<![CDATA[Background: Accurate detection of renal cysts on CT urography requires high diagnostic precision, while manual interpretation by radiologists is susceptible to inter-observer variability and potential delays in clinical decision-making. These challenges underscore the need for a reliable automated detection system to support radiological assessment. Objective: This study aims to develop and evaluate the performance of the Neo-ZasAI application based on the YOLOv8 algorithm for the automatic identification of renal cysts. Methods: Employing a Research and Development design using the ADDIE model, the study encompassed needs analysis, model design, software development, system implementation using 200 CT urography images, and diagnostic performance evaluation. Classification results generated by Neo-ZasAI were compared with radiologist readings through confusion matrix analysis and ROC–AUC assessment. Results: The findings indicate that Neo-ZasAI achieved an accuracy of 97,5%, sensitivity of 96%, specificity of 99%, positive predictive value of 98,9%, and negative predictive value of 96,1%. The ROC analysis yielded an AUC of 0.988 (p < 0.001), demonstrating excellent discriminative capability and high concordance with radiologist interpretations as the diagnostic gold standard. Conclusion: These results suggest that Neo-ZasAI is capable of performing rapid, consistent, and accurate renal cyst detection and is thus feasible for implementation as a clinical decision support system in radiology, with potential integration into PACS workflows and further development to enhance model generalizability.]]>
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