This article was originally published by Imaging Technology News (ITN).
The CentricityTM Universal Viewer1 worklist provides indications for exams with AI Findings2 to draw attention to potentially critical findings so that radiologists can prioritize their worklist and provide timely diagnosis.
On a monitor in the downtown Chicago engineering laboratories of GE Healthcare, a faux worklist appears on screen. From a list of patient exams that need interpretation, Uma Subramanian, Senior Technical Product Manager of the company’s PACS product team, clicks on a chest study. Patient information appears on the monitor along with a box showing a “confidence score” of 99.96% for the presence of pneumothorax.
A smart algorithm3 had flagged the case as being suspicious for this condition. The score indicates the algorithm’s confidence that its radiographic signs are present.
The algorithm, which was built by GE Healthcare (GEHC) in alliance with the University of California, San Francisco, works seamlessly with the company’s Edison Open AI Orchestrator. GEHC executive Karley Yoder likened the Orchestrator to a concert conductor. Rather than directing different parts of an orchestra, Open AI Orchestrator directs imaging cases to algorithms fueled by artificial intelligence. “It picks the right solution at the right time for the image coming into the workflow,” said Yoder, GEHC Vice President and General Manager of AI.
Like the pneumothorax algorithm, the Open AI Orchestrator — both of which were built by GEHC, currently for its Centricity PACS — operates automatically behind the scenes.
“The physicians (interpreting the image) don’t even realize they are using a product,” Yoder said. “They just see that their tasks are completed more efficiently.”
AI Sorts & Prioritizes4 Worklists Showing Cases that Likely Need Attention
Orchestrator uses AI results to prepare worklists on Centricity PACS, sorting and ordering cases listed on them. Radiologists can select whether to display flags on these cases to indicate visually which ones may need quick attention.
Users of the Orchestrator can also leverage smart algorithms to prioritize the worklist. This option is provided to maintain the primacy of the radiologist, while addressing the opportunity for AI to boost efficiency and, potentially, clinical effectiveness.
Once chosen from the worklist, individual cases can be called up by the radiologist. An example would be one designated as suspicious by the pneumothorax algorithm.
In her demonstration, Subramanian brought up clinical data — and a box showing a “confidence level” of the AI finding — by hovering the cursor over a case flagged as likely showing signs of pneumothorax.
Maintaining Radiologists’ Authority
GEHC purposely does this to give radiologists what they want, she said. “We heard that radiologists want to be able to (view or visually see) the original image and find out for themselves where the pneumothorax is.”
The function, however, is customizable. The system can be programmed to display the AI findings immediately, she said. If, alternatively, radiologists want to review the primary images first, the AI-enhanced image is just a mouse click away.
In the demonstration, clicking an icon at the upper left of the screen (the icon for “AI findings”) opened a separate window containing thumbnails of the AI assessment for pneumothorax.
In the near future, cases might be assessed for more conditions than just pneumothorax.
How The AI Repertoire Might Grow
Accipio Ix exemplifies a third-party algorithm. GEHC worked with the developer of the algorithm, MaxQ, to embed it in the Orchestrator.
Rather than looking for signs of a pneumothorax in chest radiographs, Accipio Ix has been designed to assess brain CTs for intracranial hemorrhage.
“The concept is the same (regardless of the condition being assessed),” Subramanian said. “The (algorithm and Orchestrator) works behind the scenes to find problems with the patient, then flag the worklist so the busy radiologist knows which of the studies have to be read quickly, so patient care can happen faster.”
At GE labs in downtown Chicago, Subramanian demonstrated how Orchestrator works with the ICH algorithm. As in the pneumothorax case, she first looked over the worklist, then hovered over a chosen case. Clicking the “View Images” box caused images to appear on the monitor — brain CT images not enhanced by AI.
When the “AI findings” icon was clicked, thumbnails of the AI assessment appeared in a separate window. Clicking one of these thumbnails opened two windows. One had the following message: “Analysis complete: Suspected acute ICH found;” the other contained brain CT slices.
Saving Time and Effort
A key point of Accipio Ix — as well as the algorithm that detects pneumothorax —- is that the algorithms, like Open AI Orchestrator, are always running in the background. This invisible assistant could help radiologists stay on top of their case loads.
Without smart algorithms — and Orchestrator to make them practical — radiologists would have to go through each exam or potentially thousands of CT slices to find evidence of disease or disorder. With these algorithms, running as part of Open AI Orchestrator, however, efficiency might be improved. Helping to reduce the time from imaging study to diagnosis might allow clinicians to start therapy earlier. And these efficiencies may only mark the beginning.
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