Artificial Intelligence in Low- and Middle-Income Countries: Innovating Global Health Radiology.

Scarce or absent radiology resources impede adoption of artificial intelligence (AI) for medical imaging by resource-poor health institutions. They face limitations in local equipment, personnel expertise, infrastructure, data-rights frameworks, and public policies. The trustworthiness of AI for medical decision making in global health and low-resource settings is hampered by insufficient data diversity, nontransparent AI algorithms, and resource-poor health institutions' limited participation in AI production and validation. RAD-AID's three-pronged integrated strategy for AI adoption in resource-poor health institutions is presented, which includes clinical radiology education, infrastructure implementation, and phased AI introduction. This strategy derives from RAD-AID's more-than-a-decade experience as a nonprofit organization developing radiology in resource-poor health institutions, both in the United States and in low- and middle-income countries. The three components synergistically provide the foundation to address health care disparities. Local radiology personnel expertise is augmented through comprehensive education. Software, hardware, and radiologic and networking infrastructure enables radiology workflows incorporating AI. These educational and infrastructure developments occur while RAD-AID delivers phased introduction, testing, and scaling of AI via global health collaborations.

The American Society of Radiologic Technologists (ASRT) AI educator survey: A cross-sectional study to explore knowledge, experience, and use of AI within education.

INTRODUCTION: Artificial Intelligence (AI) is revolutionizing medical imaging and radiation therapy. AI-powered applications are being deployed to aid Medical Radiation Technologists (MRTs) in clinical workflows, decision-making, dose optimisation, and a wide range of other tasks. Exploring the levels of AI education provided across the United States is crucial to prepare future graduates to deliver the digital future. This study aims to assess educators' levels of AI knowledge, the current state of AI educational provisions, the perceived challenges around AI education, and important factors for future advancements. METHODS: An online survey was electronically administered to all radiologic technologists in the American Society of Radiologic Technologists (ASRT) database who indicated that they had an educator role in the United States. This was distributed through the membership of the ASRT, from February to April 2023. All quantitative data was analysed using frequency and descriptive statistics. The survey's open-ended questions were analysed using a conceptual content analysis approach. RESULTS: Out of 5,066 educators in the ASRT database, 373 valid responses were received, resulting in a response rate of 7.4%. Despite 84.5% of educators expressing the importance of teaching AI, 23.7% currently included AI in academic curricula. Of the 76.3% that did not include AI in their curricula, lack of AI knowledge among educators was the top reason for not integrating AI in education (59.1%). Similarly, AI-enabled tools were utilised by only 11.1% of the programs to assist teaching. The levels of trust in AI varied among educators. CONCLUSION: The study found that although US educators of MRTs have a good baseline knowledge of general concepts regarding AI, they could improve on the teaching and use of AI in their curricula. AI training and guidance, adequate time to develop educational resources, and funding and support from higher education institutions were key priorities as highlighted by educators.

Computed Radiography Photostimulable Phosphor Plate Receptors: Effect on Grid Conversion Factors.

BACKGROUND: Grid conversion factors were established for using grids with varying ratios for film-screen systems. Evidence from the physics community suggests that the relationship between grid conversion factors and exposure to the receptor does not apply with different types of digital imaging receptors. PURPOSE: To evaluate the relationship among analog grid conversion factors when using various grid ratios with a photostimulable phosphor plate (PSP) receptor system. METHODS: Three experiments were conducted using a range of grid ratios (6:1, 8:1, 12:1) to assess the effect of conversion factors on exposure indicators with a computed radiography PSP receptor. RESULTS: When using the analog grid conversion factors established for varying grid ratios with a PSP receptor and constant peak kilovoltage (kVp), the plate was overexposed with an exposure indicator outside the acceptable limits. CONCLUSION: The discussion of antiscatter grids in radiologic technologist literature should remain in the context of receptor type and digital imaging system being used so that technologists can make appropriate decisions about the use of grids while minimizing patient radiation dose. Calibrated grid conversions based on the digital systems in use and the radiologist's image quality preference could be created within radiology departments.

2016 RAD-AID Conference on International Radiology for Developing Countries: Gaps, Growth, and United Nations Sustainable Development Goals.

The 2016 RAD-AID Conference analyzed the accelerated global activity in the radiology community that is transforming medical imaging into an effective spearhead of health care capacity building in low- and middle-income countries. Global health efforts historically emphasized disaster response, crisis zones, and infectious disease outbreaks. However, the projected doubling of cancer and cardiovascular deaths in developing countries in the next 15 years and the need for higher technology screening and diagnostic technologies in low-resource regions, as articulated by the United Nations' new Sustainable Development Goals of 2016, is heightening the role of radiology in global health. Academic US-based radiology programs with RAD-AID chapters achieved a threefold increase in global health project offerings for trainees in the past 5 years. RAD-AID's nonprofit radiology volunteer corps continue to grow by more than 40% yearly, with a volunteer base of 5,750 radiology professionals, serving in 23 countries, donating close to 20,000 pro bono hours globally in 2016. As a high-technology specialty interfacing with nearly all medical and surgical disciplines, radiology underpins vital health technology infrastructure, such as digital imaging archives, electronic medical records, and advanced diagnosis and treatment, essential for long-term future health care capacity in underserved areas of the world.

Shield placement: effect on exposure.

PURPOSE: In children, red marrow is present in the majority of bones, including the shafts of long bones. Shielding can reduce exposure to radiosensitive tissues adjacent to the collimated field of view. The goal of this study was to determine the shield placement for adjacent bone marrow (bone marrow that is not in the primary beam) that results in the greatest reduction in exposure during knee imaging. METHOD: Radiation exposure was measured with both an ion chamber and a cassette in 2 locations using a knee phantom. Location 1 was directly superior to the collimated field of view facing the primary beam on the anterior surface of the phantom. Location 2 was directly superior to the collimated field of view on the posterior surface of the phantom. Sources of exposure outside collimation include tube leakage, off-focus radiation, scatter radiation, and remnant primary radiation. RESULTS: Using an independent 2-tailed t test, it was determined that shielding in the first location resulted in a significant reduction in exposure outside of collimation. DISCUSSION: This study reinforced the finding that collimation does not entirely eliminate exposure outside the field of view. Shielding should be used in conjunction with collimation to reduce exposure as much as possible. Shielding on the surface of the patient facing the primary beam results in the greatest reduction in exposure outside of collimation. CONCLUSION: The importance of shielding as much pediatric long bone, and therefore, red marrow, as possible cannot be overstated. Shielding on the surface of the patient facing the primary beam provides the best decrease in exposure outside of collimation.