Goo Jin Mo, Kim Hyae Young, Lee Jeong Won, Lee Hyun Ju, Lee Chang Hyun, Lee Kyung Won, Kim Tae Jung, Lim Kun Young, Park Seong Ho, Bae Kyongtae T
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.
J Comput Assist Tomogr. 2008 Jul-Aug;32(4):570-5. doi: 10.1097/RCT.0b013e318146261c.
To evaluate the impact of a computer-aided diagnosis (CAD) system on the performance of observers for the detection of both lung nodules and lung cancers.
One hundred fifty computed tomographic scans were evaluated. Database included 23 lung cancers (long diameter <20 mm), nodules stable for at least 2 years, and normal cases. Five chest radiologists and 5 radiology residents each independently recorded the locus of each nodule candidate and assigned a confidence score for the likelihood of nodule and malignancy without CAD; then, the interpretation was repeated with the use of CAD. A consensus panel of 2 chest radiologists served as a reference standard for the nodules. Histological confirmation was a reference standard for the cancers. The performances of the observers for the detection of nodules and cancer with and without CAD were compared using jackknife free-response receiver operating characteristic analysis.
The performance of detecting lung nodules was increased significantly with CAD for all radiologists and subgroups (P < 0.01). Although the overall performance of detecting lung cancers was not affected significantly with the use of CAD (P > 0.05), 4 lung cancers missed by 3 residents on their initial observation were additionally detected with CAD. Eighteen of 23 lung cancers were detected by CAD itself.
The overall radiologists' performance of detecting lung nodules was improved significantly with the use of CAD, whereas no statistical significance was observed for the detection of lung cancers. The use of CAD, however, contributed to the detection of additional lung cancers for less experienced readers.
评估计算机辅助诊断（CAD）系统对观察者检测肺结节和肺癌的性能影响。
对150例计算机断层扫描进行评估。数据库包括23例肺癌（长径<20 mm）、至少稳定2年的结节以及正常病例。5名胸部放射科医生和5名放射科住院医师分别独立记录每个结节候选位置，并在无CAD辅助的情况下对结节及恶性可能性给出置信度评分；然后，在使用CAD的情况下重复解读。由2名胸部放射科医生组成的共识小组作为结节的参考标准。组织学确诊作为癌症的参考标准。使用留一法自由反应接收器操作特征分析比较观察者在有和无CAD辅助情况下检测结节和癌症的性能。
对于所有放射科医生及其亚组，使用CAD后检测肺结节的性能显著提高（P<0.01）。虽然使用CAD后检测肺癌的总体性能未受到显著影响（P>0.05），但3名住院医师在初次观察时漏诊的4例肺癌在使用CAD后被额外检测出。23例肺癌中有18例由CAD自身检测出。
使用CAD后，放射科医生检测肺结节的总体性能显著提高，而检测肺癌未观察到统计学意义。然而，对于经验较少的阅片者，使用CAD有助于额外检测出肺癌。
