Al-based diagnosis of acute aortic syndrome from noncontrast CT

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Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

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AI Diagnoses Aortic Trouble Even Without Fancy CT Scans!

An AI system called iAorta can detect acute aortic syndrome (AAS) from regular CT scans, which are cheaper and easier to access than the preferred CT angiograms. This is especially useful in China, where cost and resource limitations mean many patients only get regular CT scans initially. The system showed high accuracy in tests across multiple hospitals and significantly sped up diagnosis in a prospective trial.

Possible Conflicts of Interest

Alibaba Group has filed a patent application related to this technology on behalf of some of the authors who are also Alibaba employees.

Identified Weaknesses

Limited ethnic diversity

The AI was trained and tested mostly on Chinese patients, so it might not be as accurate for people of other ethnicities. Further studies are needed to confirm its effectiveness in diverse populations.

Room for improvement with PAU

The system isn't as good at detecting a specific type of AAS called penetrating atherosclerotic ulcer (PAU). Combining the AI with other patient information could make it better at spotting PAU.

Reliance on non-ECG-gated CT scans

The system relies primarily on non-ECG-gated CT images, which sometimes have artifacts that can look like aortic dissection, leading to false positives. While the system addresses these well in the study, it is still a limitation.

Rating Explanation

This study demonstrates a promising real-world application of AI in a medical setting with significant potential to improve patient outcomes by enabling earlier and more accurate diagnosis of a life-threatening condition. While there are limitations regarding generalizability and performance on specific subtypes, the rigorous testing and prospective validation make this a strong study.

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