A recent study in The Lancet Oncology showed that AI found 20 percent more cancers on mammogram screens than radiologists alone.
Published in The Lancet Oncology, the study analyzed the scans of 80,000 Swedish women with a moderate hereditary risk of breast cancer who had undergone a mammogram between April 2021 and July 2022. Half of these scans were read by AI and then a radiologist to double-check the findings. The second group of scans was read by two researchers without the help of AI. (Currently, the standard of care across Europe is to have two radiologists analyze a scan before diagnosing a patient with breast cancer.)
The study showed that the AI group detected cancer in 6 out of every 1,000 scans, while the radiologists detected cancer in 5 per 1,000 scans. In other words, AI found 20 percent more cancers than the highly-trained radiologists.
Scientists have been using MRI images (like the ones pictured here) to train artificial intelligence to detect cancers earlier and with more accuracy. Here, MIT's AI system, MIRAI, looks for patterns in a patient's mammograms to detect breast cancer earlier than ever before. news.mit.edu
But even though the AI was better able to pinpoint cancer on an image, it doesn’t mean radiologists will soon be out of a job. Dr. Laura Heacock, a breast radiologist at NYU, said in an interview with CNN that radiologists do much more than simply screening mammograms, and that even well-trained technology can make errors. “These tools work best when paired with highly-trained radiologists who make the final call on your mammogram. Think of it as a tool like a stethoscope for a cardiologist.”
AI is still an emerging technology, but more and more doctors are using them to detect different cancers. For example, researchers at MIT have developed a program called MIRAI, which looks at patterns in patient mammograms across a series of scans and uses an algorithm to model a patient's risk of developing breast cancer over time. The program was "trained" with more than 200,000 breast imaging scans from Massachusetts General Hospital and has been tested on over 100,000 women in different hospitals across the world. According to MIT, MIRAI "has been shown to be more accurate in predicting the risk for developing breast cancer in the short term (over a 3-year period) compared to traditional tools." It has also been able to detect breast cancer up to five years before a patient receives a diagnosis.
The challenges for cancer-detecting AI tools now is not just accuracy. AI tools are also being challenged to perform consistently well across different ages, races, and breast density profiles, particularly given the increased risks that different women face. For example, Black women are 42 percent more likely than white women to die from breast cancer, despite having nearly the same rates of breast cancer as white women. Recently, an FDA-approved AI device for screening breast cancer has come under fire for wrongly detecting cancer in Black patients significantly more often than white patients.
As AI technology improves, radiologists will be able to accurately scan a more diverse set of patients at a larger volume than ever before, potentially saving more lives than ever.
The Northern white rhinoceros Nola, the last one in the U.S. at that time in 2015, pictured here with author Jeanne Loring and Oliver Ryder (in truck), with a film crew and keepers in the San Diego Zoo's savanna. Nola sadly passed away that year.
Because of human activities that destroy habitats, creatures are now becoming extinct at a rate that is higher than any previously experienced. Some animals, like the giant panda and the California condor, have been pulled back from the brink of extinction by conserving their habitats, breeding in captivity, and educating the public about their plight.
But not the northern white rhino. This gentle giant is a vegetarian that can weigh up to 5,000 pounds. The rhino's weakness is its horn, which has become a valuable commodity because of the mistaken idea that it grants power and has medicinal value. Horns are not medicine; the horns are made of keratin, the same protein that is in fingernails. But as recently as 2017 more than 1,000 rhinos were slaughtered each year to harvest their horns.
All 6 rhino species are endangered. But the northern white has been devastated. Only two members of this species are alive now: Najin, age 32, and her daughter Fatu, 21, live in a protected park in Kenya. They are social animals and would prefer the company of other rhinos of their kind; but they can't know that they are the last two survivors of their entire species. No males exist anymore. The last male, Sudan, died in 2018 at age 45.
We are celebrating a huge milestone in the efforts to use stem cells to rescue the rhino.
I became involved in the rhino rescue project on a sunny day in February, 2008 at the San Diego Wild Animal Park in Escondido, about 30 miles north of my lab in La Jolla. My lab had relocated a couple of months earlier to Scripps Research Institute to start the Center for Regenerative Medicine for human stem cell research. To thank my staff for their hard work, I wanted to arrange a special treat. I contacted my friend Oliver Ryder, who is director of the Institute for Conservation Research at the zoo, to see if I could take them on a safari, a tour in a truck through the savanna habitat at the park.
