XRAInet: AI-based decision support for pneumothorax and pleural effusion management.

Abstract

This study aimed to develop and assess the performance of an artificial intelligence(AI)-driven decision support system, XRAInet, in accurately identifying pediatric patients with pleural effusion or pneumothorax and determining whether tube thoracostomy intervention is warranted. In this diagnostic accuracy study, we retrospectively analyzed a data set containing 510 X-ray images from 170 pediatric patients admitted between 2005 and 2022. Patients were categorized into two groups: Tube (requiring tube thoracostomy) and Conservative (managed conservatively). XRAInet, a deep learning-based algorithm, was trained using this data set. We evaluated its performance using various metrics, including mean Average Precision (mAP), recall, precision, and F1 score. XRAInet, achieved a mAP score of 0.918. This result underscores its ability to accurately identify and localize regions necessitating tube thoracostomy for pediatric patients with pneumothorax and pleural effusion. In an independent testing data set, the model exhibited a sensitivity of 64.00% and specificity of 96.15%. In conclusion, XRAInet presents a promising solution for improving the detection and decision-making process for cases of pneumothorax and pleural effusion in pediatric patients using X-ray images. These findings contribute to the expanding field of AI-driven medical imaging, with potential applications for enhancing patient outcomes. Future research endeavors should explore hybrid models, enhance interpretability, address data quality issues, and align with regulatory requirements to ensure the safe and effective deployment of XRAInet in healthcare settings.