Comparison of a Specialized Large Language Model with GPT-4o for CT and MRI Radiology Report Summarization.

Background Although the general-purpose large language model (LLM) GPT-4o (OpenAI) has shown promise in radiology language processing, it remains unclear whether the performance of GPT-4o in report summarization is better than that of an LLM specifically designed for this task. Purpose To compare the performance of a specialized LLM with that of GPT-4o in the comprehensive summarization of radiology reports. Materials and Methods A specialized LLM for report summarization (LLM-RadSum) was developed using retrospectively collected reports from a hospital, divided into training and internal test sets (9:1 ratio).

Artificial intelligence as an independent reader of risk-dominant lung nodules: influence of CT reconstruction parameters.

Objectives: To assess the impact of reconstruction parameters on AI's performance in detecting and classifying risk-dominant nodules in a baseline low-dose CT (LDCT) screening among a Chinese general population.

Materials And Methods: Baseline LDCT scans from 300 consecutive participants in the Netherlands and China Big-3 (NELCIN-B3) trial were included. AI analyzed each scan reconstructed with four settings: 1 mm/0.

A comparative analysis of heterogeneity in lung cancer screening effectiveness in two randomised controlled trials.

Clinical trials demonstrate that screening can reduce lung cancer mortality by over 20%. However, lung cancer screening effectiveness (reduction in lung cancer specific mortality) may vary by personal risk-factors. Here we evaluate heterogeneity in lung cancer screening effectiveness through traditional sub-group analyses, predictive modelling approaches and machine-learning in individual-level data from the Dutch-Belgian lung cancer screening trial (NELSON; 14,808 participants, 12,429 men, 2377 women, 2 persons with an unknown sex) and the National Lung Screening Trial (NLST; 53,405 participants, 31,501 men, 21,904 women).

Early Detection of Cardiovascular Disease in Chest Population Screening: Challenges for a Rapidly Emerging Cardiac CT Application.

While lung cancer screening (LCS) reduces lung cancer-related mortality in high-risk individuals, cardiovascular disease (CVD) remains a leading cause of death due to shared risk factors such as smoking and age. Coronary artery calcium (CAC) assessment offers an opportunity for concurrent cardiovascular screening, with higher CAC scores indicating increased CVD risk and mortality. Despite guidelines recommending CAC-scoring on all non-contrast chest CT scans, a lack of standardization leads to underreporting and missed opportunities for preventive care.

Impact of recruitment method on informed decision-making in lung cancer screening in the 4-IN-THE-LUNG-RUN trial.

Objectives: It is relatively unknown how to inform individuals about lung cancer screening to enable informed decision-making (IDM). This study aims to determine the level of IDM across different recruitment methods among participants invited for the 4-IN-THE-LUNG-RUN trial, the European implementation trial for lung cancer screening.

Methods: A 23-item online questionnaire related to decision-relevant knowledge was sent to 848 Dutch men and women, aged 60-79 years, who were randomised in 4-IN-THE-LUNG-RUN.

Comparison of nodule volumetric classification by using two different nodule segmentation algorithms in an LDCT lung cancer baseline screening dataset.

Objectives: To investigate the performance of two segmentation algorithms for nodule volumetric classification at participant/scan level in the NELCIN-B3 cohort (Netherlands and China Big-3), a lung cancer screening program (LCS) using low-dose CT (LDCT).

Methods: Baseline scans with qualified LDCT images from consecutive NELCIN-B3 participants were included from June 2017 to July 2018. Performance of two software algorithms were independently evaluated by two radiologists: software A (Syngo.

Stage- and histology-specific sensitivity for the detection of lung cancer of the NELSON screening protocol-A modeling study.

The Dutch-Belgian lung cancer (LC) screening trial (Nederlands-Leuvens Longkanker Screenings Onderzoek [NELSON]) demonstrated low-dose computed tomography (CT) reduces LC mortality by 24% among men. The NELSON protocol differed from previous trials in the eligibility criteria, the use of volume-based nodule management, and increasing screening intervals. The early-stage sensitivity of the protocol is pivotal in determining the optimal screening strategy, such as the interval and age range.

