Jacob L Jaremko

University of Alberta | UAlberta · Department of Radiology and Diagnostic Imaging

Objectives To summarize the current evidence on the performance of artificial intelligence (AI) algorithms for the temporomandibular joint (TMJ) disc assessment and TMJ internal derangement diagnosis in magnetic resonance imaging (MRI) images. Methods Studies were gathered by searching five electronic databases and partial grey literature up to Ma...

Background Sport-related ankle sprains (SASs) are prevalent in adolescents (ages 10-19), increasing the risk of developing posttraumatic osteoarthritis (PTOA). Although early ankle osteoarthritis (OA) is not well defined, OA eventually includes alterations in bone mineral density (BMD), structural changes, and soft tissue pathology. This study exam...

Background/Objective: A-lines and B-lines are key ultrasound markers that differentiate normal from abnormal lung conditions. A-lines are horizontal lines usually seen in normal aerated lungs, while B-lines are linear vertical artifacts associated with lung abnormalities such as pulmonary edema, infection, and COVID-19, where a higher number of B-l...

Foundation models like the segment anything model require high-quality manual prompts for medical image segmentation, which is time-consuming and requires expertise. SAM and its variants often fail to segment structures in ultrasound (US) images due to domain shift. We propose Sam2Rad, a prompt learning approach to adapt SAM and its variants for US...

This work aims to evaluate the performance of a new artificial intelligence tool (ExoAI) to compute the left ventricular ejection fraction (LVEF) in echocardiograms of the apical and parasternal long axis (PLAX) views. We retrospectively gathered echocardiograms from 441 individual patients (70% male, age: 67.3 ± 15.3, weight: 87.7 ± 25.4, BMI: 29....

Background A range of sacroiliac joint (SIJ) MRI protocols are used in clinical practice but not all were specifically designed for diagnostic ascertainment. This can be confusing and no standard diagnostic SIJ MRI protocol is currently accepted worldwide. Objective To develop a standardised MRI image acquisition protocol (IAP) for diagnostic asce...

Objective The goal was to develop and validate classification criteria for axial juvenile spondyloarthritis (SpA; AxJSpA). Methods This international initiative consisted of four phases: (1) item generation, (2) item reduction, (3) criteria development, and (4) validation of the AxJSpA criteria by an independent team of experts in an international...

Sacroiliitis is commonly seen in patients with axial spondyloarthritis, in whom timely diagnosis and treatment are crucial to prevent irreversible structural damage. Imaging has a prominent place in the diagnostic process and several new imaging techniques have been examined for this purpose. We present a summary of updated evidence-based practice...

Objectives The purpose of this study is to assess the equivalency of MRI-based synthetic CT (sCT) to conventional CT for sacroiliac joint bony morphology assessment in children. Methods A prospective study was performed. Children who had (PET-)CT-scan underwent additional MRI. sCT-CT image quality was analyzed by two readers subjectively overall,...

Wrist fractures are currently examined using radiograms, resulting in undesirable radiation exposure in children. Ultrasound is fast, safe, and highly sensitive to fractures, making it ideally suited for wrist examination in emergency departments (ED). However, ultrasound images are difficult to interpret, resulting in high variability in assessmen...

Supracondylar fractures are common injuries in children. Diagnosis typically relies on radiography, which can involve long wait times in the ED, emits ionizing radiation, and can miss non-displaced fractures. Ultrasound (US) has the potential to be a safer, more convenient diagnostic tool, especially with new highly portable handheld 2D point of ca...

Purpose: In this 6-year study we identified factors associated with spontaneous vertebral body reshaping in glucocorticoid (GC)-treated children with leukemia, rheumatic disorders, and nephrotic syndrome. Methods: Subjects were 79 children (mean age 7.4 years) who had VF evaluation on lateral spine radiographs at least one year after VF detectio...

This opinion article by the European Society of Musculoskeletal Radiology Arthritis and Pediatric Subcommittees discusses the current use of conventional radiography (CR) of the sacroiliac joints in adults and juveniles with suspected axial spondyloarthritis (axSpA). The strengths and limitations of CR compared with magnetic resonance imaging (MRI)...

