MacMahon H, Engelmann R, Behlen F M, Hoffmann K R, Ishida T, Roe C, Metz C E, Doi K
Department of Radiology, University of Chicago, IL 60637, USA.
Radiology. 1999 Dec;213(3):723-6. doi: 10.1148/radiology.213.3.r99dc27723.
To determine the effect of computer-aided diagnosis (CAD) on the accuracy of pulmonary nodule detection.
Twenty abnormal chest radiographs, each with a single nodule, and 20 normal radiographs were digitized with a laser scanner. These images were analyzed by using a computer program that indicates areas that may represent pulmonary nodules. The radiographs were displayed on computer workstations in randomized order, and an observer test was performed. One hundred forty-six observers participated, including 23 chest radiologists, 54 other radiologists, 27 radiology residents, and 42 nonradiologists. Cases were interpreted first without and then with the use of CAD. The observers' responses were recorded on a continuous confidence rating scale. Detection accuracy both with and without CAD was evaluated with receiver operating characteristic analysis.
The detection accuracy was significantly higher for all categories of observers when CAD was used (chest radiologists, P = 8 x 10(-6); other radiologists, P = 2 x 10(-16); radiology residents, P = 6 x 10(-7); and nonradiologists, P = 8 x 10(-9)).
CAD has the potential to improve diagnostic accuracy in the detection of lung nodules on digital radiographs.
确定计算机辅助诊断（CAD）对肺结节检测准确性的影响。
20张异常胸部X光片，每张有一个结节，以及20张正常X光片用激光扫描仪进行数字化处理。使用一个计算机程序对这些图像进行分析，该程序可指示可能代表肺结节的区域。X光片以随机顺序显示在计算机工作站上，并进行观察者测试。146名观察者参与，包括23名胸部放射科医生、54名其他放射科医生、27名放射科住院医师和42名非放射科医生。病例先在不使用CAD的情况下进行解读，然后再使用CAD进行解读。观察者的反应记录在一个连续的置信度评分量表上。使用受试者操作特征分析评估使用CAD和不使用CAD时的检测准确性。
当使用CAD时，所有类别的观察者的检测准确性均显著更高（胸部放射科医生，P = 8×10⁻⁶；其他放射科医生，P = 2×10⁻¹⁶；放射科住院医师，P = 6×10⁻⁷；非放射科医生，P = 8×10⁻⁹）。
CAD有潜力提高数字X光片上肺结节检测的诊断准确性。
