Background: There are many challenges and opportunities in the clinical deployment of AI tools in radiology. The current study describes a radiology software platform called NeoMedSys that can enable efficient deployment and refinements of AI models. We evaluated the feasibility and effectiveness of running NeoMedSys for three months in real-world clinical settings and focused on improvement performance of an in-house developed AI model (VIOLA-AI) designed for intracranial hemorrhage (ICH) detection. Methods: NeoMedSys integrates tools for deploying, testing, and optimizing AI models with a web-based medical image viewer, annotation system, and hospital-wide radiology information systems. A prospective pragmatic investigation was deployed using clinical cases of patients presenting to the largest Emergency Department in Norway (site-1) with suspected traumatic brain injury (TBI) or patients with suspected stroke (site-2). We assessed ICH classification performance as VIOLA-AI encountered new data and underwent pre-planned model retraining. Performance metrics included sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve (AUC). Results: NeoMedSys facilitated iterative improvements in the AI model, significantly enhancing its diagnostic accuracy. Automated bleed detection and segmentation were reviewed in near real-time to facilitate re-training VIOLA-AI. The iterative refinement process yielded a marked improvement in classification sensitivity, rising to 90.3% (from 79.2%), and specificity that reached 89.3% (from 80.7%). The bleed detection ROC analysis for the entire sample demonstrated a high area-under-the-curve (AUC) of 0.949 (from 0.873). Model refinement stages were associated with notable gains, highlighting the value of real-time radiologist feedback.

The intangible cultural heritage (ICH) of China, a cultural asset transmitted across generations by various ethnic groups, serves as a significant testament to the evolution of human civilization and holds irreplaceable value for the preservation of historical lineage and the enhancement of cultural self-confidence. However, the rapid pace of modernization poses formidable challenges to ICH, including threats damage, disappearance and discontinuity of inheritance. China has the highest number of items on the UNESCO Intangible Cultural Heritage List, which is indicative of the nation's abundant cultural resources and emphasises the pressing need for ICH preservation. In recent years, the rapid advancements in large language modelling have provided a novel technological approach for the preservation and dissemination of ICH. This study utilises a substantial corpus of open-source Chinese ICH data to develop a large language model, ICH-Qwen, for the ICH domain. The model employs natural language understanding and knowledge reasoning capabilities of large language models, augmented with synthetic data and fine-tuning techniques. The experimental results demonstrate the efficacy of ICH-Qwen in executing tasks specific to the ICH domain. It is anticipated that the model will provide intelligent solutions for the protection, inheritance and dissemination of intangible cultural heritage, as well as new theoretical and practical references for the sustainable development of intangible cultural heritage. Furthermore, it is expected that the study will open up new paths for digital humanities research.

A rtificial intelligence (AI) tools for radiology are commonly unmonitored once deployed . Th e lack of real - time case - by - c ase assessments of AI prediction confidence require s users to independently distinguish between trustworthy and unreliable AI predictions, which increas es cognitive burden, r educ es productivity, and potentially lead s to misdiagnos e s. To address these challenges, we introduce Ensembled Monitoring Model (EMM), a framework inspired by clinical consensus practices using multiple expert reviews. Designed specifically for black - box commercial AI products, EMM operates independently without requiring access to interna l AI components or intermediate outputs, while still providing robust confidence measurements. Using intracranial hemorrhage detection as our test case on a large, diverse dataset of 2919 studies, we demonstrate that EMM successfully categorizes confidence in the AI - generated prediction, suggesting different actions and helping improve the overall performance of AI tools to ultimately reduc e cognitive burden . Importantly, we provide key technical considerations and best practices for successfully translating EMM into clinical settings .

Cerebrovascular diseases (CVD) can lead to stroke and dementia. Stroke is the second leading cause of death world wide and dementia incidence is increasing by the year. There are several markers of CVD that are visible on brain imaging, including: white matter hyperintensities (WMH), acute and chronic ischaemic stroke lesions (ISL), lacunes, enlarged perivascular spaces (PVS), acute and chronic haemorrhagic lesions, and cerebral microbleeds (CMB). Brain atrophy also occurs in CVD. These markers are important for patient management and intervention, since they indicate elevated risk of future stroke and dementia. We systematically reviewed automated systems designed to support radiologists reporting on these CVD imaging findings. We considered commercially available software and research publications which identify at least two CVD markers. In total, we included 29 commercial products and 13 research publications. Two distinct types of commercial support system were available: those which identify acute stroke lesions (haemorrhagic and ischaemic) from computed tomography (CT) scans, mainly for the purpose of patient triage; and those which measure WMH and atrophy regionally and longitudinally. In research, WMH and ISL were the markers most frequently analysed together, from magnetic resonance imaging (MRI) scans; lacunes and PVS were each targeted only twice and CMB only once. For stroke, commercially available systems largely support the emergency setting, whilst research systems consider also follow-up and routine scans. The systems to quantify WMH and atrophy are focused on neurodegenerative disease support, where these CVD markers are also of significance. There are currently no openly validated systems, commercially, or in research, performing a comprehensive joint analysis of all CVD markers (WMH, ISL, lacunes, PVS, haemorrhagic lesions, CMB, and atrophy).

