Chest X-ray interpretation using AI can detect more TB cases

Chest X-ray interpretation using AI can detect more TB cases

Subject :Science and technology

Section: Health

Context:

• India has a powerful technology — AI-assisted chest X-ray — to screen presumptive TB cases.

AI-assisted chest X-ray- qXR:

• The AI algorithm (qXR) developed by the Mumbai-based Qure.ai, can help in early detection of people with presumptive TB disease in less than a minute, including people with subclinical TB.
• The AI software combined with molecular tests for TB disease confirmation can vastly increase detection rates.
• The qXR software got the European CE certification and the Indian drug regulator.
• WHO recommendation:
  • The qXR was one of the three AI algorithms that the WHO had referenced to when updating the TB screening guidelines in March 2021.
  • Qure.ai’s AI algorithm has a CE certification for use in the paediatric population (person below 15 years of age).
    • Unlike in adults, paediatric pulmonary TB detection using X-rays is a challenge as radiological evidence of pulmonary TB in children is less specific.
  • In 2021, WHO recommended the use of CAD products which use the AI to automate interpretation of digital chest X-rays for TB screening and triage in people older than 15 years.
  • The qXR software meets the WHO requirement with over 90% sensitivity and more than 70% specificity in people older than 15 years.
• The 2019 study demonstrated that qXR has the potential to increase capacity and aid TB diagnosis, especially in settings with a shortage of trained human readers which is a huge shortcoming in using chest X-rays for TB screening.
• The qXR algorithm is already being used in over 50 countries.
• In India, 24 States are using it in about 150 sites. But nowhere in India is the software used at scale.
  • In some States, the qXR software is used in just one site, like in Kerala.
• The use of the algorithm to screen the X-rays increased the yield (positivity) of GeneXpert molecular tests by 18-27%, as per a survey.
• The qXR algorithm can also be used for detecting TB disease from film-based X-rays.

MyBeam device:

• Active case finding got a boost when Qure.ai partnered with Mylab Discovery Solutions to use the qXR software in Mylab’s portable chest X-ray device (MyBeam).
• This will enable screening of presumptive TB cases with the AI algorithm even in rural areas.
• The portable device cuts the amount of X-ray exposure to 1/20th to 1/30th of a normal X-ray even while capturing all the details.

Ending TB by 2025:

• As per the 2019-2021 National TB prevalence survey in India report, nearly 43% of TB cases would have been missed if a chest X-ray was not included.
• Systematic screening for TB disease for early diagnosis is one of the main End TB strategies.
• Large-scale use of AI-assisted chest X-rays for screening is the first crucial step in the TB care cascade to achieve this goal.

Lower adoption rate:

• The AI algorithm was first installed in January 2021 at the S.K. Patil Hospital in Mumbai.
• The Central TB Division’s directive to States to procure and deploy the tool for early TB disease diagnosis will go a long way in widespread adoption.
• The absence of policy guidance has led to low adoption.
• The Central TB Division is yet to recommend the use of qXR.

For details of TB: https://optimizeias.com/india-tb-and-its-goal/