Automated radiology alert system for pneumothorax detection on chest radiographs improves efficiency and diagnostic performance

Cheng Yi Kao, Chiao Yun Lin, Cheng Chen Chao, Han Sheng Huang, Hsing Yu Lee, Chia Ming Chang, Kang Sung, Ting Rong Chen, Po Chang Chiang, Li Ting Huang, Bow Wang, Yi Sheng Liu, Jung Hsien Chiang, Chien Kuo Wang, Yi Shan Tsai

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


We aimed to set up an Automated Radiology Alert System (ARAS) for the detection of pneumothorax in chest radiographs by a deep learning model, and to compare its efficiency and diagnostic performance with the existing Manual Radiology Alert System (MRAS) at the tertiary medical center. This study retrospectively collected 1235 chest radiographs with pneumothorax labeling from 2013 to 2019, and 337 chest radiographs with negative findings in 2019 were separated into training and validation datasets for the deep learning model of ARAS. The efficiency before and after using the model was compared in terms of alert time and report time. During parallel running of the two systems from September to October 2020, chest radiographs prospectively acquired in the emergency department with age more than 6 years served as the testing dataset for comparison of diagnostic performance. The efficiency was improved after using the model, with mean alert time improving from 8.45 min to 0.69 min and the mean report time from 2.81 days to 1.59 days. The comparison of the diagnostic performance of both systems using 3739 chest radiographs acquired during parallel running showed that the ARAS was better than the MRAS as assessed in terms of sensitivity (recall), area under receiver operating characteristic curve, and F1 score (0.837 vs. 0.256, 0.914 vs. 0.628, and 0.754 vs. 0.407, respectively), but worse in terms of positive predictive value (PPV) (precision) (0.686 vs. 1.000). This study had successfully designed a deep learning model for pneumothorax detection on chest radiographs and set up an ARAS with improved efficiency and overall diagnostic performance.

Original languageEnglish
Article number1182
Issue number7
Publication statusPublished - 2021 Jul

All Science Journal Classification (ASJC) codes

  • Clinical Biochemistry


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