Artificial Intelligence in Sincalide-Stimulated Cholescintigraphy: A Pilot Study

Sincalide-stimulated cholescintigraphy (SSC) calculates the gallbladder ejection fraction (GBEF) to diagnose functional gallbladder disorder. Currently, artificial intelligence (AI)-driven workflows that integrate real-time image processing and organ function calculation remain unexplored in nuclear medicine practice. This pilot study explored an AI-based application for gallbladder radioactivity tracking.

We retrospectively analyzed 20 SSC exams, categorized into 10 easy and 10 challenging cases. Two human operators (H1 and H2) independently annotated the gallbladder regions of interest manually over the course of the 60-minute SSC. A U-Net-based deep learning model was developed to automatically segment gallbladder masks, and a 10-fold cross-validation was performed for both easy and challenging cases. The AI-generated masks were compared with human-annotated ones, with Dice similarity coefficients (DICE) used to assess agreement.

AI achieved an average DICE of 0.746 against H1 and 0.676 against H2, performing better in easy cases (0.781) than in challenging ones (0.641). Visual inspection showed AI was prone to errors with patient motion or low-count activity.

This study highlights AI's potential in real-time gallbladder tracking and GBEF calculation during SSC. AI-enabled real-time evaluation of nuclear imaging data holds promise for advancing clinical workflows by providing instantaneous organ function assessments and feedback to technologists. This AI-enabled workflow could enhance diagnostic efficiency, reduce scan duration, and improve patient comfort by alleviating symptoms associated with SSC, such as abdominal discomfort due to sincalide administration.