Automated detection of radiolucent foreign body aspiration on chest CT using deep learning

Radiolucent foreign body aspiration (FBA) remains diagnostically challenging due to its subtle imaging signatures on chest CT scans, often leading to delayed or missed diagnoses. We present a deep learning model integrating MedpSeg, a high-precision airway segmentation method, with a convolutional classifier to detect radiolucent FBA. The model was trained and validated across three independent cohorts, demonstrating consistent performance with accuracies above 90% and balanced recall-precision metrics. In a blinded independent evaluation cohort, the model outperformed expert radiologists in both recall (71.4% vs. 35.7%) and F1 score (74.1% vs. 52.6%), highlighting its potential to reduce missed cases (false negatives) and support clinical decision-making. This study illustrates the translational potential of artificial intelligence for addressing diagnostically complex and high-risk conditions, offering an effective tool to support radiologists in the assessment of suspected radiolucent foreign body aspiration. Code is available at https://github.com/ZheChen1999/FBA_DL .