Autonomous Chest Radiograph Reporting Using AI: Estimation of Clinical Impact.

Autor: Plesner LL; From the Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, 2730 Herlev, Copenhagen, Denmark (L.L.P., F.C.M., L.C.L., M.B.A.); Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (L.L.P., O.W.N., M.B., M.B.A.); Radiological Artificial Intelligence Testcenter, RAIT.dk, Capital region of Denmark (L.L.P., F.C.M., J.D.N., M.B., M.B.A.); Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (J.D.N., M.B.); Department of Radiology, Aarhus University Hospital, Aarhus, Denmark (F.R.); and Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (O.W.N.)., Müller FC; From the Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, 2730 Herlev, Copenhagen, Denmark (L.L.P., F.C.M., L.C.L., M.B.A.); Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (L.L.P., O.W.N., M.B., M.B.A.); Radiological Artificial Intelligence Testcenter, RAIT.dk, Capital region of Denmark (L.L.P., F.C.M., J.D.N., M.B., M.B.A.); Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (J.D.N., M.B.); Department of Radiology, Aarhus University Hospital, Aarhus, Denmark (F.R.); and Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (O.W.N.)., Nybing JD; From the Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, 2730 Herlev, Copenhagen, Denmark (L.L.P., F.C.M., L.C.L., M.B.A.); Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (L.L.P., O.W.N., M.B., M.B.A.); Radiological Artificial Intelligence Testcenter, RAIT.dk, Capital region of Denmark (L.L.P., F.C.M., J.D.N., M.B., M.B.A.); Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (J.D.N., M.B.); Department of Radiology, Aarhus University Hospital, Aarhus, Denmark (F.R.); and Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (O.W.N.)., Laustrup LC; From the Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, 2730 Herlev, Copenhagen, Denmark (L.L.P., F.C.M., L.C.L., M.B.A.); Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (L.L.P., O.W.N., M.B., M.B.A.); Radiological Artificial Intelligence Testcenter, RAIT.dk, Capital region of Denmark (L.L.P., F.C.M., J.D.N., M.B., M.B.A.); Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (J.D.N., M.B.); Department of Radiology, Aarhus University Hospital, Aarhus, Denmark (F.R.); and Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (O.W.N.)., Rasmussen F; From the Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, 2730 Herlev, Copenhagen, Denmark (L.L.P., F.C.M., L.C.L., M.B.A.); Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (L.L.P., O.W.N., M.B., M.B.A.); Radiological Artificial Intelligence Testcenter, RAIT.dk, Capital region of Denmark (L.L.P., F.C.M., J.D.N., M.B., M.B.A.); Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (J.D.N., M.B.); Department of Radiology, Aarhus University Hospital, Aarhus, Denmark (F.R.); and Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (O.W.N.)., Nielsen OW; From the Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, 2730 Herlev, Copenhagen, Denmark (L.L.P., F.C.M., L.C.L., M.B.A.); Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (L.L.P., O.W.N., M.B., M.B.A.); Radiological Artificial Intelligence Testcenter, RAIT.dk, Capital region of Denmark (L.L.P., F.C.M., J.D.N., M.B., M.B.A.); Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (J.D.N., M.B.); Department of Radiology, Aarhus University Hospital, Aarhus, Denmark (F.R.); and Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (O.W.N.)., Boesen M; From the Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, 2730 Herlev, Copenhagen, Denmark (L.L.P., F.C.M., L.C.L., M.B.A.); Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (L.L.P., O.W.N., M.B., M.B.A.); Radiological Artificial Intelligence Testcenter, RAIT.dk, Capital region of Denmark (L.L.P., F.C.M., J.D.N., M.B., M.B.A.); Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (J.D.N., M.B.); Department of Radiology, Aarhus University Hospital, Aarhus, Denmark (F.R.); and Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (O.W.N.)., Andersen MB; From the Department of Radiology, Herlev and Gentofte Hospital, Borgmester Ib Juuls vej 1, 2730 Herlev, Copenhagen, Denmark (L.L.P., F.C.M., L.C.L., M.B.A.); Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (L.L.P., O.W.N., M.B., M.B.A.); Radiological Artificial Intelligence Testcenter, RAIT.dk, Capital region of Denmark (L.L.P., F.C.M., J.D.N., M.B., M.B.A.); Department of Radiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (J.D.N., M.B.); Department of Radiology, Aarhus University Hospital, Aarhus, Denmark (F.R.); and Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (O.W.N.).
Jazyk: angličtina
Zdroj: Radiology [Radiology] 2023 May; Vol. 307 (3), pp. e222268. Date of Electronic Publication: 2023 Mar 07.
DOI: 10.1148/radiol.222268
Abstrakt: Background Automated interpretation of normal chest radiographs could alleviate the workload of radiologists. However, the performance of such an artificial intelligence (AI) tool compared with clinical radiology reports has not been established. Purpose To perform an external evaluation of a commercially available AI tool for (a) the number of chest radiographs autonomously reported, (b) the sensitivity for AI detection of abnormal chest radiographs, and (c) the performance of AI compared with that of the clinical radiology reports. Materials and Methods In this retrospective study, consecutive posteroanterior chest radiographs from adult patients in four hospitals in the capital region of Denmark were obtained in January 2020, including images from emergency department patients, in-hospital patients, and outpatients. Three thoracic radiologists labeled chest radiographs in a reference standard based on chest radiograph findings into the following categories: critical, other remarkable, unremarkable, or normal (no abnormalities). AI classified chest radiographs as high confidence normal (normal) or not high confidence normal (abnormal). Results A total of 1529 patients were included for analysis (median age, 69 years [IQR, 55-69 years]; 776 women), with 1100 (72%) classified by the reference standard as having abnormal radiographs, 617 (40%) as having critical abnormal radiographs, and 429 (28%) as having normal radiographs. For comparison, clinical radiology reports were classified based on the text and insufficient reports excluded ( n = 22). The sensitivity of AI was 99.1% (95% CI: 98.3, 99.6; 1090 of 1100 patients) for abnormal radiographs and 99.8% (95% CI: 99.1, 99.9; 616 of 617 patients) for critical radiographs. Corresponding sensitivities for radiologist reports were 72.3% (95% CI: 69.5, 74.9; 779 of 1078 patients) and 93.5% (95% CI: 91.2, 95.3; 558 of 597 patients), respectively. Specificity of AI, and hence the potential autonomous reporting rate, was 28.0% of all normal posteroanterior chest radiographs (95% CI: 23.8, 32.5; 120 of 429 patients), or 7.8% (120 of 1529 patients) of all posteroanterior chest radiographs. Conclusion Of all normal posteroanterior chest radiographs, 28% were autonomously reported by AI with a sensitivity for any abnormalities higher than 99%. This corresponded to 7.8% of the entire posteroanterior chest radiograph production. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Park in this issue.
Databáze: MEDLINE