Process optimization with rule-learning explainable AI, and its application to MRI scanning.

PURPOSE: High complexity of modern processes renders manual process optimization impossible. The main goal of our work was to formalize and to demonstrate the practical efficiency of explainable rule-learning AI in complex process optimization. MATERIALS AND METHODS: Process optimization methodology was based on globally-optimal Boolean rule-learning AI models, capable of identifying multiple inefficiency patterns, and supporting process-oriented optimization metrics. To illustrate this approach in real-word environment, the study used 3994 liver and prostate Magnetic Resonance Imaging (MRI) exams performed on five 3T scanners at three outpatient facilities from January 2019 to January 2024. Imaging exams longer than 25 minutes were labeled as requiring optimization, which applied to 35.4% of liver and 52.6% of prostate cases. Rule-learning AI was applied to the MRI scanner log data to discover short and interpretable process optimization rules. The selected Boolean rules were used to implement improved exam protocols, and a permutation test was used to measure the statistical significance of the resulting change in average exam duration. RESULTS: N=1000 top rules, identifying the most significant processing delay patterns, were discovered by rule-learning AI from the scanner log data based on F1 score. A smaller set of 20 top rules was selected using the secondary operational impact metric, an estimate of each rule's impact on average scan duration. A change in liver MRI protocols based on findings from the top rule resulted in a 10.9% reduction of median scan time. The proportion of long liver exams was reduced from 35.4% to 23.9% (p < 0.001). Similar optimizations in prostate protocols were used to add a new scanning sequence, improving exam quality. CONCLUSIONS: Globally optimal, multi-model rule-learning AI can transform feature-rich device logs into concise, interpretable, and operationally meaningful rules. When combined with domain expertise, this approach can support measurable and sustainable improvements in complex clinical workflows.