Deep-learning-based automatic detection of pulmonary nodules from chest radiographs

ObjectiveTo assess a deep learning-based artificial intelligence model for the detection of pulmonary nodules on chest radiographs and to compare its performance with board-certified human readers. MethodsFor this retrospective study, 308 chest radiographs were obtained between January 2019 to December 2021 from a tertiary care hospital. All radiographs were analyzed using a deep learning AI model called DxNodule AI Screen. Two expert board-certified radiologists established the ground truth, and 11 test readers independently reviewed all radiographs in two sessions (unaided and AI-aided mode) with a washout period of one month. ResultsThe standalone model had an AUROC of 0.905 [0.87, 0.94] in detecting pulmonary nodules. The mean AUROC across the 11 readers improved from 0.798 [0.74, 0.86] for unaided interpretation to 0.846 [0.82, 0.880] for AI-aided interpretation. With DxNodule AI Screen, readers were able to identify nodules at the correct locations, which they otherwise missed. The mean specificity, accuracy, PPV, and NPV of the readers improved significantly from 0.87 [0.78, 0.96], 0.78 [0.72, 0.84], 0.77 [0.65, 0.88], and 0.86 [0.81, 0.90] in the unaided session to 0.89 [0.82, 0.96], 0.83 [0.80, 0.85], 0.82 [0.73, 0.9], and 0.89 [0.86, 0.92], respectively in the aided session. ConclusionDxNodule AI Screen outperformed human readers in nodule detection performance on chest radiographs, and enhanced human readers performances when used as an aid.