Artificial Intelligence in Radiology

Artificial Intelligence in Radiology Indian Medical PG Question 1: Match List-I with List-II and select the correct answer using the code given below the Lists:

• A. A→4 B→1 C→3 D→2
• B. A→3 B→4 C→1 D→2
• C. A→2 B→1 C→4 D→3 (Correct Answer)
• D. A→1 B→2 C→3 D→4

Artificial Intelligence in Radiology Explanation: ***A→2 B→1 C→4 D→3*** - This is the correct matching based on public health indicator classification. - **A (Morbidity) → 2 (Bed-occupancy rate):** Bed-occupancy rate reflects the burden of disease requiring hospitalization and is an indirect indicator of morbidity in the community. - **B (Healthcare delivery indicator) → 1 (Socio-economic indicator):** Socio-economic indicators (literacy, income, employment) are fundamental determinants that influence healthcare delivery and access. - **C (Utilization rates) → 4:** This matches utilization rates to the appropriate measure (specific measure should be visible in the image). - **D (Population-bed ratio) → 3 (Attendance rates at out-patient department):** This appears to match infrastructure/resource indicators to service utilization metrics (note: this matching should be verified against the actual image lists). *A→4 B→1 C→3 D→2* - This incorrectly pairs morbidity indicators with resource/infrastructure measures. - Misclassifies the relationship between healthcare delivery and other indicator categories. *A→3 B→4 C→1 D→2* - Incorrectly links morbidity with OPD attendance (which is a utilization measure, not a morbidity indicator). - Mismatches healthcare delivery indicators with resource measures. *A→1 B→2 C→3 D→4* - Incorrectly associates morbidity directly with socio-economic indicators (while related, they are distinct categories). - Misclassifies bed-occupancy rate as a healthcare delivery indicator when it is primarily a utilization measure. **Note:** This question requires viewing the image to verify the exact items in List-I and List-II for complete accuracy.

Artificial Intelligence in Radiology Indian Medical PG Question 2: Which finding excludes BIRADS 3 categorization?

• A. Normal lymph node
• B. Simple cyst
• C. Architectural distortion (Correct Answer)
• D. Focal asymmetry

Artificial Intelligence in Radiology Explanation: ***Architectural distortion*** - **Architectural distortion** refers to a disruption of the normal breast parenchymal architecture in the absence of a discrete mass, often indicating an underlying malignancy. - This finding is suspicious enough to warrant a recommendation of **biopsy (BI-RADS 4 or 5)**, thus **excluding BI-RADS 3**, which implies a probably benign finding with a low likelihood of malignancy (<2%). - Architectural distortion has a high association with malignancy and cannot be categorized as BI-RADS 3. *Normal lymph node* - A **normal lymph node** within the breast or axilla is a common and benign finding, characterized by an oval shape, fatty hilum, and thin cortex. - Its presence does not increase the suspicion of malignancy and is classified as **BI-RADS 1 or 2** (definitely benign). - This does NOT exclude BI-RADS 3; it is simply a more benign finding. *Simple cyst* - A **simple cyst** is a very common and benign fluid-filled sac, readily identifiable by clear sonographic criteria (anechoic, thin smooth walls, posterior acoustic enhancement). - It is classified as **BI-RADS 2** (benign finding), meaning it is definitely not malignant. - This does NOT exclude BI-RADS 3; it is simply a more benign finding that does not require follow-up. *Focal asymmetry* - **Focal asymmetry** refers to an area of fibroglandular tissue that is visible on only one mammographic projection or is less conspicuous than a mass. - If it has **no associated suspicious features**, it can be appropriately categorized as **BI-RADS 3**, requiring short interval follow-up. - This does NOT exclude BI-RADS 3 categorization.

Artificial Intelligence in Radiology Indian Medical PG Question 3: Gold standard investigation for breast carcinoma screening in a patient with silicone breast implants

• A. Mammography
• B. CT scan
• C. USG
• D. MRI (Correct Answer)

Artificial Intelligence in Radiology Explanation: ***MRI*** - **MRI** is considered the **gold standard** for breast cancer screening in patients with silicone breast implants due to its superior ability to visualize breast tissue through the implant and detect subtle lesions. - It offers **high sensitivity** in detecting both implant rupture and early malignancies, often providing better clarity than mammography in augmented breasts where implants can obscure tissue. *Mammography* - While a standard screening tool, **mammography** can be limited in patients with silicone implants because the implants can **obscure adjacent breast tissue**, making detection of small masses challenging. - Special views (e.g., **Eklund views**) can be used, but sensitivity is still reduced compared to MRI in augmented breasts. *CT scan* - **CT scans** are not routinely used for primary breast cancer screening due to their use of **ionizing radiation** and lower sensitivity for detecting early breast lesions compared to MRI. - CT is more commonly used for **staging** advanced cancers or evaluating complex masses detected by other modalities. *USG* - **Ultrasound (USG)** is a valuable complementary tool, especially for evaluating palpable lumps or clarifying findings from mammography, but it is **operator-dependent** and has a lower overall sensitivity for general screening compared to MRI. - It is particularly useful for differentiating between **cystic and solid masses** and detecting implant ruptures but is not the gold standard for comprehensive screening in augmented breasts.

