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Validating Artificial Intelligence Guidance for Ultrasound Acquisition and Remote Interpretation

September 27, 2026medrxiv logopreprint

Authors

Maldonado, T.,Muluk, S.,Rali, P.,Soni, N.,Nathanson, R.,Kuttab, H.,VandeHei, M.,Michels, C.,Swietlik, J.,Speranza, G.,Schaffer, O.,Collaborating Investigators Group,,Al Noor, F.,Mischkewitz, S.,Kainz, B.,Blaivas, M.,Jacobowitz, G.

Affiliations (1)

  • NYU Langone Health

Abstract

Diagnostic pathways for deep vein thrombosis (DVT) requiring ultrasound are limited by availability and prolonged time-to-imaging. This multicenter, double-blinded, prospective, nonrandomized study evaluated the performance of an AI-guidance system (ThinkSono Guidance, ThinkSono, GmbH) enabling non-ultrasound-trained operators to acquire proximal lower extremity compression ultrasounds for remote clinician interpretation. Patients underwent AI-guided ultrasound(s) and imaging specialist-performed ultrasound(s). Primary and secondary endpoints were image quality, sensitivity/specificity for proximal DVT, and prioritization specificity (effectiveness in identifying patients requiring further ultrasound after AI-guided scan). Of 634 recruited subjects, 594 subjects (700 scans) with 67 DVTs were analyzed. 86.83% of AI-guided scans achieved diagnostic image quality; triage sensitivity was 92.86%, triage specificity 39.12%, prioritization specificity 97.96%. Imaging specialist-performed ultrasounds could be avoided in 35.32% of patients. Median AI-guided scan and review time was 7.57 minutes. These findings suggest AI-guided, clinician-reviewed ultrasound may be a scalable triage strategy to expand DVT evaluation access, particularly in resource-constrained and after-hours settings.

Topics

radiology and imaging

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