Evaluation of AI-Powered Routine Screening of Clinically Acquired cMRIs for Incidental Intracranial Aneurysms
<b>Objectives</b>: To quantify the clinical value of integrating a commercially available artificial intelligence (AI) algorithm for intracranial aneurysm detection in a screening setting that utilizes cranial magnetic resonance imaging (cMRI) scans acquired primarily for other clinical...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-01-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/15/3/254 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849717647455813632 |
|---|---|
| author | Christina Carina Schmidt Robert Stahl Franziska Mueller Thomas David Fischer Robert Forbrig Christian Brem Hakan Isik Klaus Seelos Niklas Thon Sophia Stoecklein Thomas Liebig Johannes Rueckel |
| author_facet | Christina Carina Schmidt Robert Stahl Franziska Mueller Thomas David Fischer Robert Forbrig Christian Brem Hakan Isik Klaus Seelos Niklas Thon Sophia Stoecklein Thomas Liebig Johannes Rueckel |
| author_sort | Christina Carina Schmidt |
| collection | DOAJ |
| description | <b>Objectives</b>: To quantify the clinical value of integrating a commercially available artificial intelligence (AI) algorithm for intracranial aneurysm detection in a screening setting that utilizes cranial magnetic resonance imaging (cMRI) scans acquired primarily for other clinical purposes. <b>Methods</b>: A total of 907 consecutive cMRI datasets, including time-of-flight-angiography (TOF-MRA), were retrospectively identified from patients unaware of intracranial aneurysms. cMRIs were analyzed by a commercial AI algorithm and reassessed by consultant-level neuroradiologists, who provided confidence scores and workup recommendations for suspicious findings. Patients with newly identified findings (relative to initial cMRI reports) were contacted for on-site consultations, including cMRI follow-up or catheter angiography. The number needed to screen (NNS) was defined as the cMRI quantity that must undergo AI screening to achieve various clinical endpoints. <b>Results</b>: The algorithm demonstrates high sensitivities (100% for findings >4 mm in diameter), a 17.8% MRA alert rate and positive predictive values of 11.5–43.8% (depending on whether inconclusive findings are considered or not). Initial cMRI reports missed 50 out of 59 suspicious findings, including 13 certain intradural aneurysms. The NNS for additionally identifying highly suspicious and therapeutically relevant (unruptured intracranial aneurysm treatment scores balanced or in favor of treatment) findings was 152. The NNS for recommending additional follow-/workup imaging (cMRI or catheter angiography) was 26, suggesting an additional up to 4% increase in imaging procedures resulting from a preceding AI screening. <b>Conclusions</b>: AI-powered routine screening of cMRIs clearly lowers the high risk of incidental aneurysm non-reporting but results in a substantial burden of additional imaging follow-up for minor or inconclusive findings. |
| format | Article |
| id | doaj-art-bf9bed7d4c7d49a3a2af15a7352a381e |
| institution | DOAJ |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-bf9bed7d4c7d49a3a2af15a7352a381e2025-08-20T03:12:35ZengMDPI AGDiagnostics2075-44182025-01-0115325410.3390/diagnostics15030254Evaluation of AI-Powered Routine Screening of Clinically Acquired cMRIs for Incidental Intracranial AneurysmsChristina Carina Schmidt0Robert Stahl1Franziska Mueller2Thomas David Fischer3Robert Forbrig4Christian Brem5Hakan Isik6Klaus Seelos7Niklas Thon8Sophia Stoecklein9Thomas Liebig10Johannes Rueckel11Institute of Neuroradiology, University Hospital, LMU Munich, 81377 Munich, GermanyInstitute of Neuroradiology, University Hospital, LMU Munich, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, 81377 Munich, GermanyInstitute of Neuroradiology, University Hospital, LMU Munich, 81377 Munich, GermanyInstitute of Neuroradiology, University Hospital, LMU Munich, 81377 Munich, GermanyInstitute of Neuroradiology, University Hospital, LMU Munich, 81377 Munich, GermanyInstitute of Neuroradiology, University Hospital, LMU Munich, 81377 Munich, GermanyInstitute of Neuroradiology, University Hospital, LMU Munich, 81377 Munich, GermanyDepartment of Neurosurgery, University Hospital, LMU Munich, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, 81377 Munich, GermanyInstitute of Neuroradiology, University Hospital, LMU