Prospective effects of an artificial intelligence-based computer-aided detection system for prostate imaging on routine workflow and radiologists' outcomes

Abstract

<em>Objectives:</em> Artificial intelligence (AI) is expected to alleviate the negative consequences of rising case numbers for radiologists. Currently, systematic evaluations of the impact of AI solutions in real-world radiological practice are missing. Our study addresses this gap by investigating the impact of the clinical implementation of an AI-based computer-aided detection system (CAD) for prostate MRI reading on clinicians' workflow, workflow throughput times, workload, and stress.<br /> <em>Materials and methods:</em> CAD was newly implemented into radiology workflow and accompanied by a prospective pre-post study design. We assessed prostate MRI case readings using standardized work observations and questionnaires. The observation period was three months each in a single department. Workflow throughput times, PI-RADS score, CAD usage and radiologists' self-reported workload and stress were recorded. Linear mixed models were employed for effect identification.<br /> <em>Results:</em> In data analyses, 91 observed case readings (pre: 50, post: 41) were included. Variation of routine workflow was observed following CAD implementation. A non-significant increase in overall workflow throughput time was associated with CAD implementation (mean <em>16.99</em> ± <em>6.21</em> vs <em>18.77</em> ± <em>9.69 min</em>, <em>p</em> = .51), along with an increase in diagnostic reading time for high suspicion cases (mean <em>15.73</em> ± <em>4.99</em> vs <em>23.07</em> ± <em>8.75 min</em>, <em>p</em> = .02). Changes in radiologists' self-reported workload or stress were not found.<br /> <em>Conclusion:</em> Implementation of an AI-based detection aid was associated with lower standardization and no effects over time on radiologists' workload or stress. Expectations of AI decreasing the workload of radiologists were not confirmed by our real-world study.