Novel AI-Based Quantification of Breast Arterial Calcification to Predict Cardiovascular Risk

Women are underdiagnosed and undertreated for cardiovascular disease. Automatic quantification of breast arterial calcification on screening mammography can identify women at risk for cardiovascular disease and enable earlier treatment and management of disease. In this retrospective study of 116,135 women from two healthcare systems, a transformer-based neural network quantified BAC severity (no BAC, mild, moderate, and severe) on screening mammograms. Outcomes included major adverse cardiovascular events (MACE) and all-cause mortality. BAC severity was independently associated with MACE after adjusting for cardiovascular risk factors, with increasing hazard ratios from mild (HR 1.18-1.22), moderate (HR 1.38-1.47), to severe BAC (HR 2.03-2.22) across datasets (all p<0.001). This association remained significant across all age groups, with even mild BAC indicating increased risk in women under 50. BAC remained an independent predictor when analyzed alongside ASCVD risk scores, showing significant associations with myocardial infarction, stroke, heart failure, and mortality (all p<0.005). Automated BAC quantification enables opportunistic cardiovascular risk assessment during routine mammography without additional radiation or cost. This approach provides value beyond traditional risk factors, particularly in younger women, offering potential for early CVD risk stratification in the millions of women undergoing annual mammography.

Subgroup Performance of a Commercial Digital Breast Tomosynthesis Model for Breast Cancer Detection

While research has established the potential of AI models for mammography to improve breast cancer screening outcomes, there have not been any detailed subgroup evaluations performed to assess the strengths and weaknesses of commercial models for digital breast tomosynthesis (DBT) imaging. This study presents a granular evaluation of the Lunit INSIGHT DBT model on a large retrospective cohort of 163,449 screening mammography exams from the Emory Breast Imaging Dataset (EMBED). Model performance was evaluated in a binary context with various negative exam types (162,081 exams) compared against screen detected cancers (1,368 exams) as the positive class. The analysis was stratified across demographic, imaging, and pathologic subgroups to identify potential disparities. The model achieved an overall AUC of 0.91 (95% CI: 0.90-0.92) with a precision of 0.08 (95% CI: 0.08-0.08), and a recall of 0.73 (95% CI: 0.71-0.76). Performance was found to be robust across demographics, but cases with non-invasive cancers (AUC: 0.85, 95% CI: 0.83-0.87), calcifications (AUC: 0.80, 95% CI: 0.78-0.82), and dense breast tissue (AUC: 0.90, 95% CI: 0.88-0.91) were associated with significantly lower performance compared to other groups. These results highlight the need for detailed evaluation of model characteristics and vigilance in considering adoption of new tools for clinical deployment.

Identifying Multiple Personalities in Large Language Models with External Evaluation

As Large Language Models (LLMs) are integrated with human daily applications rapidly, many societal and ethical concerns are raised regarding the behavior of LLMs. One of the ways to comprehend LLMs' behavior is to analyze their personalities. Many recent studies quantify LLMs' personalities using self-assessment tests that are created for humans. Yet many critiques question the applicability and reliability of these self-assessment tests when applied to LLMs. In this paper, we investigate LLM personalities using an alternate personality measurement method, which we refer to as the external evaluation method, where instead of prompting LLMs with multiple-choice questions in the Likert scale, we evaluate LLMs' personalities by analyzing their responses toward open-ended situational questions using an external machine learning model. We first fine-tuned a Llama2-7B model as the MBTI personality predictor that outperforms the state-of-the-art models as the tool to analyze LLMs' responses. Then, we prompt the LLMs with situational questions and ask them to generate Twitter posts and comments, respectively, in order to assess their personalities when playing two different roles. Using the external personality evaluation method, we identify that the obtained personality types for LLMs are significantly different when generating posts versus comments, whereas humans show a consistent personality profile in these two different situations. This shows that LLMs can exhibit different personalities based on different scenarios, thus highlighting a fundamental difference between personality in LLMs and humans. With our work, we call for a re-evaluation of personality definition and measurement in LLMs.

Web Neural Network with Complete DiGraphs

This paper introduces a new neural network model that aims to mimic the biological brain more closely by structuring the network as a complete directed graph that processes continuous data for each timestep. Current neural networks have structures that vaguely mimic the brain structure, such as neurons, convolutions, and recurrence. The model proposed in this paper adds additional structural properties by introducing cycles into the neuron connections and removing the sequential nature commonly seen in other network layers. Furthermore, the model has continuous input and output, inspired by spiking neural networks, which allows the network to learn a process of classification, rather than simply returning the final result.

Synthetically Enhanced: Unveiling Synthetic Data's Potential in Medical Imaging Research

Chest X-rays (CXR) are the most common medical imaging study and are used to diagnose multiple medical conditions. This study examines the impact of synthetic data supplementation, using diffusion models, on the performance of deep learning (DL) classifiers for CXR analysis. We employed three datasets: CheXpert, MIMIC-CXR, and Emory Chest X-ray, training conditional denoising diffusion probabilistic models (DDPMs) to generate synthetic frontal radiographs. Our approach ensured that synthetic images mirrored the demographic and pathological traits of the original data. Evaluating the classifiers' performance on internal and external datasets revealed that synthetic data supplementation enhances model accuracy, particularly in detecting less prevalent pathologies. Furthermore, models trained on synthetic data alone approached the performance of those trained on real data. This suggests that synthetic data can potentially compensate for real data shortages in training robust DL models. However, despite promising outcomes, the superiority of real data persists.