Medical imaging, particularly radiography, is an indispensable part of diagnosing many chest diseases. Final diagnoses are made by radiologists based on images, but the decision-making process is always associated with a risk of incorrect interpretation. Incorrectly interpreted data can lead to delays in treatment, a prescription of inappropriate therapy, or even a completely missed diagnosis. In this context, our study aims to determine whether it is possible to predict diagnostic errors made by radiologists using eye-tracking technology. For this purpose, we asked 4 radiologists with different levels of experience to analyze 1000 images covering a wide range of chest diseases. Using eye-tracking data, we calculated the radiologists' gaze fixation points and generated feature vectors based on this data to describe the radiologists' gaze behavior during image analysis. Additionally, we emulated the process of revealing the read images following radiologists' gaze data to create a more comprehensive picture of their analysis. Then we applied a recurrent neural network to predict diagnostic errors. Our results showed a 0.7755 ROC AUC score, demonstrating a significant potential for this approach in enhancing the accuracy of diagnostic error recognition.

The increase in medical imaging and, consequently, the growing workload of radiologists requires workflow optimization. The interaction between radiologists and artificial intelligence is a promising area because it can improve radiologist productivity and reduce diagnostic errors. In this study, we describe an eye-tracking experiment with four practicing radiologists who cumulatively examined 1,000 unique chest X-ray images that included samples with multiple pathologies. We demonstrate the feasibility of a self-supervised approach for gazebased data for problems with a small amount of labeled data. We achieve an accuracy of 64.7% for binary classification of radiologist diagnostic error with 218 samples per label. The proposed approach can be used in the system for assessing the need for a second opinion to improve the quality of diagnostics.

Morphological abnormalities of the femoroacetabular (hip) joint are among the most common human musculoskeletal disorders and often develop asymptomatically at early easily treatable stages. In this paper, we propose an automated framework for landmark-based detection and quantification of hip abnormalities from magnetic resonance (MR) images. The framework relies on a novel idea of multi-landmark environment analysis with reinforcement learning. In particular, we merge the concepts of the graphical lasso and Morris sensitivity analysis with deep neural networks to quantitatively estimate the contribution of individual landmark and landmark subgroup locations to the other landmark locations. Convolutional neural networks for image segmentation are utilized to propose the initial landmark locations, and landmark detection is then formulated as a reinforcement learning (RL) problem, where each landmark-agent can adjust its position by observing the local MR image neighborhood and the locations of the most-contributive landmarks. The framework was validated on T1-, T2- and proton density-weighted MR images of 260 patients with the aim to measure the lateral center-edge angle (LCEA), femoral neck-shaft angle (NSA), and the anterior and posterior acetabular sector angles (AASA and PASA) of the hip, and derive the quantitative abnormality metrics from these angles. The framework was successfully tested using the UNet and feature pyramid network (FPN) segmentation architectures for landmark proposal generation, and the deep Q-network (DeepQN), deep deterministic policy gradient (DDPG), twin delayed deep deterministic policy gradient (TD3), and actor-critic policy gradient (A2C) RL networks for landmark position optimization. The resulting overall landmark detection error of 1.5 mm and angle measurement error of 1.4° indicates a superior performance in comparison to existing methods. Moreover, the automatically estimated abnormality labels were in 95% agreement with those generated by an expert radiologist.

Around 60-80% of radiological errors are attributed to overlooked abnormalities, the rate of which increases at the end of work shifts. In this study, we run an experiment to investigate if artificial intelligence (AI) can assist in detecting radiologists' gaze patterns that correlate with fatigue. A retrospective database of lung X-ray images with the reference diagnoses was used. The X-ray images were acquired from 400 subjects with a mean age of 49 ± 17, and 61% men. Four practicing radiologists read these images while their eye movements were recorded. The radiologists passed a series of concentration tests at prearranged breaks of the experiment. A U-Net neural network was adapted to annotate lung anatomy on X-rays and calculate coverage and information gain features from the radiologists' eye movements over lung fields. The lung coverage, information gain, and eye tracker-based features were compared with the cumulative work done (CDW) label for each radiologist. The gaze-traveled distance, X-ray coverage, and lung coverage statistically significantly (p < 0.01) deteriorated with cumulative work done (CWD) for three out of four radiologists. The reading time and information gain over lungs statistically significantly deteriorated for all four radiologists. We discovered a novel AI-based metric blending reading time, speed, and organ coverage, which can be used to predict changes in the fatigue-related image reading patterns.

Pneumothorax is potentially a life-threatening disease that requires urgent diagnosis and treatment. The chest X-ray is the diagnostic modality of choice when pneumothorax is suspected. The computer-aided diagnosis of pneumothorax has received a dramatic boost in the last few years due to deep learning advances and the first public pneumothorax diagnosis competition with 15257 chest X-rays manually annotated by a team of 19 radiologists. This paper describes one of the top frameworks that participated in the competition. The framework investigates the benefits of combining the Unet convolutional neural network with various backbones, namely ResNet34, SE-ResNext50, SE-ResNext101, and DenseNet121. The paper presents a step-by-step instruction for the framework application, including data augmentation, and different pre- and post-processing steps. The performance of the framework was of 0.8574 measured in terms of the Dice coefficient. The second contribution of the paper is the comparison of the deep learning framework against three experienced radiologists on the pneumothorax detection and segmentation on challenging X-rays. We also evaluated how diagnostic confidence of radiologists affects the accuracy of the diagnosis and observed that the deep learning framework and radiologists find the same X-rays to be easy/difficult to analyze (p-value <1e4). Finally, the methodology of all top-performing teams from the competition leaderboard was analyzed to find the consistent methodological patterns of accurate pneumothorax detection and segmentation.