Radiology-Artificial Intelligence最新文献

{"title":"Retrieval-Augmented Generation with Large Language Models in Radiology: From Theory to Practice.","authors":"Anna Fink, Alexander Rau, Marco Reisert, Fabian Bamberg, Maximilian F Russe","doi":"10.1148/ryai.240790","DOIUrl":"https://doi.org/10.1148/ryai.240790","url":null,"abstract":"<p><p><i>\"Just Accepted\" papers have undergone full peer review and have been accepted for publication in <i>Radiology: Artificial Intelligence</i>. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content.</i> Large language models (LLMs) hold substantial promise in addressing the growing workload in radiology, but recent studies also reveal limitations, such as hallucinations and opacity in sources for LLM responses. Retrieval-augmented Generation (RAG) based LLMs offer a promising approach to streamline radiology workflows by integrating reliable, verifiable, and customizable information. Ongoing refinement is critical to enable RAG models to manage large amounts of input data and to engage in complex multiagent dialogues. This report provides an overview of recent advances in LLM architecture, including few-shot and zero-shot learning, RAG integration, multistep reasoning, and agentic RAG, and identifies future research directions. Exemplary cases demonstrate the practical application of these techniques in radiology practice. ©RSNA, 2025.</p>","PeriodicalId":29787,"journal":{"name":"Radiology-Artificial Intelligence","volume":" ","pages":"e240790"},"PeriodicalIF":8.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating Total Lung Volume from Pixel-Level Thickness Maps of Chest Radiographs Using Deep Learning.","authors":"Tina Dorosti, Manuel Schultheiss, Philipp Schmette, Jule Heuchert, Johannes Thalhammer, Florian T Gassert, Thorsten Sellerer, Rafael Schick, Kirsten Taphorn, Korbinian Mechlem, Lorenz Birnbacher, Florian Schaff, Franz Pfeiffer, Daniela Pfeiffer","doi":"10.1148/ryai.240484","DOIUrl":"https://doi.org/10.1148/ryai.240484","url":null,"abstract":"<p><p><i>\"Just Accepted\" papers have undergone full peer review and have been accepted for publication in <i>Radiology: Artificial Intelligence</i>. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content.</i> Purpose To estimate the total lung volume (TLV) from real and synthetic frontal chest radiographs (CXR) on a pixel level using lung thickness maps generated by a U-Net deep learning model. Materials and Methods This retrospective study included 5,959 chest CT scans from two public datasets: the lung nodule analysis 2016 (<i>n</i> = 656) and the Radiological Society of North America (RSNA) pulmonary embolism detection challenge 2020 (<i>n</i> = 5,303). Additionally, 72 participants were selected from the Klinikum Rechts der Isar dataset (October 2018 to December 2019), each with a corresponding chest radiograph taken within seven days. Synthetic radiographs and lung thickness maps were generated using forward projection of CT scans and their lung segmentations. A U-Net model was trained on synthetic radiographs to predict lung thickness maps and estimate TLV. Model performance was assessed using mean squared error (MSE), Pearson correlation coefficient <b>(r)</b>, and two-sided Student's t-distribution. Results The study included 72 participants (45 male, 27 female, 33 healthy: mean age 62 years [range 34-80]; 39 with chronic obstructive pulmonary disease: mean age 69 years [range 47-91]). TLV predictions showed low error rates (MSEPublic-Synthetic = 0.16 L², MSEKRI-Synthetic = 0.20 L², MSEKRI-Real = 0.35 L²) and strong correlations with CT-derived reference standard TLV (nPublic-Synthetic = 1,191, r = 0.99, <i>P</i> < .001; nKRI-Synthetic = 72, r = 0.97, <i>P</i> < .001; nKRI-Real = 72, r = 0.91, <i>P</i> < .001). When evaluated on different datasets, the U-Net model achieved the highest performance for TLV estimation on the Luna16 test dataset, with the lowest mean squared error (MSE = 0.09 L²) and strongest correlation (<i>r</i> = 0.99, <i>P</i> <.001) compared with CT-derived TLV. Conclusion The U-Net-generated pixel-level lung thickness maps successfully estimated TLV for both synthetic and real radiographs. ©RSNA, 2025.</p>","PeriodicalId":29787,"journal":{"name":"Radiology-Artificial Intelligence","volume":" ","pages":"e240484"},"PeriodicalIF":8.