Can AI generate diagnostic reports for radiologist approval on CXR images? A multi-reader and multi-case observer performance study.

Background: Accurately detecting a variety of lung abnormalities from heterogenous chest X-ray (CXR) images and writing radiology reports is often difficult and time-consuming.

Objective: To access the utility of a novel artificial intelligence (AI) system (MOM-ClaSeg) in enhancing the accuracy and efficiency of radiologists in detecting heterogenous lung abnormalities through a multi-reader and multi-case (MRMC) observer performance study.

Methods: Over 36,000 CXR images were retrospectively collected from 12 hospitals over 4 months and used as the experiment group and the control group. In the control group, a double reading method is used in which two radiologists interpret CXR to generate a final report, while in the experiment group, one radiologist generates the final reports based on AI-generated reports.

Results: Compared with double reading, the diagnostic accuracy and sensitivity of single reading with AI increases significantly by 1.49% and 10.95%, respectively (P <  0.001), while the difference in specificity is small (0.22%) and without statistical significance (P = 0.255). Additionally, the average image reading and diagnostic time in the experimental group is reduced by 54.70% (P <  0.001).

Conclusion: This MRMC study demonstrates that MOM-ClaSeg can potentially serve as the first reader to generate the initial diagnostic reports, with a radiologist only reviewing and making minor modifications (if needed) to arrive at the final decision. It also shows that single reading with AI can achieve a higher diagnostic accuracy and efficiency than double reading.