Research-based clinical deployment of artificial intelligence algorithm for prostate MRI.

Purpose: A critical limitation to deployment and utilization of Artificial Intelligence (AI) algorithms in radiology practice is the actual integration of algorithms directly into the clinical Picture Archiving and Communications Systems (PACS). Here, we sought to integrate an AI-based pipeline for...

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Published in:Abdominal Radiology Vol. 50; no. 12; pp. 5893 - 5903
Main Authors: Harmon, Stephanie A., Tetreault, Jesse, Esengur, Omer Tarik, Qin, Ming, Yilmaz, Enis C., Chang, Victor, Yang, Dong, Xu, Ziyue, Cohen, Gregg, Plum, Jeff, Sherif, Testi, Levin, Ron, Schmidt-Richberg, Alexander, Thompson, Scott, Coons, Samuel, Chen, Te, Choyke, Peter L., Xu, Daguang, Gurram, Sandeep, Wood, Bradford J.
Format: Journal Article
Published: Springer Nature Dec2025
Online Access:View this record in EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00261-025-05014-7
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        atl: Research-based clinical deployment of artificial intelligence algorithm for prostate MRI.
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          Harmon, Stephanie A.
          Tetreault, Jesse
          Esengur, Omer Tarik
          Qin, Ming
          Yilmaz, Enis C.
          Chang, Victor
          Yang, Dong
          Xu, Ziyue
          Cohen, Gregg
          Plum, Jeff
          Sherif, Testi
          Levin, Ron
          Schmidt-Richberg, Alexander
          Thompson, Scott
          Coons, Samuel
          Chen, Te
          Choyke, Peter L.
          Xu, Daguang
          Gurram, Sandeep
          Wood, Bradford J.
        affil: https://ror.org/01cwqze88 National Institutes of Health, Bethesda, USA
      sug:
      ab: Purpose: A critical limitation to deployment and utilization of Artificial Intelligence (AI) algorithms in radiology practice is the actual integration of algorithms directly into the clinical Picture Archiving and Communications Systems (PACS). Here, we sought to integrate an AI-based pipeline for prostate organ and intraprostatic lesion segmentation within a clinical PACS environment to enable point-of-care utilization under a prospective clinical trial scenario. Methods: A previously trained, publicly available AI model for segmentation of intra-prostatic findings on multiparametric Magnetic Resonance Imaging (mpMRI) was converted into a containerized environment compatible with MONAI Deploy Express. An inference server and dedicated clinical PACS workflow were established within our institution for evaluation of real-time use of the AI algorithm. PACS-based deployment was prospectively evaluated in two phases: first, a consecutive cohort of patients undergoing diagnostic imaging at our institution and second, a consecutive cohort of patients undergoing biopsy based on mpMRI findings. The AI pipeline was executed from within the PACS environment by the radiologist. AI findings were imported into clinical biopsy planning software for target definition. Metrics analyzing deployment success, timing, and detection performance were recorded and summarized. Results: In phase one, clinical PACS deployment was successfully executed in 57/58 cases and were obtained within one minute of activation (median 33 s [range 21–50 s]). Comparison with expert radiologist annotation demonstrated stable model performance compared to independent validation studies. In phase 2, 40/40 cases were successfully executed via PACS deployment and results were imported for biopsy targeting. Cancer detection rates for prostate cancer were 82.1% for ROI targets detected by both AI and radiologist, 47.8% in targets proposed by AI and accepted by radiologist, and 33.3% in targets identified by the radiologist alone. Conclusions: Integration of novel AI algorithms requiring multi-parametric input into clinical PACS environment is feasible and model outputs can be used for downstream clinical tasks.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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