Can GPT-4V(ision) Serve Medical Applications? Case Studies on GPT-4V for Multimodal Medical Diagnosis

Driven by the large foundation models, the development of artificial intelligence has witnessed tremendous progress lately, leading to a surge of general interest from the public. In this study, we aim to assess the performance of OpenAI's newest model, GPT-4V(ision), specifically in the realm of multimodal medical diagnosis. Our evaluation encompasses 17 human body systems, including Central Nervous System, Head and Neck, Cardiac, Chest, Hematology, Hepatobiliary, Gastrointestinal, Urogenital, Gynecology, Obstetrics, Breast, Musculoskeletal, Spine, Vascular, Oncology, Trauma, Pediatrics, with images taken from 8 modalities used in daily clinic routine, e.g., X-ray, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET), Digital Subtraction Angiography (DSA), Mammography, Ultrasound, and Pathology. We probe the GPT-4V's ability on multiple clinical tasks with or without patent history provided, including imaging modality and anatomy recognition, disease diagnosis, report generation, disease localisation. Our observation shows that, while GPT-4V demonstrates proficiency in distinguishing between medical image modalities and anatomy, it faces significant challenges in disease diagnosis and generating comprehensive reports. These findings underscore that while large multimodal models have made significant advancements in computer vision and natural language processing, it remains far from being used to effectively support real-world medical applications and clinical decision-making. All images used in this report can be found in https://github.com/chaoyi-wu/GPT-4V_Medical_Evaluation

Diffusionâ weighted imaging outside the brain: Consensus statement from an ISMRMâ sponsored workshop

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134160/1/jmri25196_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134160/2/jmri25196.pd

Rare Primary Central Nervous System Tumors in Adults: An Overview

Overall, tumors of primary central nervous system (CNS) are quite common in adults with an incidence rate close to 30 new cases/100,000 inhabitants per year. Significant clinical and biological advances have been accomplished in the most common adult primary CNS tumors (i.e., diffuse gliomas). However, most CNS tumor subtypes are rare with an incidence rate below the threshold defining rare disease of 6.0 new cases/100,000 inhabitants per year. Close to 150 entities of primary CNS tumors have now been identified by the novel integrated histomolecular classification published by the World Health Organization (WHO) and its updates by the c-IMPACT NOW consortium (the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy). While these entities can be better classified into smaller groups either by their histomolecular features and/or by their location, assessing their treatment by clinical trials and improving the survival of patients remain challenging. Despite these tumors are rare, research, and advances remain slower compared to diffuse gliomas for instance. In some cases (i.e., ependymoma, medulloblastoma) the understanding is high because single or few driver mutations have been defined. The European Union has launched European Reference Networks (ERNs) dedicated to support advances on the clinical side of rare diseases including rare cancers. The ERN for rare solid adult tumors is termed EURACAN. Within EURACAN, Domain 10 brings together the European patient advocacy groups (ePAGs) and physicians dedicated to improving outcomes in rare primary CNS tumors and also aims at supporting research, care and teaching in the field. In this review, we discuss the relevant biological and clinical characteristics, clinical management of patients, and research directions for the following types of rare primary CNS tumors: medulloblastoma, pineal region tumors, glioneuronal and rare glial tumors, ependymal tumors, grade III meningioma and mesenchymal tumors, primary central nervous system lymphoma, germ cell tumors, spinal cord tumors and rare pituitary tumors

Imaging assessment of haematopoietic and lymphoid tumours; advancing methodologies and applications