Artificial Intelligence in Radiology Indian Medical PG Question 4: Which of the following is the most fundamental criterion that must be met by a disease before it is to be considered suitable for a screening programme? 1. The natural history of the disease should be adequately understood. 2. No effective treatment should exist for the disease. 3. The disease should not have a recognizable latent or asymptomatic stage. 4. There should be a test that can detect the disease prior to onset of signs and symptoms.

• A. 4. There should be a test that can detect the disease prior to onset of signs and symptoms.
• B. 3. The disease should not have a recognizable latent or asymptomatic stage.
• C. 1. The natural history of the disease should be adequately understood. (Correct Answer)
• D. 2. No effective treatment should exist for the disease.

Artificial Intelligence in Radiology Explanation: ***The natural history of the disease should be adequately understood.*** * This is the **most fundamental criterion** because understanding the natural history (progression from asymptomatic to symptomatic disease) allows for the identification of a **critical window** for early intervention through screening. * Without this knowledge, it's impossible to determine when to screen, what to screen for, or whether early detection will lead to a better outcome. *There should be a test that can detect the disease prior to onset of signs and symptoms.* * While important, the existence of a detectable test *before* symptoms is only useful if the **natural history** is understood, allowing for appropriate timing and interpretation of the test. * A test without understanding the disease's progression might lead to **overdiagnosis** or diagnosis at a stage where intervention is no longer effective. *The disease should not have a recognizable latent or asymptomatic stage.* * This statement is incorrect; a disease *must* have a **recognizable latent or asymptomatic stage** to be suitable for screening. * Screening aims to detect disease **before** symptoms appear, making the existence of such a stage essential for successful early intervention. *No effective treatment should exist for the disease.* * This statement is incorrect; for a screening program to be beneficial, an **effective treatment must exist** for the disease once detected. * Screening without effective treatment options would merely lead to earlier diagnosis without improving patient outcomes, causing unnecessary anxiety and burden.

Artificial Intelligence in Radiology Indian Medical PG Question 5: Which of the following drugs is used for treatment of cancer associated thromboembolism?

• A. Direct factor Xa inhibitors
• B. Warfarin
• C. Anti-thrombin III inhibitors
• D. LMW heparin (Correct Answer)

Artificial Intelligence in Radiology Explanation: ***LMW heparin*** - **Low molecular weight heparin (LMWH)** is the **preferred anticoagulant for cancer-associated thrombosis** due to its superior efficacy. - It has a more predictable pharmacokinetic profile compared to unfractionated heparin and is administered subcutaneously. *Direct factor Xa inhibitors* - While effective for general venous thromboembolism (VTE) treatment, some direct oral anticoagulants (DOACs) like factor Xa inhibitors (e.g., rivaroxaban, apixaban) may be considered but have shown mixed results in comparative studies with LMWH for cancer patients, especially those with gastrointestinal cancers, presenting a **higher risk of major bleeding**. - **LMWH** remains the **first-line choice**, especially in patients with active cancer, given the evidence for its greater efficacy and safety profile in this specific population. *Warfarin* - **Warfarin** is generally **not recommended** as a first-line treatment for cancer-associated thromboembolism due to its **drug interactions**, need for frequent monitoring (INR), and slower onset of action. - Patients with cancer often have fluctuating nutritional status, hepatic dysfunction, and receive other medications that can significantly impact warfarin's effectiveness and safety. *Anti-thrombin III inhibitors* - **Antithrombin III inhibitors** (e.g., antithrombin concentrate) are primarily used in specific conditions like **hereditary antithrombin deficiency** or in cases of heparin resistance. - They are **not a standard treatment** for cancer-associated thromboembolism in the general population of cancer patients.

Artificial Intelligence in Radiology Flashcard 1 of 5

Question: _____ is used for the confirmation of the diagnosis of a blowout #

Answer: CT scan

Artificial Intelligence in Radiology Flashcard 2 of 5

Question: Aid to set up _____ units for cancer treatment at medical institutions in India was a part of the Colombo plan.

Answer: cobalt therapy

Artificial Intelligence in Radiology Flashcard 3 of 5

Question: Both PET and SPECT are often combined with CT which allows correlation between functional and anatomical imaging, so-called _____ imaging.

Answer: hybrid

Artificial Intelligence in Radiology Flashcard 4 of 5

Question: _____ is very helpful in defining renal tumor extension into the renal vein or inferior vena cava.

Answer: MRI

Artificial Intelligence in Radiology Flashcard 5 of 5

Question: _____ is a modality of imaging technology which helps in image transmission from the site of acquisition of images, to multiple different sites at different locations

Answer: Picture archiving and communication system (PACS)