{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:04:00Z","timestamp":1760058240939,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Chest imaging plays a pivotal role in screening and monitoring patients, and various predictive artificial intelligence (AI) models have been developed in support of this. However, little is known about the effect of decreasing the radiation dose and, thus, image quality on AI performance. This study aims to design a low-dose simulation and evaluate the effect of this simulation on the performance of CNNs in plain chest radiography. Seven pathology labels and corresponding images from Medical Information Mart for Intensive Care datasets were used to train AI models at two spatial resolutions. These 14 models were tested using the original images, 50% and 75% low-dose simulations. We compared the area under the receiver operator characteristic (AUROC) of the original images and both simulations using DeLong testing. The average absolute change in AUROC related to simulated dose reduction for both resolutions was &lt;0.005, and none exceeded a change of 0.014. Of the 28 test sets, 6 were significantly different. An assessment of predictions, performed through the splitting of the data by gender and patient positioning, showed a similar trend. The effect of simulated dose reductions on CNN performance, although significant in 6 of 28 cases, has minimal clinical impact. The effect of patient positioning exceeds that of dose reduction.<\/jats:p>","DOI":"10.3390\/jimaging11030090","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T12:23:11Z","timestamp":1742473391000},"page":"90","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Simulated Dose Reduction on the Performance of Artificial Intelligence in Chest Radiography"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9029-576X","authenticated-orcid":false,"given":"Hendrik","family":"Erenstein","sequence":"first","affiliation":[{"name":"Department of Medical Imaging and Radiation Therapy, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands"},{"name":"Department of Radiotherapy, University of Groningen, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands"},{"name":"Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wim P.","family":"Krijnen","sequence":"additional","affiliation":[{"name":"Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands"},{"name":"Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, 9747 AG Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemieke","family":"van der Heij-Meijer","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Radiation Therapy, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8995-1210","authenticated-orcid":false,"given":"Peter van","family":"Ooijen","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, University of Groningen, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands"},{"name":"Data Science Center in Health, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"ref_1","first-page":"574","article-title":"Chest radiography in general practice: Indications, diagnostic yield and consequences for patient management","volume":"56","author":"Speets","year":"2006","journal-title":"Br. 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