arXiv subjects

Adam E. Flanders

Publications and source records attributed to Adam E. Flanders.

6 recordsLinked to original sources

arXiv2026

CXR-LT 2026 Challenge: Multi-Center Long-Tailed and Zero Shot Chest X-ray Classification

Chest X-ray (CXR) interpretation is hindered by the long-tailed distribution of pathologies and the open-world nature of clinical environments. Existing benchmarks often rely on closed-set classes from a single institution, failing to capture the prevalence of rare diseases or the appearance of novel findings. To address this, we present the CXR-LT challenge. The first event, CXR-LT 2023, established a large-scale benchmark for long-tailed multi-label CXR classification and identified key challenges in rare disease recognition. CXR-LT 2024 further expanded the label space and introduced a zero-shot task to study generalization to unseen findings. Building on the success of CXR-LT 2023 and 2024, this third iteration of the benchmark introduces a multi-center dataset comprising over 145,000 images from PadChest and NIH Chest X-ray datasets. Additionally, all development and test sets in CXR-LT 2026 are annotated by radiologists, providing a more reliable and clinically grounded evaluation than report-derived labels. The challenge defines two core tasks this year: (1) Robust Multi-Label Classification on 30 known classes and (2) Open-World Generalization to 6 unseen (out-of-distribution) rare disease classes. This paper summarizes the overview of the CXR-LT 2026 challenge. We describe the data collection and annotation procedures, analyze solution strategies adopted by participating teams, and evaluate head-versus-tail performance, calibration, and cross-center generalization gaps. Our results show that vision-language foundation models improve both in-distribution and zero-shot performance, but detecting rare findings under multi-center shift remains challenging. Our study provides a foundation for developing and evaluating AI systems in realistic long-tailed and open-world clinical conditions.

cs.CV↗

arXiv2026

RSNA Large Language Model Benchmark Dataset for Chest Radiographs of Cardiothoracic Disease: Radiologist Evaluation and Validation Enhanced by AI Labels (REVEAL-CXR)

Multimodal large language models have demonstrated comparable performance to that of radiology trainees on multiple-choice board-style exams. However, to develop clinically useful multimodal LLM tools, high-quality benchmarks curated by domain experts are essential. To curate released and holdout datasets of 100 chest radiographic studies each and propose an artificial intelligence (AI)-assisted expert labeling procedure to allow radiologists to label studies more efficiently. A total of 13,735 deidentified chest radiographs and their corresponding reports from the MIDRC were used. GPT-4o extracted abnormal findings from the reports, which were then mapped to 12 benchmark labels with a locally hosted LLM (Phi-4-Reasoning). From these studies, 1,000 were sampled on the basis of the AI-suggested benchmark labels for expert review; the sampling algorithm ensured that the selected studies were clinically relevant and captured a range of difficulty levels. Seventeen chest radiologists participated, and they marked "Agree all", "Agree mostly" or "Disagree" to indicate their assessment of the correctness of the LLM suggested labels. Each chest radiograph was evaluated by three experts. Of these, at least two radiologists selected "Agree All" for 381 radiographs. From this set, 200 were selected, prioritizing those with less common or multiple finding labels, and divided into 100 released radiographs and 100 reserved as the holdout dataset. The holdout dataset is used exclusively by RSNA to independently evaluate different models. A benchmark of 200 chest radiographic studies with 12 benchmark labels was created and made publicly available https://imaging.rsna.org, with each chest radiograph verified by three radiologists. In addition, an AI-assisted labeling procedure was developed to help radiologists label at scale, minimize unnecessary omissions, and support a semicollaborative environment.

cs.CL↗

arXiv2025

A Multi-agent Large Language Model Framework to Automatically Assess Performance of a Clinical AI Triage Tool

Purpose: The purpose of this study was to determine if an ensemble of multiple LLM agents could be used collectively to provide a more reliable assessment of a pixel-based AI triage tool than a single LLM. Methods: 29,766 non-contrast CT head exams from fourteen hospitals were processed by a commercial intracranial hemorrhage (ICH) AI detection tool. Radiology reports were analyzed by an ensemble of eight open-source LLM models and a HIPAA compliant internal version of GPT-4o using a single multi-shot prompt that assessed for presence of ICH. 1,726 examples were manually reviewed. Performance characteristics of the eight open-source models and consensus were compared to GPT-4o. Three ideal consensus LLM ensembles were tested for rating the performance of the triage tool. Results: The cohort consisted of 29,766 head CTs exam-report pairs. The highest AUC performance was achieved with llama3.3:70b and GPT-4o (AUC= 0.78). The average precision was highest for Llama3.3:70b and GPT-4o (AP=0.75 & 0.76). Llama3.3:70b had the highest F1 score (0.81) and recall (0.85), greater precision (0.78), specificity (0.72), and MCC (0.57). Using MCC (95% CI) the ideal combination of LLMs were: Full-9 Ensemble 0.571 (0.552-0.591), Top-3 Ensemble 0.558 (0.537-0.579), Consensus 0.556 (0.539-0.574), and GPT4o 0.522 (0.500-0.543). No statistically significant differences were observed between Top-3, Full-9, and Consensus (p > 0.05). Conclusion: An ensemble of medium to large sized open-source LLMs provides a more consistent and reliable method to derive a ground truth retrospective evaluation of a clinical AI triage tool over a single LLM alone.

