New AI Tool Mimics Radiologist Gaze to Read Chest X-Rays

Artificial intelligence (AI) can scan a chest X-ray and diagnose if an abnormality is fluid in the lungs, an enlarged heart or cancer. But being right is not enough, said Ngan Le, a University of Arkansas assistant professor of computer science and computer engineering. We should understand how the computer makes its diagnosis, yet most AI systems are black boxes whose "thought process" even their creators cannot explain.

"When people understand the reasoning process and limitations behind AI decisions, they are more likely to trust and embrace the technology," Le said.

Le and her colleagues developed a transparent, and highly accurate, AI framework for reading chest X-rays called ItpCtrl-AI, which stands for interpretable and controllable artificial intelligence.

The team explained their approach in "ItpCtrl-AI: End-to-end interpretable and controllable artificial intelligence by modeling radiologists’ intentions," published in the current issue of Artificial Intelligence in Medicine.

The researchers taught the computer to look at chest X-rays like a radiologist. The gaze of radiologists, both where they looked and how long they focused on a specific area, was recorded as they reviewed chest X-rays. The heat map created from that eye-gaze dataset showed the computer where to search for abnormalities and what section of the image required less attention.

Creating an AI framework that uses a clear, transparent method to reach conclusions - in this case a gaze heat map - helps researchers adjust and correct the computer so it can provide more accurate results. In a medical context, transparency also bolsters the trust of doctors and patients in an AI-generated diagnosis.

"If an AI medical assistant system diagnoses a condition, doctors need to understand why it made that decision to ensure it is reliable and aligns with medical expertise," Le said.

A transparent AI framework is also more accountable, a legal and ethical concern in areas with high stakes, such as medicine, self-driving vehicles or financial markets. Because doctors know how ItpCtrl-AI works, they can take responsibility for its diagnosis.

"If we don't know how a system is making decisions, it’s challenging to ensure it is fair, unbiased, or aligned with societal values," Le said.

Le and her team, in collaboration with the MD Anderson Cancer Center in Houston, are now working to refine ItpCtrl-AI so it can read more complex, three-dimensional CT scans.

Trong-Thang Pham, Jacob Brecheisen, Carol C. Wu, Hien Nguyen, Zhigang Deng, Donald Adjeroh, Gianfranco Doretto, Arabinda Choudhary, Ngan Le.
ItpCtrl-AI: End-to-end interpretable and controllable artificial intelligence by modeling radiologists' intentions.
Artificial Intelligence in Medicine, 2025. doi: 10.1016/j.artmed.2024.103054

Most Popular Now

Researchers Find Telemedicine may Help R…

Low-value care - medical tests and procedures that provide little to no benefit to patients - contributes to excess medical spending and both direct and cascading harms to patients. A...

AI Revolutionizes Glaucoma Care

Imagine walking into a supermarket, train station, or shopping mall and having your eyes screened for glaucoma within seconds - no appointment needed. With the AI-based Glaucoma Screening (AI-GS) network...

AI may Help Clinicians Personalize Treat…

Individuals with generalized anxiety disorder (GAD), a condition characterized by daily excessive worry lasting at least six months, have a high relapse rate even after receiving treatment. Artificial intelligence (AI)...

Accelerating NHS Digital Maturity: Paper…

Digitised clinical noting at South Tees Hospitals NHS Foundation Trust is creating efficiencies for busy doctors and nurses. The trust’s CCIO Dr Andrew Adair, deputy CCIO Dr John Greenaway, and...

Mobile App Tracking Blood Pressure Helps…

The AHOMKA platform, an innovative mobile app for patient-to-provider communication that developed through a collaboration between the School of Engineering and leading medical institutions in Ghana, has yielded positive results...

AI can Open Up Beds in the ICU

At the height of the COVID-19 pandemic, hospitals frequently ran short of beds in intensive care units. But even earlier, ICUs faced challenges in keeping beds available. With an aging...

Can AI Help Detect Cognitive Impairment?

Mild cognitive impairment (MCI) can be an early indicator of Alzheimer's disease or dementia, so identifying those with cognitive issues early could lead to interventions and better outcomes. But diagnosing...

Customized Smartphone App Shows Promise …

A growing body of research indicates that older adults in assisted living facilities can delay or even prevent cognitive decline through interventions that combine multiple activities, such as improving diet...

New Study Shows Promise for Gamified mHe…

A new study published in Multiple Sclerosis and Related Disorders highlights the potential of More Stamina, a gamified mobile health (mHealth) app designed to help people with Multiple Sclerosis (MS)...

AI Model Predicting Two-Year Risk of Com…

AFib (short for atrial fibrillation), a common heart rhythm disorder in adults, can have disastrous consequences including life-threatening blood clots and stroke if left undetected or untreated. A new study...

Patients' Affinity for AI Messages …

In a Duke Health-led survey, patients who were shown messages written either by artificial intelligence (AI) or human clinicians indicated a preference for responses drafted by AI over a human...

New Research Explores How AI can Build T…

In today’s economy, many workers have transitioned from manual labor toward knowledge work, a move driven primarily by technological advances, and workers in this domain face challenges around managing non-routine...