Current evidence of low-dose CT screening benefit.

Lung cancer is the leading cause of cancer-related mortality worldwide, largely due to late-stage diagnosis. Low-dose computed tomography (LDCT) screening has emerged as a powerful tool for early detection, enabling diagnosis at curable stages and reducing lung cancer mortality. Despite strong evidence, LDCT screening uptake remains suboptimal globally.

Respiratory symptoms associated with a new lobe-based bronchial scoring system in an urban Chinese low-dose CT screening population.

Objective: To develop a lobe-based bronchial scoring system in a general Chinese urban population undergoing low-dose CT (LDCT) screening and examining the association between the scores and the presence and absence of respiratory symptoms.

Materials And Methods: A total of 989 Chinese participants aged 40-74 from the NELCIN-B3 study underwent LDCT screening. The scoring system assessed bronchiectasis by summing up CT findings in each of the five lung lobes, including severity and extent of bronchial dilatation and airway wall thickness, as well as the presence of mucoid impaction.

AI integrations with lung cancer screening: Considerations in developing AI in a public health setting.

Lung cancer screening implementation has led to expanded imaging of the chest in older, tobacco-exposed populations. Growing numbers of screening cases are also found to have CT-detectable emphysema or elevated levels of coronary calcium, indicating the presence of coronary artery disease. Early interventions based on these additional findings, especially with coronary calcium, are emerging and follow established protocols.

Action plan for an international imaging framework for implementation of global low-dose CT screening for lung cancer.

Reduction in lung cancer mortality is achievable through low dose computed tomography (LDCT) screening in high-risk individuals. Many countries are progressing from local LDCT screening studies to national screening programs. Implementation of effective large-scale screening programs is complex and requires a multi-disciplinary approach.

Histological proven AI performance in the UKLS CT lung cancer screening study: Potential for workload reduction.

Purpose: Artificial intelligence (AI) could reduce lung cancer screening computer tomography (CT)-reading workload if used as a first-reader, ruling-out negative CT-scans at baseline. Evidence is lacking to support AI performance when compared to gold-standard lung cancer outcomes. This study validated the performance of a commercially available AI software in the UK lung cancer screening (UKLS) trial dataset, with comparison to human reads and histological lung cancer outcomes, and estimated CT-reading workload reduction.

Paradigm shift in early detection: Lung cancer screening to comprehensive CT screening.

Large-scale lung cancer screening implementation combined with improvements in early detection techniques for three major tobacco-related diseases presents a rare opportunity to markedly improve population health outcomes for millions of people. Chest CT enables routine detection of early lung cancer as well as characterizing coronary calcium and detecting early emphysema in the course of lung cancer screening. Integrated preventive care centered on comprehensive chest CT screening has the potential to bring large benefits across co-morbid diseases with a common etiology.

Coronary Artery Calcium Scores After Prophylactic Premenopausal Bilateral Salpingo-Oophorectomy.

Background: Premenopausal risk-reducing salpingo-oophorectomy (RRSO) in women at high familial risk of ovarian cancer leads to immediate menopause. Although early natural menopause is associated with increased cardiovascular disease risk, evidence on long-term cardiovascular disease risk after early surgical menopause is scarce.

Objectives: We sought to determine the long-term influence of the timing of RRSO on the development of coronary artery calcium (CAC), an established marker for cardiovascular disease risk.

Co-occurrence of bronchiectasis, airway wall thickening, and emphysema in Chinese low-dose CT screening.

Objective: To assess the co-occurrence of incidental CT lung findings (emphysema, bronchiectasis, and airway wall thickening) as well as associated risk factors in low-dose CT (LDCT) lung cancer screening in a Chinese urban population.

Methods: Data from 978 participants aged 40-74 years from the Chinese NELCIN-B3 urban population study who underwent LDCT screening were selected. CT scans were reviewed for incidental lung findings: emphysema, bronchiectasis and airway wall thickness.

