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Article ; Online: Revolutionising paediatric radiology: the future impact of artificial intelligence.

Shelmerdine, Susan C

2023 Volume 34, Issue 4, Page(s) 2294–2296

MeSH term(s)	Child ; Humans ; Artificial Intelligence ; Radiology ; Forecasting ; Radiologists
Language	English
Publishing date	2023-10-11
Publishing country	Germany
Document type	Editorial
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-023-10288-w
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Article ; Online: Post-mortem perinatal imaging: what is the evidence?

Shelmerdine, Susan C / Arthurs, Owen J

The British journal of radiology

2022 Volume 96, Issue 1147, Page(s) 20211078

Abstract: Post-mortem imaging for the investigation of perinatal deaths is an acceptable tool amongst parents and religious groups, enabling a less invasive autopsy examination. Nevertheless, availability is scarce nationwide, and there is some debate amongst ... ...

Abstract	Post-mortem imaging for the investigation of perinatal deaths is an acceptable tool amongst parents and religious groups, enabling a less invasive autopsy examination. Nevertheless, availability is scarce nationwide, and there is some debate amongst radiologists regarding the best practice and optimal protocols for performing such studies. Much of the published literature to date focusses on single centre experiences or interesting case reports. Diagnostic accuracy studies are available for a variety of individual imaging modalities (
MeSH term(s)	Humans ; Pregnancy ; Female ; Autopsy/methods ; Magnetic Resonance Imaging ; Perinatal Death ; Ultrasonography ; Radiologists
Language	English
Publishing date	2022-05-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2982-8
ISSN	1748-880X ; 0007-1285
ISSN (online)	1748-880X
ISSN	0007-1285
DOI	10.1259/bjr.20211078
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Article ; Online: Commercially available artificial intelligence tools for fracture detection: the evidence.

Pauling, Cato / Kanber, Baris / Arthurs, Owen J / Shelmerdine, Susan C

BJR open

2023 Volume 6, Issue 1, Page(s) tzad005

Abstract: Missed fractures are a costly healthcare issue, not only negatively impacting patient lives, leading to potential long-term disability and time off work, but also responsible for high medicolegal disbursements that could otherwise be used to improve ... ...

Abstract	Missed fractures are a costly healthcare issue, not only negatively impacting patient lives, leading to potential long-term disability and time off work, but also responsible for high medicolegal disbursements that could otherwise be used to improve other healthcare services. When fractures are overlooked in children, they are particularly concerning as opportunities for safeguarding may be missed. Assistance from artificial intelligence (AI) in interpreting medical images may offer a possible solution for improving patient care, and several commercial AI tools are now available for radiology workflow implementation. However, information regarding their development, evidence for performance and validation as well as the intended target population is not always clear, but vital when evaluating a potential AI solution for implementation. In this article, we review the range of available products utilizing AI for fracture detection (in both adults and children) and summarize the evidence, or lack thereof, behind their performance. This will allow others to make better informed decisions when deciding which product to procure for their specific clinical requirements.
Language	English
Publishing date	2023-12-12
Publishing country	England
Document type	Journal Article ; Review
ISSN	2513-9878
ISSN (online)	2513-9878
DOI	10.1093/bjro/tzad005
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Article ; Online: Artificial intelligence applied to fetal MRI: A scoping review of current research.

Meshaka, Riwa / Gaunt, Trevor / Shelmerdine, Susan C

The British journal of radiology

2022 Volume 96, Issue 1147, Page(s) 20211205

Abstract: Artificial intelligence (AI) is defined as the development of computer systems to perform tasks normally requiring human intelligence. A subset of AI, known as machine learning (ML), takes this further by drawing inferences from patterns in data to ' ... ...

