Real-Life Performance of a Commercially Available AI Tool for Post-Traumatic Intracranial Hemorrhage Detection on CT Scans: A Supportive Tool

Background: Traumatic brain injury (TBI) is a major cause of morbimortality in the world, and it can cause potential intracranial hemorrhage (ICH), a life-threatening condition that requires rapid diagnosis with computed tomography (CT). Artificial intelligence tools for ICH detection are now commercially available. Objectives: Investigate the real-world performance of qER.ai, an artificial intelligence-based CT hemorrhage detection tool, in a post-traumatic population. Methods: Retrospective monocentric observational study of a dataset of consecutively acquired head CT scans at the emergency radiology unit to explore brain trauma. AI performance was compared to ground truth determined by expert consensus. A subset of night shift cases with the radiological report of a junior resident was compared to the AI results and ground truth. Results: A total of 682 head CT scans were analyzed. AI demonstrated a sensitivity of 88.8% and a specificity of 92.1% overall, with a positive predictive value of 65.4% and a negative predictive value of 98%. AI’s performance was comparable to that of junior residents in detecting ICH, with the latter showing a sensitivity of 85.7% and a high specificity of 99.3%. Interestingly, the AI detected two out of three ICH cases missed by the junior residents. When AI assistance was integrated, the combined sensitivity improved to 95.2%, and the overall accuracy reached 98.8%. Conclusions: This study shows better performance from AI and radiologist residents working together than each one alone. These results are encouraging for rethinking the radiological workflow and the future of triage of this large population of brain traumatized patients in the emergency unit.