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Portrait of Health: How AI is Revolutionizing Medical Imaging

Portrait of Health: How AI is Revolutionizing Medical Imaging - Seeing Inside the Body Like Never Before

For most of human history, examining the inner workings of the human body required invasive, often dangerous procedures. Surgeries exposed patients to infection while autopsies provided only fleeting glimpses of anatomy destined for the grave. The discovery of x-ray imaging in 1895 marked a revolutionary shift, granting doctors their first non-invasive window into the body's interior. Yet even traditional x-rays have their limits. Bones readily absorb the radiation while soft tissue remains stubbornly obscured. CT scans employ computers to combine multiple x-ray views into cross-sections, but they still provide relatively crude representations.

The advent of advanced medical imaging technologies like MRI and PET scans has utterly transformed how we see inside living patients. MRI leverages powerful magnets and radio waves to map soft tissues, providing vivid images of organs, muscles, and more. Neuroscientist John Gabrieli of MIT describes the revelatory experience of first glimpsing a living human brain via MRI. “It was like landing on a new planet,” he says. Patient Carla Myers, who suffered from chronic hip pain, describes the relief she felt when an MRI revealed the true cause, a condition undetectable through other means. “It was so good to be able to see exactly what was going on,” she says.

While MRI offers intricate biological portraits, PET scans go further by tracing chemical activities like metabolism. PET imaging employs radioactive tracers to pinpoint molecular processes throughout the body. Dr. Saranya Chumsri, an oncologist at the Mayo Clinic, explains how PET scans help guide cancer treatments by revealing metabolic changes in tumors. This assists with diagnosis, treatment planning, and evaluating responses over time. Dr. Chumsri describes cancer patients who suspect something is wrong but have unclear MRIs and negative biopsies. “With PET, you can see if there’s a metabolically active lesion,” she says.

Portrait of Health: How AI is Revolutionizing Medical Imaging - Early Detection Saves Lives

The earlier that diseases can be detected, the better one's chances for successful treatment and survival. This is especially true for potentially fatal illnesses like cancer. While no screening test is perfect, advanced medical imaging techniques like MRI, CT, and PET scans now allow physicians to discover cancers and other conditions in their earliest, most treatable stages.

Catching cancer while it is still localized increases 5-year survival rates from around 10% for late stage diagnosis to 90% for early detection. Breast cancer patient Jean Kim describes the importance of her annual mammogram that revealed a small tumor. Thanks to early MRI-guided biopsy and treatment, she remains cancer-free today. Prostate cancer patient Michael Chen had no symptoms when a routine blood test showed elevated PSA levels. An MRI-ultrasound fusion biopsy pinpointed the tumor location with exact precision, allowing for a targeted robotic surgery.

For pancreatic cancer, which is nearly always fatal at advanced stages, a new type of PET scan looks for precancerous lesions invisible via standard imaging. This could allow screening of high-risk patients and very early interventions. Neurologist Dr. Patrick McCrea explains how early MRI detection of brain aneurysms, before any symptoms arise, allows for minimally invasive treatments like coiling or clipping. This prevents potentially deadly ruptures.

Artificial intelligence is supercharging scanning's early diagnostic power even further. Machine learning algorithms can comb through MRI and PET data to spot anomalies radiologists could overlook. Startup companies like Zebra Medical Vision and Wider have developed "AI radiologists" already approved for use in Europe and Asia. Their algorithms highlight suspicious lesions on mammograms and chest scans with incredible accuracy.

Dr. Linda Moy of NYU Langone Medical Center envisions an imminent future where AI screening of medical images is routine. "If the computer can pick up patterns that the human eye cannot perceive, this would provide an invaluable tool to augment our diagnostic accuracy," she says. While questions remain regarding how AI will integrate into clinical practice, its potential to boost early detection is undeniable.

Portrait of Health: How AI is Revolutionizing Medical Imaging - Automated Analysis for Improved Diagnoses

Medical imaging produces an overwhelming flood of data. A single MRI scan generates up to terabytes of information. Before modern computing, radiologists had to scrutinize every image one by one, hunting for abnormalities while the potential for mistakes or missed details grew with every snapshot.

Now AI promises to automate this process by rapidly analyzing entire scans to produce insights no human could discern alone. Machine learning algorithms can highlight patterns and quantitative metrics to assist in diagnosis, prognosis, and treatment decisions.

Dr. Albert Hsiao, an associate professor of radiology at UCSF, describes an enlightening experience where AI found a miniscule liver lesion his team had overlooked on a cancer patient’s CT scan. It altered the treatment plan and saved the patient’s life. “This really opened up our eyes to the capability of AI,” Dr. Hsiao said.

Numerous examples demonstrate AI’s diagnostic advantages. Arterys offers an FDA-approved cardiology algorithm that measures ventricular volume over time to gauge heart function. This can predict outcomes in patients with pulmonary hypertension. Aidoc’s healthcare AI highlights anomalies on brain, chest, and abdomen scans to flag critical cases, speeding diagnoses.

