Low-dose computed tomography in COVID-19: systematic review

BACKGROUND: The increased number of computed tomography scans during the COVID-19 pandemic has emphasized the task of decreasing radiation exposure of patients, since it is known to be associated with an elevated risk of cancer development. The ALARA (as low as reasonably achievable) principle, proposed by the International Commission on Radiation Protection, should be adhered to in the operation of radiation diagnostics departments, even during the pandemic. AIM: To systematize data on the appropriateness and effectiveness of low-dose computed tomography in the diagnosis of lung lesions in COVID-19. MATERIALS AND METHODS: Relevant national and foreign literature in scientific libraries PubMed and eLIBRARY, using English and Russian queries low-dose computed tomography and COVID-19, published between 2020 and 2022 were analyzed. Publications were evaluated after assessing the relevance to the review topic by title and abstract analysis. The references were further analyzed to identify articles omitted during the search that may meet the inclusion criteria. RESULTS: Published studies summarized the current data on the imaging of COVID-19 lung lesions and the use of computed tomography scans and identified possible options for reducing the effective dose. CONCLUSION: We present techniques to reduce radiation exposure during chest computed tomography and preserve high-quality diagnostic images potentially sufficient for reliable detection of COVID-19 signs. Reducing radiation dose is a valid approach to obtain relevant diagnostic information, preserving opportunities for the introduction of advanced computational analysis technologies in clinical practice

Volumetry versus linear diameter lung nodule measurement: an ultra-low-dose computed tomography lung cancer screening study

BACKGROUND: The DutchBelgian Randomized Lung Cancer Screening Trial (NELSON) used a volume-based protocol and significantly reduced the prevalence of false-positive results (2.1%). AIM: To compare the performance of manual linear diameter and semi-automated volumetric nodule measurement in the pilot project Moscow Lung Cancer Screening ultra-low-dose computed tomography pilot study. MATERIALS AND METHODS: The study included individuals with a lung nodule of at least 4 mm on baseline-computed tomography of the Moscow lung cancer screening between February 2017 and February 2018, without verified lung cancer diagnosis until 2020. The radiation dose was selected individually and did not exceed 1 mSv. All scans were assessed by three blinded readers to measure the maximum and minimum transversal nodule diameter and extrapolated volume. As a reference value of size and volume, the average value from the results of expert measurements was obtained. A false-positive nodule was defined as a nodule 6 mm/100 mm3 and a false-negative nodule as a nodule 6 mm/100 mm3. RESULTS: Overall, 293 patients were included (166 men; mean age, 64.6 5.3years); 199 lung nodules were 6 mm/100 mm3 and 94 were 6 mm/100 mm3. Regarding volumetric measurements, 32 [10.9%; 4 false-positive, 28 false-negative], 29 [9.9%; 17 false-positive, 12 false-negative], and 30 [10.2%; 6 false-positive, 24 false-negative] nodule discrepancies were reported by readers 1, 2, and 3 respectively. For linear diameter measurement, 92 [65.5%; 107 false-positive, 85 false-negative], 146 [49.8%; 58 false-positive, 88 false-negative], and 102 [34.8%; 23 false-positive, 79 false-negative] nodule discrepancies were reported by readers 1, 2, and 3 respectively. CONCLUSIONS: The use of lung nodule volumetry strongly reduces the number of false-positive and false-negative nodules compared with nodule diameter measurements, in an ultra-low-dose computed tomography lung cancer screening program

Erratum in “Volumetry versus linear diameter lung nodule measurement: an ultra-low-dose computed tomography lung cancer screening study” (doi: 10.17816/DD117481)

In the article "Volumetry versus linear diameter lung nodule measurement: an ultra-low-dose computed tomography lung cancer screening study" published in Digital Diagnostics journal Volume 4 Issue 1 in 2023 (doi: 10.17816/DD117481) contained an error in the paragraph with data of funding sources for the study. At the request of the authors team, the error was eliminated, the original version of the published article and the information on the journals site was replaced with the corrected one. Correct text of the changed: This paper was prepared by a group of authors as part of the research work (USIS No. 123031400009-1) in accordance with the Order issued by the Moscow Health Care Department No. 1196 dated December 21, 2022. The authors and the publisher apologize to readers for the published error and express their confidence that this mistake could not significantly affect the perception and interpretation of the results of the study described in the text of the article

Methodology for testing and monitoring artificial intelligence-based software for medical diagnostics

BACKGROUND: The global amount of investment in companies developing artificial intelligence (AI)-based software technologies for medical diagnostics reached $80 million in 2016, rose to$152 million in 2017, and is expected to continue growing. While software manufacturing companies should comply with existing clinical, bioethical, legal, and methodological frameworks and standards, there is a lack of uniform national and international standards and protocols for testing and monitoring AI-based software. AIM: This objective of this study is to develop a universal methodology for testing and monitoring AI-based software for medical diagnostics, with the aim of improving its quality and implementing its integration into practical healthcare. MATERIALS AND METHODS: The research process involved an analytical phase in which a literature review was conducted on the PubMed and eLibrary databases. The practical stage included the approbation of the developed methodology within the framework of an experiment focused on the use of innovative technologies in the field of computer vision to analyze medical images and further application in the health care system of the city of Moscow. RESULTS: A methodology for testing and monitoring AI-based software for medical diagnostics has been developed, aimed at improving its quality and introducing it into practical healthcare. The methodology consists of seven stages: self-testing, functional testing, calibration testing, technological monitoring, clinical monitoring, feedback, and refinement. CONCLUSION: Distinctive features of the methodology include its cyclical stages of monitoring and software development, leading to continuous improvement of its quality, the presence of detailed requirements for the results of the software work, and the participation of doctors in software evaluation. The methodology will allow software developers to achieve significant outcomes and demonstrate achievements across various areas. It also empowers users to make informed and confident choices among software options that have passed an independent and comprehensive quality check

Diagnostic Accuracy of AI for Opportunistic Screening of Abdominal Aortic Aneurysm in CT: A Systematic Review and Narrative Synthesis

In this review, we focused on the applicability of artificial intelligence (AI) for opportunistic abdominal aortic aneurysm (AAA) detection in computed tomography (CT). We used the academic search system PubMed as the primary source for the literature search and Google Scholar as a supplementary source of evidence. We searched through 2 February 2022. All studies on automated AAA detection or segmentation in noncontrast abdominal CT were included. For bias assessment, we developed and used an adapted version of the QUADAS-2 checklist. We included eight studies with 355 cases, of which 273 (77%) contained AAA. The highest risk of bias and level of applicability concerns were observed for the “patient selection” domain, due to the 100% pathology rate in the majority (75%) of the studies. The mean sensitivity value was 95% (95% CI 100–87%), the mean specificity value was 96.6% (95% CI 100–75.7%), and the mean accuracy value was 95.2% (95% CI 100–54.5%). Half of the included studies performed diagnostic accuracy estimation, with only one study having data on all diagnostic accuracy metrics. Therefore, we conducted a narrative synthesis. Our findings indicate high study heterogeneity, requiring further research with balanced noncontrast CT datasets and adherence to reporting standards in order to validate the high sensitivity value obtained