Radiolucent foreign body aspiration (FBA) remains diagnostically challenging due to its subtle imaging signatures on chest CT scans, often leading to delayed or missed diagnoses. We present a deep learning model integrating MedpSeg, a high-precision airway segmentation method, with a convolutional classifier to detect radiolucent FBA. The model was trained and validated across three independent cohorts, demonstrating consistent performance with accuracies above 90% and balanced recall-precision metrics. In a blinded independent evaluation cohort, the model outperformed expert radiologists in both recall (71.4% vs. 35.7%) and F1 score (74.1% vs. 52.6%), highlighting its potential to reduce missed cases (false negatives) and support clinical decision-making. This study illustrates the translational potential of artificial intelligence for addressing diagnostically complex and high-risk conditions, offering an effective tool to support radiologists in the assessment of suspected radiolucent foreign body aspiration. Code is available at https://github.com/ZheChen1999/FBA_DL .
© 2025. The Author(s).