Haematological malignancies are a burden being the fifth most common cancer and the second leading cause of cancer mortality on a global scale. Their presentation is complex due to disparate patterns of biological behaviour and anatomical involvement. Accurate detection of disease and precise assessment of treatment response is critical for optimal patient management. However, the appropriate use of imaging tests requires awareness of their strengths and limitations and appreciation of the myriad biological behaviours of haematological malignancies. This thesis presents research undertaken to enhance the imaging assessment of haematological malignancies. Four key themes of concern were identified and addressed. Firstly, general reporting of haematological malignancies lacked standardisation in staging, response, and prognostication assessment across all imaging studies: computed tomography (CT), positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI). A multimodality imaging report with a multidisciplinary team meeting (MDTM) style conclusion needs to be issued at each relevant timepoint in the patient pathway. The aim was to reduce imaging ‘error’ rates by using template reports, produce comparative datasets from different centres, and improve patient outcomes. Analogous to UK developments in pathology reporting, a robust and adaptable methodology, termed ‘Specialist Integrated Haematological Malignancy Imaging Reporting’ (SIHMIR), was formulated. Secondly, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) imaging guidance varied widely. There was no detailed analysis of the strengths and weaknesses of the numerous imaging tests used, and patient data was prone to misinterpretation. No comprehensive imaging guidance was available for the distinct types of BIA-ALCL, a ‘cascade’ of investigations being performed. An assessment of the strengths and limitations of all anatomical and functional imaging investigations in BIA-ALCL was undertaken, and patient imaging pathways were developed. Thirdly, a prompt diagnosis of Richter’s transformation (RT) from chronic lymphocytic leukaemia (CLL) was needed. The selection of a biopsy target to diagnose RT was a particular challenge in clinical practice. A PET-CT driven decision-making pathway to decide whether biopsy was required and, if so, to select a representative biopsy site in the era of novel therapies was developed. Lastly, MRI, used for central nervous system lymphoma (CNSL) imaging, was unable to differentiate disease activity from benign post-biopsy and inflammatory change and did not provide prognostic information. Two imaging applications for this purpose were developed: (i) the theoretical concept and clinical use of contrast clearance analysis (CCA), with its ability to differentiate viable CNSL from benign enhancement, and (ii) 18F-choline radiotracer (FCH) cranial PET-CT for staging, response-assessment, and prognostication. This thesis advances the imaging assessment in haematopoietic and lymphoid tumours, most notably with a standardised reporting framework (SIHMIR), guidance in both BIA-ALCL and CLL RT, and two CNSL imaging applications. The disease-histology specific approach to the use of imaging tests has been endorsed by the UK National Institute of Health and Care Excellence (NICE) Guidelines and UK Medicines and Healthcare products Regulatory Agency (MHRA) Guidelines. The new methodologies and tools described, particularly the two new tools for CNSL assessment, have the capacity to change global clinical and research trial practice

Recent Progress in Transformer-based Medical Image Analysis

The transformer is primarily used in the field of natural language processing. Recently, it has been adopted and shows promise in the computer vision (CV) field. Medical image analysis (MIA), as a critical branch of CV, also greatly benefits from this state-of-the-art technique. In this review, we first recap the core component of the transformer, the attention mechanism, and the detailed structures of the transformer. After that, we depict the recent progress of the transformer in the field of MIA. We organize the applications in a sequence of different tasks, including classification, segmentation, captioning, registration, detection, enhancement, localization, and synthesis. The mainstream classification and segmentation tasks are further divided into eleven medical image modalities. A large number of experiments studied in this review illustrate that the transformer-based method outperforms existing methods through comparisons with multiple evaluation metrics. Finally, we discuss the open challenges and future opportunities in this field. This task-modality review with the latest contents, detailed information, and comprehensive comparison may greatly benefit the broad MIA community.Comment: Computers in Biology and Medicine Accepte

Peripheral Neuropathy

Over the last two decades we have seen extensive progress within the practice of neurology. We have refined our understanding of the etiology and pathogenesis for both peripheral and central nervous system diseases, and developed new therapeutic approaches towards these diseases. Peripheral neuropathy is a common disorder seen by many specialists and can pose a diagnostic dilemma. Many etiologies, including drugs that are used to treat other diseases, can cause peripheral neuropathy. However, the most common cause is Diabetes Mellitus, a disease all physicians encounter. Disability due to peripheral neuropathy can be severe, as the patients suffer from symptoms daily. This book addresses the advances in the diagnosis and therapies of peripheral neuropathy over the last decade. The basics of different peripheral neuropathies is briefly discussed, however, the book focuses on topics that address new approaches to peripheral neuropathies

Diseases of the Brain, Head and Neck, Spine 2020–2023

This open access book offers an essential overview of brain, head and neck, and spine imaging. Over the last few years, there have been considerable advances in this area, driven by both clinical and technological developments. Written by leading international experts and teachers, the chapters are disease-oriented and cover all relevant imaging modalities, with a focus on magnetic resonance imaging and computed tomography. The book also includes a synopsis of pediatric imaging. IDKD books are rewritten (not merely updated) every four years, which means they offer a comprehensive review of the state-of-the-art in imaging. The book is clearly structured and features learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers navigate the text. It will particularly appeal to general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic expertise, as well as clinicians from other specialties who are interested in imaging for their patient care