Munich, 81377 Munich, GermanyInstitute of Neuroradiology, University Hospital, LMU Munich, 81377 Munich, Germany<b>Objectives</b>: To quantify the clinical value of integrating a commercially available artificial intelligence (AI) algorithm for intracranial aneurysm detection in a screening setting that utilizes cranial magnetic resonance imaging (cMRI) scans acquired primarily for other clinical purposes. <b>Methods</b>: A total of 907 consecutive cMRI datasets, including time-of-flight-angiography (TOF-MRA), were retrospectively identified from patients unaware of intracranial aneurysms. cMRIs were analyzed by a commercial AI algorithm and reassessed by consultant-level neuroradiologists, who provided confidence scores and workup recommendations for suspicious findings. Patients with newly identified findings (relative to initial cMRI reports) were contacted for on-site consultations, including cMRI follow-up or catheter angiography. The number needed to screen (NNS) was defined as the cMRI quantity that must undergo AI screening to achieve various clinical endpoints. <b>Results</b>: The algorithm demonstrates high sensitivities (100% for findings >4 mm in diameter), a 17.8% MRA alert rate and positive predictive values of 11.5–43.8% (depending on whether inconclusive findings are considered or not). Initial cMRI reports missed 50 out of 59 suspicious findings, including 13 certain intradural aneurysms. The NNS for additionally identifying highly suspicious and therapeutically relevant (unruptured intracranial aneurysm treatment scores balanced or in favor of treatment) findings was 152. The NNS for recommending additional follow-/workup imaging (cMRI or catheter angiography) was 26, suggesting an additional up to 4% increase in imaging procedures resulting from a preceding AI screening. <b>Conclusions</b>: AI-powered routine screening of cMRIs clearly lowers the high risk of incidental aneurysm non-reporting but results in a substantial burden of additional imaging follow-up for minor or inconclusive findings.https://www.mdpi.com/2075-4418/15/3/254artificial intelligenceintracranial aneurysmsMRIscreeningTOF-MRA |
| spellingShingle | Christina Carina Schmidt Robert Stahl Franziska Mueller Thomas David Fischer Robert Forbrig Christian Brem Hakan Isik Klaus Seelos Niklas Thon Sophia Stoecklein Thomas Liebig Johannes Rueckel Evaluation of AI-Powered Routine Screening of Clinically Acquired cMRIs for Incidental Intracranial Aneurysms Diagnostics artificial intelligence intracranial aneurysms MRI screening TOF-MRA |
| title | Evaluation of AI-Powered Routine Screening of Clinically Acquired cMRIs for Incidental Intracranial Aneurysms |
| title_full | Evaluation of AI-Powered Routine Screening of Clinically Acquired cMRIs for Incidental Intracranial Aneurysms |
| title_fullStr | Evaluation of AI-Powered Routine Screening of Clinically Acquired cMRIs for Incidental Intracranial Aneurysms |
| title_full_unstemmed | Evaluation of AI-Powered Routine Screening of Clinically Acquired cMRIs for Incidental Intracranial Aneurysms |
| title_short | Evaluation of AI-Powered Routine Screening of Clinically Acquired cMRIs for Incidental Intracranial Aneurysms |
| title_sort | evaluation of ai powered routine screening of clinically acquired cmris for incidental intracranial aneurysms |
| topic | artificial intelligence intracranial aneurysms MRI screening TOF-MRA |
| url | https://www.mdpi.com/2075-4418/15/3/254 |
| work_keys_str_mv | AT christinacarinaschmidt evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms AT robertstahl evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms AT franziskamueller evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms AT thomasdavidfischer evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms AT robertforbrig evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms AT christianbrem evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms AT hakanisik evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms AT klausseelos evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms AT niklasthon evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms AT sophiastoecklein evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms AT thomasliebig evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms AT johannesrueckel evaluationofaipoweredroutinescreeningofclinicallyacquiredcmrisforincidentalintracranialaneurysms |