Rafail C. Christodoulou

Dr. Rafail C. Christodoulou

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Research Focus & Metrics

Academic Career Length

2Years (2025-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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21 August 2025 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
Rafail C. ChristodoulouRafail C. Christodoulou
Rafail C. Christodoulou
AWAmanda Woodward
Amanda Woodward
RPRafael Pitsillos
Rafael Pitsillos
RIReina Ibrahim
Reina Ibrahim
MGMichalis F Georgiou
Michalis F Georgiou
Background: Artificial intelligence (AI) is reshaping neuroimaging workflows for Alzheimer’s disease (AD) diagnosis, particularly through PET and MRI analysis advances. Since the FDA approval of Tauvid, a PET tracer targeting tau pathology, there has been a notable increase in studies applying AI to neuroimaging data. This narrative review synthesizes recent, high-impact literature to highlight clinically relevant AI applications in AD imaging. Methods: This review examined peer-reviewed studies published between January 2020 and January 2025, focusing on the use of AI, including machine learning, deep learning, and hybrid models for diagnostic and prognostic tasks in AD using PET and/or MRI. Studies were identified through targeted PubMed, Scopus, and Embase searches, emphasizing methodological diversity and clinical relevance. Results: A total of 109 studies were categorized into five thematic areas: Image preprocessing and segmentation, diagnostic classification, prognosis and disease staging, multimodal data fusion, and emerging innovations. Deep learning models such as convolutional neural networks (CNNs), generative adversarial networks (GANs), and transformer-based architectures were widely employed by the research community in the field of AD. At the same time, several models reported strong diagnostic performance, but methodological challenges such as reproducibility, small sample sizes, and lack of external validation limit clinical translation. Trends in explainable AI, synthetic imaging, and integration of clinical biomarkers are also discussed. Conclusions: AI is rapidly advancing the field of AD imaging, offering tools for enhanced segmentation, staging, and early diagnosis. Multimodal approaches and biomarker-guided models show particular promise. However, future research must focus on reproducibility, interpretability, and standardized validation to bridge the gap between research and clinical practice.

Verified
Journal Article
Open access
PDF file
Rafail C. ChristodoulouRafail C. Christodoulou
Rafail C. Christodoulou
DEDaniel Eller
Daniel Eller
PPPlaton S. Papageorgiou
Platon S. Papageorgiou
Efthalia AngelopoulouEfthalia Angelopoulou
Efthalia Angelopoulou
EVEvros Vassiliou
Evros Vassiliou
SPSokratis G. Papageorgiou
Sokratis G. Papageorgiou
Objective: Alzheimer’s disease (AD) is traditionally characterized by amyloid-β and tau pathology; however, accumulating evidence indicates that metabolic and inflammatory dysfunctions are early, central contributors to disease development. This narrative review explores how metabolic disturbances influence AD pathophysiology. Methods: A comprehensive literature search was performed on PubMed, Embase, and Scopus. Selected studies were original studies or reviews published in English within the past five years involving human subjects. Case reports, case series, editorials, and non-human studies were excluded. A total of 64 articles were reviewed and summarized. Results: Cerebral glucose hypometabolism, mitochondrial impairment, insulin resistance, oxidative stress, and neuroinflammation were observed throughout the AD spectrum. These metabolic changes often appeared before significant amyloid accumulation and were more closely linked to tau pathology and cognitive decline. Early microglial activation was linked to transient glucose hypermetabolism, progressing to glucose hypometabolism and neurodegeneration as the disease advanced. Conclusions: AD is associated with a gradual breakdown of metabolic and inflammatory homeostasis, which occurs before and promotes the development of traditional neuropathological features. Addressing early metabolic vulnerabilities may be essential for effective disease intervention and prevention.

4 July 2025 in Diagnostics
Verified
Journal Article
Open access
PDF file
PPPlaton S. Papageorgiou
Platon S. Papageorgiou
Rafail C. ChristodoulouRafail C. Christodoulou
Rafail C. Christodoulou
PKPanagiotis Korfiatis
Panagiotis Korfiatis
DPDimitra Papagelopoulos
Dimitra Papagelopoulos
OLYMPIA PAPAKONSTANTINOUOLYMPIA PAPAKONSTANTINOU
OLYMPIA PAPAKONSTANTINOU
PPPanayiotis J. Papagelopoulos
Panayiotis J. Papagelopoulos
Artificial Intelligence (AI) has emerged as a transformative force in orthopedic oncology, offering significant advances in the diagnosis, classification, and prediction of treatment response for primary malignant bone tumors (PBT). Through machine learning and deep learning techniques, AI leverages computational algorithms and large datasets to enhance medical imaging interpretation and support clinical decision-making. The integration of radiomics with AI enables the extraction of quantitative features from medical images, allowing for precise tumor characterization and the development of personalized therapeutic strategies. Notably, convolutional neural networks have demonstrated exceptional capabilities in pattern recognition, significantly improving tumor detection, segmentation, and differentiation. This narrative review synthesizes the evolving applications of AI in PBTs, focusing on early tumor detection, imaging analysis, therapy response prediction, and histological classification. AI-driven radiomics and predictive models have yielded promising results in assessing chemotherapy efficacy, optimizing preoperative imaging, and predicting treatment outcomes, thereby advancing the field of precision medicine. Innovative segmentation techniques and multimodal imaging models have further enhanced healthcare efficiency by reducing physician workload and improving diagnostic accuracy. Despite these advancements, challenges remain. The rarity of PBTs limits the availability of robust, high-quality datasets for model development and validation, while the lack of standardized imaging protocols complicates reproducibility. Ethical considerations, including data privacy and the interpretability of complex AI algorithms, also warrant careful attention. Future research should prioritize multicenter collaborations, external validation of AI models, and the integration of explainable AI systems into clinical practice. Addressing these challenges will unlock AI’s full potential to revolutionize PBT management, ultimately improving patient outcomes and advancing personalized care.

