Shan Xiong, Wenze Wu, Sibin Liu, Jianmin Cheng, Bing Wan
Abstract
The peculiarities of older individuals related to osteoporosis and hyperostosis may lead to a higher rate of misdiagnosis of rib fractures on computed tomography (CT) images in older than in middle-aged/young people when using radiologist-only reading.
Introduction
Rib fractures commonly occur in patients with blunt chest trauma [1]. While minor fractures have minimal health consequences, rib fractures can be life-threatening as the number of fractures increases and complications worsen [2]. Hence, accurate diagnosis of patients with rib fractures is essential.
Materials and methods
All procedures involving human participants were performed per the ethical standards of the Institutional Research Committee and the 1964 Helsinki Declaration. The authors/radiologists did not have access to information that could identify the individual participants during or after data collection.
Results
Sensitivities for fresh fracture diagnosis among the six radiologists ranged from 87.9% to 88.2%. FPPPs for fresh fracture diagnosis among the six radiologists ranged from 0.42 to 0.44 (Table 1 in S2 File).
Discussion
Recently, DL-based CAD systems have been used to diagnose rib fractures. Meng et al. [25] detected and classified rib fractures in 300 CT images and found that radiologists assisted by a DL model obtained a higher F1-score (0.960) and recall rate (0.978) than those who read independently.
Conclusion
In summary, intermediate-level radiologists’ efficiency in diagnosing fresh rib fractures by radiologist-only reading was lower in older emergency patients than in middle-aged/young patients. Moreover, the potential value of using a DL-based CAD system to assist radiologists in diagnosing rib fractures in older emergency patients may be higher than in middle-aged/young patients.
Citation: Xiong S, Wu W, Liu S, Cheng J, Wan B (2026) Computer-aided diagnosis system for thoracic computed tomography of rib fractures in older emergency patients: A preliminary study. PLoS One 21(6): e0351988. https://doi.org/10.1371/journal.pone.0351988
Editor: Christopher Njeh, Indiana University School of Medicine, UNITED STATES OF AMERICA
Received: November 24, 2023; Accepted: June 3, 2026; Published: June 17, 2026
Copyright: © 2026 Xiong et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the manuscript and its Supporting Information files.
Funding: This work was supported by the Hubei Provincial Department of Education of China (Grant Number B2022032). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