Abstract	Artificial intelligence (AI) is defined as the development of computer systems to perform tasks normally requiring human intelligence. A subset of AI, known as machine learning (ML), takes this further by drawing inferences from patterns in data to 'learn' and 'adapt' without explicit instructions meaning that computer systems can 'evolve' and hopefully improve without necessarily requiring external human influences. The potential for this novel technology has resulted in great interest from the medical community regarding how it can be applied in healthcare. Within radiology, the focus has mostly been for applications in oncological imaging, although new roles in other subspecialty fields are slowly emerging.In this scoping review, we performed a literature search of the current state-of-the-art and emerging trends for the use of artificial intelligence as applied to fetal magnetic resonance imaging (MRI). Our search yielded several publications covering AI tools for anatomical organ segmentation, improved imaging sequences and aiding in diagnostic applications such as automated biometric fetal measurements and the detection of congenital and acquired abnormalities. We highlight our own perceived gaps in this literature and suggest future avenues for further research. It is our hope that the information presented highlights the varied ways and potential that novel digital technology could make an impact to future clinical practice with regards to fetal MRI.
MeSH term(s)	Humans ; Artificial Intelligence ; Fetus/diagnostic imaging ; Magnetic Resonance Imaging ; Machine Learning ; Medical Oncology
Language	English
Publishing date	2022-03-18
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2982-8
ISSN	1748-880X ; 0007-1285
ISSN (online)	1748-880X
ISSN	0007-1285
DOI	10.1259/bjr.20211205
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Article ; Online: Body weight-based iodinated contrast immersion timing for human fetal postmortem microfocus computed tomography.

Simcock, Ian C / Shelmerdine, Susan C / Hutchinson, John Ciaran / Sebire, Neil J / Arthurs, Owen J

BJR open

2023 Volume 6, Issue 1, Page(s) tzad006

Abstract: Objectives: The aim of this study was to evaluate the length of time required to achieve full iodination using potassium tri-iodide as a contrast agent, prior to human fetal postmortem microfocus computed tomography (micro-CT) imaging.: Methods: ... ...

Abstract	Objectives: The aim of this study was to evaluate the length of time required to achieve full iodination using potassium tri-iodide as a contrast agent, prior to human fetal postmortem microfocus computed tomography (micro-CT) imaging. Methods: Prospective assessment of optimal contrast iodination was conducted across 157 human fetuses (postmortem weight range 2-298 g; gestational age range 12-37 weeks), following micro-CT imaging. Simple linear regression was conducted to analyse which fetal demographic factors could produce the most accurate estimate for optimal iodination time. Results: Postmortem body weight ( Conclusions: The simplified equation can now be used to provide estimation times for fetal contrast preparation time prior to micro-CT imaging and can be used to manage service throughput and parental expectation for return of their fetus. Advances in knowledge: A simple equation from empirical data can now be used to estimate preparation time for human fetal postmortem micro-CT imaging.
Language	English
Publishing date	2023-12-12
Publishing country	England
Document type	Journal Article
ISSN	2513-9878
ISSN (online)	2513-9878
DOI	10.1093/bjro/tzad006
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Article ; Online: Less-invasive autopsy for early pregnancy loss.

Simcock, Ian C / Lamouroux, Audrey / Sebire, Neil J / Shelmerdine, Susan C / Arthurs, Owen J

Prenatal diagnosis

2023 Volume 43, Issue 7, Page(s) 937–949

Abstract: Autopsy investigations provide valuable information regarding fetal death that can assist in the parental bereavement process, and influence future pregnancies, but conventional autopsy is often declined by parents because of its invasive approach. This ... ...

Abstract	Autopsy investigations provide valuable information regarding fetal death that can assist in the parental bereavement process, and influence future pregnancies, but conventional autopsy is often declined by parents because of its invasive approach. This has led to the development of less-invasive autopsy investigations based on imaging technology to provide a more accessible and acceptable choice for parents when investigating their loss. Whilst the development and use of more conventional clinical imaging techniques (radiographs, CT, MRI, US) are well described in the literature for fetuses over 20 weeks of gestational age, these investigations have limited diagnostic accuracy in imaging smaller fetuses. Techniques such as ultra-high-field MRI (>3T) and micro-focus computed tomography have been shown to have higher diagnostic accuracy whilst still being acceptable to parents. By further developing and increasing the availability of these more innovative imaging techniques, parents will be provided with a greater choice of acceptable options to investigate their loss, which may in turn increase their uptake. We provide a narrative review focussing on the development of high-resolution, non-invasive imaging techniques to evaluate early gestational pregnancy loss.
MeSH term(s)	Humans ; Female ; Pregnancy ; Adult ; Autopsy ; Magnetic Resonance Imaging ; Abortion, Spontaneous/diagnostic imaging ; Abortion, Spontaneous/etiology ; Gestational Age ; Fetal Death/etiology
Language	English
Publishing date	2023-05-09
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	82031-3
ISSN	1097-0223 ; 0197-3851
ISSN (online)	1097-0223
ISSN	0197-3851
DOI	10.1002/pd.6361
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Article ; Online: Three-dimensional versus two-dimensional postmortem ultrasound: feasibility in perinatal death investigation.