Patients with Intracranial Hemorrhage (ICH) face a potentially life-threatening condition, and patient-centered individualized treatment remains challenging due to possible clinical complications. Deep-Learning-based methods can efficiently analyze the routinely acquired head CTs to support the clinical decision-making. The majority of early work focuses on the detection and segmentation of ICH, but do not model the complex relations between ICH and adjacent brain structures. In this work, we design a tailored object detection method for ICH, which we unite with segmentation-grounded Scene Graph Generation (SGG) methods to learn a holistic representation of the clinical cerebral scene. To the best of our knowledge, this is the first application of SGG for 3D voxel images. We evaluate our method on two head-CT datasets and demonstrate that our model can recall up to 74% of clinically relevant relations. This work lays the foundation towards SGG for 3D voxel data. The generated Scene Graphs can already provide insights for the clinician, but are also valuable for all downstream tasks as a compact and interpretable representation.

We present RICHES, a novel approach that interleaves retrieval with sequence generation tasks. RICHES offers an alternative to conventional RAG systems by eliminating the need for separate retriever and generator. It retrieves documents by directly decoding their contents, constrained on the corpus. Unifying retrieval with generation allows us to adapt to diverse new tasks via prompting alone. RICHES can work with any Instruction-tuned model, without additional training. It provides attributed evidence, supports multi-hop retrievals and interleaves thoughts to plan on what to retrieve next, all within a single decoding pass of the LLM. We demonstrate the strong performance of RICHES across ODQA tasks including attributed and multi-hop QA.

Multiple Instance Learning (MIL) has been widely applied to medical imaging diagnosis, where bag labels are known and instance labels inside bags are unknown. Traditional MIL assumes that instances in each bag are independent samples from a given distribution. However, instances are often spatially or sequentially ordered, and one would expect similar diagnostic importance for neighboring instances. To address this, in this study, we propose a smooth attention deep MIL (SA-DMIL) model. Smoothness is achieved by the introduction of first and second order constraints on the latent function encoding the attention paid to each instance in a bag. The method is applied to the detection of intracranial hemorrhage (ICH) on head CT scans. The results show that this novel SA-DMIL: (a) achieves better performance than the non-smooth attention MIL at both scan (bag) and slice (instance) levels; (b) learns spatial dependencies between slices; and (c) outperforms current state-of-the-art MIL methods on the same ICH test set.

Authors implemented an artificial intelligence (AI)–based detection tool for intracranial hemorrhage (ICH) on noncontrast CT images into an emergent workflow, evaluated its diagnostic performance, and assessed clinical workflow metrics compared with pre-AI implementation. The finalized radiology report constituted the ground truth for the analysis, and CT examinations (n 4450) before and after implementation were retrieved using various keywords for ICH. Diagnostic performance was assessed, and mean values with their respective 95% CIs were reported to compare workflow metrics (report turnaround time, communication time of a finding, consultation time of another specialty, and turnaround time in the emergency department). Although practicable diagnostic performance was observed for overall ICH detection with 93.0% diagnostic accuracy, 87.2% sensitivity, and 97.8% negative predictive value, the tool yielded lower detection rates for specific subtypes of ICH (eg, 69.2% [74 of 107] for subdural hemorrhage and 77.4% [24 of 31] for acute subarachnoid hemorrhage). Common false-positive findings included postoperative and postischemic defects (23.6%, 37 of 157), artifacts (19.7%, 31 of 157), and tumors (15.3%, 24 of 157).

People use artificial intelligence – or AI – any time they ask Siri, Alexa or Google to help them find something. But AI is also changing how health care providers treat patients. "Finding data that's faster, that works continuously like computers do to help make rare diagnoses or faster diagnoses," Dr. David Freeman, a Mayo Clinic neurologist, says. Dr. Freeman has helped develop AI that could soon improve outcomes for people who suffer from a certain kind of stroke called an intracerebral hemorrhage, or ICH. Right now, patients with an ICH go to a hospital with symptoms, get a CAT scan, then have to wait for results and for doctors to figure out how to address it.

Previous approaches of analyzing spontaneously spoken language often have been based on encoding syntactic and semantic knowledge manually and symbolically. While there has been some progress using statistical or connectionist language models, many current spoken- language systems still use a relatively brittle, hand-coded symbolic grammar or symbolic semantic component. In contrast, we describe a so-called screening approach for learning robust processing of spontaneously spoken language. A screening approach is a flat analysis which uses shallow sequences of category representations for analyzing an utterance at various syntactic, semantic and dialog levels. Rather than using a deeply structured symbolic analysis, we use a flat connectionist analysis. This screening approach aims at supporting speech and language processing by using (1) data-driven learning and (2) robustness of connectionist networks. In order to test this approach, we have developed the SCREEN system which is based on this new robust, learned and flat analysis. In this paper, we focus on a detailed description of SCREEN's architecture, the flat syntactic and semantic analysis, the interaction with a speech recognizer, and a detailed evaluation analysis of the robustness under the influence of noisy or incomplete input. The main result of this paper is that flat representations allow more robust processing of spontaneous spoken language than deeply structured representations. In particular, we show how the fault-tolerance and learning capability of connectionist networks can support a flat analysis for providing more robust spoken-language processing within an overall hybrid symbolic/connectionist framework.