Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, MD 20892-1182, USA.
Acad Radiol. 2010 Aug;17(8):948-59. doi: 10.1016/j.acra.2010.03.024. Epub 2010 Jun 12.
To determine whether the display of computer-aided detection (CAD) marks on individual polyps on both the supine and prone scans leads to improved polyp detection by radiologists compared to the display of CAD marks on individual polyps on either the supine or the prone scan, but not both.
The acquisition of patient data for this study was approved by the Institutional Review Board and was Health Insurance Portability and Accountability Act-compliant. Subsequently, the use of the data was declared exempt from further institutional review board review. Four radiologists interpreted 33 computed tomography colonography cases, 21 of which had one adenoma 6-9 mm in size, with the assistance of a CAD system in the first reader mode (ie, the radiologists reviewed only the CAD marks). The radiologists were shown each case twice, with different sets of CAD marks for each of the two readings. In one reading, a true-positive CAD mark for the same polyp was displayed on both the supine and prone scans (a double-mark reading). In the other reading, a true-positive CAD mark was displayed either on the supine or prone scan, but not both (a single-mark reading). True-positive marks were randomized between readings and there was at least a 1-month delay between readings to minimize recall bias. Sensitivity and specificity were determined and receiver operating characteristic (ROC) and multiple-reader multiple-case analyses were performed.
The average per polyp sensitivities were 60% (38%-81%) versus 71% (52%-91%) (P = .03) for single-mark and double-mark readings, respectively. The areas (95% confidence intervals) under the ROC curves were 0.76 (0.62-0.88) and 0.79 (0.58-0.96), respectively (P = NS). Specificities were similar for the single-mark compared with the double-mark readings.
The display of CAD marks on a polyp on both the supine and prone scans led to more frequent detection of polyps by radiologists without adversely affecting specificity for detecting 6-9 mm adenomas.
确定在仰卧和俯卧扫描时在单个息肉上显示计算机辅助检测 (CAD) 标记是否比在仰卧或俯卧扫描时仅在单个息肉上显示 CAD 标记更能提高放射科医生的息肉检测率，但不是两者都显示。
本研究获得了机构审查委员会的批准，符合《健康保险流通与责任法案》的规定。随后，宣布使用该数据免于进一步的机构审查委员会审查。四名放射科医生使用 CAD 系统在第一读者模式下（即，放射科医生仅查看 CAD 标记）解释了 33 例 CT 结肠成像病例，其中 21 例有一个 6-9 毫米大小的腺瘤。放射科医生两次查看每个病例，两次阅读时 CAD 标记的设置不同。在一次阅读中，同一息肉的真阳性 CAD 标记同时显示在仰卧和俯卧扫描上（双标记阅读）。在另一次阅读中，真阳性 CAD 标记显示在仰卧或俯卧扫描上，但不是两者都显示（单标记阅读）。在阅读之间随机分配真阳性标记，并且两次阅读之间至少有 1 个月的延迟以最小化召回偏倚。确定了敏感性和特异性，并进行了接收器操作特征 (ROC) 和多读者多病例分析。
平均每个息肉的敏感性分别为 60%（38%-81%）和 71%（52%-91%）（P =.03），用于单标记和双标记阅读。ROC 曲线下面积（95%置信区间）分别为 0.76（0.62-0.88）和 0.79（0.58-0.96）（P = NS）。与双标记阅读相比，单标记阅读的特异性相似。
在仰卧和俯卧扫描时在单个息肉上显示 CAD 标记可使放射科医生更频繁地检测到息肉，而不会对检测 6-9 毫米腺瘤的特异性产生不利影响。
