A Machine Learning System to Automate Body Computed Tomography Protocoling
- PMID: 41102427
- DOI: 10.1007/s10278-025-01715-z
A Machine Learning System to Automate Body Computed Tomography Protocoling
Abstract
Selection of radiology imaging protocols is a vital step in the radiology workflow as incorrect protocol selection can lead to suboptimal imaging and thereby jeopardize patient health, delay treatments, and/or increase healthcare costs. However, this process is generally thought of as an inefficient use of radiologist's time. We developed a machine learning (ML) system that can predict radiology protocols accurately based on patients' electronic medical record (EMR) data. The system is an ensemble of three decision tree (DT)-based techniques trained to provide protocols for body computed tomography (CT) examinations. The most common 15 CT abdomen protocols were used to tune the models, with the system designed to provide the three most probable predictions for further radiologist revision. Our ensemble classifier, with the F1 score of approximately 83%, outperformed each model with the mean F1 score of approximately 80% in 5-fold cross-validation and performed the best with an F1 score of 95.5% for the top three predictions, surpassing the individual models with F1 scores ranging from 87.6% to 92.9%. In conclusion, the present study demonstrates that ML techniques can predict radiology protocols and identify key classification-dependent features. These models could be leveraged for use as a clinical decision support system to improve radiologists' efficiency.
Keywords: And Radiology Protocol; Boosting Models; Computed Tomography; Decision Tree Models; Decision-Support System; Machine Learning.
© 2025. The Author(s) under exclusive licence to Society for Imaging Informatics in Medicine.
Conflict of interest statement
Declarations. Ethics Approval: The study was approved by the Stanford University Institutional Review Board (IRB) under protocol number 56914 (approval date: October 26, 2020). Consent to Participate: This retrospective study was approved by the Stanford University Institutional Review Board (protocol no. 56914; date of approval: 10/26/2020), and the requirement for informed consent was waived due to the use of de-identified data. Consent for Publication: Not applicable. This study used only de-identified retrospective data, and no individual person’s data in any form (including images or videos) is included in the manuscript. Competing Interests: The authors declare no competing interests.
References
-
- OECD. Computed tomography (CT) exams (indicator). Available at: https://data.oecd.org/healthcare/computed-tomography-ct-exams.htm . Accessed June 6, 2025
-
- Harvard Health Publishing. Radiation risk from medical imaging. Available at: https://www.health.harvard.edu/cancer/radiation-risk-from-medical-imaging . Accessed June 6, 2025
-
- iData Research. Over 75 million CT scans are performed each year and growing despite radiation concerns. Available at: https://idataresearch.com/over-75-million-ct-scans-are-performed-each-ye... . Accessed June 6, 2025
-
- Mileto A, Guimaraes LS, McCollough CH, Fletcher JG, Yu L: State of the art in abdominal CT: the limits of iterative reconstruction algorithms. Radiol 293(3):491-503, 2019 - DOI
-
- Muhammad NA, Sabarudin A, Ismail N, Karim MKA: A systematic review and meta-analysis of radiation dose exposure from computed tomography examination of thorax-abdomen-pelvic regions among paediatric population. Radiat Phys Chem 179:109148, 2021 - DOI