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning with Domain Randomization in Image and Feature Spaces for Abdominal Multiorgan Segmentation on CT and MRI Scans.","authors":"Yu Shi, Lixia Wang, Touseef Ahmad Qureshi, Zengtian Deng, Yibin Xie, Debiao Li","doi":"10.1148/ryai.240586","DOIUrl":"https://doi.org/10.1148/ryai.240586","url":null,"abstract":"<p><p><i>\"Just Accepted\" papers have undergone full peer review and have been accepted for publication in <i>Radiology: Artificial Intelligence</i>. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content.</i> Purpose To develop a deep learning segmentation model that can segment abdominal organs on CT and MR images with high accuracy and generalization ability. Materials and Methods In this study, an extended nnU-Net model was trained for abdominal organ segmentation. A domain randomization method in both the image and feature space was developed to improve the generalization ability under cross-site and cross-modality settings on public prostate MRI and abdominal CT and MRI datasets. The prostate MRI dataset contains data from multiple health care institutions with domain shifts. The abdominal CT and MRI dataset is structured for cross-modality evaluation, training on one modality (eg, MRI) and testing on the other (eg, CT). This domain randomization method was then used to train a segmentation model with enhanced generalization ability on the abdominal multiorgan segmentation challenge (AMOS) dataset to improve abdominal CT and MR multiorgan segmentation, and the model was compared with two commonly used segmentation algorithms (TotalSegmentator and MRSegmentator). Model performance was evaluated using the Dice similarity coefficient (DSC). Results The proposed domain randomization method showed improved generalization ability on the cross-site and cross-modality datasets compared with the state-of-the-art methods. The segmentation model using this method outperformed two other publicly available segmentation models on data from unseen test domains (Average DSC: 0.88 versus 0.79; <i>P</i> < .001 and 0.88 versus 0.76; <i>P</i> < .001). Conclusion The combination of image and feature domain randomizations improved the accuracy and generalization ability of deep learning-based abdominal segmentation on CT and MR images. © RSNA, 2025.</p>","PeriodicalId":29787,"journal":{"name":"Radiology-Artificial Intelligence","volume":" ","pages":"e240586"},"PeriodicalIF":8.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cybersecurity Threats and Mitigation Strategies for Large Language Models in Health Care.","authors":"Tugba Akinci D'Antonoli, Ali S Tejani, Bardia Khosravi, Christian Bluethgen, Felix Busch, Keno K Bressem, Lisa Christine Adams, Mana Moassefi, Shahriar Faghani, Judy Wawira Gichoya","doi":"10.1148/ryai.240739","DOIUrl":"https://doi.org/10.1148/ryai.240739","url":null,"abstract":"<p><p><i>\"Just Accepted\" papers have undergone full peer review and have been accepted for publication in <i>Radiology: Artificial Intelligence</i>. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content.</i> The integration of large language models (LLMs) into health care offers tremendous opportunities to improve medical practice and patient care. Besides being susceptible to biases and threats common to all artificial intelligence systems, LLMs pose unique cybersecurity risks that must be carefully evaluated before these AI models are deployed in health care. LLMs can be exploited in several ways, such as malicious attacks, privacy breaches, and unauthorized manipulation of patient data. Moreover, malicious actors could use LLMs to infer sensitive patient information from training data. Furthermore, manipulated or poisoned data fed into these models could change their results in a way that is beneficial for the malicious actors. This report presents the cybersecurity challenges posed by LLMs in health care and provides strategies for mitigation. By implementing robust security measures and adhering to best practices during the model development, training, and deployment stages, stakeholders can help minimize these risks and protect patient privacy. ©RSNA, 2025.</p>","PeriodicalId":29787,"journal":{"name":"Radiology-Artificial Intelligence","volume":" ","pages":"e240739"},"PeriodicalIF":8.