3 October 2025 in Eng
Verified
Journal Article
Open access
PDF file
Rafail C. ChristodoulouRafail C. Christodoulou
Rafail C. Christodoulou
RPRafael Pitsillos
Rafael Pitsillos
PPPlaton S. Papageorgiou
Platon S. Papageorgiou
VPVasileia Petrou
Vasileia Petrou
GVGeorgios Vamvouras
Georgios Vamvouras
MGMichalis F Georgiou
Michalis F Georgiou
Background: This narrative review summarizes recent progress in artificial intelligence (AI), especially radiomics and deep learning, for non-invasive diagnosis and molecular profiling of gliomas. Methodology: A thorough literature search was conducted on PubMed, Scopus, and Embase for studies published from January 2020 to July 2025, focusing on clinical and technical research. In key areas, these studies examine AI models’ predictive capabilities with multi-parametric Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET). Results: The domains identified in the literature include the advancement of radiomic models for tumor grading and biomarker prediction, such as Isocitrate Dehydrogenase (IDH) mutation, O6-methylguanine-dna methyltransferase (MGMT) promoter methylation, and 1p/19q codeletion. The growing use of convolutional neural networks (CNNs) and generative adversarial networks (GANs) in tumor segmentation, classification, and prognosis was also a significant topic discussed in the literature. Deep learning (DL) methods are evaluated against traditional radiomics regarding feature extraction, scalability, and robustness to imaging protocol differences across institutions. Conclusions: This review analyzes emerging efforts to combine clinical, imaging, and histology data within hybrid or transformer-based AI systems to enhance diagnostic accuracy. Significant findings include the application of DL to predict cyclin-dependent kinase inhibitor 2A/B (CDKN2A/B) deletion and chemokine CCL2 expression. These highlight the expanding capabilities of imaging-based genomic inference and the importance of clinical data in multimodal fusion. Challenges such as data harmonization, model interpretability, and external validation still need to be addressed.

Verified
Journal Article
Open access
Rafail C. ChristodoulouRafail C. Christodoulou
Rafail C. Christodoulou
PPPlaton S. Papageorgiou
Platon S. Papageorgiou
RPRafael Pitsillos
Rafael Pitsillos
AWAmanda Woodward
Amanda Woodward
SPSokratis G. Papageorgiou
Sokratis G. Papageorgiou
MGMichalis F. Georgiou
Michalis F. Georgiou
This narrative review explores the integration of theranostics and artificial intelligence (AI) in neuro-oncology, addressing the urgent need for improved diagnostic and treatment strategies for brain tumors, including gliomas, meningiomas, and pediatric central nervous system neoplasms. A comprehensive literature search was conducted through PubMed, Scopus, and Embase for articles published between January 2020 and May 2025, focusing on recent clinical and preclinical advancements in personalized neuro-oncology. The review synthesizes evidence on novel theranostic agents—such as Lu-177-based radiopharmaceuticals, CXCR4-targeted PET tracers, and multifunctional nanoparticles—and highlights the role of AI in enhancing tumor detection, segmentation, and treatment planning through advanced imaging analysis, radiogenomics, and predictive modeling. Key findings include the emergence of nanotheranostics for targeted drug delivery and real-time monitoring, the application of AI-driven algorithms for improved image interpretation and therapy guidance, and the identification of current limitations such as data standardization, regulatory challenges, and limited multicenter validation. The review concludes that the convergence of AI and theranostic technologies holds significant promise for advancing precision medicine in neuro-oncology, but emphasizes the need for collaborative, multidisciplinary research to overcome existing barriers and enable widespread clinical adoption.

15 August 2025 in Applied Sciences
Verified
Journal Article
Open access
PDF file
PPPlaton S. Papageorgiou
Platon S. Papageorgiou
Rafail C. ChristodoulouRafail C. Christodoulou
Rafail C. Christodoulou
RPRafael Pitsillos
Rafael Pitsillos
VPVasileia Petrou
Vasileia Petrou
GVGeorgios Vamvouras
Georgios Vamvouras
MGMichalis F Georgiou
Michalis F Georgiou
Large language models (LLMs) rapidly transform healthcare by automating tasks, streamlining administration, and enhancing clinical decision support. This rapid review assesses current and emerging applications of LLMs in diagnostic-related group (DRG) assignment and clinical decision support systems (CDSS), with emphasis on radiology and nuclear medicine. Evidence shows that LLMs, particularly those tailored for medical domains, improve efficiency and accuracy in DRG coding and radiology report generation, providing clinicians with actionable, context-sensitive insights by integrating diverse data sources. Advances like retrieval-augmented generation and multimodal architecture further increase reliability and minimize incorrect or misleading results that AI models generate, a term that is known as hallucination. Despite these benefits, challenges remain regarding safety, explainability, bias, and regulatory compliance, necessitating ongoing validation and oversight. The review prioritizes recent, peer-reviewed literature on radiology and nuclear medicine to provide a practical synthesis for clinicians, administrators, and researchers. While LLMs show strong promise for enhancing DRG assignment and radiological decision-making, their integration into clinical workflows requires careful management. Ongoing technological advances and emerging evidence may quickly change the landscape, so findings should be interpreted in context. This review offers a timely overview of the evolving role of LLMs while recognizing the need for continuous re-evaluation.