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The New Coffee Room

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  3. Today's medical mysterie.

Today's medical mysterie.

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  • George KG Offline
    George KG Offline
    George K
    wrote on last edited by
    #14

    I posted it because it's one of the most obvious ones that Ghali has tweeted.

    "Now look here, you Baltic gas passer... " - Mik, 6/14/08

    The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.

    1 Reply Last reply
    • KlausK Offline
      KlausK Offline
      Klaus
      wrote on last edited by Klaus
      #15

      OK, here's XRayGPT's take.

      Upon reviewing this chest X-ray, here are the key observations:

      1.	Lung Fields: Both lungs appear well-aerated with no focal consolidation, pleural effusion, or pneumothorax visible. The lung markings are symmetrical and extend to the periphery without any obvious abnormal opacities.
      2.	Cardiomediastinal Contour: The heart size is within normal limits, and there is no visible widening of the mediastinum. The aortic arch appears normal, with no signs of enlargement.
      3.	Bony Structures: The ribs, clavicles, and visible parts of the spine do not show any fractures or lytic lesions. The bones appear intact.
      4.	Diaphragm and Costophrenic Angles: The diaphragms are well-defined, with sharp costophrenic angles bilaterally. No subdiaphragmatic free air is observed, which would suggest pneumoperitoneum.
      

      Impression

      This is a normal chest X-ray with no evident pathology. If the patient is symptomatic, further investigation might be necessary, as subtle or early pathologies (e.g., small nodules or early interstitial lung disease) may not be readily visible on standard X-ray.

      If there’s any relevant history or clinical symptoms, feel free to share them, as they could guide additional diagnostic steps.*

      Then I asked it to look at the left side.

      Thank you for directing my attention. Upon closer examination of the left side of the chest X-ray, the following observation stands out:

      •	There is a relative increase in radiolucency (darkness) on the left side, particularly in the upper and mid-lung zones. This increased radiolucency suggests a potential left-sided pneumothorax or hyperinflation of the left lung.
      •	The lung markings appear to be diminished or absent in the outer portion of the left hemithorax, which further supports the suspicion of a pneumothorax.
      •	Additionally, the left hemidiaphragm and left lateral costophrenic angle are visible, without any obscuring opacities, which is consistent with a pneumothorax rather than effusion.
      

      Impression

      This X-ray is suggestive of a left-sided pneumothorax. The absence of lung markings in the periphery and the increased radiolucency on the left side are key indicators. However, confirming the size and clinical significance of this pneumothorax would be essential, as well as assessing the patient’s respiratory status to determine if urgent intervention is needed.

      If the patient has symptoms like sudden shortness of breath, chest pain, or hypoxia, they may require immediate treatment.*

      I wonder how well a specialized AI model would do in such cases. My guess is that it's way better.

      George KG 1 Reply Last reply
      • KlausK Klaus

        OK, here's XRayGPT's take.

        Upon reviewing this chest X-ray, here are the key observations:

        1.	Lung Fields: Both lungs appear well-aerated with no focal consolidation, pleural effusion, or pneumothorax visible. The lung markings are symmetrical and extend to the periphery without any obvious abnormal opacities.
        2.	Cardiomediastinal Contour: The heart size is within normal limits, and there is no visible widening of the mediastinum. The aortic arch appears normal, with no signs of enlargement.
        3.	Bony Structures: The ribs, clavicles, and visible parts of the spine do not show any fractures or lytic lesions. The bones appear intact.
        4.	Diaphragm and Costophrenic Angles: The diaphragms are well-defined, with sharp costophrenic angles bilaterally. No subdiaphragmatic free air is observed, which would suggest pneumoperitoneum.
        

        Impression

        This is a normal chest X-ray with no evident pathology. If the patient is symptomatic, further investigation might be necessary, as subtle or early pathologies (e.g., small nodules or early interstitial lung disease) may not be readily visible on standard X-ray.

        If there’s any relevant history or clinical symptoms, feel free to share them, as they could guide additional diagnostic steps.*

        Then I asked it to look at the left side.

        Thank you for directing my attention. Upon closer examination of the left side of the chest X-ray, the following observation stands out:

        •	There is a relative increase in radiolucency (darkness) on the left side, particularly in the upper and mid-lung zones. This increased radiolucency suggests a potential left-sided pneumothorax or hyperinflation of the left lung.
        •	The lung markings appear to be diminished or absent in the outer portion of the left hemithorax, which further supports the suspicion of a pneumothorax.
        •	Additionally, the left hemidiaphragm and left lateral costophrenic angle are visible, without any obscuring opacities, which is consistent with a pneumothorax rather than effusion.
        

