Validation of an AI-based algorithm for measurement of the thoracic aortic diameter in low-dose chest CT.

OBJECTIVES: To evaluate the performance of artificial intelligence (AI) software for automatic thoracic aortic diameter assessment in a heterogeneous cohort with low-dose, non-contrast chest computed tomography (CT). MATERIALS AND METHODS: Participants of the Imaging in Lifelines (ImaLife) study who underwent low-dose, non-contrast chest CT (August 2017-May 2022) were included using random samples of 80 participants <50y, ≥80y, and with thoracic aortic diameter ≥40 mm. AI-based aortic diameters at eight guideline compliant positions were compared with manual measurements. In 90 examinations (30 per group) diameters were reassessed for intra- and inter-reader variability, which was compared to discrepancy of the AI system using Bland-Altman analysis, paired samples t-testing and linear mixed models. RESULTS: We analyzed 240 participants (63 ± 16 years; 50 % men). AI evaluation failed in 11 cases due to incorrect segmentation (4.6 %), leaving 229 cases for analysis. No difference was found in aortic diameter between manual and automatic measurements (32.7 ± 6.4 mm vs 32.7 ± 6.0 mm, p = 0.70). Bland-Altman analysis yielded no systematic bias and a repeatability coefficient of 4.0 mm for AI. Mean discrepancy of AI (1.3 ± 1.6 mm) was comparable to inter-reader variability (1.4 ± 1.4 mm); only at the proximal aortic arch showed AI higher discrepancy (2.0 ± 1.8 mm vs 0.9 ± 0.9 mm, p < 0.001). No difference between AI discrepancy and inter-reader variability was found for any subgroup (all: p > 0.05). CONCLUSION: The AI software can accurately measure thoracic aortic diameters, with discrepancy to a human reader similar to inter-reader variability in a range from normal to dilated aortas.

[Summary of the practice guideline 'Diagnosis of breast cancer' (second revision) from the Dutch College of General Practitioners]. / Beknopte weergave van de standaard 'Diagnostiek van mammacarcinoom (tweede herziening)' van het Nederlands Huisartsen Genootschap.

Breast cancer is the most prevalent malignancy among Dutch women; life prevalence is about 10%. A tumour in the breast of a woman of 35 years or older is always an indication for mammography, while a woman younger than 35 should have an ultrasound investigation. This is also the case if the woman can feel the tumour but the doctor is unable to. In breast pain without palpable abnormalities at physical examination, the risk of breast cancer is a lot lower and diagnostics may not need to be instigated immediately. However, persistent localized pain is an indication for breast imaging. Women with at least a doubled risk of getting breast cancer due to the occurrence of breast cancer in their relatives are recommended to undergo mammography every year from the ages of 40-49 years supplementary to the national screening programme. The Dutch national screening programme invites women aged between 50 and 75 to undergo mammography every two years. Follow-up of women of 60 years and older treated by lumpectomy 5 years or more previously, can be done by the general practitioner.