[Intl_DxMedPhys] FW: Diagnostic Physics work and AI

[Jie Zhang]

I have been thinking about AI in diagnostic medical physics for a while,
and I’m glad to see more people are considering it. Clearly, there is a lot
of potential.

I strongly suggest developing a working group or subcommittee to brainstorm
this topic.

Jie

*Jie Zhang, PhD, DABR (D, N), FAAPM*

Professor of Radiology and Biomedical Engineering

Chief, Division of Diagnostic & Nuclear Medical Physics

Program Director, Diagnostic Imaging Physics Residency

Department of Radiology

University of Kentucky College of Medicine

UK HealthCare

800 Rose Street, Room HX-307

Lexington, KY 40536-0293

Phone: (859) 323-2954

Email: jnzh222 at uky.edu

On Mon, Mar 24, 2025 at 8:00 AM troyxzhou--- via Intl_dxmedphys_wd_osu_list
<intl_dxmedphys_wd_osu_list at lists.osu.edu> wrote:

> Here is the link to the full text of the EU AI act. https:
> //artificialintelligenceact. eu/ai-act-explorer/ it entered into force in
> August, 2024. Happy Monday Troy From: Alisa Walz-Flannigan <walzflanniga@
> wisc. edu> Sent: Sunday, March 23,
>
> Here is the link to the full text of the EU AI act.
>
>
>
> https://urldefense.com/v3/__https://artificialintelligenceact.eu/ai-act-explorer/__;!!KGKeukY!2L4_CNCwcV8F1iM-KUZR4auaqYFAJ3LxZwXcNKktgqc-e1Q3AuVFElK7vytBH9b46t8ASJ1y9EPmju7bIFll4xFlcKati73V25R2HQ$ 
> <https://urldefense.com/v3/__https://artificialintelligenceact.eu/ai-act-explorer/__;!!KGKeukY!0LRIRKDq-tX-QGZVZnSxZB--nv9VLvzumASXTug03vS_6zKQCCtOrSDBa8eyvvw9bkaV1oycYGrH_jXDJndCEpxtaImwU43PmVh5iVqG$>
>
>
>
> it entered into force in August, 2024.
>
>
>
> Happy Monday
>
>
>
> Troy
>
>
>
> *From:* Alisa Walz-Flannigan <walzflanniga at wisc.edu>
> *Sent:* Sunday, March 23, 2025 6:36 PM
> *To:* Nicole Ranger <nicoletranger at yahoo.com>; troyxzhou at icloud.com
> *Cc:* intl_dxmedphys_wd_osu_list at lists.osu.edu
> *Subject:* RE: [Intl_DxMedPhys] FW: Diagnostic Physics work and AI
>
>
>
> Mary Ellen
>
>
>
> I think it would be excellent to have more and better continuous quality
> improvement tools,
>
>
>
> Tools to monitor for transducer dropout, failed detector elements, or
> damage to readout electronics, would improve the quality control that could
> be done (instead of waiting 6 months or a year for a physicist to show up
> who may or may not catch the problem).
>
> Or tools that provide better feedback to technologists on positioning or
> manual modifications for acquisition or postprocessing, would be great too
> (anyone involved with EQUIP, or looking at centering in review of strange
> dose CT exams ?)
>
>
>
> I don’t know if I see this as replacing ‘bread and butter” activities, but
> they could be tools to help us be more useful in our work, and “findings”
> would need human qc and evaluation. And I don’t see us throwing away our
> dosimeters, but how we evaluate AEC should evolve as AEC operates
> differently, for example.
>
>
>
> Beyond the QC scope in healthcare, as Troy mentioned, there is great needs
> for knowledgeable and engaged people for oversight, governance, and
> validation.
>
> Troy is this what you refer to by what the EU is doing: Artificial
> Intelligence in healthcare - European Commission
> <https://urldefense.com/v3/__https://health.ec.europa.eu/ehealth-digital-health-and-care/artificial-intelligence-healthcare_en*aicareeu-deployment-of-ai-in-healthcare__;Iw!!KGKeukY!0LRIRKDq-tX-QGZVZnSxZB--nv9VLvzumASXTug03vS_6zKQCCtOrSDBa8eyvvw9bkaV1oycYGrH_jXDJndCEpxtaImwU43PmTSMuuiN$>
> ?
>
> Even if there are/were (2025 has been rough) resources at the FDA working
> on validation, the rate of creation of tools + variation in utilization+
> variation in inputs wrt to training :  means that practices themselves are
> going to need to establish process and governance for their own validation;
> at least until we have better paradigm for data standardization, standards
