Applications of artificial intelligence in magnetic resonance imaging of primary pediatric cancers: a scoping review and CLAIM score assessment.

PURPOSES: To review the uses of AI for magnetic resonance (MR) imaging assessment of primary pediatric cancer and identify common literature topics and knowledge gaps. To assess the adherence of the existing literature to the Checklist for Artificial Intelligence in Medical Imaging (CLAIM) guidelines. MATERIALS AND METHODS: A scoping literature search using MEDLINE, EMBASE and Cochrane databases was performed, including studies of > 10 subjects with a mean age of < 21 years. Relevant data were summarized into three categories based on AI application: detection, characterization, treatment and monitoring. Readers independently scored each study using CLAIM guidelines, and inter-rater reproducibility was assessed using intraclass correlation coefficients. RESULTS: Twenty-one studies were included. The most common AI application for pediatric cancer MR imaging was pediatric tumor diagnosis and detection (13/21 [62%] studies). The most commonly studied tumor was posterior fossa tumors (14 [67%] studies). Knowledge gaps included a lack of research in AI-driven tumor staging (0/21 [0%] studies), imaging genomics (1/21 [5%] studies), and tumor segmentation (2/21 [10%] studies). Adherence to CLAIM guidelines was moderate in primary studies, with an average (range) of 55% (34%-73%) CLAIM items reported. Adherence has improved over time based on publication year. CONCLUSION: The literature surrounding AI applications of MR imaging in pediatric cancers is limited. The existing literature shows moderate adherence to CLAIM guidelines, suggesting that better adherence is required for future studies.

Virtual Reality as a Non-Pharmacological Adjunct to Reduce the Use of Analgesics in Hospitals.

Virtual reality (VR) has become an increasingly viable non-pharmacological adjunct to reduce the use of analgesics in hospitals. Within the context of the ongoing opioid epidemic, VR can serve as an invaluable alternative to traditional pain management techniques. While VR research continues to advance, there is no clear consensus on the terms used to describe critical aspects of VR. This paper presents how immersion, presence, and agency encapsulate the VR experience and investigates the methods by which VR can relieve pain by changing users' cognition and perception of pain. Multiple clinical studies investigating VR efficacy indicate that higher degrees of immersion, presence, and agency are all correlated with greater pain reduction. These studies also demonstrate that VR analgesia is effective for patients with various medical conditions and for those undergoing painful medical procedures. Furthermore, the shared biological mechanisms between pain and anxiety suggest that reducing either through the use of VR will reduce the other. As a nascent field of research, VR analgesia has key obstacles to overcome in order to become a mainstream intervention for pain management in hospital settings.