Liu X, Xie H H, Xu Y F, Zhang X D, Tao X F, Liu L, Wang X Y
Department of Radiology, Peking University First Hospital, Beijing 100034, China.
Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Aug 18;55(4):670-675. doi: 10.19723/j.issn.1671-167X.2023.04.017.
To explore the value of artificial intelligence (AI) in improving the detection rate of traumatic rib fractures by radiologist residents and the consistency among different readers.
Chest CT images of 393 patients with acute trauma from China-Japan Union Hospital of Jilin University (hospital 02) and Shanghai Ninth People' s Hospital (hospital 03) were collected in this research. The consensus achieved by three radiology experts was regarded as the reference standard. All the images assigned to three hospitals: Peking University First Hospital (hospital 01), hospital 02 and hospital 03, and were then randomly divided into two groups (group A and group B: group A included 197 patients, and group B included 196 patients). Each group was read by one radiologist resident from each hospital for rib fracture detection. Each case was read twice by the same radiologist, with and without the assistance of the AI ["radiologist-only" reading and "radiologist + AI" reading]. The detection rates of different types of rib fractures (displaced fractures and occult fractures) were compared between "radiologist-only" reading and "radiologist + AI" reading. The consistencies of different radiologists with different reading methods were evaluated.
The detection rates of displaced rib fractures and occult rib fractures by "radiologist + AI" reading were significantly higher than those read by "radiologist-only" reading (94.56% . 78.40%, 76.60% . 49.42%, < 0.001). For "radiologist-only reading", the Kappa coefficients of the radiologists between hospital 01 and hospital 03 were slightly greater than 0.4 (indicating moderate consistency), the coefficients of the radiologists between hospital 01/hospital 02 and hospital 02/hospital 03 were less than 0.4 (indicating poor consistency). The Phi coefficients of the radiologists among different hospitals were all less than 0.6 (indicating moderate correlation). With "radiologist + AI" reading, the Kappa and Phi coefficient among the radiologists in dif-ferent hospitals were greater than or equal to 0.6 (indicating good consistency and correlation).
AI software can be used to automatically detect suspected rib fracture lesions, which helps to improve the detection rate of fracture lesions and the consistency among different readers.
探讨人工智能(AI)在提高放射科住院医师对创伤性肋骨骨折的检出率及不同阅片者之间一致性方面的价值。
本研究收集了吉林大学中日联谊医院(医院02)和上海交通大学医学院附属第九人民医院(医院03)393例急性创伤患者的胸部CT图像。三位放射科专家达成的共识被视为参考标准。所有图像被分配到三家医院:北京大学第一医院(医院01)、医院02和医院03,然后随机分为两组(A组和B组:A组包括197例患者,B组包括196例患者)。每组由来自每家医院的一名放射科住院医师进行肋骨骨折检测阅片。每个病例由同一名放射科医师分别在有无AI辅助的情况下阅片两次["仅放射科医师"阅片和"放射科医师+AI"阅片]。比较"仅放射科医师"阅片和"放射科医师+AI"阅片对不同类型肋骨骨折(移位骨折和隐匿性骨折)的检出率。评估不同阅片方法下不同放射科医师之间的一致性。
"放射科医师+AI"阅片对移位肋骨骨折和隐匿性肋骨骨折的检出率显著高于"仅放射科医师"阅片(94.56%对78.40%,76.60%对49.42%,P<0.001)。对于"仅放射科医师阅片",医院01和医院03之间放射科医师的Kappa系数略大于0.4(表明中度一致性),医院01/医院02与医院02/医院03之间放射科医师的系数小于0.4(表明一致性较差)。不同医院放射科医师之间的Phi系数均小于0.6(表明中度相关性)。采用"放射科医师+AI"阅片时,不同医院放射科医师之间的Kappa和Phi系数大于或等于0.6(表明一致性和相关性良好)。
AI软件可用于自动检测可疑肋骨骨折病变,有助于提高骨折病变的检出率及不同阅片者之间的一致性。