Department of Radiology, University of Michigan, Ann Arbor, MI 48109-5842, USA.
Acad Radiol. 2010 Mar;17(3):323-32. doi: 10.1016/j.acra.2009.10.016.
The aim of this study was to evaluate the effect of computer-aided diagnosis (CAD) on radiologists' estimates of the likelihood of malignancy of lung nodules on computed tomographic (CT) imaging.
A total of 256 lung nodules (124 malignant, 132 benign) were retrospectively collected from the thoracic CT scans of 152 patients. An automated CAD system was developed to characterize and provide malignancy ratings for lung nodules on CT volumetric images. An observer study was conducted using receiver-operating characteristic analysis to evaluate the effect of CAD on radiologists' characterization of lung nodules. Six fellowship-trained thoracic radiologists served as readers. The readers rated the likelihood of malignancy on a scale of 0% to 100% and recommended appropriate action first without CAD and then with CAD. The observer ratings were analyzed using the Dorfman-Berbaum-Metz multireader, multicase method.
The CAD system achieved a test area under the receiver-operating characteristic curve (A(z)) of 0.857 +/- 0.023 using the perimeter, two nodule radii measures, two texture features, and two gradient field features. All six radiologists obtained improved performance with CAD. The average A(z) of the radiologists improved significantly (P < .01) from 0.833 (range, 0.817-0.847) to 0.853 (range, 0.834-0.887).
CAD has the potential to increase radiologists' accuracy in assessing the likelihood of malignancy of lung nodules on CT imaging.
本研究旨在评估计算机辅助诊断（CAD）对放射科医生评估 CT 成像肺部结节恶性程度的影响。
共回顾性收集了 152 例患者的胸部 CT 扫描中 256 个肺部结节（124 个恶性，132 个良性）。开发了一种自动 CAD 系统，用于对 CT 容积图像上的肺部结节进行特征描述并提供恶性程度评分。采用受试者工作特征分析进行观察者研究，以评估 CAD 对放射科医生对肺部结节进行特征描述的影响。六名胸科放射学研究员担任读者。读者在 0%到 100%的范围内对恶性可能性进行评分，并在没有 CAD 时首先推荐适当的行动，然后在有 CAD 时推荐适当的行动。使用 Dorfman-Berbaum-Metz 多读者、多病例方法分析观察者评分。
CAD 系统使用周长、两个结节半径测量值、两个纹理特征和两个梯度场特征，获得了 0.857 +/- 0.023 的测试受试者工作特征曲线下面积（A(z)）。所有六名放射科医生在使用 CAD 时都获得了更好的性能。放射科医生的平均 A(z)显著提高（P <.01），从 0.833（范围，0.817-0.847）提高到 0.853（范围，0.834-0.887）。
CAD 有可能提高放射科医生在 CT 成像上评估肺部结节恶性程度的准确性。
