Analysis of the diagnostic and economic impact of the combined artificial intelligence algorithm for analysis of 10 pathological findings on chest computed tomography

Abstract

Background: Artificial intelligence (AI) technologies can help to solve the problem of missed findings in radiology studies. An important issue is assessing the economic benefits of implementing AI.
 Aim: to evaluate the incidence of pathologies and the economic potential of AI technology for chest CT, validated by radiologists, compared with radiologists without access to AI in a private medical centre.
 Methods: An observational, single-center retrospective study was conducted. The study included chest CTs without IV contrast performed from 01.06.2022 to 31.07.2022 in "YAUZA MEDICAL CENTER LLC", Moscow. The CTs were processed using a complex AI algorithm for 10 pathologies: infiltrative changes in the lungs, typical for viral pneumonia (COVID-19 in pandemic conditions); pulmonary nodules; free fluid in pleural cavities; pulmonary emphysema; increased thoracic aortic diameter; increased pulmonary artery trunk diameter; coronary calcinosis; adrenal thickness evaluation; vertebral body height and density. 2 experts analysed CTs and compared results with AI. For all findings detected and not detected by radiologists, further routing was determined, according to clinical guidelines. An under-recovery was calculated for each patient according to the hospital price list.
 Results: From the final 160 CTs the AI identified 90 (56%) studies with pathology, of which 81 (51%) were missing at least one pathology in the report. The "second-stage" lost profit for all pathologies from 81 patients was 2,847,760 RUB (37250.99＄ or 256,217.95 CNY). The "second-stage" profit shortfall only for those pathologies that were missed by radiologists but detected by AI was RUB 2,065,360 (＄27,016.57 or CNY 185,824.05).
 Conclusion: The use of AI for chest CTs as an assistant to the radiologist can significantly reduce the number of missed abnormalities. The use of AI can bring 3.6 times more benefit compared to the standard model without AI. The use of complex AI for chest CT can be cost-effective.