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AI Detects Over Half of Metastases Overlooked by Radiologists on CT

By MedImaging International staff writers
Posted on 13 Apr 2023

Image: AI-powered software reduces frequency of overlooked small liver metastases on contrast-enhanced CT (Photo courtesy of Freepik)

Early detection of liver metastases is critical for improving patient outcomes, but physicians may sometimes miss the most common malignant liver tumors, resulting in delayed or missed treatment opportunities. Now, a new study has discovered that artificial intelligence (AI) can detect over 50% of liver metastases that radiologists overlook on contrast-enhanced CT scans.

Scientists at Kyoto University Graduate School of Medicine (Kyoto, Japan) aimed to determine whether AI could assist radiologists in reducing the number of missed cases. They reviewed the records of close to 750 patients diagnosed with liver metastases at their institution between 2010-2017. Two expert abdominal radiologists categorized cases as either missed or correctly identified by physicians at the time. This led to a final sample of approximately 135 patients, with 68 classified as having overlooked metastases.

The AI software was then used to process the 100-plus images and successfully detected liver metastases in 54% of patients whose findings were missed by human readers. The per-lesion sensitivity was 70.1% across all liver lesion types, 70.8% for metastases, and 55% for those overlooked by radiologists. Overall, the AI tool identified metastases in 92.7% of all cases and 53.7% of overlooked instances, with an average of around 0.48 false positives per patient.

Both the software and radiologists commonly failed to detect metastases with smaller size, low contrast, and background fatty liver. The researchers suggest that the gap between AI and physicians could be attributed to factors such as the purpose of the examination, with CT scans for non-liver-related concerns sometimes resulting in misses, and the radiologists' physical and mental condition, including fatigue, anxiety, or lack of concentration. The researchers also noted that the software failed to detect 16% of liver metastases identified by radiologists, emphasizing its role as a support tool rather than a replacement.

“Our results suggest the potential of AI-powered software in reducing the frequency of overlooked small liver metastases when used in conjunction with the radiologists’ clinical interpretation,” concluded Hirotsugu Nakai, with the Kyoto University Graduate School of Medicine.

Related Links:
Kyoto University Graduate School of Medicine

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71 (358.10470581055): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796837 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (58.889389038086): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (88.930130004883): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (40.769577026367): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (64.13459777832): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (42.200088500977): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (77.962875366211): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294796837 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (46.968460083008): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796837 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (51.021575927734): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (84.877014160156): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (44.822692871094): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (89.883804321289): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

105 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

106 (104.90417480469): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294796837 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 2624.0348815918): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294796837 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (121.11663818359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

109 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

110 (70.810317993164): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294796837 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (634.90867614746): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294796837 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1449.8233795166): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (772.95303344727): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (!!!!! 1925.9452819824): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

115 (108.95729064941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

116 (111.10305786133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

117 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

118 (93.936920166016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

119 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

120 (394.10591125488): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 91724.872589111): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (386.95335388184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

123 (849.00856018066): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

124 (!!!!! 1153.9459228516): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294796837 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796837 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1237528.0857086): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (100.13580322266): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (161.17095947266): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (49.114227294922): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (132.79914855957): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (77.962875366211): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (78.916549682617): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (70.095062255859): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (387.90702819824): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (286.10229492188): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (37.908554077148): SELECT name FROM jos_deeppockets WHERE id=215

136 (27.179718017578): SELECT name FROM jos_deeppockets WHERE id=215

137 (472.06878662109): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (349.99847412109): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (134.94491577148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

140 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

141 (!!!!! 4831.075668335): TRUNCATE TABLE jos_trademed_module

142 (495.91064453125): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294796837 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (159.02519226074): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294796837 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (491.14227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (104.18891906738): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

147 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

148 (!!!!! 1101.016998291): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

150 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

151 (49.114227294922): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294796837 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796837 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (30.040740966797): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (27.894973754883): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (30.994415283203): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (111.81831359863): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

156 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796837 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796837 AND published='1' LIMIT 1

157 (51.975250244141): select jos_twitters.link from jos_twitters where cat=10

158 (25.98762512207): select jos_facebook.link from jos_facebook where cat=10

159 (25.98762512207): select jos_google_plus.link from jos_google_plus where cat=10

160 (26.941299438477): select jos_linkedin.link from jos_linkedin where cat=10

161 (275.1350402832): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1792.1924591064): insert into jos_banners_delta values (14615,'2025-04-30 12:26:38','3.143.247.141','view'),(14202,'2025-04-30 12:26:38','3.143.247.141','view'),(14203,'2025-04-30 12:26:38','3.143.247.141','view')

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