Opportunistic Screening: Radiology Scientific Expert Panel.
Opportunistic Screening: Radiology Scientific Expert Panel.
复制标题
机会性筛查：放射学科学专家小组。
DOI：
10.1148/radiol.222044
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发表时间：
2023
期刊：
影响因子：
19.7
通讯作者：
Nicola,GregoryN
中科院分区：
文献类型：
--
作者：
Pickhardt,PerryJ;Summers,RonaldM;Garrett,JohnW;Krishnaraj,Arun;Agarwal,Sheela;Dreyer,KeithJ;Nicola,GregoryN
放射学检查通常包含与临床检查不相关的丰富成像数据。 适应症药物筛选是指系统地 利用这些偶然的成像发现。虽然机会性筛查 可以应用于成像模式，如传统的放射线照相术、US和MRI， 迄今为止，大多数注意力都集中在使用人工智能的身体CT上 （1）辅助方法。身体CT是一种理想的高容量模式 由此对组织组成（例如，骨，肌肉，脂肪， 和血管钙）可以提供有价值的风险分层， 未被怀疑的症状前疾病“可解释”的出现 完全自动化这些测量的人工智能算法最终可能导致 常规临床应用。广泛执行《公约》的潜在障碍 机会性CT筛查包括需要放射科医生的支持， 转诊提供者和患者。采集和报告标准化 除了根据年龄扩大规范数据外，还需要采取措施， 性别、种族和民族。监管和报销障碍不是 但对商业化和临床应用构成了巨大挑战 使用.通过展示改善的人口健康成果， 成本效益，这些机会主义的CT为基础的措施应该是有吸引力的 作为基于价值的报销模式， 成熟如果非常成功，机会主义筛查最终可以证明 独立“预期”CT筛查的实践。© RSNA，2023
Radiologic tests often contain rich imaging data not relevant to the clinical indication. Opportunistic screening refers to the practice of systematically leveraging these incidental imaging findings. Although opportunistic screening can apply to imaging modalities such as conventional radiography, US, and MRI, most attention to date has focused on body CT by using artificial intelligence (AI)–assisted methods. Body CT represents an ideal high-volume modality whereby a quantitative assessment of tissue composition (eg, bone, muscle, fat, and vascular calcium) can provide valuable risk stratification and help detect unsuspected presymptomatic disease. The emergence of “explainable” AI algorithms that fully automate these measurements could eventually lead to their routine clinical use. Potential barriers to widespread implementation of opportunistic CT screening include the need for buy-in from radiologists, referring providers, and patients. Standardization of acquiring and reporting measures is needed, in addition to expanded normative data according to age, sex, and race and ethnicity. Regulatory and reimbursement hurdles are not insurmountable but pose substantial challenges to commercialization and clinical use. Through demonstration of improved population health outcomes and cost-effectiveness, these opportunistic CT-based measures should be attractive to both payers and health care systems as value-based reimbursement models mature. If highly successful, opportunistic screening could eventually justify a practice of standalone “intended” CT screening.© RSNA, 2023