Acta Radiologica Open | VOL. 11

Observer performance evaluation of the feasibility of a deep learning model to detect cardiomegaly on chest radiographs

Publication Date Jul 1, 2022


Background Cardiothoracic ratio (CTR) is the ratio of the diameter of the heart to the diameter of the thorax. An abnormal CTR (>0.55) is often an indicator of an underlying pathological condition. The accurate prediction of an abnormal CTR chest X-rays (CXRs) aids in the early diagnosis of clinical conditions. Purpose We propose a deep learning (DL)-based model for automatic CTR calculation to assist radiologists with rapid diagnosis of cardiomegaly and thus optimise the radiology flow. Material and Methods The study population included 1012 posteroanterior CXRs from a single institution. The Attention U-Net DL architecture was used for the automatic calculation of CTR. An observer performance test was conducted to assess the radiologist’s performance in diagnosing cardiomegaly with and without artificial intelligence assistance. Results U-Net model exhibited a sensitivity of 0.80 [95% CI: 0.75, 0.85], specificity >99%, precision of 0.99 [95% CI: 0.98, 1], and a F1 score of 0.88 [95% CI: 0.85, 0.91]. Furthermore, the sensitivity of the reviewing radiologist in identifying cardiomegaly increased from 40.50% to 88.4% when aided by the AI-generated CTR. Conclusion Our segmentation-based AI model demonstrated high specificity (>99%) and sensitivity (80%) for CTR calculation. The performance of the radiologist on the observer performance test improved significantly with provision of AI assistance. A DL-based segmentation model for rapid quantification of CTR can therefore have significant potential to be used in clinica...


Cardiothoracic Ratio Artificial Intelligence Assistance Observer Performance Test Clinical Workflows Automatic Calculation Abnormal Chest X-rays Single Institution Chest Radiographs Deep Learning Provision Of Assistance

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