Interpretable Artificial Intelligence for Detecting Acute Heart Failure on Acute Chest CT Scans

Fuente: arXiv
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Auteurs principaux: Ørting, Silas Nyboe, Miger, Kristina, Olesen, Anne Sophie Overgaard, Boesen, Mikael Ploug, Andersen, Michael Brun, Petersen, Jens, Nielsen, Olav W., de Bruijne, Marleen
Format: Preprint
Publié: 2025
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author Ørting, Silas Nyboe
Miger, Kristina
Olesen, Anne Sophie Overgaard
Boesen, Mikael Ploug
Andersen, Michael Brun
Petersen, Jens
Nielsen, Olav W.
de Bruijne, Marleen
author_facet Ørting, Silas Nyboe
Miger, Kristina
Olesen, Anne Sophie Overgaard
Boesen, Mikael Ploug
Andersen, Michael Brun
Petersen, Jens
Nielsen, Olav W.
de Bruijne, Marleen
contents Introduction: Chest CT scans are increasingly used in dyspneic patients where acute heart failure (AHF) is a key differential diagnosis. Interpretation remains challenging and radiology reports are frequently delayed due to a radiologist shortage, although flagging such information for emergency physicians would have therapeutic implication. Artificial intelligence (AI) can be a complementary tool to enhance the diagnostic precision. We aim to develop an explainable AI model to detect radiological signs of AHF in chest CT with an accuracy comparable to thoracic radiologists. Methods: A single-center, retrospective study during 2016-2021 at Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark. A Boosted Trees model was trained to predict AHF based on measurements of segmented cardiac and pulmonary structures from acute thoracic CT scans. Diagnostic labels for training and testing were extracted from radiology reports. Structures were segmented with TotalSegmentator. Shapley Additive explanations values were used to explain the impact of each measurement on the final prediction. Results: Of the 4,672 subjects, 49% were female. The final model incorporated twelve key features of AHF and achieved an area under the ROC of 0.87 on the independent test set. Expert radiologist review of model misclassifications found that 24 out of 64 (38%) false positives and 24 out of 61 (39%) false negatives were actually correct model predictions, with the errors originating from inaccuracies in the initial radiology reports. Conclusion: We developed an explainable AI model with strong discriminatory performance, comparable to thoracic radiologists. The AI model's stepwise, transparent predictions may support decision-making.
format Preprint
id arxiv_https___arxiv_org_abs_2507_08952
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Interpretable Artificial Intelligence for Detecting Acute Heart Failure on Acute Chest CT Scans
Ørting, Silas Nyboe
Miger, Kristina
Olesen, Anne Sophie Overgaard
Boesen, Mikael Ploug
Andersen, Michael Brun
Petersen, Jens
Nielsen, Olav W.
de Bruijne, Marleen
Image and Video Processing
Computer Vision and Pattern Recognition
Introduction: Chest CT scans are increasingly used in dyspneic patients where acute heart failure (AHF) is a key differential diagnosis. Interpretation remains challenging and radiology reports are frequently delayed due to a radiologist shortage, although flagging such information for emergency physicians would have therapeutic implication. Artificial intelligence (AI) can be a complementary tool to enhance the diagnostic precision. We aim to develop an explainable AI model to detect radiological signs of AHF in chest CT with an accuracy comparable to thoracic radiologists. Methods: A single-center, retrospective study during 2016-2021 at Copenhagen University Hospital - Bispebjerg and Frederiksberg, Denmark. A Boosted Trees model was trained to predict AHF based on measurements of segmented cardiac and pulmonary structures from acute thoracic CT scans. Diagnostic labels for training and testing were extracted from radiology reports. Structures were segmented with TotalSegmentator. Shapley Additive explanations values were used to explain the impact of each measurement on the final prediction. Results: Of the 4,672 subjects, 49% were female. The final model incorporated twelve key features of AHF and achieved an area under the ROC of 0.87 on the independent test set. Expert radiologist review of model misclassifications found that 24 out of 64 (38%) false positives and 24 out of 61 (39%) false negatives were actually correct model predictions, with the errors originating from inaccuracies in the initial radiology reports. Conclusion: We developed an explainable AI model with strong discriminatory performance, comparable to thoracic radiologists. The AI model's stepwise, transparent predictions may support decision-making.
title Interpretable Artificial Intelligence for Detecting Acute Heart Failure on Acute Chest CT Scans
topic Image and Video Processing
Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2507.08952