Artificial Intelligence-Supported Early Detection of Lung Cancer from Chest X-ray in Routine Clinical Practice: Real-World, Multicenter Study Across Czech Hospitals
| Autoři | |
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| Rok publikování | 2025 |
| Druh | Konferenční abstrakty |
| Citace | |
| Popis | Background Although AI systems for chest X-ray (CXR) interpretation may enable earlier detection of thoracic malignancy in routine care, large-scale real-world evidence remains limited. We present results of a joint Carebot–Bristol Myers Squibb (BMS) program integrating AI decision-support into routine workflows to evaluate feasibility, flagged-case yield, and downstream actions for suspected thoracic malignancy (primary lung cancer or pulmonary metastases). Methods All CXRs across nine Czech hospitals (regional and tertiary; two pneumo-oncology centers) from Jan 1–Jun 30, 2025 were automatically analyzed with commercial-stage AI software (Carebot AI CXR; Carebot s.r.o., Czechia). The AI flagged abnormalities; a joint panel of hospital and interim Carebot radiologists reviewed and classified exams as suspicious or not for thoracic malignancy. Suspicious cases entered fast-track diagnostics. Primary outcomes: (i) proportion flagged as suspicious, (ii) patients referred for diagnostic work-up, and (iii) confirmed malignancies. Results Among 96 459 CXRs, the algorithm identified abnormalities in 16 030 exams (16.6%). Multidisciplinary review classified 837 CXRs (0.87%) as suspicious. Follow-up status was available in 561/837 (67.0%): 211 (25.2% of all suspicious; 37.6% of those with status) were referred for immediate diagnostic work-up, 350 (41.8% of all; 62.4% of recorded) were cleared without further work-up, and 276 (33.0%) remain under evaluation. Among the 211 investigated, 54 previously undiagnosed thoracic cancers were detected, 70 confirmed known malignancies or pulmonary metastases, 38 await confirmation of nodule origin (biopsy or PET/CT), 20 entered long-term radiologic surveillance, and 29 were recalled owing to missing clinical data. Conclusions In this single-country, real-world, multicenter analysis of routine CXR exams during H1-2025, the Carebot–BMS AI triage workflow enabled early identification of thoracic malignancies within routine care while triaging <1% of exams for expedited review. Ongoing follow-up and planned health-economic work will further characterize long-term value and scalability of this AI-supported workflow. |