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Journal of the American College of Radiology : JACR

Prospective Shadow-Mode Evaluation of an Artificial Intelligence Tool for Intracranial Aneurysm Detection on CT Angiography: Incremental Yield and Operational Impact

This prospective shadow-mode study evaluated an FDA-cleared AI algorithm (Aidoc) for intracranial aneurysm detection on 3,856 consecutive brain CT angiographies (November 7 to December 19, 2023) with radiologists blinded to AI, finding that AI alone achieved higher sensitivity (0.846) than radiologists alone (0.718) with similar specificity (0.987 vs 0.985), radiologist-AI concordance was 96.3%, AI surfaced additional aneurysms missed by radiologists with a relative enhanced detection rate (rEDR) of 39% (55 AI-only true-positives per 140 radiologist true-positives), an AI:radiologist incremental detection ratio of 1.83 (55 of 30), a favorable gain-to-pain ratio (GPR) of 1.20 (55 of 46), and a number-needed-to-examine (NNE) of 70.