The spine is often difficult to evaluate clinically in children, increasing the importance of diagnostic imaging to detect a wide variety of spinal disorders ranging from congenital abnormalities to severe infections. Clinical history and physical examination can help determine whether imaging is needed and which imaging technique would be best. Th...

Deep learning automation of medical image analysis is highly desirable for purposes including organ/tissue segmentation and disease detection. However, deep learning traditionally relies on supervised training methods, while medical images are far more expensive to label than natural images. Self-supervised learning (SSL) has been gaining attention...

Objective: To determine the prevalence of sacroiliac joint variants in patients with axial spondyloarthritis (axSpA) using MRI-based synthetic CT images and to evaluate their relationships with the presence of bone marrow edema, as this may potentially complicate diagnosing active sacroiliitis on MRI in patients with suspected axSpA. Methods: 17...

Wrist trauma is common in children and generally requires radiography for exclusion of fractures, subjecting children to radiation and long wait times in the emergency department. Ultrasound (US) has potential to be a safer, faster diagnostic tool. This study aimed to determine how reliably US could detect distal radius fractures in children, to co...

Recent advances in deep learning algorithms have led to significant benefits for solving many medical image analysis problems. Training deep learning models commonly requires large datasets with expert-labeled annotations. However, acquiring expert-labeled annotation is not only expensive but also is subjective, error-prone, and inter-/intra- obser...

Background Bone marrow lesions (BMLs) and synovitis on magnetic resonance imaging (MRI) are associated with symptoms and predict degeneration of articular cartilage in osteoarthritis (OA). Validated methods for their semiquantitative assessment on MRI are available, but they all have similar scoring designs and questionable sensitivity to change. N...

Aging is a known risk factor for Osteoarthritis (OA), however, relations between cartilage composition and aging remain largely unknown in understanding human OA. T2 imaging provides an approach to assess cartilage composition. Whether these T2 relaxation times in the joint contact region change with time during gait remain unexplored. The study pu...

Osteonecrosis (ON) is a serious complication of childhood acute lymphoblastic leukemia. We determined the prevalence of osteonecrotic lesions in our patient population by a one-time multi-site magnetic resonance imaging (MRI) more than one year following leukemia therapy. MRI findings were evaluated in relationship to clinical factors (including lo...

Purpose: In this cross-sectional study, we compared patellofemoral geometry in individuals with a youth-sport-related intra-articular knee injury to uninjured individuals, and the association between patellofemoral geometry and MRI-defined osteoarthritis (OA) features. Methods: In the Youth Prevention of Early OA (PrE-OA) cohort, we assessed 10...

OBJECTIVE: To describe the knee- and overall health-related quality of life (QOL) 3 to 12 years after anterior cruciate ligament (ACL) tear, and to assess the association of clinical and structural features with QOL after ACL tear. DESIGN: Cross-sectional analysis of combined data from Australian (n = 76, 5.4 years postinjury) and Canadian (n = 50,...

Developmental dysplasia of the hip (DDH) is a common cause of premature osteoarthritis. This osteoarthritis can be prevented if DDH is detected by ultrasound and treated in infancy, but universal DDH screening is generally not cost-effective due to the need for experts to perform the scans. The purpose of our study was to evaluate the feasibility o...

Background Semi-quantitative magnetic resonance imaging (MRI) scoring is more challenging in some anatomic regions than others. Bone marrow lesion (BML) is an important scoring feature and may be more closely related to clinical outcomes in arthritis in some anatomic regions than others. The Knee Inflammation MRI Scoring System (KIMRISS) scores BML...

Objectives: To evaluate the feasibility and diagnostic accuracy of a deep learning network for detection of structural lesions of sacroiliitis on multicentre pelvic CT scans. Methods: Pelvic CT scans of 145 patients (81 female, 121 Ghent University/24 Alberta University, 18-87 years old, mean 40 ± 13 years, 2005-2021) with a clinical suspicion o...

