A scoping review of interpretability and explainability concerning artificial intelligence methods in medical imaging

Purpose: to review eXplainable Artificial Intelligence/(XAI) methods available for medical imaging/(MI). Method: a scoping review was conducted following the Joanna Briggs Institute's methodology. The search was performed on Pubmed, Embase, Cinhal, Web of Science, BioRxiv, MedRxiv, and Google Scholar. Studies published in French and English after 2017 were included. Keyword combinations and descriptors related to explainability, and MI modalities were employed. Two independent reviewers screened abstracts, titles and full text, resolving differences through discussion. Results: 228 studies met the criteria. XAI publications are increasing, targeting MRI (n = 73), radiography (n = 47), CT (n = 46). Lung (n = 82) and brain (n = 74) pathologies, Covid-19 (n = 48), Alzheimer's disease (n = 25), brain tumors (n = 15) are the main pathologies explained. Explanations are presented visually (n = 186), numerically (n = 67), rule-based (n = 11), textually (n = 11), and example-based (n = 6). Commonly explained tasks include classification (n = 89), prediction (n = 47), diagnosis (n = 39), detection (n = 29), segmentation (n = 13), and image quality improvement (n = 6). The most frequently provided explanations were local (78.1 %), 5.7 % were global, and 16.2 % combined both local and global approaches. Post-hoc approaches were predominantly employed. The used terminology varied, sometimes indistinctively using explainable (n = 207), interpretable (n = 187), understandable (n = 112), transparent (n = 61), reliable (n = 31), and intelligible (n = 3). Conclusion: the number of XAI publications in medical imaging is increasing, primarily focusing on applying XAI techniques to MRI, CT, and radiography for classifying and predicting lung and brain pathologies. Visual and numerical output formats are predominantly used. Terminology standardisation remains a challenge, as terms like “explainable” and “interpretable” are sometimes being used indistinctively. Future XAI development should consider user needs and perspectives

The role of radiographers in nuclear medicine; the link between patient and technology

Recently, Slart and de Geus‑Oei published an editorial entitled: A new colleague in nuclear medicine, the clinical technologist: quo vadis? [1]. The authors describe how the new healthcare profession, clinical technologists, contributes to the field of nuclear medicine with a position between the physicist and the physician in the healthcare sector in the Netherlands. Furthermore, the editorial emphasizes how the clinical technologist plays a role in developing molecular imaging, dosimetry, and radionuclide therapy in a multidisciplinary environment.info:eu-repo/semantics/publishedVersio

Plain radiography has a role to play in current clinical practice in Western Switzerland

Aim: The aim of the study was to investigate the current role of conventional radiography examinations in Western Switzerland and the main clinical indications required to justify the use of this imaging examination. Methods: Ethical approval was obtained from the Vaud Ethics Committee (Ref 2020–00311). An online questionnaire was specifically designed and implemented on the data collection tool LimeSurvey composed of two parts: a) to characterise the participants’ profile and their institutions and b) 169 projections for the different anatomical areas (upper and lower limbs, pelvis, skull, spine, thorax, abdomen) were presented to collect data about the frequency and main clinical indications. Statistical analysis was performed using the software IBM SPSS® (Statistical Package for the Social Sciences) version 26. Results: Radiographers from 60% (26/43) of the invited institutions participated in this survey, mainly from the Vaud region. The upper and lower limbs were the most commonly examined by using conventional radiography mainly for trauma and degenerative disorders. The thorax was also an anatomical area commonly explored by X-rays, and so was the spine (cervical and lumbar lateral). The skull radiographs were rarely performed in clinical practice and some of the projections were not being used, namely Hirtz, Tangential Nose Bones, Worms, and Caldwell's views. Conclusions: Plain radiography is being used in clinical practice mainly for appendicular skeleton studies and for trauma and degenerative pathologies. Adaptations in radiographers’ education and training and other healthcare professionals are needed to provide the judicious use of data that radiographs can give to better manage the patients’ imaging pathway.info:eu-repo/semantics/publishedVersio

Plain radiography has a role to play in current clinical practice in Western Switzerland

