Awai Kazuo, Murao Kohei, Ozawa Akio, Nakayama Yoshiharu, Nakaura Takeshi, Liu Duo, Kawanaka Koichi, Funama Yoshinori, Morishita Shoji, Yamashita Yasuyuki
Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto 860-8556, Japan.
Radiology. 2006 Apr;239(1):276-84. doi: 10.1148/radiol.2383050167. Epub 2006 Feb 7.
To evaluate the effect of a computer-aided diagnosis (CAD) system on the diagnostic performance of radiologists for the estimation of the malignancy of pulmonary nodules on thin-section helical computed tomographic (CT) scans.
The institutional review board approved use of the CT database; informed specific study-related consent was waived. The institutional review board approved participation of radiologists; informed consent was obtained from all observers. Thirty-three (18 malignant, 15 benign) pulmonary nodules of less than 3.0 cm in maximal diameter were evaluated. Receiver operating characteristic (ROC) analysis with a continuous rating scale was used to compare observer performance for the estimation of the likelihood of malignancy first without and then with the CAD system. The participants were 10 board-certified radiologists and nine radiology residents.
For all 19 participants, the mean area under the best-fit ROC curve (A(z)) values achieved without and with the CAD system were 0.843 +/- 0.097 (standard deviation) and 0.924 +/- 0.043, respectively. The difference was significant (P = .021). The mean A(z) values achieved without and with the CAD system were 0.910 +/- 0.052 and 0.944 +/- 0.040, respectively, for the 10 board-certified radiologists (P = .190) and 0.768 +/- 0.078 and 0.901 +/- 0.036, respectively, for the nine radiology residents (P = .009).
Use of the CAD system significantly (P = .009) improved the diagnostic performance of radiology residents for assessment of the malignancy of pulmonary nodules; however, it did not improve that of board-certified radiologists.
评估计算机辅助诊断（CAD）系统对放射科医生在薄层螺旋计算机断层扫描（CT）上评估肺结节恶性程度的诊断性能的影响。
机构审查委员会批准使用CT数据库；免除了与特定研究相关的知情同意。机构审查委员会批准放射科医生参与；所有观察者均获得了知情同意。对33个最大直径小于3.0 cm的肺结节（18个恶性，15个良性）进行了评估。采用连续评分量表的受试者操作特征（ROC）分析，比较观察者在无CAD系统和有CAD系统时评估恶性可能性的表现。参与者包括10名获得委员会认证的放射科医生和9名放射科住院医师。
对于所有19名参与者，无CAD系统和有CAD系统时获得的最佳拟合ROC曲线下平均面积（A(z)）值分别为0.843±0.097（标准差）和0.924±0.043。差异具有统计学意义（P = .021）。10名获得委员会认证的放射科医生无CAD系统和有CAD系统时获得的平均A(z)值分别为0.910±0.052和0.944±0.040（P = .190），9名放射科住院医师分别为0.768±0.078和0.901±0.036（P = .009）。
使用CAD系统显著（P = .009）提高了放射科住院医师评估肺结节恶性程度的诊断性能；然而，对获得委员会认证的放射科医生没有改善。
