Artificial intelligence (AI) in diagnostic imaging. / Künstliche Intelligenz (KI) in der Bildgebenden Diagnostik.

PURPOSE: In the last few years artificial intelligence (AI) has increasingly become a topic of interest, especially in diagnostic imaging. There are two main expected potential benefits: workflow effectiveness and diagnostic support systems, particularly as far as quality assurance is concerned. METHODS: To meet these objectives, it is necessary to define what artificial intelligence in medicine means and to discuss which detailed steps should be fulfilled, e. g., for MSK imaging in the daily routine. In addition, this article provides an overview of what is necessary for an efficient IT-based workflow including the clinical question, the choice of modalities and investigation protocols, structured reports, and clinical classification. This is particularly interesting for potential providers, who are keen to apply new soft skills to support imaging diagnostic processes. RESULTS: The use of AI-supported diagnostic imaging could result in a paradigm shift from a modality-oriented to a clinical problem-oriented workflow. In order to streamline trauma, degeneration, inflammation, and oncology-MSK diagnostic imaging, the potential benefits of AI-based workflow optimization should be taken advantage of. The following article describes a five-point plan combining patient expectations and specialized radiological standards with respect to investigation protocols and reports. Moreover, this AI-based strategy could help to improve interdisciplinary networking, e. g., boards etc., and facilitate the required leap in quality towards "personalized precision medicine" for the patient. According to the global discussion, there is a need to point out that it is not currently realistic to replace doctors with AI. KEY POINTS: · AI as support-system has a paramount clinical impact. · AI in the daily routine could be for work-flow-support (processing) - a physician-replacement is un-realistic yet. · Standardization of work-flow by AI could be an important contribution of quality assurance. CITATION FORMAT: · Braunschweig R, Kildal D, Janka R. Artificial intelligence (AI) in diagnostic imaging . Fortschr Röntgenstr 2024; DOI: 10.1055/a-2208-6487.

Structured image diagnosis of vertebral body degeneration and intervertebral disc damage - Binary image criteria and comparison for systematic image analysis for occupational diseases 2108 and 2110. / Strukturierte Bild-Befundung von Wirbelkörperdegeneration und Bandscheibenschäden ­ Binäre Bildkriterien und Vergleichsbilder für die systematische Bildanalyse bei den Berufskrankheiten 2108 und 2110.

BACKGROUND: Job-related limitations of earning capacity are eligible for recognition under social legislation and may be subject to compensation (see Part 1). METHOD: For the recognition of an occupational disease (BK), diagnostic imaging is required as part of the legal determination procedure for occupational diseases 2108/2110 ("occupational disc disease"). The focus is on image criteria on X-ray images and MRI examinations. In a consensus paper under the guidance of the German Social Accident Insurance Institutions from 2005, the characteristic patterns are defined and explained extensively and summarized in typical occupation-related constellations. This article presents representative image examples as a reference system for expert reporting as far as the typical patterns from the consensus paper are concerned. CONCLUSION: In Part 2, comparison images with the typical findings of the vertebral bodies and intervertebral discs according to occupational diseases are systematically presented, explained, and offered as a reference system for expert assessment. The image criteria can be used as "evidence by eye" (Heuck) in the recognition procedure. KEY POINTS: · Occupational diseases are defined by the legislator in the "List of Occupational Diseases".. · For occupational intervertebral disc diseases (OD nos. 2108/2110), constellations of findings are defined.. · Within the scope of diagnostic imaging, a large number of image criteria are used.. · Part 1 explains the basics and the legal background.. · Part 2 provides the image criteria on the basis of "comparison images" as a reference catalog.. CITATION FORMAT: · Braunschweig R, Kildal D, Meyer-Clement M et al. Structured image diagnosis of vertebral body degeneration and intervertebral disc damage - Binary image criteria and comparison for systematic image analysis for occupational diseases 2108 and 2110. Fortschr Röntgenstr 2024; DOI: 10.1055/a-2224-9100.

Structured image diagnosis of vertebral body degeneration and disc damage - Binary image criteria and comparison for systematic image analysis in occupational diseases 2108/2110. / Strukturierte Bild-Befundung von Wirbelkörperdegeneration und Bandscheibenschäden ­ Binäre Bildkriterien und Vergleichs-Bilder für die systematische Bildanalyse bei den Berufskrankheiten 2108 und 2110.