        Impression

        This X-ray is suggestive of a left-sided pneumothorax. The absence of lung markings in the periphery and the increased radiolucency on the left side are key indicators. However, confirming the size and clinical significance of this pneumothorax would be essential, as well as assessing the patient’s respiratory status to determine if urgent intervention is needed.

        If the patient has symptoms like sudden shortness of breath, chest pain, or hypoxia, they may require immediate treatment.*

        I wonder how well a specialized AI model would do in such cases. My guess is that it's way better.

        George KG Offline
        George KG Offline
        George K
        wrote on last edited by
        #16

        @Klaus said in Today's medical mysterie.:

        I wonder how well a specialized AI model would do in such cases. My guess is that it's way better.

        I've read that AI-assisted radiology is remarkably good, particularly for breast imaging. @bachophile knows more about that than I do.

        "Now look here, you Baltic gas passer... " - Mik, 6/14/08

        The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.

        1 Reply Last reply
        👍
        • LuFins DadL Offline
          LuFins DadL Offline
          LuFins Dad
          wrote on last edited by
          #17

          And here I thought he problem was that he was see through. I mean, you can see past his skin and blood and everything. That’s nuts!

          The Brad

          CopperC 1 Reply Last reply
          • bachophileB Offline
            bachophileB Offline
            bachophile
            wrote on last edited by
            #18

            every one of our chest X-rays in my institution (must be hundreds a day) undergo AI reading in addition to being read by a radiologist. This has resulted in numerous call backs for CTs because of missed small lesions susp for lung cancer.
            Yes in breast imaging also pretty sharp but we don’t have that incorporated automatically like chest films.
            We also are beginning to use AI in pathology slide readings.

            JollyJ B 2 Replies Last reply
            • bachophileB bachophile

              every one of our chest X-rays in my institution (must be hundreds a day) undergo AI reading in addition to being read by a radiologist. This has resulted in numerous call backs for CTs because of missed small lesions susp for lung cancer.
              Yes in breast imaging also pretty sharp but we don’t have that incorporated automatically like chest films.
              We also are beginning to use AI in pathology slide readings.

              JollyJ Offline
              JollyJ Offline
              Jolly
              wrote on last edited by
              #19

              @bachophile said in Today's medical mysterie.:

              We also are beginning to use AI in pathology slide readings.

              Makes sense. Head scratchers do occur.

              “Cry havoc and let slip the DOGE of war!”

              Those who cheered as J-6 American prisoners were locked in solitary for 18 months without trial, now suddenly fight tooth and nail for foreign terrorists’ "due process". — Buck Sexton

              1 Reply Last reply
              • bachophileB Offline
                bachophileB Offline
                bachophile
                wrote on last edited by
                #20

                93a7c309-3949-49df-8daf-53786c433b3e.jpeg

                8283ea94-75dd-4f69-966a-5d63ac358e6a.jpeg

                Just an example of two random chest X-rays I pulled up just now. On the bottom of each is the abnormality score rated by an AI. One was completely normal. The other showed a bilateral pneumonia. Those would be seen easily anyway. The tricky ones are the small nodules which can be missed and may be early lung cancer. And it works. We have picked up otherwise occult cancers missed by the radiologist.

                1 Reply Last reply
                • George KG Offline
                  George KG Offline
                  George K
                  wrote on last edited by
                  #21

                  Nice mitral valve in pic #2.

                  "Now look here, you Baltic gas passer... " - Mik, 6/14/08

                  The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.

                  1 Reply Last reply
                  • bachophileB Offline
                    bachophileB Offline
                    bachophile
                    wrote on last edited by
                    #22

                    35c0f9c9-837d-4724-9cf0-35f83121cf2e.jpeg

                    06beb26c-e287-499e-91f1-280c6cbdd97b.jpeg

                    Found an example

                    George KG 1 Reply Last reply
                    • bachophileB bachophile

                      35c0f9c9-837d-4724-9cf0-35f83121cf2e.jpeg

                      06beb26c-e287-499e-91f1-280c6cbdd97b.jpeg

                      Found an example

                      George KG Offline
                      George KG Offline
                      George K
                      wrote on last edited by
                      #23

                      @bachophile said in Today's medical mysterie.:

                      Found an example

                      I'm no photon-shooter, but that one's pretty obvious.

                      "Now look here, you Baltic gas passer... " - Mik, 6/14/08

                      The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.

                      1 Reply Last reply
                      • bachophileB Offline
                        bachophileB Offline
                        bachophile
                        wrote on last edited by
                        #24

                        whatever

                        1 Reply Last reply
                        • bachophileB Offline
                          bachophileB Offline
                          bachophile
                          wrote on last edited by
                          #25

                          in the meantime, im not that far away from retirement, when i come into the the ER with my congestive heart failure or pneumonia, i presume the AI will be all there is.