Hip disorders are common in children. Prompt diagnosis and treatment are important and mainly focus on preventing complications. Symptoms are frequently nonspecific and can be vague, and clinical examination can be difficult and unreliable, especially in smaller children. Because the diagnosis is often not clear, imaging can be of value. Imaging fi...

This study aims to determine the relative weights (point value) of items of the juvenile idiopathic arthritis magnetic resonance imaging-sacroiliac joint scoring system (JAMRIS-SIJ). An adaptive multicriteria decision analysis was performed using the 1000Minds web application to determine the relative weights of the items in the JAMRIS-SIJ inflamma...

Objectives: To determine whether MRI with metal artifact reduction sequencing (MARS) is superior to conventional knee MRI in the evaluation of the injured anterior cruciate ligament graft where visualization on conventional MRI can be limited by metal artifact from fixation devices. Methods: Eighteen patients who underwent conventional MRI seque...

Segmentation of anatomical structures in ultrasound images is a challenging task due to existence of artifacts inherit to the modality such as speckle noise, attenuation, shadowing, uneven textures and blurred boundaries. This paper presents a novel attention-based predict-refine network, called ACU2E-Net, for segmentation of soft-tissue structures...

Background Synthetic computed tomography (sCT) images are magnetic resonance imaging (MRI)-based images, generated using artificial intelligence. This study aimed to determine the prevalence of anatomical variants of sacroiliac joints (SIJ) on sCT images and the correlation with age, sex and body weight. Methods MRI of the SIJ including sCT images...

Wrist trauma is common in children and generally requires radiography for exclusion of fractures, subjecting children to radiation and long wait times in the emergency department. Ultrasound (US) has potential to be a safer, faster diagnostic tool. This study aimed to determine how reliably US could detect distal radius fractures in children, to co...

Objective We aimed to determine quantitative sacroiliac (SI) joint magnetic resonance imaging (MRI) cutoffs for active and structural lesions that will be incorporated as imaging domains in classification criteria of axial disease in juvenile spondyloarthritis (SpA). Methods MRI scans from an international cross‐section of juvenile SpA patients we...

Background: Developmental dysplasia of the hip (DDH) is a common cause of premature osteoarthritis. This osteoarthritis can be prevented if DDH is detected by ultrasound and treated in infancy, but universal DDH screening is generally not cost-effective due to the need for experts to perform the scans. Questions/purposes: The purpose of our study w...

Objectives Temporomandibular joint (TMJ) internal derangements (ID) represent the most prevalent temporomandibular joint disorder (TMD) in the population and its diagnosis typically relies on magnetic resonance imaging (MRI). TMJ articular discs in MRIs usually suffer from low resolution and contrast, and it is difficult to identify them. In this s...

Background/Purpose: Several types of active and structural lesions have been identified on sacroiliac joint MRI of spondyloarthritis (SpA) patients. Various combinations of these lesions may be present on a single scan, and some lesions may occur in cases of non-inflammatory back pain. The CHAID algorithm can quickly evaluate multiple lesion variab...

Patients with Duchenne muscular dystrophy (DMD) have a high fracture burden due to progressive myopathy and steroid-induced osteoporosis. This study in males with DMD showed that markers of systemic glucocorticoid exposure including shorter stature, greater bone age delay, and lower lumbar spine bone mineral density were associated with spine fragi...

Purpose To evaluate bone morbidity and the response to intravenous (IV) bisphosphonate therapy in children with Sickle Cell Disease (SCD). Methods We conducted a retrospective review of patient records from 2003 to 2019 at three Canadian pediatric tertiary care centers. Radiographs, magnetic resonance images, and computed tomography scans were rev...

Supervised deep learning techniques have been very popular in medical imaging for various tasks of classification, segmentation, and object detection. However, they require a large number of labelled data which is expensive and requires many hours of careful annotation by experts. In this paper, an unsupervised transporter neural network framework...

Aims Studies of infant hip development to date have been limited by considering only the changes in appearance of a single ultrasound slice (Graf’s standard plane). We used 3D ultrasound (3DUS) to establish maturation curves of normal infant hip development, quantifying variation by age, sex, side, and anteroposterior location in the hip. Methods...

