BACKGROUND: Radiology reporting of emergency whole-body computed tomography (CT) scans is time-critical and therefore involves a significant risk of pathology under-detection. We hypothesize a relevant number of initially missed secondary thoracic findings that would have been detected by an artificial intelligence (AI) software platform including several pathology-specific AI algorithms. METHODS: This retrospective proof-of-concept-study consecutively included 105 shock-room whole-body CT scans. Image data was analyzed by platform-bundled AI-algorithms, findings were reviewed by radiology experts and compared with the original radiologist's reports. We focused on secondary thoracic findings, such as cardiomegaly, coronary artery plaques, lung lesions, aortic aneurysms and vertebral fractures. RESULTS: We identified a relevant number of initially missed findings, with their quantification based on 105 analyzed CT scans as follows: up to 25 patients (23.8%) with cardiomegaly or borderline heart size, 17 patients (16.2%) with coronary plaques, 34 patients (32.4%) with aortic ectasia, 2 patients (1.9%) with lung lesions classified as "recommended to control" and 13 initially missed vertebral fractures (two with an acute traumatic origin). A high number of false positive or non-relevant AI-based findings remain problematic especially regarding lung lesions and vertebral fractures. CONCLUSIONS: We consider AI to be a promising approach to reduce the number of missed findings in clinical settings with a necessary time-critical radiological reporting. Nevertheless, algorithm improvement is necessary focusing on a reduction of "false positive" findings and on algorithm features assessing the finding relevance, e.g., fracture age or lung lesion malignancy. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
BACKGROUND: Radiology reporting of emergency whole-body computed tomography (CT) scans is time-critical and therefore involves a significant risk of pathology under-detection. We hypothesize a relevant number of initially missed secondary thoracic findings that would have been detected by an artificial intelligence (AI) software platform including several pathology-specific AI algorithms. METHODS: This retrospective proof-of-concept-study consecutively included 105 shock-room whole-body CT scans. Image data was analyzed by platform-bundled AI-algorithms, findings were reviewed by radiology experts and compared with the original radiologist's reports. We focused on secondary thoracic findings, such as cardiomegaly, coronary artery plaques, lung lesions, aortic aneurysms and vertebral fractures. RESULTS: We identified a relevant number of initially missed findings, with their quantification based on 105 analyzed CT scans as follows: up to 25 patients (23.8%) with cardiomegaly or borderline heart size, 17 patients (16.2%) with coronary plaques, 34 patients (32.4%) with aortic ectasia, 2 patients (1.9%) with lung lesions classified as "recommended to control" and 13 initially missed vertebral fractures (two with an acute traumatic origin). A high number of false positive or non-relevant AI-based findings remain problematic especially regarding lung lesions and vertebral fractures. CONCLUSIONS: We consider AI to be a promising approach to reduce the number of missed findings in clinical settings with a necessary time-critical radiological reporting. Nevertheless, algorithm improvement is necessary focusing on a reduction of "false positive" findings and on algorithm features assessing the finding relevance, e.g., fracture age or lung lesion malignancy. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Authors: Loren F Hiratzka; George L Bakris; Joshua A Beckman; Robert M Bersin; Vincent F Carr; Donald E Casey; Kim A Eagle; Luke K Hermann; Eric M Isselbacher; Ella A Kazerooni; Nicholas T Kouchoukos; Bruce W Lytle; Dianna M Milewicz; David L Reich; Souvik Sen; Julie A Shinn; Lars G Svensson; David M Williams Journal: Circulation Date: 2010-03-16 Impact factor: 29.690
Authors: Raimund Erbel; Victor Aboyans; Catherine Boileau; Eduardo Bossone; Roberto Di Bartolomeo; Holger Eggebrecht; Arturo Evangelista; Volkmar Falk; Herbert Frank; Oliver Gaemperli; Martin Grabenwöger; Axel Haverich; Bernard Iung; Athanasios John Manolis; Folkert Meijboom; Christoph A Nienaber; Marco Roffi; Hervé Rousseau; Udo Sechtem; Per Anton Sirnes; Regula S von Allmen; Christiaan J M Vrints Journal: Eur Heart J Date: 2014-08-29 Impact factor: 29.983
Authors: Scott Mayer McKinney; Marcin Sieniek; Varun Godbole; Jonathan Godwin; Natasha Antropova; Hutan Ashrafian; Trevor Back; Mary Chesus; Greg S Corrado; Ara Darzi; Mozziyar Etemadi; Florencia Garcia-Vicente; Fiona J Gilbert; Mark Halling-Brown; Demis Hassabis; Sunny Jansen; Alan Karthikesalingam; Christopher J Kelly; Dominic King; Joseph R Ledsam; David Melnick; Hormuz Mostofi; Lily Peng; Joshua Jay Reicher; Bernardino Romera-Paredes; Richard Sidebottom; Mustafa Suleyman; Daniel Tse; Kenneth C Young; Jeffrey De Fauw; Shravya Shetty Journal: Nature Date: 2020-01-01 Impact factor: 49.962
Authors: R Guven; Ali Haydar Akca; C Caltili; M I Sasmaz; E K Kaykisiz; S Baran; L Sahin; A Ari; G Eyupoglu; V Kirpat Journal: Niger J Clin Pract Date: 2018-10 Impact factor: 0.968