BACKGROUND: Occupationally related limitations of earning capacity can be recognized under social legislation and may be subject to compensation ("reduction in earning capacity"). For this purpose, legislators have defined a list of occupational diseases ("BK list"). Recognition of an occupational disease requires a legal assessment procedure based on a medical appraisal. The aim of the assessment is to prove the "causality" and the "causality giving rise to liability". METHOD: In addition to clinical findings and workplace analyses, imaging methods (projection radiography, MRI) are primarily used to substantiate liability. These methods enable proof of load-conforming damage patterns for occupational diseases 2108/2110 (damage to intervertebral discs). RESULTS AND CONCLUSION: In addition to the legal background, the following review article primarily presents the image criteria for load-conforming damage patterns of the spine. On the basis of the consensus paper on the "Assessment of occupational disc diseases of the lumbar spine", image criteria are assigned to age-atypical grades of findings, and "typical constellations of findings" are defined for vibration (BK 2108) or lifting (BK 2110) loads. The aim of Part 1 is to explain the image criteria of the comparative images presented as image plates in Part 2 and thus to present a reference catalog of findings. KEY STATEMENTS: · Occupational diseases are defined by legislators in the "List of Occupational Diseases".. · For occupational intervertebral disc diseases (BK 2108/2110), constellations of findings are defined.. · In the context of imaging diagnostics, a large number of image criteria are used.. · Part 1 explains the basics.. · Part 2 provides the image criteria on the basis of "comparative images" as a reference catalog.. CITATION FORMAT: · Braunschweig R, Kildal D, Meyer-Clement M et al. Structured image diagnosis of vertebral body degeneration and disc damage - Binary image criteria and comparison for systematic image analysis in occupational diseases 2108/2110. Fortschr Röntgenstr 2024; 196: 347 - 353.

[Sclerosing hyperostotic bone disorders]. / Sklerosierende hyperostotische Skelettveränderungen.

CLINICAL/METHODICAL ISSUE: Diagnosis of sclerosing and hyperostotic bone disorders (SHS) is challenging. The correct and early identification of SHS can have therapeutic, prognostic and, in case of genetic SHS with regard to the risk of inheritance, advisory consequences. STANDARD RADIOLOGICAL METHODS: For diagnosis, radiographic examinations and supplementary computed tomography (CT) and magnetic resonance imaging (MRI) are used. These are of indicative nature. Definitive diagnosis is usually made by genetic differentiation. METHODICAL INNOVATIONS: In combination with the age of the affected person and the location of the osseous changes the characteristic image criteria are important. These are summarized in groups in this overview. PRACTICAL RECOMMENDATIONS: Projection radiography in two planes is the imaging modality of choice. CT and MR can detect additional differential diagnostic criteria and should be indicated when needed.

Incidence and outcome of endophthalmitis over a 13-year period.

OBJECTIVE: The aim of the study was to assess the functional results and long-term visual prognosis in patients treated for acute endophthalmitis (AE). DESIGN: Observational clinical series. PARTICIPANTS: Evaluation of 120 eyes of 114 patients with AE treated between 1991 and 2004. METHODS: This retrospective institutional analysis included 120 eyes of 114 patients (52 male, 68 female) with AE and a minimum follow-up of half a year. The patients had a mean follow-up of 23 months (6-135 months) and a mean age of 61 years (8 months-94 years) at the time of treatment. Treatment included intraocular injection of antibiotics alone (n = 18, 15%) and vitrectomy combined with intraocular and topical postoperative antibiotics (n = 85, 70%). RESULTS: The most frequent complications were vitreous or retinal hemorrhages (n = 17, 14%), retinal detachment (n = 17, 14%), choroidal detachment (n = 3, 3%), secondary glaucoma (n = 7, 6%), and recurrent endophthalmitis (n = 3, 3%). Four eyes had to be enucleated because of recurrent and uncontrollable infection. Positive microbiological results were achieved in 67 of 88 specimens (76%). The most common isolate was Staphylococcus. At the end of follow-up, visual acuity was reduced (more than 2 lines) in 18 eyes (15%), stable in 22 (18%), and improved (more than 2 lines) in 72 eyes (60%). CONCLUSIONS: AE is a rare but severe disease with a potentially deleterious outcome in affected eyes. In our series, 78% of all eyes had stable or improved postoperative visual acuity following various treatment regimens, depending on the severity of each case.