White Charles S, Pugatch Robert, Koonce Thomas, Rust Steven W, Dharaiya Ekta
University of Maryland Medical Center, 22 S. Greene Street, Baltimore, MD 21201, USA.
Acad Radiol. 2008 Mar;15(3):326-33. doi: 10.1016/j.acra.2007.09.027.
The purpose of this multicenter, multireader study was to evaluate the performance of computed tomography (CT) lung nodule computer-aided detection (CAD) software as a second reader.
The study involved 109 patients from four sites. The data were collected from a variety of multidetector CT scanners and had different scan parameters. Each chest CT scan was divided into four quadrants. A group of three expert thoracic radiologists identified nodules between 4 and 30 mm in maximum diameter within each quadrant. The standard of reference was established by a consensus read of these experienced radiologists. The cases were then interpreted by 10 other radiologist readers with varying degrees of experience, without and then with CAD software. These readers identified nodules and assigned an actionability rating to each quadrant before and after using CAD software. Receiver operating characteristic curves were used to measure the performance of the readers without and with CAD software.
The average increase in area under the curve for the 10 readers with CAD software was 1.9% for a 95% confidence interval (0.8-8.0%). The area under the curve without CAD software was 86.7% and with CAD software was 88.7%. A nonsignificant correlation was observed between the improvement in sensitivity and experience of the radiologists. The readers also showed a greater improvement in patients with cancer as compared to those without cancer.
In this multicenter trial, CAD software was shown to be effective as a second reader by improving the sensitivity of the radiologists in detecting pulmonary nodules.
这项多中心、多阅片者研究的目的是评估计算机断层扫描（CT）肺结节计算机辅助检测（CAD）软件作为第二阅片者的性能。
该研究纳入了来自四个地点的109名患者。数据采集自各种多排CT扫描仪，且扫描参数不同。每次胸部CT扫描被分为四个象限。一组三名胸科专家放射科医生在每个象限内识别最大直径在4至30毫米之间的结节。参考标准由这些经验丰富的放射科医生通过共识阅片确定。然后由另外10名经验程度不同的放射科阅片者在不使用和使用CAD软件的情况下对病例进行解读。这些阅片者在使用CAD软件前后识别结节并为每个象限分配可操作性评级。使用受试者操作特征曲线来衡量不使用和使用CAD软件时阅片者的性能。
使用CAD软件的10名阅片者曲线下面积的平均增加为1.9%，95%置信区间为（0.8 - 8.0%）。不使用CAD软件时曲线下面积为86.7%，使用CAD软件时为88.7%。在敏感性改善与放射科医生经验之间观察到无显著相关性。与无癌症患者相比，阅片者在癌症患者中也显示出更大的改善。
在这项多中心试验中，CAD软件被证明作为第二阅片者是有效的，可提高放射科医生检测肺结节的敏感性。