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Privacy-preserving Federated Learning and Uncertainty Quantification in Medical Imaging.","authors":"Nikolas Koutsoubis, Asim Waqas, Yasin Yilmaz, Ravi P Ramachandran, Matthew B Schabath, Ghulam Rasool","doi":"10.1148/ryai.240637","DOIUrl":"https://doi.org/10.1148/ryai.240637","url":null,"abstract":"<p><p><i>\"Just Accepted\" papers have undergone full peer review and have been accepted for publication in <i>Radiology: Artificial Intelligence</i>. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content.</i> Artificial Intelligence (AI) has demonstrated strong potential in automating medical imaging tasks, with potential applications across disease diagnosis, prognosis, treatment planning, and posttreatment surveillance. However, privacy concerns surrounding patient data remain a major barrier to the widespread adoption of AI in clinical practice, as large and diverse training datasets are essential for developing accurate, robust, and generalizable AI models. Federated Learning offers a privacy-preserving solution by enabling collaborative model training across institutions without sharing sensitive data. Instead, model parameters, such as model weights, are exchanged between participating sites. Despite its potential, federated learning is still in its early stages of development and faces several challenges. Notably, sensitive information can still be inferred from the shared model parameters. Additionally, postdeployment data distribution shifts can degrade model performance, making uncertainty quantification essential. In federated learning, this task is particularly challenging due to data heterogeneity across participating sites. This review provides a comprehensive overview of federated learning, privacy-preserving federated learning, and uncertainty quantification in federated learning. Key limitations in current methodologies are identified, and future research directions are proposed to enhance data privacy and trustworthiness in medical imaging applications. ©RSNA, 2025.</p>","PeriodicalId":29787,"journal":{"name":"Radiology-Artificial Intelligence","volume":" ","pages":"e240637"},"PeriodicalIF":8.1,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural Language Processing for Everyone.","authors":"Quirin D Strotzer","doi":"10.1148/ryai.250218","DOIUrl":"https://doi.org/10.1148/ryai.250218","url":null,"abstract":"","PeriodicalId":29787,"journal":{"name":"Radiology-Artificial Intelligence","volume":"7 3","pages":"e250218"},"PeriodicalIF":8.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning-based Aligned Strain from Cine Cardiac MRI for Detection of Fibrotic Myocardial Tissue in Patients with Duchenne Muscular Dystrophy.","authors":"Sven Koehler, Julian Kuhm, Tyler Huffaker, Daniel Young, Animesh Tandon, Florian André, Norbert Frey, Gerald Greil, Tarique Hussain, Sandy Engelhardt","doi":"10.1148/ryai.240303","DOIUrl":"10.1148/ryai.240303","url":null,"abstract":"<p><p>Purpose To develop a deep learning (DL) model that derives aligned strain values from cine (noncontrast) cardiac MRI and evaluate performance of these values to predict myocardial fibrosis in patients with Duchenne muscular dystrophy (DMD). Materials and Methods This retrospective study included 139 male patients with DMD who underwent cardiac MRI at a single center between February 2018 and April 2023. A DL pipeline was developed to detect five key frames throughout the cardiac cycle and respective dense deformation fields, allowing for phase-specific strain analysis across patients and from one key frame to the next. Effectiveness of these strain values in identifying abnormal deformations associated with fibrotic segments was evaluated in 57 patients (mean age [± SD], 15.2 years ± 3.1), and reproducibility was assessed in 82 patients by comparing the study method with existing feature-tracking and DL-based methods. Statistical analysis compared strain values using <i>t</i> tests, mixed models, and more than 2000 machine learning models; accuracy, F1 score, sensitivity, and specificity are reported. Results DL-based aligned strain identified five times more differences (29 vs five; <i>P</i> < .01) between fibrotic and nonfibrotic segments compared with traditional strain values and identified abnormal diastolic deformation patterns often missed with traditional methods. In addition, aligned strain values enhanced performance of predictive models for myocardial fibrosis detection, improving specificity by 40%, overall accuracy by 17%, and accuracy in patients with preserved ejection fraction by 61%. Conclusion The proposed aligned strain technique enables motion-based detection of myocardial dysfunction at noncontrast cardiac MRI, facilitating detailed interpatient strain analysis and allowing precise tracking of disease progression in DMD. <b>Keywords:</b> Pediatrics, Image Postprocessing, Heart, Cardiac, Convolutional Neural Network (CNN) Duchenne Muscular Dystrophy <i>Supplemental material is available for this article.