Cardiac injury due to the rapid progress of the dislocation of rib fractures: A rare case that required urgent open reduction and internal rib fixation

Clinical evaluation of AI software for rib fracture detection and its impact on junior radiologist performance

BACKGROUND

The detection of rib fractures (RFs) on computed tomography (CT) images is time-consuming and susceptible to missed diagnosis. An automated artificial intelligence (AI) detection system may be helpful to improve the diagnostic efficiency for junior radiologists.

PURPOSE

To compare the diagnostic performance of junior radiologists with and without AI software for RF detection on chest CT images.

MATERIALS AND METHODS

Six junior radiologists from three institutions interpreted 393 CT images of patients with acute chest trauma, with and without AI software. The CT images were randomly split into two sets at each institution, with each set assigned to a different radiologist First, the detection of all fractures (AFs), including displaced fractures (DFs), non-displaced fractures and buckle fractures, was analyzed. Next, the DFs were selected for analysis. The sensitivity and specificity of the radiologist-only and radiologist-AI groups at the patient level were set as primary endpoints, and secondary endpoints were at the rib and lesion level.

RESULTS

Regarding AFs, the sensitivity difference between the radiologist-AI group and the radiologist-only group were significant at different levels (patient-level: 26.20%; rib-level: 22.18%; lesion-level: 23.74%; P < 0.001). Regarding DFs, the sensitivity difference was 16.67%, 14.19%, and 16.16% at the patient, rib, and lesion levels, respectively (P < 0.001). No significant difference was found in the specificity between the two groups for AFs and DFs at the patient and rib levels (P > 0.05).

CONCLUSION

AI software improved the sensitivity of RF detection on CT images for junior radiologists and reduced the reading time by approximately 1 min per patient without decreasing the specificity.

Surgical Stabilization of Rib Fractures: Indications, Techniques, and Pitfalls

Rib fractures are a common thoracic injury that is encountered in 20% to 39% of patients with blunt chest trauma and is associated with substantial morbidity and mortality^1,2. Traditionally, the majority of patient with rib fractures have been managed nonoperatively. Recently, the utilization of surgical stabilization of rib fractures has increased considerably because the procedure has shown improved outcomes^3-5.