AI-assisted diagnostic potential of CT in bone oncology and its impact on clinical decision-making for intensive care

• Published in: Journal of bone oncology 2024-10, Vol.48, p.100639, Article 100639
• Main Authors: Hua, Wei, Xu, Bing, Zhang, Xianwen, Chen, Tingting
• Format: Article
• Language: English
• Subjects: AI-assisted diagnostic; Bone cancer; Computed tomography; CT phenotypes; Disease severity; Oncology; Patient management; Post-treatment; Pre-treatment; VSI: MI Orthopedics
• ISSN: 2212-1374; 2212-1366; 2212-1374
• DOI: 10.1016/j.jbo.2024.100639

•AI-assisted diagnostic potential of CT for bone cancer and its impact on patient care.•Conducted retrospective analysis of 50 patients with bone cancer by SPECT and histopathology.•Timely CT examination is crucial in achieving accurate staging of bone tumors.•Specific consolidation patterns and extent of lesion spread were predictive of risks necessitating ICU intervention.•CT severity scores proved invaluable in forecasting the need for therapeutic interventions. This study evaluates the AI-assisted diagnostic potential of computed tomography (CT) for bone cancer and its influence on patient care during the pre- and post-treatment phases. It compares patient management approaches based on CT severity levels and identifies distinct CT phenotypes linked to disease severity. We retrospectively examined 50 patients diagnosed with bone cancer between December 2022 and June 2023. The CT scans were analyzed according to the Radiological Society of North America (RSNA) guidelines. This study was performed using the deep convolutional neutral network (DCNN) model to assist doctors in diagnosing bone tumors through CT scanning. Patients’ management approaches were compared based on the severity levels indicated by CT scans. Fifty patients participated in this study, with a median age of 67.2 years, ranging from 32 to 89 years. Of them, 38 % were female and 62 % were male. In 2022, 19 individuals (13 males and 6 females, ages 32 to 84) were assessed, with a mean age of 59.9 years. In 2023, 31 individuals, aged 54 to 89 with a mean age of 71.6 years, were assessed; among them were 18 men and 13 women. SPECT scans revealed the following key diagnostic features: 85.9 % of patients exhibited bone lesions with ground-glass opacities, 88 % had multipolar involvement, 92.8 % had bilateral involvement, and 92.8 % showed peripheral involvement. The severity scores based on CT scans were significantly higher in patients requiring intensive care, with scores above 14 being more common in this group. Distinct CT findings during the AI-assisted diagnosis and treatment of bone cancer provided prompt and sensitive examination capabilities. Notably, two CT phenotypes emerged, associated with large consolidation patterns and high severity scores, offering crucial insights into disease severity and aiding in clinical decision-making for intensive care requirements. The study underscores the importance of CT in the effective monitoring and management of bone cancer pre- and post-trea