Diagnostic Accuracy of Ultra-Low Dose CT Compared to Standard Dose CT for Identification of Fresh Rib Fractures by Deep Learning Algorithm

The present study aimed to evaluate the diagnostic accuracy of ultra-low dose computed tomography (ULD-CT) compared to standard dose computed tomography (SD-CT) in discerning recent rib fractures using a deep learning algorithm detection of rib fractures (DLADRF). A total of 158 patients undergoing forensic diagnosis for rib fractures were included in this study: 50 underwent SD-CT, and 108 were assessed using ULD-CT. Junior and senior radiologists independently evaluated the images to identify and characterize the rib fractures. The sensitivity of rib fracture diagnosis by radiologists and radiologist + DLADRF was better using SD-CT than ULD-CT. However, the diagnosis sensitivity of DLADRF using ULD-CT alone was slightly more than SD-CT. Nonetheless, no substantial differences were observed in specificity, positive predictive value, and negative predictive value between SD-CT and ULD-CT by the same radiologist, radiologist + DLADRF, and DLADRF (P > 0.05). The area under the curve (AUC) of receiver operating characteristic indicated that senior radiologist + DLADRF was significantly better than senior and junior radiologists, junior radiologists + DLADRF, and DLADRF alone using SD-CT or ULD-CT (all P < 0.05). Also, junior radiologists + DLADRF was better with ULD-CT than senior and junior radiologists (P < 0.05). The AUC of the rib fracture diagnosed by senior radiologists did not differ from DLADRF using ULD-CT. Also, no significant differences were observed between junior + AI and senior and between junior and DLADRF using SD-CT. DLADRF enhanced the diagnostic performance of radiologists in detecting recent rib fractures. The diagnostic outcomes between SD-CT and ULD-CT across radiologists' experience and DLADRF did not differ significantly.