Shelmerdine, Susan C / Sebire, Neil J / Arthurs, Owen J

Pediatric radiology

2021 Volume 51, Issue 7, Page(s) 1259–1266

Abstract: Three- and four-dimensional US techniques in antenatal screening are commonplace, but they are not routinely used for perinatal postmortem US. In this technical innovation, we performed both two-dimensional (2-D) and three-dimensional (3-D) postmortem US ...

Abstract	Three- and four-dimensional US techniques in antenatal screening are commonplace, but they are not routinely used for perinatal postmortem US. In this technical innovation, we performed both two-dimensional (2-D) and three-dimensional (3-D) postmortem US on 11 foetuses (mean gestation: 23 weeks; range: 15-32 weeks) to determine whether there was any benefit in 3-D over conventional 2-D methods. In one case of osteogenesis imperfecta, both 2-D and 3-D US images were non-diagnostic because of small foetal size. Of the remaining 10 foetuses, 7 were normal at imaging and autopsy, and 3 had abnormalities detected on both 2-D and 3-D US. There were no false-positive diagnoses by 2-D or 3-D US. Whilst 3-D postmortem US was a feasible technique, it did not provide additional information over 2-D US. Routine 3-D postmortem US cannot therefore be routinely recommended based on our findings.
MeSH term(s)	Autopsy ; Feasibility Studies ; Female ; Fetal Death ; Gestational Age ; Humans ; Perinatal Death ; Pregnancy
Language	English
Publishing date	2021-03-05
Publishing country	Germany
Document type	Journal Article
ZDB-ID	124459-0
ISSN	1432-1998 ; 0301-0449
ISSN (online)	1432-1998
ISSN	0301-0449
DOI	10.1007/s00247-020-04934-4
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Article ; Online: Artificial intelligence in paediatric radiology: international survey of health care professionals' opinions.

Shelmerdine, Susan C / Rosendahl, Karen / Arthurs, Owen J

Pediatric radiology

2021 Volume 52, Issue 1, Page(s) 30–41

Abstract: Background: The nature of paediatric radiology work poses several challenges for developing and implementing artificial intelligence (AI) tools, but opinions of those working in the field are currently unknown.: Objective: To evaluate the attitudes ... ...

Abstract	Background: The nature of paediatric radiology work poses several challenges for developing and implementing artificial intelligence (AI) tools, but opinions of those working in the field are currently unknown. Objective: To evaluate the attitudes and perceptions toward AI amongst health care professionals working within children's imaging services. Materials and methods: A web-based questionnaire was distributed to the membership of several paediatric and general radiological societies over a 4-month period (1 Feb - 31 May 2020). Survey questions covered attitudes toward AI in general, future impacts and suggested areas for development specifically within paediatric imaging. Results: Two hundred and forty responses were collected with the majority being from radiologists (159/240, 66.3%; 95% confidence interval [CI] 59.8-72.2%) or allied health care professionals (72/240, 31.3%; 95% CI 25.4-37.5%). Respondents agreed that AI could potentially alert radiologists to imaging abnormalities (148/240, 61.7%; 95% CI 55.2-67.9%) but preferred that results were checked by a human (200/240, 83.3%; 95% CI 78.0-87.8%). The majority did not believe jobs in paediatric radiology would be replaced by AI (205/240, 85.4%; 95% CI 80.3-89.6%) and that the development of AI tools should focus on improved diagnostic accuracy (77/240, 32.1%; 95% CI 26.2-38.4%), workflow efficiencies (60/240, 25.0%; 95% CI 19.7-30.9%) and patient safety (54/240, 22.5%; 95% CI 17.4-28.3%). The majority of European Society of Paediatric Radiology (ESPR) members (67/81, 82.7%; 95% CI 72.7-90.2%) welcomed the idea of a dedicated paediatric radiology AI task force with emphasis on educational events and anonymised dataset curation. Conclusion: Imaging health care professionals working with children had a positive outlook regarding the use of AI in paediatric radiology, and did not feel their jobs were threatened. Future AI tools would be most beneficial for easily automated tasks and most practitioners welcomed the opportunity for further AI educational activities.
MeSH term(s)	Artificial Intelligence ; Attitude of Health Personnel ; Child ; Humans ; Radiologists ; Radiology ; Surveys and Questionnaires
Language	English
Publishing date	2021-10-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	124459-0
ISSN	1432-1998 ; 0301-0449
ISSN (online)	1432-1998
ISSN	0301-0449
DOI	10.1007/s00247-021-05195-5
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Article ; Online: Post-mortem skeletal survey (PMSS) versus post-mortem computed tomography (PMCT) for the detection of corner metaphyseal lesions (CML) in children.

