Multi-Centre Validation of a Deep Learning Model for Scoliosis Assessment

Scoliosis affects roughly 2 to 4 percent of adolescents, and treatment decisions depend on precise Cobb angle measurement. Manual assessment is time consuming and subject to inter observer variation. We conducted a retrospective, multi centre evaluation of a fully automated deep learning software (Carebot AI Bones, Spine Measurement functionality; Carebot s.r.o.) on 103 standing anteroposterior whole spine radiographs collected from ten hospitals. Two musculoskeletal radiologists independently measured each study and served as reference readers. Agreement between the AI and each radiologist was assessed with Bland Altman analysis, mean absolute error (MAE), root mean squared error (RMSE), Pearson correlation coefficient, and Cohen kappa for four grade severity classification. Against Radiologist 1 the AI achieved an MAE of 3.89 degrees (RMSE 4.77 degrees) with a bias of 0.70 degrees and limits of agreement from minus 8.59 to plus 9.99 degrees. Against Radiologist 2 the AI achieved an MAE of 3.90 degrees (RMSE 5.68 degrees) with a bias of 2.14 degrees and limits from minus 8.23 to plus 12.50 degrees. Pearson correlations were r equals 0.906 and r equals 0.880 (inter reader r equals 0.928), while Cohen kappa for severity grading reached 0.51 and 0.64 (inter reader kappa 0.59). These results demonstrate that the proposed software reproduces expert level Cobb angle measurements and categorical grading across multiple centres, suggesting its utility for streamlining scoliosis reporting and triage in clinical workflows.

Can Deep Learning Reliably Recognize Abnormality Patterns on Chest X-rays? A Multi-Reader Study Examining One Month of AI Implementation in Everyday Radiology Clinical Practice

In this study, we developed a deep-learning-based automatic detection algorithm (DLAD, Carebot AI CXR) to detect and localize seven specific radiological findings (atelectasis (ATE), consolidation (CON), pleural effusion (EFF), pulmonary lesion (LES), subcutaneous emphysema (SCE), cardiomegaly (CMG), pneumothorax (PNO)) on chest X-rays (CXR). We collected 956 CXRs and compared the performance of the DLAD with that of six individual radiologists who assessed the images in a hospital setting. The proposed DLAD achieved high sensitivity (ATE 1.000 (0.624-1.000), CON 0.864 (0.671-0.956), EFF 0.953 (0.887-0.983), LES 0.905 (0.715-0.978), SCE 1.000 (0.366-1.000), CMG 0.837 (0.711-0.917), PNO 0.875 (0.538-0.986)), even when compared to the radiologists (LOWEST: ATE 0.000 (0.000-0.376), CON 0.182 (0.070-0.382), EFF 0.400 (0.302-0.506), LES 0.238 (0.103-0.448), SCE 0.000 (0.000-0.634), CMG 0.347 (0.228-0.486), PNO 0.375 (0.134-0.691), HIGHEST: ATE 1.000 (0.624-1.000), CON 0.864 (0.671-0.956), EFF 0.953 (0.887-0.983), LES 0.667 (0.456-0.830), SCE 1.000 (0.366-1.000), CMG 0.980 (0.896-0.999), PNO 0.875 (0.538-0.986)). The findings of the study demonstrate that the suggested DLAD holds potential for integration into everyday clinical practice as a decision support system, effectively mitigating the false negative rate associated with junior and intermediate radiologists.