Lee In Jae, Gamsu Gordon, Czum Julianna, Wu Ning, Johnson Rebecca, Chakrapani Sanjay
Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA.
Korean J Radiol. 2005 Apr-Jun;6(2):89-93. doi: 10.3348/kjr.2005.6.2.89.
To evaluate the capacity of a computer-aided detection (CAD) system to detect lung nodules in clinical chest CT.
A total of 210 consecutive clinical chest CT scans and their reports were reviewed by two chest radiologists and 70 were selected (33 without nodules and 37 with 1-6 nodules, 4-15.4 mm in diameter). The CAD system (ImageChecker CT LN-1000) developed by R2 Technology, Inc. (Sunnyvale, CA) was used. Its algorithm was designed to detect nodules with a diameter of 4-20 mm. The two chest radiologists working with the CAD system detected a total of 78 nodules. These 78 nodules form the database for this study. Four independent observers interpreted the studies with and without the CAD system.
The detection rates of the four independent observers without CAD were 81% (63/78), 85% (66/78), 83% (65/78), and 83% (65/78), respectively. With CAD their rates were 87% (68/78), 85% (66/78), 86% (67/78), and 85% (66/78), respectively. The differences between these two sets of detection rates did not reach statistical significance. In addition, CAD detected eight nodules that were not mentioned in the original clinical radiology reports. The CAD system produced 1.56 false-positive nodules per CT study. The four test observers had 0, 0.1, 0.17, and 0.26 false-positive results per study without CAD and 0.07, 0.2, 0.23, and 0.39 with CAD, respectively.
The CAD system can assist radiologists in detecting pulmonary nodules in chest CT, but with a potential increase in their false positive rates. Technological improvements to the system could increase the sensitivity and specificity for the detection of pulmonary nodules and reduce these false-positive results.
评估计算机辅助检测（CAD）系统在临床胸部CT中检测肺结节的能力。
两位胸部放射科医生对连续的210例临床胸部CT扫描及其报告进行了回顾，并选取了70例（33例无结节，37例有1 - 6个结节，直径4 - 15.4毫米）。使用了由R2 Technology公司（加利福尼亚州桑尼维尔）开发的CAD系统（ImageChecker CT LN - 1000）。其算法设计用于检测直径4 - 20毫米的结节。两位使用CAD系统的胸部放射科医生共检测到78个结节。这78个结节构成了本研究的数据库。四位独立观察者分别在有和没有CAD系统的情况下解读这些研究。
四位独立观察者在没有CAD系统时的检测率分别为81%（63/78）、85%（66/78）、83%（65/78）和83%（65/78）。使用CAD系统时，他们的检测率分别为87%（68/78）、85%（66/78）、86%（67/78）和85%（66/78）。这两组检测率之间的差异未达到统计学显著性。此外，CAD检测到8个在原始临床放射学报告中未提及的结节。CAD系统每例CT研究产生1.56个假阳性结节。四位测试观察者在没有CAD系统时每例研究的假阳性结果分别为0、0.1、0.17和0.26，使用CAD系统时分别为0.07、0.2、0.23和0.39。
CAD系统可协助放射科医生在胸部CT中检测肺结节，但可能会使假阳性率有所增加。对该系统的技术改进可提高检测肺结节的敏感性和特异性，并减少这些假阳性结果。