Shelmerdine, Susan Cheng / Davendralingam, Natasha / Langan, Dean / Palm, Liina / Mangham, Chas / Arthurs, Owen J

European radiology

2024

Abstract: Objectives: Corner metaphyseal lesions (CMLs) are specific for child abuse but challenging to detect on radiographs. The accuracy of CT for CML detection is unknown. Our aim was to compare diagnostic accuracy for CML detection on post-mortem skeletal ... ...

Abstract	Objectives: Corner metaphyseal lesions (CMLs) are specific for child abuse but challenging to detect on radiographs. The accuracy of CT for CML detection is unknown. Our aim was to compare diagnostic accuracy for CML detection on post-mortem skeletal surveys (PMSS, plain radiography) versus post-mortem CT (PMCT). Methods: A 10-year retrospective review was performed at a children's hospital for patients having PMSS, PMCT and histopathological correlation (reference standard) for suspected CMLs. Twenty-four radiologists independently reported the presence or absence of CMLs in all cases in a blinded randomised cross-over design across two rounds. Logistic regression models were used to compare accuracy between modalities. Results: Twenty CMLs were reviewed for each of the 10 subjects (200 metaphyses in all). Among them, 20 CMLs were confirmed by bone histopathology. Sensitivity for these CMLs was significantly higher for PMSS (69.6%, 95% CI 61.7 to 76.7) than PMCT (60.5%, 95% CI 51.9 to 68.6). Using PMSS for detection of CMLs would yield one extra correct diagnosis for every 11.1 (95% CI 6.6 to 37.0) fractured bones. In contrast, specificity was higher on PMCT (92.7%, 95% CI 90.3 to 94.5) than PMSS (90.5%, 95% CI 87.6 to 92.8) with an absolute difference of 2.2% (95% CI 1.0 to 3.4, p < 0.001). More fractures were reported collectively by readers on PMSS (785) than on PMCT (640). Conclusion: PMSS remains preferable to PMCT for CML evaluation. Any investigation of suspected abuse or unexplained deaths should include radiographs of the limbs to exclude CMLs. Clinical relevance statement: In order to avoid missing evidence that could indicate child abuse as a contributory cause for death in children, radiographs of the limbs should be performed to exclude CMLs, even if a PMCT is being acquired. Key points: • Corner metaphyseal lesions (CMLs) are indicative for abuse, but challenging to detect. Skeletal surveys (i.e. radiographs) are standard practice; however, accuracy of CT is unknown. • Sensitivity for CML detection on radiographs is significantly higher than CT. • Investigation of unexplained paediatric deaths should include radiographs to exclude CMLs even if CT is also being performed.
Language	English
Publishing date	2024-03-09
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-024-10679-7
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Article ; Online: Neonatal Autopsy: A 21st Century Approach?

Shelmerdine, Susan C / Klein, Willemijn / Arthurs, Owen J

Neonatology

2019 Volume 115, Issue 3, Page(s) 275–276

MeSH term(s)	Autopsy ; Humans ; Infant, Newborn
Language	English
Publishing date	2019-02-13
Publishing country	Switzerland
Document type	Letter ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	2266911-5
ISSN	1661-7819 ; 1661-7800
ISSN (online)	1661-7819
ISSN	1661-7800
DOI	10.1159/000495912
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