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Artificial intelligence (AI) is rapidly moving from an experimental phase to an implementation phase in many fields, including medicine. The combination of improved availability of large datasets, increasing computing power, and advances in learning algorithms has created major performance breakthroughs in the development of AI applications. In the last 5 years, AI techniques known as deep learning have delivered rapidly improving performance in image recognition, caption generation, and speech recognition. Radiology, in particular, is a prime candidate for early adoption of these techniques. It is anticipated that the implementation of AI in radiology over the next decade will significantly improve the quality, value, and depth of radiology's contribution to patient care and population health, and will revolutionize radiologists' workflows. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI working group with the mandate to discuss and deliberate on practice, policy, and patient care issues related to the introduction and implementation of AI in imaging. This white paper provides recommendations for the CAR derived from deliberations between members of the AI working group. This white paper on AI in radiology will inform CAR members and policymakers on key terminology, educational needs of members, research and development, partnerships, potential clinical applications, implementation, structure and governance, role of radiologists, and potential impact of AI on radiology in Canada.

Background Intercostal artery aneurysms are rare vascular abnormalities that are typically diagnosed following rupture in patients with predisposing conditions. Our report is the first to document a patient with unruptured intercostal artery aneurysms in the absence of any associated disease. Case presentation A 70-year-old male with prostatic adenocarcinoma was incidentally discovered to have multiple unruptured aneurysms of his intercostal arteries. Three of the aneurysms were embolized utilizing microcoils and glue. At six-month follow-up the patient remained asymptomatic. Conclusion We demonstrate successful endovascular management of a unique case of multiple idiopathic unruptured intercostal artery aneurysms. Appropriate diagnosis and prompt treatment of these rare vascular lesions is essential in preventing the potentially catastrophic consequences of rupture.

‘In the published article (Fenwick et al., 2019) the statement under the subheading ‘Consent for publication’ is incorrect.

Purpose The authors report on the use of Palmaz balloon-expandable intraluminal metallic stents to supplement conventional balloon angioplasty and to primarily treat a variety of supra-aortic arterial atherosclerotic lesions manifested by claudication or embolic phenomena. Patients and Methods Results from a series of seven patients are reported. Five patients received stents following percutaneous balloon angioplasty (PTA): four patients received five stents for suboptimal initial result of PTA and one patient received one stent for early restenosis following successful PTA. Two patients received three stents primarily: one patient had one stent placed for a highly eccentric innominate lesion and the other patient had two stents placed for an ulcerated nonocclusive subclavian lesion causing blue digits. Results Treatment produced immediate angiographic or hemodynamic improvement in all seven patients. Clinical follow-up was obtained on all patients (mean, 10 months; range, 3–18 months). One patient had an episode of vertigo after PTA of a right subclavian lesion that resolved after thrombolytic therapy and stent placement. Conclusion The placement of metallic stents in supra-aortic arteries represented an effective adjunct to PTA of atherosclerotic stenoses in these vessels. Primary stent placement may be an effective treatment for selected lesions.

[1] Lian K, Trollip J, Sandhu S, et al. Audit of atypical femoral fracture and a description of some of their features. Can Assoc Radiol J 2015;67:69e75. [2] Shane E, Burr D, Abrahamsen B, et al. Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2014;29:1e23. [3] Probyn L, Cheung AM, Lang C, et al. Bilateral atypical femoral fractures: how much symmetry is there on imaging? Skeletal Radiol 2015; 44:1579e84. [4] Khan AA, Leslie WD, Lentle B, et al. Atypical femoral fractures: a teaching perspective. Can Assoc Radiol J 2015;66:102e7. [5] Khan AA, Fortier M, Menopause and Osteoporosis Working Group, et al. Osteoporosis in menopause. J Obstet Gynaecol Can 2014;36: 839e40.

Purpose To retrospectively review and to report the results of stent placement for focal mid-abdominal aortic stenoses. Materials and Methods During a 4-year period, 10 focal mid-abdominal aortic stenoses were treated with stent placement in nine patients (six women and three men; mean age, 61 years; range, 49–73 years). All of the stenoses were atherosclerotic in nature except for one at the proximal anastomosis of an aortobifemoral graft, which may have been from fibrointimal hyperplasia. Seven of the 10 stenoses were treated with primary stent placement, whereas three were treated with stent placement after sub-optimal angioplasty. Results The technical success rate was 100%. Clinical success, defined as complete elimination or improvement of symptoms present before stent placement, was achieved in eight of the nine patients with a mean duration of follow-up of 1.6 years (range, 0.2–3.0 years). Conclusion In view of the excellent technical and clinical success, the authors believe that stent placement should be considered as an adjunctive therapy to angioplasty or as a primary method of treatment in properly selected patients with focal mid-abdominal aortic stenoses.