Assessing an AI-based Smart Imagery Framing and Truthing (SIFT) system to assist radiologists annotating lung...

To assess a Smart Imagery Framing and Truthing (SIFT) system in automatically labeling and annotating chest X-ray (CXR) images with multiple diseases as an assist to radiologists on multi-disease CXRs. SIFT system was developed by integrating a convolutional neural network based-augmented MaskR-CNN and a multi-layer perceptron neural network. It is trained with images containing 307,415 ROIs representing 69 different abnormalities and 67,071 normal CXRs. SIFT automatically labels ROIs with a specific type of abnormality, annotates fine-grained boundary, gives confidence score, and recommends other possible types of abnormality. An independent set of 178 CXRs containing 272 ROIs depicting five different abnormalities including pulmonary tuberculosis, pulmonary nodule, pneumonia, COVID-19, and fibrogenesis was used to evaluate radiologists' performance based on three radiologists in a double-blinded study. The radiologist first manually annotated each ROI without SIFT. Two weeks later, the radiologist annotated the same ROIs with SIFT aid to generate final results. Evaluation of consistency, efficiency and accuracy for radiologists with and without SIFT was conducted. After using SIFT, radiologists accept 93% SIFT annotated area, and variation across annotated area reduce by 28.23%. Inter-observer variation improves by 25.27% on averaged IOU. The consensus true positive rate increases by 5.00% (p=0.16), and false positive rate decreases by 27.70% (p<0.001). The radiologist's time to annotate these cases decreases by 42.30%. Performance in labelling abnormalities statistically remains the same. Independent observer study showed that SIFT is a promising step toward improving the consistency and efficiency of annotation, which is important for improving clinical X-ray diagnostic and monitoring efficiency.