when artificial intelligence meets radiology: novel ... · boutet et al. 2012 neuroradiology bosco...
TRANSCRIPT
WHEN ARTIFICIAL
INTELLIGENCE MEETS
RADIOLOGY: NOVEL BIOMARKERS FOR DEMENTIA
SIMON DUCHARME, MD MSC FRCP(C)
CANADIAN CONFERENCE ON DEMENTIA
OCTOBER 4TH, 2019
DISCLOSURE
• SITE PI FOR SPONSORED DEMENTIA CLINICAL TRIALS
• BIOGEN
• IONIS PHARMACEUTICALS
• NOVARTIS
• AZTHERAPIES INC.
• MEDITI PHARMA
• CO-FOUNDER ARCTIC FOX AI (AI BRAIN ANALYTICS FOR CLINICAL APPLICATIONS)
DISCLOSURE!
• I AM A CLINICIAN-SCIENTIST
INTERESTED IN AI FOR
DEMENTIA, NOT AN AI EXPERT!
• I AM NOT A RADIOLOGIST!
OUTLINE
• AI BACKGROUND
• AI IN RADIOLOGY
• AI APPLICATIONS IN DEMENTIA
• DISCUSSION
WHAT IS ARTIFICIAL INTELLIGENCE?
• COMPUTER SYSTEMS WITH THE ABILITY TO:
• INTERPRET EXTERNAL DATA
• LEARN FROM DATA
• ACHIEVE A TASK OR GOAL BASED ON THAT LEARNING
• INFORMAL DEFINITION: MACHINES THAT PERFORM TASKS RESEMBLING HUMAN COGNITIVE FUNCTIONS
Copied from
Deep Learning – A
visual introduction
(slideshare.net)
AI IN RADIOLOGY • POTENTIAL APPLICATIONS
• FRACTURE DETECTION
• LUNG NODULES
• MAMMOGRAMS – PREDICT FUTURE
CANCERS
• DETECTION OF INTRACRANIAL
HEMORRHAGE
• ACCELERATING IMAGE ACQUISITIONS
• TRIAGE OF SCAN PRIORITIES
• MAJOR POTENTIAL BENEFITS
• DETECTING PATTERNS NOT SEEN BY THE
HUMAN EYE
• INCREASING PRODUCTIVITY
• NOT INFLUENCED BY EXTERNAL
CONDITIONS
• REPLICATING PERFORMANCE OF
EXPERT RADIOLOGISTS IN SUBOPTIMAL CONDITIONS
• LOWERING COST?
• MAJOR CHALLENGES
• ACCESS TO HIGH QUALITY DATASETS
• CONFIDENTIALITY
• INTELLECTUAL PROPERTY
• DISTRIBUTION OF SOLUTIONS
• BUY IN FROM PHYSICIANS
• LOW MARKET PENETRANCE DESPITE THE
HYPE
• TRUST
• MEDICAL LIABILITY
AI FOR DEMENTIA
• SCREENING
• DIAGNOSIS
• PROGNOSIS
• TREATMENT?
AI FOR SCREENING LARGE AT-RISK POPULATIONS
AI FOR BRAIN MRI DIAGNOSIS
• CCCDTD5 NEUROIMAGING CONSENSUS
• INCLUDE 3D T1 VOLUMETRIC SEQUENCE
• SEMI-QUANTITATIVE SCALES: GLOBAL CORTICAL ATROPHY, MEDIAL TEMPORAL ATROPHY SCALE, FAZEKAS SCALE
• AUTOMATED VOLUMETRY REQUIRES LARGER STUDIES BUT:
• MOST REPORTS DO NOT INCLUDE STRUCTURED SEMI-QUANTITATIVE SCALES
• PERFORMANCE OF VOLUMETRY SIMILAR TO EXPERT RADIOLOGISTS
• HIPPOCAMPAL VOLUMETRY INCREASES DIAGNOSTIC CONFIDENCE
• AI COULD MAKE THIS TOOL MORE RELIABLE AND AVAILABLE
Boutet et al. 2012 Neuroradiology Bosco et al. 2017 Alzheimer Dement
• 2014 Open challenge
• Best performance accuracy 63%
(chance 33%) to distinguish AD, MCI
and controls
• Best performance combined volumes
with other features (cortical thickness,
shape, intensity)
AI FOR DEMENTIA
PROGNOSIS
AI FOR DEMENTIA PROGNOSIS – SNIPE SCORE
…
AlzMETRIX ™
…
Control
Alzheimer
Normal controls with automatic priors
Patients with AD with automatic priors
P. Coupé et al. Simultaneous Segmentation and Grading of Anatomical Structures for Patient's Classification, NeuroImage 2012 McGill Patent
• Shape analysis of hippocampal
structures
• MCI to dementia conversion -
87% prediction accuracy at
five years follow-up, with an
AUC > 0.85 from two to seven
years (peaking at 0.92 at five
years combined with ADAS-
Cog
• Predicts conversion to MCI from
SCI
Azar et al. Under review
INTEGRATING MULTIMODAL INFORMATION FOR
DIAGNOSIS AND PROGNOSIS
• ACCURACY REMAINS BELOW 80% IN
MOST STUDIES TO PREDICT MCI TO AD
CONVERSION
• BINARY PREDICTION FROM MCI TO AD
LESS INTERESTING THAN COURSE
PREDICTION
• MOST MODELS USE ML, LESS
PUBLICATIONS ON DL
Liu et al. 2018 Use of multimodality imaging and artificial
intelligence for diagnosis and prognosis of early stages of
Alzheimer's disease. Translational Research
AI FOR DEMENTIA
COURSE PREDICTION
• BEST COURSE PREDICTIONS FROM TWO
VISITS
• MARGINAL IMPACT OF ADDING CORTICAL
THICKNESS ON CLINICAL FEATURES
TREATMENT PREDICTIONS?
DISCUSSION QUESTIONS
• WOULD YOU WELCOME THE INPUT OF AI FOR MORE
PRECISE DIAGNOSES AND PROGNOSIS
• DO YOU TRUST AI ALGORITHMS FOR RADIOLOGICAL
INTERPRETATIONS?
• WHAT ARE YOUR CONCERS WITH AI IN MEDICINE?