%0 Journal Article
%T Radiologist-Trained AI Model for Identifying Suboptimal Chest-Radiographs.
%A Dasegowda G
%A Bizzo BC
%A Gupta RV
%A Kaviani P
%A Ebrahimian S
%A Ricciardelli D
%A Abedi-Tari F
%A Neumark N
%A Digumarthy SR
%A Kalra MK
%A Dreyer KJ
%J Acad Radiol
%V 30
%N 12
%D 12 2023 3
%M 37019698
%F 5.482
%R 10.1016/j.acra.2023.03.006
%X Suboptimal chest radiographs (CXR) can limit interpretation of critical findings. Radiologist-trained AI models were evaluated for differentiating suboptimal(sCXR) and optimal(oCXR) chest radiographs.<BR>Our IRB-approved study included 3278 CXRs from adult patients (mean age 55 ± 20 years) identified from a retrospective search of CXR in radiology reports from 5 sites. A chest radiologist reviewed all CXRs for the cause of suboptimality. The de-identified CXRs were uploaded into an AI server application for training and testing 5 AI models. The training set consisted of 2202 CXRs (n = 807 oCXR; n = 1395 sCXR) while 1076 CXRs (n = 729 sCXR; n = 347 oCXR) were used for testing. Data were analyzed with the Area under the curve (AUC) for the model's ability to classify oCXR and sCXR correctly.<BR>For the two-class classification into sCXR or oCXR from all sites, for CXR with missing anatomy, AI had sensitivity, specificity, accuracy, and AUC of 78%, 95%, 91%, 0.87(95% CI 0.82-0.92), respectively. AI identified obscured thoracic anatomy with 91% sensitivity, 97% specificity, 95% accuracy, and 0.94 AUC (95% CI 0.90-0.97). Inadequate exposure with 90% sensitivity, 93% specificity, 92% accuracy, and AUC of 0.91 (95% CI 0.88-0.95). The presence of low lung volume was identified with 96% sensitivity, 92% specificity, 93% accuracy, and 0.94 AUC (95% CI 0.92-0.96). The sensitivity, specificity, accuracy, and AUC of AI in identifying patient rotation were 92%, 96%, 95%, and 0.94 (95% CI 0.91-0.98), respectively.<BR>The radiologist-trained AI models can accurately classify optimal and suboptimal CXRs. Such AI models at the front end of radiographic equipment can enable radiographers to repeat sCXRs when necessary.