AI辅助医生复查胸片,发现漏诊病灶并推荐可疑区域。
Beyond the First Read: AI-Assisted Perceptual Error Detection in Chest Radiography Accounting for Interobserver Variability
- 基于医生已标注结果,分析局部区域漏诊可能
- 召回率达78%,90%推荐区域重合度超0.5
- 适合需要提升诊断一致性的人工智能辅助场景
胸部X光广泛用于诊断影像。然而,感知错误——尤其是被忽略但可见的异常——仍常见且具临床意义。当前工作流程和AI系统在解读后对这类错误支持有限,且缺乏有意义的人机协作。我们提出RADAR( Radiologist--AI Diagnostic Assistance and Review),一种解读后的辅助系统。RADAR接收已定稿的放射科医生标注和胸片图像,进行区域级分析,检测并提示潜在漏诊区域。该系统支持‘二次检查’流程,提供建议感兴趣区域(ROIs)而非固定标签,以适应观察者间差异。我们在一个源自匿名胸片案例的模拟感知错误数据集上评估RADAR,使用F1分数和交并比(IoU)为主要指标。RADAR在检测漏诊异常中达到0.78的召回率、0.44的精确率和0.56的F1分数。尽管精确率中等,这降低了对AI的过度依赖,鼓励医生在人机协作中保持审慎。中位IoU为0.78,超过90%的推荐区域交并比高于0.5,表明定位准确。RADAR有效补充医生判断,为胸片解读中的感知错误检测提供有价值的读片后支持。其灵活的ROI建议与非侵入式集成使其成为真实放射科工作流中的有前景工具。为促进可复现性和进一步评估,我们发布全开源网页实现及模拟错误数据集。所有代码、数据、演示视频和应用均公开于https://github.com/avutukuri01/RADAR。
原文摘要 · Abstract (English)
Chest radiography is widely used in diagnostic imaging. However, perceptual errors -- especially overlooked but visible abnormalities -- remain common and clinically significant. Current workflows and AI systems provide limited support for detecting such errors after interpretation and often lack meaningful human--AI collaboration. We introduce RADAR (Radiologist--AI Diagnostic Assistance and Review), a post-interpretation companion system. RADAR ingests finalized radiologist annotations and CXR images, then performs regional-level analysis to detect and refer potentially missed abnormal regions. The system supports a "second-look" workflow and offers suggested regions of interest (ROIs) rather than fixed labels to accommodate inter-observer variation. We evaluated RADAR on a simulated perceptual-error dataset derived from de-identified CXR cases, using F1 score and Intersection over Union (IoU) as primary metrics. RADAR achieved a recall of 0.78, precision of 0.44, and an F1 score of 0.56 in detecting missed abnormalities in the simulated perceptual-error dataset. Although precision is moderate, this reduces over-reliance on AI by encouraging radiologist oversight in human--AI collaboration. The median IoU was 0.78, with more than 90% of referrals exceeding 0.5 IoU, indicating accurate regional localization. RADAR effectively complements radiologist judgment, providing valuable post-read support for perceptual-error detection in CXR interpretation. Its flexible ROI suggestions and non-intrusive integration position it as a promising tool in real-world radiology workflows. To facilitate reproducibility and further evaluation, we release a fully open-source web implementation alongside a simulated error dataset. All code, data, demonstration videos, and the application are publicly available at https://github.com/avutukuri01/RADAR.
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