Fletcher J G, Booya Fargol, Summers Ronald M, Roy David, Guendel Lutz, Schmidt Bernhard, McCollough Cynthia H, Fidler Jeff L
Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
AJR Am J Roentgenol. 2007 Aug;189(2):277-82. doi: 10.2214/AJR.07.2289.
The purpose of our study was to evaluate two current automatic polyp detection systems to determine their sensitivity and false-positive rate in patients who have undergone CT colonography and subsequent endoscopy.
We evaluated two polyp detection systems--Polyp Enhanced Viewing (PEV) and the Summers computer-aided detection (CAD) system (National Institutes of Health [NIH]) using a unique cohort of CT colonography examinations: 31 examinations with true-positive lesions identified by radiologists and 34 examinations with false-positive lesions incorrectly identified by radiologists. All patients had reference-standard colonoscopy within 7 days of CT. Candidate lesions were compared with the endoscopic reference standard and prospective radiologist interpretation. The sensitivity and false-positive rates were calculated for each system.
The NIH system had a higher sensitivity than the PEV tool for polyps > or = 1 cm (22/23, 96%; 78-99%, 95% CI vs 14/23, 61%; 38-81%, 95% CI; p = 0.008, respectively). There was no significant difference in the detection of medium-sized polyps 6-9 mm in size (8/13 vs 6/13, p = 0.68, respectively). The PEV tool had an average of 1.18 false-positive detections per patient, whereas the NIH tool had an average of 5.20 false-positive detections per patient, with the PEV tool having significantly fewer false-positive detections in both patient groups (p < 0.001).
One polyp detection system tended to operate with a higher sensitivity, whereas the other tended to operate with a lower false-positive rate. Prospective trials using polyp detection systems as a primary or secondary means of CT colonography interpretation appear warranted.
我们研究的目的是评估两种当前的自动息肉检测系统，以确定它们在接受CT结肠成像及后续内镜检查的患者中的灵敏度和假阳性率。
我们使用一组独特的CT结肠成像检查评估了两种息肉检测系统——息肉增强视图（PEV）和萨默斯计算机辅助检测（CAD）系统（美国国立卫生研究院[NIH]）：31例经放射科医生识别出真阳性病变的检查，以及34例经放射科医生错误识别出假阳性病变的检查。所有患者在CT检查后7天内接受了参考标准的结肠镜检查。将候选病变与内镜参考标准及放射科医生的前瞻性解读进行比较。计算每个系统的灵敏度和假阳性率。
对于直径大于或等于1 cm的息肉，NIH系统的灵敏度高于PEV工具（22/23，96%；78 - 99%，95%置信区间，对比14/23，61%；38 - 81%，95%置信区间；p分别为0.008）。对于6 - 9 mm大小的中等息肉，检测率无显著差异（分别为8/13对比6/13，p = 0.68）。PEV工具每位患者平均有1.18例假阳性检测，而NIH工具每位患者平均有5.20例假阳性检测，在两个患者组中PEV工具的假阳性检测均显著更少（p < 0.001）。
一种息肉检测系统倾向于以更高的灵敏度运行，而另一种则倾向于以更低的假阳性率运行。使用息肉检测系统作为CT结肠成像解读的主要或次要手段的前瞻性试验似乎是有必要的。
