Burdenless Incidental AI

A team of IBM Watson Health researchers developed an interesting image and text-based AI system that could significantly improve incidental lung nodule detection, without being “overly burdensome” for radiologists. That seems like a clinical and workflow win-win for any incidental AI system, and makes this study worth a deeper look.

Watson Health’s R&D-stage AI system automatically detects potential lung nodules in chest and abdominal CTs, and then analyzes the text in corresponding radiology reports to confirm whether they mention lung nodules. In clinical practice, the system would flag exams with potentially missed nodules for radiologist review.

The researchers used the AI system to analyze 32k CTs sourced from three health systems in the US and UK. They then had radiologists review the 415 studies that the AI system flagged for potentially missed pulmonary nodules, finding that it:

  • Caught 100 exams containing at least one missed nodule
  • Flagged 315 exams that didn’t feature nodules (false positives)
  • Achieved a 24% overall positive predictive value
  • Produced just a 1% false positive rate

The AI system’s combined ability to detect missed pulmonology nodules while “minimizing” radiologists’ re-reading labor was enough to make the authors optimistic about this type of AI. They specifically suggested that it could be a valuable addition to Quality Assurance programs, improving patient care while avoiding the healthcare and litigation costs that can come from missed findings.

The Takeaway

Watson Health’s new AI system adds to incidental AI’s growing momentum, joining a number of research and clinical-stage solutions that emerged in the last two years. However, this system’s ability to cross-reference radiology report text and apparent ability to minimize false positives are relatively unique. 

Even if most incidental AI tools aren’t ready for everyday clinical use, and their potential to increase re-read labor might be alarming to some rads, these solutions’ ability to catch earlier stage diseases and minimize the impact of diagnostic “misses” could earn the attention of a wide range of healthcare stakeholders going forward.

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-- The Imaging Wire team