</i> © RSNA, 2025.</p>","PeriodicalId":29787,"journal":{"name":"Radiology-Artificial Intelligence","volume":" ","pages":"e240303"},"PeriodicalIF":8.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unsupervised Deep Learning for Blood-Brain Barrier Leakage Detection in Diffuse Glioma Using Dynamic Contrast-enhanced MRI.","authors":"Joon Jang, Kyu Sung Choi, Junhyeok Lee, Hyochul Lee, Inpyeong Hwang, Jung Hyun Park, Jin Wook Chung, Seung Hong Choi, Hyeonjin Kim","doi":"10.1148/ryai.240507","DOIUrl":"10.1148/ryai.240507","url":null,"abstract":"<p><p>Purpose To develop an unsupervised deep learning framework for generalizable blood-brain barrier leakage detection using dynamic contrast-enhanced MRI, without requiring pharmacokinetic models and arterial input function estimation. Materials and Methods This retrospective study included data from patients who underwent dynamic contrast-enhanced MRI between April 2010 and December 2020. An autoencoder-based anomaly detection approach identified one-dimensional voxel-wise time-series abnormal signals through reconstruction residuals, separating them into residual leakage signals (RLSs) and residual vascular signals. The RLS maps were evaluated and compared with the volume transfer constant (<i>K</i>^trans) using the structural similarity index and correlation coefficient. Generalizability was tested on subsampled data, and isocitrate dehydrogenase (<i>IDH</i>) status classification performance was assessed using area under the receiver operating characteristic curve (AUC). Results A total of 274 patients (mean age, 54.4 years ± 14.6 [SD]; 164 male) were included in the study. RLS showed high structural similarity (structural similarity index, 0.91 ± 0.02) and correlation (<i>r</i> = 0.56; <i>P</i> < .001) with <i>K</i>^trans. On subsampled data, RLS maps showed better correlation with RLS values from the original data (0.89 vs 0.72; <i>P</i> < .001), higher peak signal-to-noise ratio (33.09 dB vs 28.94 dB; <i>P</i> < .001), and higher structural similarity index (0.92 vs 0.87; <i>P</i> < .001) compared with <i>K</i>^trans maps. RLS maps also outperformed <i>K</i>^trans maps in predicting <i>IDH</i> mutation status (AUC, 0.87 [95% CI: 0.83, 0.91] vs 0.81 [95% CI: 0.76, 0.85]; <i>P</i> = .02). Conclusion The unsupervised framework effectively detected blood-brain barrier leakage without pharmacokinetic models and arterial input function. <b>Keywords:</b> Dynamic Contrast-enhanced MRI, Unsupervised Learning, Feature Detection, Blood-Brain Barrier Leakage Detection <i>Supplemental material is available for this article.</i> © RSNA, 2025 See also commentary by Júdice de Mattos Farina and Kuriki in this issue.</p>","PeriodicalId":29787,"journal":{"name":"Radiology-Artificial Intelligence","volume":" ","pages":"e240507"},"PeriodicalIF":8.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open-Weight Language Models and Retrieval-Augmented Generation for Automated Structured Data Extraction from Diagnostic Reports: Assessment of Approaches and Parameters.","authors":"Mohamed Sobhi Jabal, Pranav Warman, Jikai Zhang, Kartikeye Gupta, Ayush Jain, Maciej Mazurowski, Walter Wiggins, Kirti Magudia, Evan Calabrese","doi":"10.1148/ryai.240551","DOIUrl":"10.1148/ryai.240551","url":null,"abstract":"<p><p>Purpose To develop and evaluate an automated system for extracting structured clinical information from unstructured radiology and pathology reports using open-weight language models (LMs) and retrieval-augmented generation (RAG) and to assess the effects of model configuration variables on extraction performance. Materials and Methods This retrospective study used two datasets: 7294 radiology reports annotated for Brain Tumor Reporting and Data System (BT-RADS) scores and 2154 pathology reports annotated for <i>IDH</i> mutation status (January 2017-July 2021). An automated pipeline was developed to benchmark the performance of various LMs and RAG configurations for accuracy of structured data extraction from reports. The effect of model size, quantization, prompting strategies, output