Vertebral fractures (VF) cause excess morbidity in glucocorticoid (GC)-treated DMD. Vamorolone (VAM/VBP15) is a dissociative steroid that retains anti-inflammatory properties with reduced positive transcriptional activity, leading to fewer side effects in pre-clinical studies compared with classic GC. We determined VF burden in VAM-treated boys vs....

The COVID-19 pandemic has highlighted the need for a tool to speed up triage in ultrasound scans and provide clinicians with fast access to relevant information. To this end, we propose a new unsupervised reinforcement learning (RL) framework with novel rewards to facilitate unsupervised learning by avoiding tedious and impractical manual labelling...

Recent advances in deep learning algorithms have led to significant benefits for solving many medical image analysis problems. Training deep learning models commonly requires large datasets with expert-labeled annotations. However, acquiring expert-labeled annotation is not only expensive but also is subjective, error-prone, and inter-/intra- obser...

Objective To determine prevalence of variations of subchondral bone appearance that may mimic erosions on T1‐weighted magnetic resonance imaging (MRI) of pediatric sacroiliac (SI) joints according to age and sex. Methods With ethics committee approval and informed consent, SI joint MRIs of 251 children (132 girls), mean age 12.4 years (range 6.1–1...

Background Three-dimensional (3D) Ultrasonography of the hip introduces opportunities for automation by artificial intelligence (AI) to diagnose developmental dysplasia of the hip (DDH). We compared conventional clinical diagnosis and a commercial FDA-cleared AI algorithm in detecting and classifying hip dysplasia on 3DUS. Purpose To validate the...

The need for summarizing long medical scan videos for automatic triage in Emergency Departments and transmission of the summarized videos for telemedicine has gained significance during the COVID-19 pandemic. However, supervised learning schemes for summarizing videos are infeasible as manual labeling of scans for large datasets is impractical by f...

Early diagnosis of Developmental Dysplasia of Hip (DDH) using ultrasound can result in simpler and more effective treatment options. Handheld ultrasound probes are ideally suited for such screening due to their low cost and portability. However, images from the pocket-sized probes are of lower quality than conventional probes. Image quality can be...

Children with sickle cell disease (SCD) have the potential for extensive and early-onset bone morbidity. This study reports on the diversity of bone morbidity seen in children with SCD followed at three tertiary centers. IV bisphosphonates were effective for bone pain analgesia and did not trigger sickle cell complications. Introduction: To evalu...

Many successful methods developed for medical image analysis that are based on machine learning use supervised learning approaches, which often require large datasets annotated by experts to achieve high accuracy. However, medical data annotation is time-consuming and expensive, especially for segmentation tasks. To solve the problem of learning wi...

Ultrasound (US) is an increasingly popular medical imaging modality in clinical practice due to its low cost, portability, and real-time dynamic display. It is ideally suited for wrist and elbow fracture detection in children as it does not involve any ionizing radiation. Automatic assessment of wrist images requires delineation of relevant bony st...

INTRODUCTION Accurate quantification of effusion volume is becoming more important as OA is increasingly recognized to have inflammatory components including joint effusion. Effective clinical management requires accurate quantification of features related to inflammation; particularly synovitis and joint effusion which represents a target for ther...

Background For classification in juvenile spondyloarthritis (JSpA), it is important to develop cut-offs for active and structural lesions typical of axial disease on MRI that are readily and consistently interpreted. Since the maturing sacroiliac joint (SIJ) looks different from the adult SIJ, the criteria developed for positive MRI in adults may n...

Background In 2009, ASAS published a ‘Definition of active sacroiliitis on MRI for classification of axial spondyloarthritis (axSpA)’. This definition relied on two MRI sequences to make this determination – semicoronal T1 and STIR. Since then, this approach has frequently been used for diagnosis, even though that was never the intent of the defini...

Background The lack of pediatric classification criteria for axial disease is a major impediment to the conduct of clinical trials for juvenile spondyloarthritis (JSpA). Objectives We aimed to develop classification criteria for axial JSpA that will enable identification of a more homogeneous group representative of children with SpA and axial dis...

