Abstract：
BACKGROUND: Neuroendovascular procedures require careful and simultaneous attention to multiple devices on multiple screens. Overlooking unintended device movements can result in complications. Advancements in artificial intelligence (AI) have enabled real-time notifications of device movements during procedures. We report our preliminary experience with real-time AI-assisted cerebral aneurysm coiling in humans.
METHODS: A real-time AI-assistance software (Neuro-Vascular Assist, iMed technologies, Tokyo, Japan) was used during coil embolization procedures in nine patients with an unruptured aneurysm. The AI system provided real-time notifications for \'coil marker approaching\', \'guidewire movement\', and \'device entry\' on biplane fluoroscopic images. The efficacy, accuracy, and safety of the notifications were evaluated using video recordings.
RESULTS: The AI system functioned properly in all cases. The mean number of notifications for coil marker approaching, guidewire movement, and device entry per procedure was 20.0, 3.0, and 18.3, respectively. The overall precision and recall were 92.7% and 97.2%, respectively. Five of 26 true positive guidewire notifications (19%) resulted in adjustment of the guidewire back toward its original position, indicating the potential effectiveness of the AI system. No adverse events occurred.
CONCLUSIONS: The software was sufficiently accurate and safe in this preliminary study, suggesting its potential usefulness. To the best of our knowledge, this is the first reported use of a real-time AI system for assisting cerebral aneurysm coiling in humans. Large scale studies are warranted to validate its effectiveness. Real-time AI assistance has significant potential for future neuroendovascular therapy.
METHODS: A real-time AI-assistance software (Neuro-Vascular Assist, iMed technologies, Tokyo, Japan) was used during coil embolization procedures in nine patients with an unruptured aneurysm. The AI system provided real-time notifications for \'coil marker approaching\', \'guidewire movement\', and \'device entry\' on biplane fluoroscopic images. The efficacy, accuracy, and safety of the notifications were evaluated using video recordings.
RESULTS: The AI system functioned properly in all cases. The mean number of notifications for coil marker approaching, guidewire movement, and device entry per procedure was 20.0, 3.0, and 18.3, respectively. The overall precision and recall were 92.7% and 97.2%, respectively. Five of 26 true positive guidewire notifications (19%) resulted in adjustment of the guidewire back toward its original position, indicating the potential effectiveness of the AI system. No adverse events occurred.
CONCLUSIONS: The software was sufficiently accurate and safe in this preliminary study, suggesting its potential usefulness. To the best of our knowledge, this is the first reported use of a real-time AI system for assisting cerebral aneurysm coiling in humans. Large scale studies are warranted to validate its effectiveness. Real-time AI assistance has significant potential for future neuroendovascular therapy.
摘要：
背景：神经血管内手术需要仔细且同时注意多个屏幕上的多个设备。忽略意外的设备移动会导致并发症。人工智能(AI)的进步使得能够在手术过程中实时通知设备移动。我们报告了我们在人类中进行实时AI辅助脑动脉瘤盘绕的初步经验。
方法：一个实时AI辅助软件（神经血管辅助，iMed技术，东京,日本）在9例未破裂动脉瘤患者的线圈栓塞手术中使用。人工智能系统提供了“线圈标记接近”的实时通知，\'导丝运动\',和双平面荧光图像上的“设备条目”。功效,准确度,并使用录像记录评估通知的安全性.
结果：AI系统在所有情况下都能正常运行。线圈标记接近的平均通知次数，导丝运动,每个程序的装置输入分别为20.0,3.0和18.3.总体准确率和召回率分别为92.7%和97.2%,分别。26个真阳性导丝通知中有5个（19％）导致导丝向其原始位置调整。表明人工智能系统的潜在有效性。无不良事件发生。
结论：在这项初步研究中，该软件足够准确和安全，表明其潜在的有用性。据我们所知,这是首次报道使用实时AI系统来辅助人类的脑动脉瘤盘绕。有必要进行大规模研究以验证其有效性。实时AI辅助在未来的神经血管内治疗中具有巨大的潜力。
方法：一个实时AI辅助软件（神经血管辅助，iMed技术，东京,日本）在9例未破裂动脉瘤患者的线圈栓塞手术中使用。人工智能系统提供了“线圈标记接近”的实时通知，\'导丝运动\',和双平面荧光图像上的“设备条目”。功效,准确度,并使用录像记录评估通知的安全性.
结果：AI系统在所有情况下都能正常运行。线圈标记接近的平均通知次数，导丝运动,每个程序的装置输入分别为20.0,3.0和18.3.总体准确率和召回率分别为92.7%和97.2%,分别。26个真阳性导丝通知中有5个（19％）导致导丝向其原始位置调整。表明人工智能系统的潜在有效性。无不良事件发生。
结论：在这项初步研究中，该软件足够准确和安全，表明其潜在的有用性。据我们所知,这是首次报道使用实时AI系统来辅助人类的脑动脉瘤盘绕。有必要进行大规模研究以验证其有效性。实时AI辅助在未来的神经血管内治疗中具有巨大的潜力。