> for utilization and tools for validation . And there are folk more
> knowledgeable than me working on this, see ARCH AI
> <https://urldefense.com/v3/__https://www.acr.org/Data-Science-and-Informatics/AI-in-Your-Practice/ARCH-AI__;!!KGKeukY!0LRIRKDq-tX-QGZVZnSxZB--nv9VLvzumASXTug03vS_6zKQCCtOrSDBa8eyvvw9bkaV1oycYGrH_jXDJndCEpxtaImwU43PmXQMAu6z$>.
>
>
>
>
> But regardless, I hope in all our work we are focused on making things
> better and not hung-up on how this impacts our turf (such prognostication
> is fraught and limiting).
>
> I don’t think work for skilled experts is going to go away, but it should
> evolve, hopefully to be more effective.
>
>
>
> Instead, we could focus on lobbying vendors to provide “for processing” or
> raw data as standard outputs for all their customers and not just to
> Microsoft Healthcare AI or whoever the highest bidder is, or keeping locked
> up for their own private development. This paradigm limits what can be
> developed and can limit robustness in clinical AI tools as well, or make
> training and validation that much harder .
>
>
>
> And if we don’t want to see tools locked down in licensing subscriptions
> for 10 different companies, it would be fabulous to have vendor-neutral
> data , that could setup for proper competition and better product
> development, that better empower (whether that’s me or a lead tech, I’m not
> too worried. I see plenty of work around for me to do, and more than happy
> to share the load with whatever FTE we can find).
>
>
>
> Nicole,
>
>
>
> I don’t know who the arbiters or poster kids of Med Phys 3.0 are, but I’ve
> been involved evaluating or commissioning of CAD/AI since I started in
> medical physics.
>
> And I continue to work in my role on such evaluation, as do others I know
> who are much more deeply and knowledgeably involved than me (I work with
> several).
>
> And this topic is relevant to the imaging informatics education that I
> hope residents get (its on my radar as a program director).
>
>
>
> -Alisa
>
>
>
>
>
> Alisa Walz-Flannigan, PhD (DABR, FAAPM, MRSE)
>
> Program Director, Imaging Physics Residency: Department of Medical Physics
>
> Section Chief, Clinical Imaging Physics: UW Health-Radiology
>
> University of Wisconsin, Madison, WI
>
> walzflanniga at wisc.edu
>
> 608-265-9685
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
> *From:* Intl_dxmedphys_wd_osu_list <
> intl_dxmedphys_wd_osu_list-bounces+walzflanniga=wisc.edu at lists.osu.edu> *On
> Behalf Of *Nicole Ranger via Intl_dxmedphys_wd_osu_list
> *Sent:* Sunday, March 23, 2025 3:14 PM
> *To:* troyxzhou at icloud.com
> *Cc:* intl_dxmedphys_wd_osu_list at lists.osu.edu
> *Subject:* Re: [Intl_DxMedPhys] FW: Diagnostic Physics work and AI
>
>
>
> Troy, That is an interesting perspective. I’ve often wondered why
> proponents of Medical Physics 3. 0 did not propose more involvement by
> medical physicists in validating and monitoring Mammo CAD systems which
> were the precursors to more sophisticated
>
> Troy,
>
>
>
> That is an interesting perspective.  I’ve often wondered why proponents of
> Medical Physics 3.0 did not propose more involvement by medical physicists
> in validating and monitoring Mammo CAD systems which were the precursors to
> more sophisticated AI approaches in mammography imaging.  This would
> require a shift in training and necessitate developing consensus guidelines
> from the community.
>
>
>
> Regarding QC and AI, I see a role for more automation in acquisition,
> analysis, and trend monitoring but the goal is to avoid demonstrable
> artifacts in clinical images so I would want to focus that effort on QC
> images which ensuring that clinical AI algorithms are clever enough to be
> able to detect macro effects introduced by equipment failure such that they
> would auto-route those images to MPs for investigation and remediation.
>
>
>
> One thing is certain, the scope and practice of medical physics is