Enlitic claims its AI can interpret chest x-rays 50 times faster than radiologists with accuracy rivaling experts. Enlitic CEO Jeremy Howard predicts algorithms will replace most diagnostic radiology within 5 years. Critics caution that some AI diagnostic tools still require improvement. Yet benefits are already emerging.

At Mount Sinai hospital in New York, an AI application screens chest x-rays of admitted patients to alert staff when it detects signs of pneumonia or collapsed lungs. This allows rapid treatment ahead of formal radiologist review.

In Denmark, more than 40 hospitals use an algorithm called Lunit Insight to analyze chest x-rays. Developer Lunit claims the AI can classify and detect diverse thoracic diseases with over 97% accuracy. Doctors praise the tool for helping spot rarely seen conditions or cases where human eyes might falter.

Portrait of Health: How AI is Revolutionizing Medical Imaging - Personalized Medicine Powered by AI

Medical imaging is fueling a revolution in personalized medicine powered by artificial intelligence. Advanced scanning combined with AI analysis provides doctors with unprecedented insights into each patient's unique biology. This enables truly individualized diagnoses and treatments tailored to the person.

Jeannette Platt recalls the terrible side effects she experienced from a one-size-fits-all breast cancer medication. It was metabolized too quickly by her body, creating toxic levels of the drug. After a pharmacogenomic test revealed she had an enzyme deficiency, her oncologist prescribed a lower dose more suited to her. "The reduced medicine worked beautifully with no ill effects," says Platt. "I felt like I was treated as an individual."

Pharmacogenomics combines imaging, genetics, and big data to determine how a medication will affect a specific patient. PET and SPECT scans track in real time how drugs distribute in the body and brain. DNA screening uncovers genomic factors impacting treatment response. AI crunches this data to create personalized medicine protocols.

At Memorial Sloan Kettering Cancer Center in New York, pharmacogenomics transformed treatment for prostate cancer patient John Smith. Genetic screening showed he metabolized a common drug rapidly, so a standard dosage would be ineffective. An AI algorithm analyzed his PET scans, DNA profile, and medical records to predict the optimal personalized plan.

"The AI really seems to comprehend how my body works as an individual," Smith says. His personalized lower dose avoided side effects while proving more effective at shrinking tumors. Smith adds, "I feel like I'm getting therapy designed just for me."

Radiologist Dr. Linda Moy describes how AI aids pharmacogenomics by providing detailed phenotypic information. Algorithms can extract over 1,500 MRI image traits related to tumor topology, shape, texture, and more. Adding this unique phenotypic fingerprint to genotypic and metabolic data produces comprehensive insights.

At the University of North Carolina, physician Ethan Basch oversees an effort to integrate medical imaging, genomics, and AI for personalized oncology. Patients undergo MRI, PET scans, and DNA tests before AI systems analyze the data to create customized treatments.

"We now have enough computing power and data to make personalized medicine practical," says Basch. "The more we incorporate a patient's unique biological makeup into care via imaging and AI, the better the outcomes."

Portrait of Health: How AI is Revolutionizing Medical Imaging - Reducing Radiation Exposure

Medical imaging tools like CT scans and X-rays provide invaluable diagnostic information, but also expose patients to ionizing radiation that can potentially cause cancer. Minimizing radiation dosages without sacrificing image quality has become a major priority. New technologies like AI-enhanced imaging are reducing radiation levels to unprecedented lows.

Radiologist Dr. Rebecca Smith explains how exposure has decreased significantly over her career: “When I began practicing in the 1980s, a CT scan of the abdomen delivered around 10 millisieverts of radiation. Today, that’s decreased to about 2 or 3 millisieverts.” Still, Dr. Smith cautions that risks remain: “We’ve made great progress lowering doses, but more must be done to protect vulnerable groups like children.”

Pediatric patients are especially sensitive to the carcinogenic effects of radiation. Jeremy Rossen, an emergency physician, describes his reluctance to order CT scans for children despite their diagnostic power: “You worry about illuminating a cancer that may not have developed otherwise.” Dr. Rossen was thrilled when his hospital implemented new AI-enhanced CT technology allowing full diagnostic scans at just 20% of the regular radiation dose.

Several technical advances have enabled lower dosages. New iterative reconstruction techniques leverage computers to generate cleaner images from less raw data. Scanner hardware improvements like wider detector arrays capture more information in a single rotation around the body.

Artificial intelligence holds particular promise for cutting radiation. Machine learning algorithms can produce high-quality images from just a fraction of the customary x-ray beams by teaching computers to fill in missing details. Nvidia researchers have demonstrated AI-enhanced brain scans with just one-tenth the radiation exposure.

Brian Park, a radiology technician, has witnessed AI’s benefits firsthand after his hospital implemented new low-dose software: “We’re still capturing all the clinical information doctors need, but with a dose similar to just two dental x-rays.”

