用AI把普通CT变出无对比剂脑灌注图,更安全省钱。
Physiology-Informed Generative Multi-Task Network for Contrast-Free CT Perfusion
- 融合生理学知识的生成模型,从普通CT重建多张灌注图。
- 双盲评测中诊断准确率与带对比剂的CTP相当。
- 适合需快速评估卒中的临床场景,尤其忌讳对比剂者。
灌注成像广泛用于评估器官血流动力学状态与组织灌注。计算机断层扫描灌注(CTP)在卒中早期评估与治疗规划中起关键作用。尽管CTP能提供关键灌注参数以识别脑部异常血流,但其使用对比剂可能导致过敏反应及副作用,且2022年全球成本达49亿美元。为应对这一挑战,我们提出一种新型深度学习框架——多任务自动生成跨模态CT灌注图(MAGIC)。该框架结合生成式人工智能与生理信息,将非对比剂CT图像映射至多种无对比剂CTP图像。通过在损失函数中引入生理特性,显著提升图像保真度。模型基于佛罗里达大学健康中心卒中患者的数据训练与验证,对脑灌注异常具有鲁棒性。一项包含七名资深神经放射科医师和血管神经科医生的双盲研究显示,MAGIC在视觉质量与诊断准确性方面表现优异,优于临床对比剂增强的灌注成像。总体而言,MAGIC有望通过提供无对比剂、低成本、快速的灌注成像,革新医疗实践。
原文摘要 · Abstract (English)
Perfusion imaging is extensively utilized to assess hemodynamic status and tissue perfusion in various organs. Computed tomography perfusion (CTP) imaging plays a key role in the early assessment and planning of stroke treatment. While CTP provides essential perfusion parameters to identify abnormal blood flow in the brain, the use of contrast agents in CTP can lead to allergic reactions and adverse side effects, along with costing USD 4.9 billion worldwide in 2022. To address these challenges, we propose a novel deep learning framework called Multitask Automated Generation of Intermodal CT perfusion maps (MAGIC). This framework combines generative artificial intelligence and physiological information to map non-contrast computed tomography (CT) imaging to multiple contrast-free CTP imaging maps. We demonstrate enhanced image fidelity by incorporating physiological characteristics into the loss terms. Our network was trained and validated using CT image data from patients referred for stroke at UF Health and demonstrated robustness to abnormalities in brain perfusion activity. A double-blinded study was conducted involving seven experienced neuroradiologists and vascular neurologists. This study validated MAGIC's visual quality and diagnostic accuracy showing favorable performance compared to clinical perfusion imaging with intravenous contrast injection. Overall, MAGIC holds great promise in revolutionizing healthcare by offering contrast-free, cost-effective, and rapid perfusion imaging.
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