Why a Second Look Matters
Busy clinics read a lot of images quickly. Most missed findings are not exotic: an interproximal shadow on the last bitewing of the day, a widened apical PDL space on a tooth you were not looking at, or a small opacity at the edge of a chest film. A structured second look catches some of these. BossCE can provide that second look in seconds, as long as you understand what it is and what it is not.
What BossCE Actually Does With an Image
BossCE uses a general-purpose multimodal AI model (Google Gemini). When you upload an anonymised image and ask a question, the model describes what it sees, organises a systematic review, and suggests what to check next. It is not a purpose-built radiology device: it has not been trained or validated on a specific radiograph dataset, it does not segment anatomy, and it cannot reliably measure distances or lesion sizes on an uploaded JPEG.
| Useful for | Not reliable for |
|---|---|
| Walking through a systematic review checklist so nothing is skipped | Measurements in millimetres, bone-loss percentages or lesion dimensions |
| Describing visible features in plain clinical language | Detecting subtle or early findings with known sensitivity |
| Listing differentials to consider for a finding you have already seen | Making or ruling out a diagnosis |
| Suggesting the next clinical tests or views to confirm a suspicion | Replacing a specialist or radiologist report |
| Drafting a clear explanation of a finding for the patient | Images with poor resolution, heavy compression or cropped anatomy |
How to Use It Well
- Anonymise. Export the image and crop out names, IC or ID numbers, dates of birth, clinic record numbers and faces.
- Give context. State the modality (bitewing, periapical, OPG, chest PA), the area of interest and the relevant history. AI reads an image far better when it knows what question you are asking.
- Ask for structure, not a verdict. Ask it to work through a checklist and list differentials, rather than asking “what is wrong with this?”
- Confirm clinically. Treat every observation as a prompt for your own examination, tests or further imaging.
Copy-Paste Prompts
Dental: bitewing or periapical series
“This is an anonymised bitewing of the right posterior teeth in a 34-year-old with no symptoms. Work through a systematic review: interproximal surfaces, existing restorations and margins, crestal bone levels, and any periapical areas visible. For each area, describe what is visible and say whether it needs a closer clinical look. Do not estimate measurements.”
Dental: a finding you have already spotted
“On this anonymised periapical of a lower first molar I can see a radiolucency at the mesial root apex. List the differentials to consider, the clinical tests that would distinguish them, and when CBCT would be justified.”
Medical: chest radiograph
“This is an anonymised PA chest radiograph of an older adult with a chronic cough. Walk me through a systematic review (airways, lungs, pleura, heart, mediastinum, bones, soft tissues and review areas). Describe what is visible in each area and list what should be confirmed with clinical findings, blood tests or a formal radiology report.”
A Realistic Example of the Output
For the bitewing prompt above, a good BossCE answer will typically give a section-by-section description (for example, “a darker area is visible at the distal contact of the upper second premolar; assess clinically and consider caries risk”), flag areas it cannot assess because of image quality, and end with a list of checks: tactile and visual examination, transillumination where available, and comparison with previous radiographs. It should not give exact depths or sizes. If it does, disregard those numbers.
Guardrails
- Human in the loop: BossCE output is reference information, not a diagnosis. The treating clinician is responsible for every diagnostic decision.
- Formal reporting: where a radiology report is required, for example most medical imaging and CBCT, BossCE does not replace it.
- Privacy: never upload images with identifiable patient information. See our Privacy Policy.