Utility of Artificial Intelligence Tool as a Prospective Radiology Peer Reviewer — Detection of Unreported Intracranial Hemorrhage

Balaji Rao MBBS,FRCR, Vahe Zohrabian, MD, Paul Cedeno, MD, Atin Saha MD, MS, Jay Pahade MD, Melissa A.Davis MD,MBA

Misdiagnosis of intracranial hemorrhage (ICH) can adversely impact patient outcomes. The increasing workload on the radiologists may increase the chance of error and compromise the quality of care provided by the radiologists.

We used an FDA approved artificial intelligence (AI) solution based on a convolutional neural network to assess the prevalence of ICH in scans, which were reported as negative for ICH. We retrospectively applied the AI solution to all consecutive noncontrast computed tomography (CT) head scans performed at eight imaging sites affiliated to our institution.

In the 6565 noncontrast CT head scans, which met the inclusion criteria, 5585 scans were reported to have no ICH (“negative-by-report” cases). We applied AI solution to these “negative-by-report” cases. AI solution suggested there were ICH in 28 of these scans (“negative-by-report” and “positive-by-AI solution”). After consensus review by three neuroradiologists, 16 of these scans were found to have ICH, which was not reported (missed diagnosis by radiologists), with a false-negative rate of radiologists for ICH detection at 1.6%. Most commonly missed ICH was overlying the cerebral convexity and in the parafalcine regions.

Our study demonstrates that an AI solution can help radiologists to diagnose ICH and thus decrease the error rate. AI solution can serve as a prospective peer review tool for non-contrast head CT scans to identify ICH and thus minimize false negatives.

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