Artificial intelligence can help detecting incidental intracranial aneurysm on routine brain MRI using TOF MRA data sets and improve the time required for analysis of these images.

Purpose: The aim of our study was to assess the diagnostic performance of commercially available AI software for intracranial aneurysm detection and to determine if the AI system enhances the radiologist's accuracy in identifying aneurysms and reduces image analysis time.

Methods: TOF-MRA clinical brain examinations were analyzed using commercially available software and by an consultant neuroradiologist for the presence of intracranial aneurysms. The results were compared with the reference standard, to measure the sensitivity and specificity of the software and the consultant neuroradiologist. Furthermore, we examined the time required for the neuroradiologist to analyze the TOF-MRA image set, both with and without use of the AI software.

Results: In 500 TOF-MRI brain studies, 106 aneurysms were detected in 85 examinations by combining AI software with neuroradiologist readings. The neuroradiologist identified 98 aneurysms (92.5% sensitivity), while AI detected 77 aneurysms (72.6% sensitivity). Specificity and sensitivity were calculated from the combined effort as reference. Combining AI and neuroradiologist readings significantly improves detection reliability. Additionally, AI integration reduced TOF-MRA analysis time by 19 s (23% reduction).

Conclusions: Our findings indicate that the AI-based software can support neuroradiologists in interpreting brain TOF-MRA. A combined reading of the AI-based software and the neuroradiologist demonstrated higher reliability in identifying intracranial aneurysms as compared to reading by either neuroradiologist or software, thus improving diagnostic accuracy of the neuroradiologist. Simultaneously, reading time for the neuroradiologist was reduced by approximately one quarter.