Dr. S.T. Sathya Meonah
Coupling Artificial Intelligence and Fluoroscopy – The Future of Imaging Technology
Life has been made much simpler after the advent of AI and automation. The astounding new-age technologies like remote sensors, robotics, 3D printing, and Big data Analytics have also crept into today’s healthcare technology to make life easier. I have always been fascinated with AI’s mind-blowing healthcare modalities which have translated the quality of healthcare to its highest pinnacle in history. Some AI-assisted modern-day modalities are more patient-friendly with a high degree of precision and efficiency.
The utilization of fluoroscopy has disseminated to diverse medical specialties other than radiology including interventional cardiology, vascular surgery, and gastroenterology.
In this article, I drop my two cents on some recent AI-assisted fluoroscopic systems in diagnosing diverse disease conditions.
The Future of AI based Imaging System in Cardiology
Present-day cardiac resynchronization therapy (CRT) deploys an X-ray fluoroscopy system which involves a multimodality approach using ultrasound parametric imaging, 3-D geometric fluoroscopy, and coronary venogram for lead implantation in the left ventricle. This multimodal approach assists physicians to have a wide spectral assessment on the plaque buildup in the myocardial tissues and specific activation patterns in the left ventricle before choosing the spot for lead positioning.
AI-Induced Interventional Endoscopy
The functionality of fluoroscopy is perhaps most crucial for endoscopic retrograde cholangiopancreatography, which is used to treat bile duct calculi, chronic hepatitis and bile infections. The system includes a duodenoscope followed by a catheter, which injects the contrast to perform the cholangiogram. Fluoroscopy-assisted stents have become the new normal when treating oesophageal, gastric, duodenal, and enteric malignancies. The system also is widely used in corrective surgeries for complications such as stent displacement and perforation. Other diverse treatment interventions including biopsies, balloon sweeps, and stent placement in bile duct and pancreas for calculi removal, warrant the assistance of AI-induced fluoroscopy.
AI based Solution for reducing radiations
Medical technology has seen vibrant changes during the last two decades with increasing diagnostic procedures and eventually high radiation exposure. GE’s imaging technology-based interventional fluoroscopy system offers high imaging quality with very low radiation hazards at the rate of 22-75% minimal radiation compared to other panel detectors. Other salient features like X-ray tunneling systems, Automatic Exposure control technology, Linear Dose Reduction Strategies upsurge the Detective Quantum Efficiency (DQE) rate enabling better quality images with lower body absorption rate.
To greatly reduce the hazards of radiations, DQE, the index criterion for detector performance dictates the use of high-grade collimators, flat-panel detectors and AI induced high image processing platforms to produce a full field of view (FOV) images on multiple frames. The novel automated control system regulates the radiation with copper spectral beam filters of different width capacities to effectively reduce dose radiation. The dose reduction software assists manual adjustment of a dose at the clinician’s convenience by the click of a button.
Coupling AI and Radiological fluoroscopy to increase Patient and Physician safety
AI-based modalities that increase safety and minimize radiations.
Table 1: Dose Management AI technologies to reduce excess dosing
|AI-based Patient-Physician safety Systems||Features|
|Dose map||Calculates the distribution of local radiation exposures performed on the angiographic system|
|InnovaSense||Optimize the best position for patient to minimize radiation exposure|
|Virtual collimation||Visualize blade position to reduce radiation exposure|
|Dose Watch||Analyze radiation levels|
|Dose Reports||Give periodic dose report|
|RaySafe||Calculate radiation exposure in real-time for medical staff|
Single – and Dual-Plane Imaging Systems
Single- and dual-plane fluoroscopy has been successful in precisely measuring the tibia, talus, and calcaneus of the ankle and to study the axial rotation of the subtalar joints. Dual-plane fluoroscopy performs clinically significant reconstruction of three-dimensional (3D) locales of bone structures and carefully analyzes the quasi-static motion of the joints. The unique combination of high-speed dual-plane fluoroscopy and treadmill helps in assessing ankle kinematics in vivo, during motion. Flat-panel X-ray detectors include an X-ray scintillator and photodiode and have been preferred to the image intensifier/TV, and are immensely beneficial for invasive procedures in pediatric patients. The novel flat-panel detectors exhibit low geometric distortion, high-resolution images, and excellent ergonomics, in accordance with principles of ALARA (As Low As Reasonably Achievable).
Table 2: AI assisted fluoroscopy techniques in gastroenterology
|Disease Condition||AI assisted fluoroscopy technique|
|Gastric outlet obstruction||Gastroduodenal stent|
|Peritoneal carcinomatosis||Stricture removal|
|Bowel obstruction||Colonic stent|
|Acute colonic obstruction||Endoscopic stent|
|Benign strictures||Balloon dilation|
|Chronic fistula||Over the scope clips, through the scope clips and suture.|
AI has integrated into life itself. The influence of AI and Automation has crept into man’s technological and scientific endeavors. More upgrades with AI and Big Data are in the pipeline as necessity urges the spirit of innovation.