This was the first of the "stem cell safaris" that the lab would enjoy over the next few years. On the safari we saw elands and cape buffalo, and fed giraffes and rhinos. And we talked about stem cells; in particular, we discussed a surprising technological breakthrough recently reported by the Japanese scientist Shinya Yamanaka that enabled conversion of ordinary skin cells into pluripotent stem cells.
Pluripotent stem cells can develop into virtually any cell type in the body. They exist when we are very young embryos; five days after we were just fertilized eggs, we became blastocysts, invisible tiny balls of a few hundred cells packed with the power to develop into an entire human being. Long before we are born, these cells of vast potential transform into highly specialized cells that generate our brains, our hearts, and everything else.
Human pluripotent stem cells from blastocysts can be cultured in the lab, and are called embryonic stem cells. But thanks to Dr. Yamanaka, anyone can have their skin cells reprogrammed into pluripotent stem cells, just like the ones we had when we were embryos. Dr. Yamanaka won the Nobel Prize for these cells, called "induced pluripotent stem cells" (iPSCs) several years later.
On our safari we realized that if we could make these reprogrammed stem cells from human skin cells, why couldn't we make them from animals' cells? How about endangered animals? Could such stem cells be made from animals whose skin cells had been being preserved since the 1970s in the San Diego Zoo's Frozen Zoo®? Our safari leader, Oliver Ryder, was the curator of the Frozen Zoo and knew what animal cells were stored in its giant liquid nitrogen tanks at −196°C (-320° F). The Frozen Zoo was established by Dr. Kurt Benirschke in 1975 in the hope that someday the collection would aid in rescue of animals that were on the brink of extinction. The frozen collection reached 10,000 cell lines this year.
We returned to the lab after the safari, and I asked my scientists if any of them would like to take on the challenge of making reprogrammed stem cells from endangered species. My new postdoctoral fellow, Inbar Friedrich Ben-Nun, raised her hand. Inbar had arrived only a few weeks earlier from Israel, and she was excited about doing something that had never been done before. Oliver picked the animals we would use. He chose his favorite animal, the critically endangered northern white rhinoceros, and the drill, which is an endangered primate related to the mandrill monkey,
When Inbar started work on reprogramming cells from the Frozen Zoo, there were 8 living northern rhinoceros around the world: Nola, Angalifu, Nesari, Nabire, Suni, Sudan, Najin, and Fatu. We chose to reprogram Fatu, the youngest of the remaining animals.
Through sheer determination and trial and error, Inbar got the reprogramming technique to work, and in 2011 we published the first report of iPSCs from endangered species in the scientific journal Nature Methods. The cover of the journal featured a drawing of an ark packed with animals that might someday be rescued through iPSC technology. By 2011, one of the 8 rhinos, Nesari, had died.
This kernel of hope for using iPSCs to rescue rhinos grew over the next 10 years. The zoo built the Rhino Rescue Center, and brought in 6 females of the closely related species, the southern white rhinoceros, from Africa. Southern white rhino populations are on the rise, and it appears that this species will survive, at least in captivity. The females are destined to be surrogate mothers for embryos made from northern white rhino cells, when eventually we hope to generate sperm and eggs from the reprogrammed stem cells, and fertilize the eggs in vitro, much the same as human IVF.
The author, Jeanne Loring, at the Rhino Rescue Center with one of the southern white rhino surrogates.
David Barker
As this project has progressed, we've been saddened by the loss of all but the last two remaining members of the species. Nola, the last northern white rhino in the U.S., who was at the San Diego Zoo, died in 2015.
But we are celebrating a huge milestone in the efforts to use stem cells to rescue the rhino. Just over a month ago, we reported that by reprogramming cells preserved in the Frozen Zoo, we produced iPSCs from stored cells of 9 northern white rhinos: Fatu, Najin, Nola, Suni, Nadi, Dinka, Nasima, Saut, and Angalifu. We also reprogrammed cells from two of the southern white females, Amani and Wallis.
We don't know when it will be possible to make a northern white rhino embryo; we have to figure out how to use methods already developed for laboratory mice to generate sperm and eggs from these cells. The male rhino Angalifu died in 2014, but ever since I saw beating heart cells derived from his very own cells in a culture dish, I've felt hope that he will one day have children who will seed a thriving new herd of northern white rhinos.
