Examining Deployment and Refinement of the VIOLA-AI Intracranial Hemorrhage Model Using an Interactive NeoMedSys Platform

Qinghui Liu; Jon E. Nesvold; Hanna Raaum; Elakkyen Murugesu; Martin Røvang; Bradley J Maclntosh; Atle Bjørnerud; Karoline Skogen

arXiv · 2505.09380

Examining Deployment and Refinement of the VIOLA-AI Intracranial Hemorrhage Model Using an Interactive NeoMedSys Platform

Qinghui Liu·Jon E. Nesvold·Hanna Raaum·Elakkyen Murugesu·Martin Røvang·Bradley J Maclntosh·Atle Bjørnerud·Karoline Skogen

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Abstract

Background: There are many challenges and opportunities in the clinical deployment of AI tools in radiology. The current study describes a radiology software platform called NeoMedSys that can enable efficient deployment and refinements of AI models. We evaluated the feasibility and effectiveness of running NeoMedSys for three months in real-world clinical settings and focused on improvement performance of an in-house developed AI model (VIOLA-AI) designed for intracranial hemorrhage (ICH) detection. Methods: NeoMedSys integrates tools for deploying, testing, and optimizing AI models with a web-based medical image viewer, annotation system, and hospital-wide radiology information systems. A prospective pragmatic investigation was deployed using clinical cases of patients presenting to the largest Emergency Department in Norway (site-1) with suspected traumatic brain injury (TBI) or patients with suspected stroke (site-2). We assessed ICH classification performance as VIOLA-AI encountered new data and underwent pre-planned model retraining. Performance metrics included sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve (AUC). Results: NeoMedSys facilitated iterative improvements in the AI model, significantly enhancing its diagnostic accuracy. Automated bleed detection and segmentation were reviewed in near real-time to facilitate re-training VIOLA-AI. The iterative refinement process yielded a marked improvement in classification sensitivity, rising to 90.3% (from 79.2%), and specificity that reached 89.3% (from 80.7%). The bleed detection ROC analysis for the entire sample demonstrated a high area-under-the-curve (AUC) of 0.949 (from 0.873). Model refinement stages were associated with notable gains, highlighting the value of real-time radiologist feedback.

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Qinghui Liu, Jon E. Nesvold, Hanna Raaum, Elakkyen Murugesu, Martin Røvang, Bradley J Maclntosh, Atle Bjørnerud, Karoline Skogen. 2025-09-19. Examining Deployment and Refinement of the VIOLA-AI Intracranial Hemorrhage Model Using an Interactive NeoMedSys Platform. https://arxiv.org/abs/2505.09380

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