Assisting radiologists with transformer-based fracture detection for chest radiographs

Chest x-rays are a widely used diagnostic imaging technique in the medical field, but expert interpretation can be time-consuming and subjective, leading to potential diagnostic errors. To overcome these limitations, computer-aided diagnostic (CAD) systems using artificial intelligence (AI) have been developed, with transformer-based object detectors showing promising results. This study explores the rib fracture detection power of an out-of-the-box transformer detector and examines its adaptability to medical imaging. A private dataset of 30,000 chest radiographs was used to conduct experiments and compare the performance of transformer-based object detectors with a traditional CNN-based Faster-RCNN implementation. A retrospective analysis showed that transformer detectors had superior performance (i.e., 25.3mAP vs. 23.6mAP). Additionally, a reader study was conducted to evaluate the added diagnostic value of the AI system when assisting two radiologists in diagnosing chest x-rays. The results showed that the AI system provided valuable support improving the true positive rates from 73.6% to 83.4%. In conclusion, the study highlights the potential of transformer-based object detectors as a valuable tool in medical imaging, particularly in the diagnosis of chest x-ray rib fractures.