cs.CL↗

arXiv2025

The RSNA Lumbar Degenerative Imaging Spine Classification (LumbarDISC) Dataset

The Radiological Society of North America (RSNA) Lumbar Degenerative Imaging Spine Classification (LumbarDISC) dataset is the largest publicly available dataset of adult MRI lumbar spine examinations annotated for degenerative changes. The dataset includes 2,697 patients with a total of 8,593 image series from 8 institutions across 6 countries and 5 continents. The dataset is available for free for non-commercial use via Kaggle and RSNA Medical Imaging Resource of AI (MIRA). The dataset was created for the RSNA 2024 Lumbar Spine Degenerative Classification competition where competitors developed deep learning models to grade degenerative changes in the lumbar spine. The degree of spinal canal, subarticular recess, and neural foraminal stenosis was graded at each intervertebral disc level in the lumbar spine. The images were annotated by expert volunteer neuroradiologists and musculoskeletal radiologists from the RSNA, American Society of Neuroradiology, and the American Society of Spine Radiology. This dataset aims to facilitate research and development in machine learning and lumbar spine imaging to lead to improved patient care and clinical efficiency.

eess.IV↗

arXiv2024

The RSNA Abdominal Traumatic Injury CT (RATIC) Dataset

The RSNA Abdominal Traumatic Injury CT (RATIC) dataset is the largest publicly available collection of adult abdominal CT studies annotated for traumatic injuries. This dataset includes 4,274 studies from 23 institutions across 14 countries. The dataset is freely available for non-commercial use via Kaggle at https://www.kaggle.com/competitions/rsna-2023-abdominal-trauma-detection. Created for the RSNA 2023 Abdominal Trauma Detection competition, the dataset encourages the development of advanced machine learning models for detecting abdominal injuries on CT scans. The dataset encompasses detection and classification of traumatic injuries across multiple organs, including the liver, spleen, kidneys, bowel, and mesentery. Annotations were created by expert radiologists from the American Society of Emergency Radiology (ASER) and Society of Abdominal Radiology (SAR). The dataset is annotated at multiple levels, including the presence of injuries in three solid organs with injury grading, image-level annotations for active extravasations and bowel injury, and voxelwise segmentations of each of the potentially injured organs. With the release of this dataset, we hope to facilitate research and development in machine learning and abdominal trauma that can lead to improved patient care and outcomes.

cs.CV↗

arXiv2017

Application of Deep Learning in Neuroradiology: Automated Detection of Basal Ganglia Hemorrhage using 2D-Convolutional Neural Networks

Background: Deep learning techniques have achieved high accuracy in image classification tasks, and there is interest in applicability to neuroimaging critical findings. This study evaluates the efficacy of 2D deep convolutional neural networks (DCNNs) for detecting basal ganglia (BG) hemorrhage on noncontrast head CT. Materials and Methods: 170 unique de-identified HIPAA-compliant noncontrast head CTs were obtained, those with and without BG hemorrhage. 110 cases were held-out for test, and 60 were split into training (45) and validation (15), consisting of 20 right, 20 left, and 20 no BG hemorrhage. Data augmentation was performed to increase size and variation of the training dataset by 48-fold. Two DCNNs were used to classify the images-AlexNet and GoogLeNet-using untrained networks and those pre-trained on ImageNet. Area under the curves (AUC) for the receiver-operator characteristic (ROC) curves were calculated, using the DeLong method for statistical comparison of ROCs. Results: The best performing model was the pre-trained augmented GoogLeNet, which had an AUC of 1.00 in classification of hemorrhage. Preprocessing augmentation increased accuracy for all networks (p<0.001), and pretrained networks outperformed untrained ones (p<0.001) for the unaugmented models. The best performing GoogLeNet model (AUC 1.00) outperformed the best performing AlexNet model (AUC 0.95)(p=0.01). Conclusion: For this dataset, the best performing DCNN identified BG hemorrhage on noncontrast head CT with an AUC of 1.00. Pretrained networks and data augmentation increased classifier accuracy. Future prospective research would be important to determine if the accuracy can be maintained on a larger cohort of patients and for very small hemorrhages.

cs.CV↗