Post-traumatic knee osteoarthritis is attributed to alterations in joint morphology, alignment, and biomechanics triggered by injury. While magnetic resonance (MR) imaging-based measures of joint morphology and alignment are relevant to understanding osteoarthritis risk, time consuming manual data extraction and measurement limit the number of outc...

Ultrasound images can reliably detect Developmental Dysplasia of the Hip (DDH) during early infancy. Accuracy of diagnosis depends on the scan quality, which is subjectively assessed by the sonographer during ultrasound examination. Such assessment is prone to errors and often results in poor-quality scans not being reported, risking misdiagnosis....

IntroductionObjective Assessment of osteoarthritis (OA) Magnetic Resonance Imaging (MRI) scans can address the limitations of the current OA assessment approaches. Detecting and extracting bone, cartilage, and joint fluid is a necessary component for the objective assessment of OA, which helps to quantify tissue characteristics such as volume and t...

Background: Ultrasound for developmental dysplasia of the hip (DDH) is challenging for nonexperts to perform and interpret. Recording "sweep" images allows more complete hip assessment, suitable for automation by artificial intelligence (AI), but reliability has not been established. We assessed agreement between readers of varying experience and...

Objective To determine the relative importance weights of items and grades of a newly developed additive outcome measure called the juvenile idiopathic arthritis (JIA) magnetic resonance imaging (MRI) scoring system for the temporomandibular joint (TMJ) (JAMRIS‐TMJ). Methods An adaptive partial‐profile, discrete choice experiment (DCE) survey usin...

Background Magnetic resonance imaging (MRI) features of active sacroiliac joint inflammation include joint space fluid and enhancement, but it is unclear to what extent these are present in normal children.Objective To describe normal MRI appearances of pediatric sacroiliac joint spaces in boys and girls of varying ages.Materials and methodsIn this...

Joint effusion is a hallmark of osteoarthritis (OA) associated with stiffness, and may relate to pain, disability, and long-term outcomes. However, it is difficult to quantify accurately. We propose a new Deep Learning (DL) approach for automatic effusion assessment from Magnetic Resonance Imaging (MRI) using volumetric quantification measures (VQM...

Delineation of thyroid nodule boundaries is necessary for cancer risk assessment and accurate categorization of nodules. Clinicians often use manual or bounding-box approach for nodule assessment which leads to subjective results. Consequently, agreement in thyroid nodule categorization is poor even among experts. Computer-aided diagnosis systems c...

Background Developmental dysplasia of hip (DDH) represents a spectrum from acetabular dysplasia to fixed dislocation, giving disability through premature osteoarthritis. Most DDH cases continue to present without any known risk factors such as breech presentation, female sex, and family history. Incidence and population-based outcomes of DDH are di...

Although bone fragility may already be present at diagnosis of pediatric acute lymphoblastic leukemia (ALL), routine performance of dual-energy X-ray absorptiometry (DXA) in every child is not universally feasible. The aim of this study was to develop and validate a risk prediction model for low lumbar spine bone mineral density (LS BMD Z-score ≤ -...

This study reports the reliability of the juvenile idiopathic arthritis magnetic resonance imaging scoring system (JAMRIS-SIJ). The study comprised of eight raters—two rheumatologists and six radiologists—and 30 coronal T1 and Short-Tau Inversion Recovery (STIR) MRI scans of patients with enthesitis-related juvenile spondylarthritis. The median age...

This paper presents a novel one-stage detection model, TUN-Det, for thyroid nodule detection from ultrasound scans. The main contributions are (i) introducing Residual U-blocks (RSU) to build the backbone of our TUN-Det, and (ii) a newly designed multi-head architecture comprised of three parallel RSU variants to replace the plain convolution layer...

Contrast-enhanced magnetic resonance imaging (MRI) remains the most comprehensive modality to assess juvenile idiopathic arthritis (JIA)-related inflammation and osteochondral damage in the temporomandibular joints (TMJ). This study tested the reliability of a new JIA MRI scoring system for TMJ (JAMRIS-TMJ) and the impact of variations in calibrati...