Ingrid Hein

November 17, 2017

CHICAGO — Artificial intelligence, deep learning, and radiomics — quantitative features that enable the mining of data from images — will be in the spotlight here at the Radiological Society of North America (RSNA) 2017 Annual Meeting.

"This is a blowout year for deep learning and artificial intelligence," said Linda Moy, MD, from the NYU Langone Medical Center in New York City, who is chair of the scientific program breast subcommittee.

"Last year it started growing, so this year the board of directors anticipated it," she told Medscape Medical News. "We're excited to see all the robust tools emerging. And we get to see them in person and test them out."

"Radiology is clearly a technology-driven field of medicine. Our ability to look at the body in noninvasive ways, at earlier and earlier changes, is improving dramatically every year," said Chadwick Wright, MD, PhD, from the Ohio State University Wexner Medical Center in Columbus, who is chair of the scientific program nuclear medicine subcommittee.

"This meeting gives us an opportunity to share and glimpse concepts and approaches not yet commercially available that we will be using in just a few years," he explained.

In the field of radiology, artificial intelligence has been on an "exponential trajectory," said Dr Moy.

The whole field is changing.

Among the more than 100 sessions on artificial intelligence and deep learning will be a presentation by Keith Dreyer, DO, PhD, director of the Center for Clinical Data Science at Massachusetts General Hospital in Boston, entitled Harnessing Artificial Intelligence. And Richard Ehman, MD, from the Mayo Clinic in Rochester, Minnesota, in his presentation, will ask: Is it Time to Reinvent Radiology?

Big data will also be up for discussion. "The whole field is changing," Dr Moy explained. "This year, we're seeing a groundswell phenomenon with big data. We really have a critical mass that is being shared."

Abbreviated Breast MRI and 3D Mammography

A session on abbreviated breast MRI, which can be performed in less than 5 minutes, is definitely going to attract a large audience, Dr Moy said. "Instead of taking a full long MRI study, you can just do a few sequences and use that to screen a patient."

During that session, this game-changing procedure will be discussed by Christiane Kuhl, MD, from RWTH Aachen University in Germany; a 2-minute screening protocol will be presented by Ritse Mann MD, PhD, from Radboud University Medical Center in Nijmegen, the Netherlands; and new biomarkers will be addressed by Gregory Karczmar, PhD, from the University of Chicago.

A session on multimodality screening will examine the interpretation of screen-detected cancers with tomosynthesis, look at independent double-reading, and compare breast density determined with synthesized and full-field digital mammography.

"Synthesized mammography means we can try to decrease radiation dose; we can make these images with a computer software," Dr Moy said.

Researchers will also be exploring the role of multilayered 3D mammography. Instead of two conventional views of the breast, this gives radiologists images of layers of the breast they can look at in "multiple slices." Several vendors are now providing these specialized mammography machines, she reported.

New Prostate Cancer Theranostics Emerging

In the field of nuclear medicine, Dr Wright said he is looking forward to presentations on emerging theranostic agents, which have both diagnostic and therapeutic properties and are the basis for new approaches to advanced molecular imaging and targeted radiotherapy for specific tumor biologies.

Agents that target the prostate-specific membrane antigen (PSMA) are not yet approved by the US Food and Drug Administration, and "there are relatively few American sites participating in the related clinical trials," Dr Wright said.

Novel targeted radiotracers have the potential to radically advance precision and personalized medicine, and results from clinical studies will be presented. "This is a very exciting time for nuclear medicine," he pointed out.

Research from trials looking at fluorine-labeled fluciclovine, fluorine-labeled PSMA agents, and gallium-labeled PSMA agents will be presented.

This is a very exciting time for nuclear medicine.

And new research from Heidelberg, Germany, where the first PSMA agents were developed, will be presented by Fredrick Geisel, MD. "I will be paying particular attention to that," Dr Wright told Medscape Medical News.

He also pointed to a gastrointestinal abstract that will look at the newly approved PET radiotracer ⁶⁸Ga-DOTATATE for the evaluation of neuroendocrine tumors, and a movement to investigate existing oncologic PET radiotracers for cardiovascular applications, such as sodium ¹⁸fluoride for the assessment of cardiovascular disease and ¹⁸F-fluorothymidine for the assessment of sarcoidosis.

"There is a trend to advance cardiovascular PET imaging beyond routine perfusion and FDG imaging," he explained.

The field is changing. Instead of the "wait and see" approach, radiologists are increasingly turning not only to artificial-intelligence algorithms and computer-aided tools to analyze images, but also to more targeted diagnostic tools. "We are excited about the technology improving our accuracy. The more tools we have to push indeterminate lesions, the better it will be for doctors and patients," Dr Wright explained.

The conference, in its one hundred and third year, offers educational opportunities and the largest radiology vendor hall in the world.

"If you walk into this looking for something in particular, it's unlikely you'll walk away disappointed." In the 10 years he has been attending the meeting, Dr Wright said he's never left without saying, "Wow! I had no idea that was possible."

Dr Moy and Dr Wright have no relevant financial relationships to disclose.

Follow Medscape on Twitter @Medscape and Ingrid Hein @ingridhein

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