Artificial Intelligence for Clinical Interpretation of Bedside Chest Radiographs

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Firas Khader - , RWTH Aachen University (Autor:in)
  • Tianyu Han - , RWTH Aachen University (Autor:in)
  • Gustav Müller-Franzes - , RWTH Aachen University (Autor:in)
  • Luisa Huck - , RWTH Aachen University (Autor:in)
  • Philipp Schad - , RWTH Aachen University (Autor:in)
  • Sebastian Keil - , RWTH Aachen University (Autor:in)
  • Emona Barzakova - , RWTH Aachen University (Autor:in)
  • Maximilian Schulze-Hagen - , RWTH Aachen University (Autor:in)
  • Federico Pedersoli - , RWTH Aachen University (Autor:in)
  • Volkmar Schulz - , RWTH Aachen University (Autor:in)
  • Markus Zimmermann - , RWTH Aachen University (Autor:in)
  • Lina Nebelung - , Luisen Hospital Aachen (Autor:in)
  • Jakob Kather - , RWTH Aachen University (Autor:in)
  • Karim Hamesch - , RWTH Aachen University (Autor:in)
  • Christoph Haarburger - , Ocumeda AG (Autor:in)
  • Gernot Marx - , RWTH Aachen University (Autor:in)
  • Johannes Stegmaier - , RWTH Aachen University (Autor:in)
  • Christiane Kuhl - , RWTH Aachen University (Autor:in)
  • Philipp Bruners - , RWTH Aachen University (Autor:in)
  • Sven Nebelung - , RWTH Aachen University (Autor:in)
  • Daniel Truhn - , RWTH Aachen University (Autor:in)

Abstract

Background: Supine chest radiography for bedridden patients in intensive care units (ICUs) is one of the most frequently ordered imaging studies worldwide. Purpose: To evaluate the diagnostic performance of a neural network.based model that is trained on structured semiquantitative radiologic reports of bedside chest radiographs. Materials and Methods: For this retrospective single-center study, children and adults in the ICU of a university hospital who had been imaged using bedside chest radiography from January 2009 to December 2020 were reported by using a structured and itemized template. Ninety-eight radiologists rated the radiographs semiquantitatively for the severity of disease patterns. These data were used to train a neural network to identify cardiomegaly, pulmonary congestion, pleural effusion, pulmonary opacities, and atelectasis. A held-out internal test set (100 radiographs from 100 patients) that was assessed independently by an expert panel of six radiologists provided the ground truth. Individual assessments by each of these six radiologists, by two nonradiologist physicians in the ICU, and by the neural network were compared with the ground truth. Separately, the nonradiologist physicians assessed the images without and with preliminary readings provided by the neural network. The weighted Cohen κ coefficient was used to measure agreement between the readers and the ground truth. Results: A total of 193 566 radiographs in 45 016 patients (mean age, 66 years ± 16 [SD]; 61% men) were included and divided into training (n = 122 294; 64%), validation (n = 31 243; 16%), and test (n = 40 029; 20%) sets. The neural network exhibited higher agreement with a majority vote of the expert panel (κ = 0.86) than each individual radiologist compared with the majority vote of the expert panel (κ = 0.81 to .0.84). When the neural network provided preliminary readings, the reports of the nonradiologist physicians improved considerably (aided vs unaided, κ = 0.87 vs 0.79, respectively; P < .001). Conclusion: A neural network trained with structured semiquantitative bedside chest radiography reports allowed nonradiologist physicians improved interpretations compared with the consensus reading of expert radiologists.

Details

OriginalspracheEnglisch
Aufsatznummere220510
FachzeitschriftRadiology
Jahrgang307
Ausgabenummer1
PublikationsstatusVeröffentlicht - Apr. 2023
Peer-Review-StatusJa
Extern publiziertJa

Externe IDs

PubMed 36472534

Schlagworte

Schlagwörter

  • Radiography, Radiography, Thoracic/methods, Humans, Artificial Intelligence, Lung, Male, Adult, Female, Aged, Retrospective Studies, Child