Aim: The aim of the study was to investigate the current role of conventional radiography examinations in Western Switzerland and the main clinical indications required to justify the use of this imaging examination. Methods: Ethical approval was obtained from Vaud Ethics committee (Ref 2020–00311). An online questionnaire was specifically designed and implemented on the data collection tool LimeSurvey composed of two parts: a) to characterise the participants’ profile and their institutions and b) 169 projections for the different anatomical area (upper and lower limbs, pelvis, skull, spine, thorax, abdomen) were presented to collect data about the frequency and main clinical indications. Statistical analysis was performed using the software IBM SPSS®(Statis- tical Package for the Social Sciences) version 26. Results: Radiographers from 60% (26/43) of the invited institutions participated in this survey, mainly from Vaud region. The upper and lower limbs were the most commonly examined by using conventional radiography mainly for trauma and degenerative disorders. The thorax was also an anatomical area commonly explored by X-rays, so were the spine (cervical and lumbar lateral). The skull radiographs were rarely performed in clinical practice and some of the projections were not being used, namely Hirtz, Tangential Nose Bones, Worms and Cald- well’s views. Conclusions: Plain radiography is being used in clinical practice mainly for appendicular skeleton studies and for trauma and degenerative pathologies. Adaptations in radiographers’ education and training and other healthcare professionals are needed to provide the judicious use of data that radiographs can give to better manage the patients’ imaging pathway.But: Le but de l’étude était d’étudier le rôle actuel des examens de radiographie conventionnelle en Suisse occidentale et les principales indications cliniques requises pour justifier l’utilisation de cet examen d’imagerie. Méthodologie: L’approbation éthique a été obtenue auprès de la Commission d’éthique du canton de Vaud (Ref 2020-00311). Un questionnaire en ligne a été spécifiquement conçu et implémenté sur l’outil de collecte de données LimeSurvey composé de deux parties: a) caractériser le profil des participants et leurs institutions et b) 169 projections pour les différentes zones anatomiques (membres supérieurs et inférieurs, bassin, crâne, colonne vertébrale, thorax, abdomen) ont été présentées pour recueillir des données sur la fréquence et les principales indications cliniques. L’analyse statistique a été réalisée à l’aide du logiciel IBM SPSS®(Statistical Package for the Social Sciences) version 26. Résultats: Des radiographes de 60 % (26/43) des institutions invitées ont participé à cette enquête, principalement de la région vaudoise. Les membres supérieurs et inférieurs étaient les plus fréquemment examinés par radiographie conventionnelle, principalement pour les traumatismes et les troubles dégénératifs. Le thorax était également une zone anatomique couramment explorée par radiographie, de même que la colonne vertébrale (cervicale et lombaire latérale). Les radiographies du crâne étaient rarement réalisées en pratique clinique et certaines projections n’étaient pas utilisées, notamment les vues de Hirtz, des os du nez tangentiels, de Worms et de Caldwell. Conclusions: La radiographie simple est utilisée en pratique clinique principalement pour les études du squelette appendiculaire et pour les traumatismes et les pathologies dégénératives. Des adaptations dans la formation des radiographes et des autres professionnels de la santé sont nécessaires pour permettre une utilisation judicieuse des données que les radiographies peuvent fournir afin de mieux gérer le parcours d’imagerie des patients

Feasibility and performance of free-hand single-photon computed tomography/ultrasonography for preoperative parathyroid adenoma localization ::a pilot study

The aim of this prospective pilot study was to evaluate the feasibility of a new hybrid imaging modality, free-hand single-photon computed tomography/ultrasonography (fhSPECT/US), for preoperative localization of parathyroid adenomas and to compare its performance with conventional ultrasonography and SPECT/CT. Twelve patients diagnosed with primary hyperparathyroidism underwent sequentially US and parathyroid scintigraphy, including SPECT/CT, followed by fhSPECT/US, allowing for real-time fusion between US and freehand-generated gamma-camera images. The fhSPECT/US detection rates were correlated with histopathology, when available, or with the imaging modality showing the most lesions. Based on a per patient analysis, the detection rate was significantly different when comparing SPECT/CT to fhSPECT/US (p = 0.03), and not significantly different when comparing SPECT/CT to US (p = 0.16) and US to fhSPECT/US (p = 0.08). Based on a per-lesion analysis, the detection rate of SPECT/CT was significantly higher than that of US (p = 0.01) and fhSEPCT/US (p = 0.003), and there was no significant difference in detection rate when comparing US to fhSPECT/US (p = 0.08). The main perceived limitations of fhSPECT/US in lesion detection were: (i) lesions localized at a depth 4.5 cm; (ii) imperfect image fusion due to tissue compression; (iii) limited spatial manipulation ability of the SPECT mobile camera handheld probe; and (iv) a wide spread of detected activity. In conclusion, clinical use of fhSPECT/US for localization of parathyroid adenomas is feasible, but shows lower sensitivity than conventional modalities and requires technical improvements

Alumni, radiographers, clinical placement tutors and industry insights about current radiographers practice, competences and autonomy in western Switzerland

Introduction: Radiographers' profession is constantly evolving, which demands adaptation of education and training programs to build up medical imaging and radiation therapy professionals (MIRTPs) that provide healthcare to improve patient experience and outcomes. This study aimed to map radiographers’ practices, competences, and autonomy level in Western Switzerland. Methods: Data was collected by 2 cross-sectional online surveys targeting Alumni, radiographers, clinical placement tutors and medical imaging equipment specialists from industry, with opened and closed-end questions. Descriptive statistics and thematic analysis were used to analyse the data. Results: 81 Alumni and 93 Chief-Radiographers, clinical tutors, practitioner-radiographers and industry answered the questionnaires. The competences considered as the most “acquired or completely acquired” by the Alumni were: adopt a reflective posture on practice (90.1 %; 73/81), adopt ethical behaviour (90.1 %; 73/81), carrying out and providing radiological services for diagnostic, therapeutic and preventive purposes (81.5 %; 68/81), adapting communication to the other surrounding persons (81.5 %; 6/81), and check compliance of procedures with standards (69.1 %; 56/81). Similar results were referred by Employers. The autonomy of the participant radiographers was considered as average, and it focuses only the preparation of the patient and the protocol optimisation. The development and integration of research is weak as well as the application of competences regarding professionalism. Conclusions: A better link between educational institutions and clinical practice can help on the integration of research and evidence-based on practice, necessary to progress the radiographers' profession in Western Switzerland. The autonomy needs to be further developed and leadership courses must be integrated in the curricula to facilitate the implementation of new approaches to reinforce radiographer's profession. Implications for practice: Practice must be revised to integrate evidence-based; to facilitate research development, the managers need to increase support