> constantly evolving.
>
>
>
> Nicole
>
>
>
>
>
> Sent from my iPhone
>
>
>
> On Mar 23, 2025, at 2:55 PM, troyxzhou--- via Intl_dxmedphys_wd_osu_list <
> intl_dxmedphys_wd_osu_list at lists.osu.edu> wrote:
>
> 
>
> Forwarded from the old listserv. Thank you for initiating this insightful
> discussion on the potential evolution in the role of diagnostic medical
> physicists with the advent of AI in medical imaging. I appreciate your
> perspective on the possibility
>
> *Forwarded from the old listserv.*
>
>
>
>
>
> Thank you for initiating this insightful discussion on the potential
> evolution in the role of diagnostic medical physicists with the advent of
> AI in medical imaging.
>
>
>
> I appreciate your perspective on the possibility of AI replacing
> traditional testing and compliance tasks. However, I see this shift
> differently. With the recent regulatory advancements in AI, such as the
> EU's comprehensive regulations, there's a clear emphasis on ensuring the
> safety, transparency, and HUMAN oversight of AI systems, especially in
> high-risk medical applications like diagnostic imaging.
>
>
>
> As AI becomes more integrated into medical devices, including imaging
> equipment, there arises a critical need for medical physicists to serve as
> vigilant watchdogs. Our role will evolve to include rigorous quality
> assurance of AI algorithms. Are AI-assisted collimation techniques
> accurately aligning with anatomical regions? Are AI-driven breast lesion
> detection systems effectively distinguishing true positives while
> minimizing the risk of false negatives?  These are just few essential
> questions that require human-driven oversight to maintain diagnostic
> accuracy and patient safety.
>
>
>
> While AI offers promising advancements in medical imaging, it's crucial to
> proceed thoughtfully, ensuring that rigorous standards and human expertise
> are upheld to mitigate risks and optimize patient outcomes.
>
>
>
> By the way it was written by ChatGPT and QA’d by me 😊
>
>
>
> Happy Sunday
>
>
>
> Troy
>
>
>
>
>
>
>
>
>
> *From:* Diagnostic Imaging Physics List <DXIMGMEDPHYS at HERMES.GWU.EDU> *On
> Behalf Of *Mary Ellen Jafari
> *Sent:* Sunday, March 23, 2025 3:09 PM
> *To:* DXIMGMEDPHYS at HERMES.GWU.EDU
> *Subject:* Diagnostic Physics work and AI
>
>
>
> Hello Listmembers, the recent discussion over the new CMS eCQM on
> Excessive Radiation Dose or Inadequate Image Quality for Diagnostic CT made
> me think there could be a shift coming in the role of diagnostic medical
> physicists
>
>
>
> The “bread and butter” of work done by many diagnostic medical physicists,
> and certainly consultants, is testing imaging equipment for compliance with
> regulatory requirement and accreditation standards.  Could thistesting be
> replaced by using a combination of AI applied to clinical images and remote
> access by the vendor to monitor imaging equipment?  Our vendors already can
> “remote in” to do diagnostics and monitor equipment performance.
>
>
>
> Vendors would like this because they could charge for the service and more
> deeply embed their customers with their products.  Employers would like it
> because they could potentially employ fewer physicists.  I’m not saying it
> would be either a good thing or a bad thing, change is always happening and
> is something we need to consider thoughtfully.
>
>
>
> Is this something other list members could see potentially happening?
>
>
>
> Mary Ellen
>
>
>
> Mary Ellen Jafari, MS, DABR (D,N), MRSE, MRSO, FACR, FAAPM, CIIP
>
> Chief Physicist and Regional Radiation Safety Officer
>
>
>
> *Kaiser Permanente*
>
> *Southern California Permanente Medical Group*
> Medical Imaging Technology and Informatics
> 199 S. Los Robles Ave., Pasadena CA 91101
>
> 626-430-1231 (office mobile)
>
> Maryellen.Jafari at kp.org
>
>
>
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