Feasibility of AI as first reader in the 4-IN-THE-LUNG-RUN lung cancer screening trial: impact on negative-misclassifications and clinical referral rate.

Background: Lung cancer screening (LCS) with low-dose CT (LDCT) reduces lung-cancer-related mortality in high-risk individuals. AI can potentially reduce radiologist workload as first-read-filter by ruling-out negative cases. The feasibility of AI as first reader was evaluated in the European 4-IN-THE-LUNG-RUN (4ITLR) trial, comparing its negative-misclassifications (NMs) to those of radiologists and the impact on referral rates.

Short-term impact of cardiovascular screening by traditional risk assessment or coronary artery calcium score on health-related quality of life: the ROBINSCA trial.

Aims: Evidence on the impact of screening for cardiovascular diseases (CVDs) on health-related quality of life (HRQoL) is important for policy decisions about screening implementation and to uncover teachable moments to motivate healthy lifestyle choices. It is unknown whether screening by cardiac computed tomography (CT) scan has a stronger impact on HRQoL than screening by traditional risk prediction models. The study aims to investigate differences in HRQoL across the screening process between participants who were randomized to CVD risk estimation by coronary artery calcium score or Systematic COronary Risk Evaluation.

Lung cancer volume doubling time by computed tomography: A systematic review and meta-analysis.

Aim: Lung cancer growth rate influences screening strategies and treatment decisions. This review aims to provide an overview of primary lung cancer growth rate, quantified by volume doubling time (VDT) through computed tomography (CT) measurement.

Methods: Using PRISMA-DTA guideline, PubMed, EMBASE, and Web of Science were searched until March 2024 for studies reporting CT-measured VDT of pathologically confirmed primary lung cancer before intervention.

Association between skin autofluorescence and coronary calcification in the general population.

Objective: To address the relationship between tissue accumulation of advanced glycation end-products, assessed by skin autofluorescence (SAF), and subclinical atherosclerosis quantified with coronary artery calcium score (CACS) in the general Dutch population.

Methods: A total of 3,839 participants of the LifeLines Cohort Study without diabetes or cardiovascular disease were included in this cross-sectional evaluation. They underwent SAF measurement and cardiac computed tomography to measure CACS.

An optimized D-dimer cut-off value to predict pulmonary thromboembolism in COVID-19 patients.

Pulmonary thromboembolism (PTE) is a common complication in coronavirus disease 2019 (COVID-19) patients. Elevated D-dimer levels are observed even in the absence of PTE, reducing its discriminative ability as a screening test. It is unknown whether conventional D-dimer cut-off values, as used in the YEARS algorithm, apply to COVID-19 patients.

Cost-effectiveness of volume computed tomography in lung cancer screening: a cohort simulation based on Nelson study outcomes.

Objectives: This study aimed to evaluate the cost-effectiveness of lung cancer screening (LCS) with volume-based low-dose computed tomography (CT) versus no screening for an asymptomatic high-risk population in the United Kingdom (UK), utilising the long-term insights provided by the NELSON study, the largest European randomized control trial investigating LCS.

Methods: A cost-effectiveness analysis was conducted using a decision tree and a state-transition Markov model to simulate the identification, diagnosis, and treatments for a lung cancer high-risk population, from a UK National Health Service (NHS) perspective. Eligible participants underwent annual volume CT screening and were compared to a cohort without the option of screening.

Image quality of DWI at breast MRI depends on the amount of fibroglandular tissue: implications for unenhanced screening.

Objectives: To compare image quality of diffusion-weighted imaging (DWI) and contrast-enhanced breast MRI (DCE-T1) stratified by the amount of fibroglandular tissue (FGT) as a measure of breast density.

Methods: Retrospective, multi-reader, bicentric visual grading analysis study on breast density (A-D) and overall image and fat suppression quality of DWI and DCE-T1, scored on a standard 5-point Likert scale. Cross tabulations and visual grading characteristic (VGC) curves were calculated for fatty breasts (A/B) versus dense breasts (C/D).