicine, University of Maryland
School of Medicine, 22 S Greene St, Baltimore, MD 21201 (F.X.D., D.S., A.K.,
P.H.Y., V.S.P.); Department of Radiology, University of Michigan, Ann Arbor,
Mich (R.C.C.); and Department of Computer Science and Electrical Engineering,
University of Maryland Baltimore County, Baltimore, Md (A.J.)
| |
Collapse
|
11
|
McKee H, Brown MJ, Kim HHR, Doo FX, Panet H, Rockall AG, Omary RA, Hanneman K. Planetary Health and Radiology: Why We Should Care and What We Can Do. Radiology 2024; 311:e240219. [PMID: 38652030 DOI: 10.1148/radiol.240219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Climate change adversely affects the well-being of humans and the entire planet. A planetary health framework recognizes that sustaining a healthy planet is essential to achieving individual, community, and global health. Radiology contributes to the climate crisis by generating greenhouse gas (GHG) emissions during the production and use of medical imaging equipment and supplies. To promote planetary health, strategies that mitigate and adapt to climate change in radiology are needed. Mitigation strategies to reduce GHG emissions include switching to renewable energy sources, refurbishing rather than replacing imaging scanners, and powering down unused scanners. Radiology departments must also build resiliency to the now unavoidable impacts of the climate crisis. Adaptation strategies include education, upgrading building infrastructure, and developing departmental sustainability dashboards to track progress in achieving sustainability goals. Shifting practices to catalyze these necessary changes in radiology requires a coordinated approach. This includes partnering with key stakeholders, providing effective communication, and prioritizing high-impact interventions. This article reviews the intersection of planetary health and radiology. Its goals are to emphasize why we should care about sustainability, showcase actions we can take to mitigate our impact, and prepare us to adapt to the effects of climate change. © RSNA, 2024 Supplemental material is available for this article. See also the article by Ibrahim et al in this issue. See also the article by Lenkinski and Rofsky in this issue.
Collapse
Affiliation(s)
- Hayley McKee
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Maura J Brown
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Helen H R Kim
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Florence X Doo
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Hayley Panet
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Andrea G Rockall
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Reed A Omary
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| | - Kate Hanneman
- From the Temerty Faculty of Medicine (H.M.) and Department of Medical Imaging (H.M., H.P., K.H.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (M.J.B.); Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash (H.H.R.K.); University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, Md (F.X.D.); Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, England (A.G.R.); Department of Radiology, Imperial College Healthcare NHS Trust, London, England (A.G.R.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (R.A.O.); Joint Department of Medical Imaging, University Medical Imaging Toronto, Toronto, Ontario, Canada (K.H.); and Toronto General Hospital Research Institute, University Health Network, University of Toronto, 1 PMB-298, 585 University Ave, Toronto, ON, Canada M5G 2N2 (K.H.)
| |
Collapse
|
12
|
Lepri G, Oddi F, Gulino RA, Giansanti D. Reimagining Radiology: A Comprehensive Overview of Reviews at the Intersection of Mobile and Domiciliary Radiology over the Last Five Years. Bioengineering (Basel) 2024; 11:216. [PMID: 38534491 DOI: 10.3390/bioengineering11030216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/28/2024] Open
Abstract
(Background) Domiciliary radiology, which originated in pioneering studies in 1958, has transformed healthcare, particularly during the COVID-19 pandemic, through advancements such as miniaturization and digitization. This evolution, driven by the synergy of advanced technologies and robust data networks, reshapes the intersection of domiciliary radiology and mobile technology in healthcare delivery. (Objective) The objective of this study is to overview the reviews in this field with reference to the last five years to face the state of development and integration of this practice in the health domain. (Methods) A review was conducted on PubMed and Scopus, applying a standard checklist and a qualification process. The outcome detected 21 studies. (Key Content and Findings) The exploration of mobile and domiciliary radiology unveils a compelling and optimistic perspective. Notable strides in this dynamic field include the integration of Artificial Intelligence (AI), revolutionary applications in telemedicine, and the educational potential of mobile devices. Post-COVID-19, telemedicine advances and the influential role of AI in pediatric radiology signify significant progress. Mobile mammography units emerge as a solution for underserved women, highlighting the crucial importance of early breast cancer detection. The investigation into domiciliary radiology, especially with mobile X-ray equipment, points toward a promising frontier, prompting in-depth research for comprehensive insights into its potential benefits for diverse populations. The study also identifies limitations and suggests future exploration in various domains of mobile and domiciliary radiology. A key recommendation stresses the strategic prioritization of multi-domain technology assessment initiatives, with scientific societies' endorsement, emphasizing regulatory considerations for responsible and ethical technology integration in healthcare practices. The broader landscape of technology assessment should aim to be innovative, ethical, and aligned with societal needs and regulatory standards. (Conclusions) The dynamic state of the field is evident, with active exploration of new frontiers. This overview also provides a roadmap, urging scholars, industry players, and regulators to collectively contribute to the further integration of this technology in the health domain.