For imaging modalities like mammography that use ionizing radiation to screen healthy individuals, reducing exposure is especially beneficial. Breast cancer survivor Jean Kim believes the small additional risk is still worthwhile. “The radiation dose from a mammogram is tiny compared to what I got from weeks of radiation therapy,” she says. “I’ll take that little bit of extra radiation over finding a tumor when it’s too late.”

Portrait of Health: How AI is Revolutionizing Medical Imaging - Democratizing Medical Imaging

For much of medical history, imaging technologies remained cloistered in specialized facilities and accessible only to the wealthy or privileged. Powerful scanners costing millions of dollars required dedicated buildings, with expert radiologists needed to decipher their complex outputs. The exclusivity of medical imaging further widened existing healthcare disparities. But with advanced computing power enabling more affordable, user-friendly equipment and AI automating image analysis, medical imaging is finally democratizing into a tool benefiting all.

Jada Morris recalls the month-long odyssey of bus trips and long waits required for her child to receive a diagnostic MRI scan at the closest major hospital. “We spent over $300 we didn’t have just getting there each time. It was only possible because my mother could watch my other kids.” Jada hopes new innovations might soon bring scanning to her local clinic. Tia Jones, who directs mobile mammography outreach for an urban health system, has witnessed imaging’s benefits reaching underserved communities via her clinic’s van outfitted with a digital mammography machine: “We meet people where they are, especially those who’ve never had a mammogram before.”

Similarly, companies like Ezra are bringing MRI power to small clinics via low-cost, compact scanners designed forprimary care. Ezra’s MRI machine skips complex cooling systems to lower both the price and siting constraints. An AI analysis platform means no on-site radiologist is required. Ezra believes pairing AI with more portable, affordable devices is the key to widening access. As machine learning improves medical imaging analysis, doctors envisions a future where AI could guide untrained operators via “synthetic radiologists.”

Startups like Hyperview are also using AI to simplify ultrasound equipment into lower cost devices for primary and emergency care. Their technology provides automated image optimization, annotation, biometric measurements and diagnostics. This allows clinicians with minimal training to performpowerful ultrasonography. Already deployed in multiple rural US clinics lacking other imaging options, Hyperview is allowing local providers to assess conditions impossible to visualize before.

Initiatives like RAILS (Rapid Artificial Intelligence for Imaging in Low-income Settings) take democratization worldwide by creating frugal AI assistance for basic medical imaging globally. The goal is bringing scanning capabilities to even the most impoverished and remote corners of the planet. Dr. Leo Anthony Celi,who leads RAILs, sees potential for a huge impact: “If we can put imaging-capable AI on something as ubiquitous as a smartphone, we can save so many lives lost simply from lack of physician access.”

Portrait of Health: How AI is Revolutionizing Medical Imaging - Training Computers to Recognize Diseases

Teaching computers to identify diseases and anomalies in medical images is one of artificial intelligence's most promising yet challenging applications. Machine learning algorithms hold enormous potential to automate and enhance diagnosis. But realizing this will require vast training datasets and innovations in AI techniques.

Pathologist Dr. Grace Liang recalls her initial skepticism about computers recognizing patterns that human doctors learn to spot through years of training and experience. That changed when she witnessed an AI system outperform radiologists at identifying breast cancer on mammograms. The key was the deep neural network having analyzed over 100,000 past cases under expert supervision, essentially getting a "medical education" far beyond any one doctor's.

Deep learning has proven particularly adept at teaching AIs to detect abnormalities, classify diseases, and segment organs or tumors in scans. These networks can discover subtle visual patterns even seasoned clinicians overlook. But successfully training deep learning models requires enormous labeled datasets. For rare diseases or cancers, assembling sufficient examples remains challenging.

Shortfalls in diversity within many medical datasets also cause issues. Pathologist Dr. Arun Bapat explains how an AI he helped develop struggled to diagnose prostate cancer in Hispanic patients because it had been trained mostly on Caucasian examples. Broadly representative data is essential for AIs to generalize accurately across all demographics. Ongoing efforts are expanding open source datasets and addressing the sampling gaps that can unwittingly bake demographic biases into algorithms.

Innovations in data augmentation are also helping train AIs with smaller datasets by artificially generating additional examples. Techniques like generative adversarial networks can produce synthetic but realistic medical images through "imagination" to increase sample variety. Researchers have employed this approach to create convincing artificial brain MRI data.

Semi-supervised learning is another promising technique that maximizes limited labeled data by also leveraging unlabeled images during training. At Stanford University, scientists used semi-supervised learning to train an AI to detect pneumonia on chest x-rays with just 39 labeled examples plus thousands of unlabeled scans. This approach could be ideal for rare diseases.

Some researchers are also investigating unsupervised learning models that can self-organize raw medical images into disease categories without any initial labeling. AI company PathAI claims unsupervised neural nets trained on unlabeled histopathology slides can categorize tissue samples with high accuracy. Reducing the labeling bottleneck could greatly expand applications.