用红外成像加AI生成无辐射儿童骨骼影像，替代传统X光。
Infrared Imaging Empowered by Artificial Intelligence for Pediatric Skeletal Triage: A Narrative Review and Future Perspectives
- 结合多波段红外与深度学习，从非电离数据生成类X光图像。
- 近红外可穿透儿童薄骨皮，信号足够用于骨骼成像。
- 适合需要频繁检查的儿童患者，尤其关注辐射安全的场景。
儿科骨科创伤占急诊就诊量的18%，但诊断仍依赖电离辐射的X光。早期累积低剂量辐射会增加白血病和脑部恶性肿瘤风险，推动无辐射分诊方案的发展。本文综述一种融合宽谱红外（IR）成像与深度学习跨模态转换的混合框架，旨在从非电离数据生成临床可用的合成放射影像。涵盖650 nm至1 mm的五个红外波段（NIR-I、NIR-II、SWIR、MIR/LWIR、THz），以及透射/反射双几何采集策略，利用不同波长对组织深度和生化成分的敏感性。总结了用于图像对齐与融合的网络模型（Pix2Pix、CycleGAN、Swin-Unet）及特征匹配算法（SuperPoint、SuperGlue、ALIKED、LightGlue）。儿童解剖特点——横截面更小、皮质骨更薄——有利于红外穿透，支持便携式、低成本的无辐射分诊设备实现。可行性基于功能近红外光谱（fNIRS）和经颅光生物调节证据：近红外可穿透皮肤、颅骨和皮层，其路径比小儿前臂或远端腿部更长且衰减更大，但仍保留足够信号。主要障碍包括配对红外/X光数据集构建、AI医疗设备监管路径、跨体型与肤色泛化能力，以及采集协议标准化。结论指出，多光谱红外+AI成像是极具前景的无辐射骨骼影像补充手段。进展需依赖多中心配对数据集、外部验证模型，以及符合IEC 60825-1标准的红外光源安全性认证。
原文摘要 · Abstract (English)
Background. Pediatric musculoskeletal trauma represents up to 18% of pediatric ED visits, yet diagnosis still depends on ionizing radiography. Cumulative low-dose radiation in early life raises lifetime leukemia and brain malignancy risk, motivating radiation-free triage alternatives. Objective. To synthesize evidence for a hybrid framework coupling broad-spectrum infrared (IR) imaging with deep-learning cross-modal translation to generate clinically interpretable synthetic-radiograph reconstructions from non-ionizing data. Approach. We review five IR spectral windows spanning 650 nm to 1 mm - NIR-I, NIR-II, SWIR, MIR/LWIR, and THz - and how dual-geometry (transmission/reflection) acquisition exploits wavelength-specific tissue depth and biochemical sensitivity. We summarize image-to-image translation networks (Pix2Pix, CycleGAN, Swin-Unet) and feature-matching algorithms (SuperPoint, SuperGlue, ALIKED, LightGlue) used to align and fuse IR data into radiograph-equivalent reconstructions. Implications. Pediatric anatomy - smaller cross-sections, thinner cortical bone - favors IR penetration, enabling compact, portable, non-ionizing triage hardware. Feasibility is grounded in fNIRS and transcranial photobiomodulation evidence: near-infrared light passes through skin, skull, and cortex with sufficient signal for hemodynamic monitoring - a longer, more attenuating path than through a pediatric forearm or distal leg. Key barriers: paired IR/X-ray dataset construction, AI-as-medical-device regulatory pathways, generalization across body habitus and skin pigmentation, and acquisition-protocol standardization. Conclusions. Integrated multi-spectral IR+AI imaging is a promising radiation-free complement to pediatric skeletal radiography. Progress requires multi-center paired datasets, externally validated models, and IR source safety qualification under IEC 60825-1.
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