Collapse
Affiliation(s)
- Graziano Lepri
- Azienda Unità Sanitaria Locale Umbria 1, Via Guerriero Guerra 21, 06127 Perugia, Italy
| | - Francesco Oddi
- Facoltà di Ingegneria, Università di Tor Vergata, Via del Politecnico, 1, 00133 Roma, Italy
| | - Rosario Alfio Gulino
- Facoltà di Ingegneria, Università di Tor Vergata, Via del Politecnico, 1, 00133 Roma, Italy
| | - Daniele Giansanti
- Centro Nazionale TISP, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
| |
Collapse
|
13
|
Doo FX, Parekh VS, Kanhere A, Savani D, Tejani AS, Sapkota A, Yi PH. Evaluation of Climate-Aware Metrics Tools for Radiology Informatics and Artificial Intelligence: Toward a Potential Radiology Ecolabel. J Am Coll Radiol 2024; 21:239-247. [PMID: 38043630 DOI: 10.1016/j.jacr.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/10/2023] [Accepted: 11/22/2023] [Indexed: 12/05/2023]
Abstract
Radiology is a major contributor to health care's impact on climate change, in part due to its reliance on energy-intensive equipment as well as its growing technological reliance. Delivering modern patient care requires a robust informatics team to move images from the imaging equipment to the workstations and the health care system. Radiology informatics is the field that manages medical imaging IT. This involves the acquisition, storage, retrieval, and use of imaging information in health care to improve access and quality, which includes PACS, cloud services, and artificial intelligence. However, the electricity consumption of computing and the life cycle of various computer components expands the carbon footprint of health care. The authors provide a general framework to understand the environmental impact of clinical radiology informatics, which includes using the international Greenhouse Gas Protocol to draft a definition of scopes of emissions pertinent to radiology informatics, as well as exploring existing tools to measure and account for these emissions. A novel standard ecolabel for radiology informatics tools, such as the Energy Star label for consumer devices or Leadership in Energy and Environmental Design certification for buildings, should be developed to promote awareness and guide radiologists and radiology informatics leaders in making environmentally conscious decisions for their clinical practice. At this critical climate juncture, the radiology community has a unique and pressing obligation to consider our shared environmental responsibility in innovating clinical technology for patient care.
Collapse
Affiliation(s)
- Florence X Doo
- University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland.
| | - Vishwa S Parekh
- University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland. https://twitter.com/vishwa_parekh
| | - Adway Kanhere
- University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland. https://twitter.com/AdwayKanhere
| | - Dharmam Savani
- University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland
| | - Ali S Tejani
- University of Texas Southwestern Medical Center, Dallas, Texas; and Co-Chair, Resident-Fellow Section AI Subcommittee. https://twitter.com/AliTejaniMD
| | - Amir Sapkota
- Chair, Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland
| | - Paul H Yi
- University of Maryland Medical Intelligent Imaging (UM2ii) Center, Department of Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland; Vice Chair, Program Planning Committee, Society for Imaging Informatics in Medicine; and Associate Editor of Radiology: Artificial Intelligence. https://twitter.com/PaulYiMD
| |
Collapse
|