Brochu B, Beigelman-Aubry C, Goldmard J-L, Raffy P, Grenier P A, Lucidarme O
Service de Radiologie, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie, Paris Cedex 13, France.
J Radiol. 2007 Apr;88(4):573-8. doi: 10.1016/s0221-0363(07)89857-x.
Evaluate the improvement in detecting lung nodules when using multidetector CT (MDCT) computer-assisted diagnosis (CAD).
Three radiologists (R1, R2, R3) with different levels of experience independently interpreted 30 MDCT examinations of the thorax taken for screening purposes, first without and then with CAD. The diagnosis was established by two of the three radiologists interpreting the images together, assisted by the CAD.
The consensus reading identified 133 nodules, 61 (46%) of which were 4 mm or larger. The sensitivity values in the detection of nodules before and after using the CAD were 54% and 80% (R1), 38% and 71% (R2), and 70% and 88% (R3), respectively. When considering only the nodules that were 4 mm or larger, the sensitivity values varied before and after using the CAD, from 62% to 95% (R1), from 41% to 84% (R2), and from 74% to 92% (R3). By combining two by two the three radiologists' results obtained without the CAD, the sensitivity values were 65%, 83%, and 77%, respectively, for all the nodules, and 70%, 85%, and 77% for the nodules that were 4 mm or larger. The CAD induced a total of 105 false-positive results, with a mean of 3.5 per examination.
The lung nodules missed by the radiologist can be detected if the CAD is used as a second reader. The CAD can be at least as beneficial as the use of a second independent reader.
评估使用多排螺旋CT（MDCT）计算机辅助诊断（CAD）时在检测肺结节方面的改善情况。
三位经验水平不同的放射科医生（R1、R2、R3）独立解读30例用于筛查目的的胸部MDCT检查，先是不使用CAD，然后使用CAD。由三位放射科医生中的两位在CAD辅助下共同解读图像来确定诊断结果。
一致性读片共识别出133个结节，其中61个（46%）直径为4毫米或更大。使用CAD前后检测结节的敏感度值分别为：R1为54%和80%，R2为38%和71%，R3为70%和88%。仅考虑直径4毫米或更大的结节时，使用CAD前后的敏感度值有所不同，R1从62%至95%，R2从41%至84%，R3从74%至92%。将三位放射科医生在不使用CAD时获得的结果两两组合，所有结节的敏感度值分别为65%、83%和77%，直径4毫米或更大结节的敏感度值分别为70%、85%和77%。CAD共产生105例假阳性结果，平均每次检查3.5个。
如果将CAD用作第二阅片者，放射科医生漏诊的肺结节能够被检测出来。CAD至少与使用第二位独立阅片者一样有益。
