Mohammed Fahim Mohammed

Background Emergency/trauma radiology artificial intelligence (AI) is maturing along all stages of technology readiness, with research and development (R&D) ranging from data curation and algorithm development to post-market monitoring and retraining. Purpose To develop an expert consensus document on best research practices and methodological priorities for emergency/trauma radiology AI. Methods A Delphi consensus exercise was conducted by the ASER AI/ML expert panel between 2022-2024. In phase 1, a steering committee (7 panelists) established key themes- curation; validity; human factors; workflow; barriers; future avenues; and ethics- and generated an edited, collated long-list of statements. In phase 2, two Delphi rounds using anonymous RAND/UCLA Likert grading were conducted with web-based data capture (round 1) and a bespoke excel document with literature hyperlinks (round 2). Between rounds, editing and knowledge synthesis helped maximize consensus. Statements reaching ≥80% agreement were included in the final document. Results Delphi rounds 1 and 2 consisted of 81 and 78 items, respectively.18/21 expert panelists (86%) responded to round 1, and 15 to round 2 (17% drop-out). Consensus was reached for 65 statements. Observations were summarized and contextualized. Statements with unanimous consensus centered around transparent methodologic reporting; testing for generalizability and robustness with external data; and benchmarking performance with appropriate metrics and baselines. A manuscript draft was circulated to panelists for editing and final approval. Conclusions The document is meant as a framework to foster best-practices and further discussion among researchers working on various aspects of emergency and trauma radiology AI. Graphical abstract

Imaging of pregnant patients who sustained trauma often causes fear and confusion among patients, their families, and health care professionals regarding the potential for detrimental effects from radiation exposure to the fetus. Unnecessary delays or potentially harmful avoidance of the justified imaging studies may result from this understandable anxiety. This guideline was developed by the Canadian Emergency, Trauma and Acute Care Radiology Society (CETARS) and the Canadian Association of Radiologists (CAR) Working Group on Imaging the Pregnant Trauma Patient, informed by a literature review as well as multidisciplinary expert panel opinions and discussions. The working group included academic subspecialty radiologists, a trauma team leader, an emergency physician, and an obstetriciangynaecologist/maternal fetal medicine specialist, who were brought together to provide updated, evidence-based recommendations for the imaging of pregnant trauma patients, including patient safety aspects (eg, radiation and contrast concerns) and counselling, initial imaging in maternal trauma, specific considerations for the use of fluoroscopy, angiography, and magnetic resonance imaging. The guideline strives to achieve clarity and prevent added anxiety in an already stressful situation of injury to a pregnant patient, who should not be imaged differently.

Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide with a poor prognosis. Treatment with immune checkpoint inhibitors (ICIs) has improved overall survival in patients with HCC. However, not all patients benefit from the treatment. In this study, 59 patients with HCC were enrolled from two medical centers in Saudi Arabia, with 34% using antibiotics concurrently with their Nivolumab (anti-PD1 blockade). The impact of antibiotic use on the clinical outcomes of patients with HCC undergoing treatment with anti-PD1 blockade was examined. The patients’ overall survival (OS) was 5 months (95% CI: 3.2, 6.7) compared to 10 months (95% CI: 0, 22.2) (p = 0.08). Notably, patients with Child–Pugh A cirrhosis receiving anti-PD1 blockade treatment without concurrent antibiotic use showed a significantly longer median OS reaching 22 months (95% CI: 6.5, 37.4) compared to those who were given antibiotics with a median OS of 6 months (95% CI: 2.7, 9.2) (p = 0.02). This difference in overall survival was particularly found in Child–Pugh class A patients receiving anti-PD1 blockade. These findings suggest that antibiotic use may negatively affect survival outcomes in HCC patients undergoing anti-PD1 blockade, potentially due to antibiotic-induced alterations to the gut microbiome impacting the anti-PD1 blockade response. This study suggests the need for careful consideration when prescribing antibiotics to patients with HCC receiving anti-PD1 blockade.

This article reviews the basics of dual-energy CT to highlight its clinical applications in evaluating nontraumatic acute abdominal emergencies of the gallbladder, biliary system, pancreas, bowel, kidneys, and vasculature. Evaluation of the nontraumatic acute abdomen with multidetector CT has long been accepted and validated as the reference standard in the acute setting. Dual-energy CT has emerged as a promising tool, with multiple clinical applications in abdominal imaging already demonstrated. With its ability to allow characterization of materials on the basis of their differential attenuation when imaged at two different energy levels, dual-energy CT can help identify the composition of internal body constituents. Therefore, it is possible to selectively identify iodine to assess the enhancement pattern of an organ, including the identification of hyperenhancement in cases of inflammatory processes, or ischemic changes secondary to vascular compromise. Quantification of iodine uptake with contrast material–enhanced dual-energy CT is also possible, and this quantification has been suggested to be useful in differentiating inflammatory from neoplastic conditions. Dual-energy CT can help determine the composition of galls...

The original version of this article unfortunately contained few mistakes. Under the subheading “Data extraction and review process”, in line 12 the word “prospective” is incorrectly given by the auth