Clinical Validation of Commercial AI Software for the Detection of Incidental Vertebral Compression Fractures in CT Scans of the Chest and Abdomen
<b>Background/Objectives:</b> The objective of this study was to clinically validate the performance of the Nanox.AI HealthOST software in detecting incidental vertebral compression fractures (VCFs) on outpatient chest and abdomen CT scans using sensitivity, specificity, positive predict...
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MDPI AG
2025-06-01
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| author | Vinu Mathew Dawn Pearce Noah Kates Rose Sidharth Saini Earl Bogoch |
| author_facet | Vinu Mathew Dawn Pearce Noah Kates Rose Sidharth Saini Earl Bogoch |
| author_sort | Vinu Mathew |
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| description | <b>Background/Objectives:</b> The objective of this study was to clinically validate the performance of the Nanox.AI HealthOST software in detecting incidental vertebral compression fractures (VCFs) on outpatient chest and abdomen CT scans using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A secondary aim was to assess the rate of missed VCFs using initial radiologist reports. <b>Methods:</b> A retrospective analysis was performed on 590 outpatient CT scans. HealthOST, an artificial intelligence solution from Nanox.AI that allows for automated spine analysis using CT images was evaluated against a consensus ground truth established by two radiologists, including a senior musculoskeletal radiologist. Two vertebral body height reduction thresholds were tested: mild (>20%) and moderate (>25%). Original radiologist reports were reviewed to identify missed VCFs. <b>Results:</b> At the 20% threshold, the AI achieved a sensitivity of 92.0%, a specificity of 52.7%, a PPV of 16.5%, and an NPV of 98.5%. At the 25% threshold, sensitivity decreased to 78.0%, while specificity improved to 94.2%, with a PPV of 51.1% and an NPV of 98.2%. The AI identified 88% and 92% of fractures missed by radiologists at the 20% and 25% thresholds, respectively. <b>Conclusions:</b> The Nanox HealthOST AI solution demonstrates potential as an effective screening tool, with threshold selection adaptable to clinical needs with a secondary review by a radiologist that is advisable to ensure diagnostic accuracy. The study further indicates that radiologists often overlook VCFs in reporting non-indicated cases and that AI has a role in enhancing the detection and reporting of vertebral compression fractures in routine clinical practice. |
| format | Article |
| id | doaj-art-64d6f91e9cd24bc597a22b850deb0f56 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-06-01 |
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| series | Diagnostics |
| spelling | doaj-art-64d6f91e9cd24bc597a22b850deb0f562025-08-20T03:24:32ZengMDPI AGDiagnostics2075-44182025-06-011512153010.3390/diagnostics15121530Clinical Validation of Commercial AI Software for the Detection of Incidental Vertebral Compression Fractures in CT Scans of the Chest and AbdomenVinu Mathew0Dawn Pearce1Noah Kates Rose2Sidharth Saini3Earl Bogoch4Department of Medical Imaging, University of Toronto, Toronto, ON M5T 1W7, CanadaDepartment of Medical Imaging, Musculoskeletal Division, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, CanadaDepartment of Medical Imaging, University of Toronto, Toronto, ON M5T 1W7, CanadaDepartment of Medical Imaging, Musculoskeletal Division, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, CanadaDepartment of Surgery, University of Toronto, Toronto, ON M5S 1A1, Canada<b>Background/Objectives:</b> The objective of this study was to clinically validate the performance of the Nanox.AI HealthOST software in detecting incidental vertebral compression fractures (VCFs) on outpatient chest and abdomen CT scans using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A secondary aim was to assess the rate of missed VCFs using initial radiologist reports. <b>Methods:</b> A retrospective analysis was performed on 590 outpatient CT scans. HealthOST, an artificial intelligence solution from Nanox.AI that allows for automated spine analysis using CT images was evaluated against a consensus ground truth established by two radiologists, including a senior musculoskeletal radiologist. Two vertebral body height reduction thresholds were tested: mild (>20%) and moderate (>25%). Original radiologist reports were reviewed to identify missed VCFs. <b>Results:</b> At the 20% threshold, the AI achieved a sensitivity of 92.0%, a specificity of 52.7%, a PPV of 16.5%, and an NPV of 98.5%. At the 25% threshold, sensitivity decreased to 78.0%, while specificity improved to 94.2%, with a PPV of 51.1% and an NPV of 98.2%. The AI identified 88% and 92% of fractures missed by radiologists at the 20% and 25% thresholds, respectively. <b>Conclusions:</b> The Nanox HealthOST AI solution demonstrates potential as an effective screening tool, with threshold selection adaptable to clinical needs with a secondary review by a radiologist that is advisable to ensure diagnostic accuracy. The study further indicates that radiologists often overlook VCFs in reporting non-indicated cases and that AI has a role in enhancing the detection and reporting of vertebral compression fractures in routine clinical practice.https://www.mdpi.com/2075-4418/15/12/1530vertebral compression fracturesartificial intelligenceosteoporosisspine imaging |
| spellingShingle | Vinu Mathew Dawn Pearce Noah Kates Rose Sidharth Saini Earl Bogoch Clinical Validation of Commercial AI Software for the Detection of Incidental Vertebral Compression Fractures in CT Scans of the Chest and Abdomen Diagnostics vertebral compression fractures artificial intelligence osteoporosis spine imaging |
| title | Clinical Validation of Commercial AI Software for the Detection of Incidental Vertebral Compression Fractures in CT Scans of the Chest and Abdomen |
| title_full | Clinical Validation of Commercial AI Software for the Detection of Incidental Vertebral Compression Fractures in CT Scans of the Chest and Abdomen |
| title_fullStr | Clinical Validation of Commercial AI Software for the Detection of Incidental Vertebral Compression Fractures in CT Scans of the Chest and Abdomen |
| title_full_unstemmed | Clinical Validation of Commercial AI Software for the Detection of Incidental Vertebral Compression Fractures in CT Scans of the Chest and Abdomen |
| title_short | Clinical Validation of Commercial AI Software for the Detection of Incidental Vertebral Compression Fractures in CT Scans of the Chest and Abdomen |
| title_sort | clinical validation of commercial ai software for the detection of incidental vertebral compression fractures in ct scans of the chest and abdomen |
| topic | vertebral compression fractures artificial intelligence osteoporosis spine imaging |
| url | https://www.mdpi.com/2075-4418/15/12/1530 |
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