                          B George KG 2 Replies Last reply
                          • LuFins DadL LuFins Dad

                            And here I thought he problem was that he was see through. I mean, you can see past his skin and blood and everything. That’s nuts!

                            CopperC Offline
                            CopperC Offline
                            Copper
                            wrote on last edited by
                            #26

                            @LuFins-Dad said in Today's medical mysterie.:

                            I thought he problem was that he was see through

                            Doctors get so serious about this stuff.

                            1 Reply Last reply
                            • bachophileB bachophile

                              every one of our chest X-rays in my institution (must be hundreds a day) undergo AI reading in addition to being read by a radiologist. This has resulted in numerous call backs for CTs because of missed small lesions susp for lung cancer.
                              Yes in breast imaging also pretty sharp but we don’t have that incorporated automatically like chest films.
                              We also are beginning to use AI in pathology slide readings.

                              B Offline
                              B Offline
                              blondie
                              wrote on last edited by
                              #27

                              @bachophile said in Today's medical mysterie.:

                              every one of our chest X-rays in my institution (must be hundreds a day) undergo AI reading in addition to being read by a radiologist. This has resulted in numerous call backs for CTs because of missed small lesions susp for lung cancer.
                              Yes in breast imaging also pretty sharp but we don’t have that incorporated automatically like chest films.
                              We also are beginning to use AI in pathology slide readings.

                              I wonder if our spanky new oh so supposedly awesome Cancer Centre uses this technology? Ever think of an interim pre-retirement move? I’m sure we’d really appreciate you here @bachophile 😊

                              George KG 1 Reply Last reply
                              • bachophileB bachophile

                                in the meantime, im not that far away from retirement, when i come into the the ER with my congestive heart failure or pneumonia, i presume the AI will be all there is.

                                B Offline
                                B Offline
                                blondie
                                wrote on last edited by
                                #28

                                @bachophile said in Today's medical mysterie.:

                                in the meantime, im not that far away from retirement, when i come into the the ER with my congestive heart failure or pneumonia, i presume the AI will be all there is.

                                Oh, negate my last comment. You don’t want to die here. Truly.

                                1 Reply Last reply
                                • B blondie

                                  @bachophile said in Today's medical mysterie.:

                                  every one of our chest X-rays in my institution (must be hundreds a day) undergo AI reading in addition to being read by a radiologist. This has resulted in numerous call backs for CTs because of missed small lesions susp for lung cancer.
                                  Yes in breast imaging also pretty sharp but we don’t have that incorporated automatically like chest films.
                                  We also are beginning to use AI in pathology slide readings.

                                  I wonder if our spanky new oh so supposedly awesome Cancer Centre uses this technology? Ever think of an interim pre-retirement move? I’m sure we’d really appreciate you here @bachophile 😊

                                  George KG Offline
                                  George KG Offline
                                  George K
                                  wrote on last edited by
                                  #29

                                  @blondie said in Today's medical mysterie.:

                                  I’m sure we’d really appreciate you here

                                  I believe he spent time in Calgary for fellowship.

                                  "Now look here, you Baltic gas passer... " - Mik, 6/14/08

                                  The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.

                                  bachophileB 1 Reply Last reply
                                  • B Offline
                                    B Offline
                                    blondie
                                    wrote on last edited by
                                    #30
                                    This post is deleted!
                                    B 1 Reply Last reply
                                    • B blondie

                                      This post is deleted!

                                      B Offline
                                      B Offline
                                      blondie
                                      wrote on last edited by
                                      #31
                                      This post is deleted!
                                      1 Reply Last reply
                                      • George KG Offline
                                        George KG Offline
                                        George K
                                        wrote on last edited by
                                        #32

                                        "Now look here, you Baltic gas passer... " - Mik, 6/14/08

                                        The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.

                                        1 Reply Last reply
                                        • George KG George K

                                          @blondie said in Today's medical mysterie.:

                                          I’m sure we’d really appreciate you here

                                          I believe he spent time in Calgary for fellowship.

                                          bachophileB Offline
                                          bachophileB Offline
                                          bachophile
                                          wrote on last edited by
                                          #33

                                          @George-K yea I did my surg onc fellowship in Calgary. Loved it.

                                          my institution invests a lot in innovation ( we r number 10 in worlds smart hospitals https://www.newsweek.com/rankings/worlds-best-smart-hospitals-2025. )

                                          So we have lots of things like AI stuff in various disciplines

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