Awai Kazuo, Murao Kohei, Ozawa Akio, Komi Masanori, Hayakawa Haruo, Hori Shinichi, Nishimura Yasumasa
Department of Radiology, Kinki University School of Medicine, 377-2 Oono-higashi, Osaka-Sayama City, Osaka 589-8511, Japan.
Radiology. 2004 Feb;230(2):347-52. doi: 10.1148/radiol.2302030049.
To evaluate the effect of computer-aided diagnosis (CAD) on radiologists' detection of pulmonary nodules.
Fifty chest computed tomographic (CT) examination cases were used. The mean nodule size was 0.81 cm +/- 0.60 (SD) (range, 0.3-2.9 cm). Alternative free-response receiver operating characteristic (ROC) analysis with a continuous rating scale was used to compare the observers' performance in detecting nodules with and without use of CAD. Five board-certified radiologists and five radiology residents participated in an observer performance study. First they were asked to rate the probability of nodule presence without using CAD; then they were asked to rate the probability of nodule presence by using CAD.
For all radiologists, the mean areas under the best-fit alternative free-response ROC curves (Az) without and with CAD were 0.64 +/- 0.08 and 0.67 +/- 0.09, respectively, indicating a significant difference (P <.01). For the five board-certified radiologists, the mean Az values without and with CAD were 0.63 +/- 0.08 and 0.66 +/- 0.09, respectively, indicating a significant difference (P <.01). For the five resident radiologists, the mean Az values without and with CAD were 0.66 +/- 0.04 and 0.68 +/- 0.04, respectively, indicating a significant difference (P =.02). At observer performance analyses, there were no significant differences in Az values obtained either without (P =.61) or with (P =.88) CAD between the board-certified radiologists and the residents. For all radiologists, in the detection of pulmonary nodules 1.0 cm in diameter or smaller, the mean Az values without and with CAD were 0.60 +/- 0.11 and 0.64 +/- 0.11, respectively, indicating a significant difference (P <.01).
Use of the CAD system improved the board-certified radiologists' and residents' detection of pulmonary nodules at chest CT.
评估计算机辅助诊断（CAD）对放射科医生检测肺结节的影响。
使用了50例胸部计算机断层扫描（CT）检查病例。结节平均大小为0.81 cm±0.60（标准差）（范围0.3 - 2.9 cm）。采用带有连续评分量表的交替自由反应式接收器操作特征（ROC）分析，比较观察者在使用和不使用CAD情况下检测结节的表现。5名获得委员会认证的放射科医生和5名放射科住院医师参与了观察者表现研究。首先要求他们在不使用CAD的情况下对结节存在的可能性进行评分；然后要求他们在使用CAD的情况下对结节存在的可能性进行评分。
对于所有放射科医生，不使用CAD和使用CAD时，最佳拟合交替自由反应ROC曲线下的平均面积（Az）分别为0.64±0.08和0.67±0.09，差异有统计学意义（P <.01）。对于5名获得委员会认证的放射科医生，不使用CAD和使用CAD时的平均Az值分别为0.63±0.08和0.66±0.09，差异有统计学意义（P <.01）。对于5名住院放射科医生，不使用CAD和使用CAD时的平均Az值分别为0.66±0.04和0.68±0.04，差异有统计学意义（P =.02）。在观察者表现分析中，获得委员会认证的放射科医生和住院医师在不使用CAD（P =.61）或使用CAD（P =.88）时获得的Az值没有显著差异。对于所有放射科医生，在检测直径1.0 cm或更小的肺结节时，不使用CAD和使用CAD时的平均Az值分别为0.60±0.11和0.64±0.11，差异有统计学意义（P <.01）。
使用CAD系统提高了获得委员会认证的放射科医生和住院医师在胸部CT上检测肺结节的能力。