formatting, and inference parameters on model accuracy was systematically evaluated. Results The best-performing models achieved up to 98% accuracy in extracting BT-RADS scores from radiology reports and greater than 90% accuracy for extraction of <i>IDH</i> mutation status from pathology reports. The best model was medical fine-tuned Llama 3. Larger, newer, and domain fine-tuned models consistently outperformed older and smaller models (mean accuracy, 86% vs 75%; <i>P</i> < .001). Model quantization had minimal effect on performance. Few-shot prompting significantly improved accuracy (mean [±SD] increase, 32% ± 32; <i>P</i> = .02). RAG improved performance for complex pathology reports by a mean of 48% ± 11 (<i>P</i> = .001) but not for shorter radiology reports (-8% ± 31; <i>P</i> = .39). Conclusion This study demonstrates the potential of open LMs in automated extraction of structured clinical data from unstructured clinical reports with local privacy-preserving application. Careful model selection, prompt engineering, and semiautomated optimization using annotated data are critical for optimal performance. <b>Keywords:</b> Large Language Models, Retrieval-Augmented Generation, Radiology, Pathology, Health Care Reports <i>Supplemental material is available for this article.</i> © RSNA, 2025 See also commentary by Tejani and Rauschecker in this issue.</p>","PeriodicalId":29787,"journal":{"name":"Radiology-Artificial Intelligence","volume":" ","pages":"e240551"},"PeriodicalIF":8.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Sham-AI Model for Intracranial Aneurysm Detection at CT Angiography.","authors":"Zhao Shi, Bin Hu, Mengjie Lu, Manting Zhang, Haiting Yang, Bo He, Jiyao Ma, Chunfeng Hu, Li Lu, Sheng Li, Shiyu Ren, Yonggao Zhang, Jun Li, Mayidili Nijiati, Jiake Dong, Hao Wang, Zhen Zhou, Fandong Zhang, Chengwei Pan, Yizhou Yu, Zijian Chen, Chang Sheng Zhou, Yongyue Wei, Junlin Zhou, Long Jiang Zhang","doi":"10.1148/ryai.240140","DOIUrl":"10.1148/ryai.240140","url":null,"abstract":"<p><p>Purpose To evaluate a sham-artificial intelligence (AI) model acting as a placebo control for a standard-AI model for diagnosis of intracranial aneurysm. Materials and Methods This retrospective crossover, blinded, multireader, multicase study was conducted from November 2022 to March 2023. A sham-AI model with near-zero sensitivity and similar specificity to a standard AI model was developed using 16 422 CT angiography examinations. Digital subtraction angiography-verified CT angiographic examinations from four hospitals were collected, half of which were processed by standard AI and the others by sham AI to generate sequence A; sequence B was generated in the reverse order. Twenty-eight radiologists from seven hospitals were randomly assigned to either sequence and then assigned to the other sequence after a washout period. The diagnostic performances of radiologists alone, radiologists with standard-AI assistance, and radiologists with sham-AI assistance were compared using sensitivity and specificity, and radiologists' susceptibility to sham AI suggestions was assessed. Results The testing dataset included 300 patients (median age, 61.0 years [IQR, 52.0-67.0]; 199 male), 50 of whom had aneurysms. Standard AI and sham AI performed as expected (sensitivity, 96.0% vs 0.0%; specificity, 82.0% vs 76.0%). The differences in sensitivity and specificity between standard AI-assisted and sham AI-assisted readings were 20.7% (95% CI: 15.8, 25.5 [superiority]) and 0.0% (95% CI: -2.0, 2.0 [noninferiority]), respectively. The difference between sham AI-assisted readings and radiologists alone was -2.6% (95% CI: -3.8, -1.4 [noninferiority]) for both sensitivity and specificity. After sham-AI suggestions, 5.3% (44 of 823) of true-positive and 1.2% (seven of 577) of false-negative results of radiologists alone were changed. Conclusion Radiologists' diagnostic performance was not compromised when aided by the proposed sham-AI model compared with their unassisted performance. <b>Keywords:</b> CT Angiography, Vascular, Intracranial Aneurysm, Sham AI <i>Supplemental material is available for this article.</i> Published under a CC BY 4.0 license. See also commentary by Mayfield and Romero in this issue.</p>","PeriodicalId":29787,"journal":{"name":"Radiology-Artificial Intelligence","volume":" ","pages":"e240140"},"PeriodicalIF":8.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}