biostudies-literatureUnknown15(1)Chiu IMDelays or misdiagnoses in detecting pneumoperitoneum can significantly increase mortality and morbidity. We developed and validated a deep learning model designed to identify pneumoperitoneum in computed tomography images. The model is trained on abdominal scans from Far Eastern Memorial Hospital (January 2012-December 2021) and evaluated using a simulated test set (14,039 scans) and a prospective test set (6351 scans) collected from the same center between December 2022 and May 2023. External validation included 480 scans from Cedars-Sinai Medical Center. Overall, the model achieves a sensitivity of 0.81-0.83 and a specificity of 0.97-0.99 across retrospective, prospective, and external validation; sensitivity improves to 0.92-0.98 when cases with a small amount of free air (total volume Nature communications9660https://www.ebi.ac.uk/biostudies/studies/S-EPMC11544264biostudies-literaturePACT-3D, a deep learning algorithm for pneumoperitoneum detection in abdominal CT scans.PMC11544264Ouyang DLin WCChiu IMKuo KHHuang TYPan YJLu CYfalsePACT-3D, a deep learning algorithm for pneumoperitoneum detection in abdominal CT scans.Delays or misdiagnoses in detecting pneumoperitoneum can significantly increase mortality and morbidity. We developed and validated a deep learning model designed to identify pneumoperitoneum in computed tomography images. The model is trained on abdominal scans from Far Eastern Memorial Hospital (January 2012-December 2021) and evaluated using a simulated test set (14,039 scans) and a prospective test set (6351 scans) collected from the same center between December 2022 and May 2023. External validation included 480 scans from Cedars-Sinai Medical Center. Overall, the model achieves a sensitivity of 0.81-0.83 and a specificity of 0.97-0.99 across retrospective, prospective, and external validation; sensitivity improves to 0.92-0.98 when cases with a small amount of free air (total volume 2024-01-01T00:00:00Z2024 Nov2026-07-16T18:50:32.675Z2025-04-04T18:56:21.074ZS-EPMC115442643951122910.1038/s41467-024-54043-1