AUTHOR=Wang Dongang , Jin Ruilin , Shieh Chun-Chien , Ng Adrian Y. , Pham Hiep , Dugal Tej , Barnett Michael , Winoto Luis , Wang Chenyu , Barnett Yael TITLE=Real world validation of an AI-based CT hemorrhage detection tool JOURNAL=Frontiers in Neurology VOLUME=14 YEAR=2023 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1177723 DOI=10.3389/fneur.2023.1177723 ISSN=1664-2295 ABSTRACT=Introduction

Intracranial hemorrhage (ICH) is a potentially life-threatening medical event that requires expedited diagnosis with computed tomography (CT). Automated medical imaging triaging tools can rapidly bring scans containing critical abnormalities, such as ICH, to the attention of radiologists and clinicians. Here, we retrospectively investigated the real-world performance of VeriScout, an artificial intelligence-based CT hemorrhage detection and triage tool.

Methods

Ground truth for the presence or absence of ICH was iteratively determined by expert consensus in an unselected dataset of 527 consecutively acquired non-contrast head CT scans, which were sub-grouped according to the presence of artefact, post-operative features and referral source. The performance of VeriScout was compared with the ground truths for all groups.

Results

VeriScout detected hemorrhage with a sensitivity of 0.92 (CI 0.84–0.96) and a specificity of 0.96 (CI 0.94–0.98) in the global dataset, exceeding the sensitivity of general radiologists (0.88) with only a minor relative decrement in specificity (0.98). Crucially, the AI tool detected 13/14 cases of subarachnoid hemorrhage, a potentially fatal condition that is often missed in emergency department settings. There was no decrement in the performance of VeriScout in scans containing artefact or postoperative change. Using an integrated informatics platform, VeriScout was deployed into the existing radiology workflow. Detected hemorrhage cases were flagged in the hospital radiology information system (RIS) and relevant, annotated, preview images made available in the picture archiving and communications system (PACS) within 10 min.

Conclusion

AI-based radiology worklist prioritization for critical abnormalities, such as ICH, may enhance patient care without adding to radiologist or clinician burden.