Department of Radiology, China-Japan Union Hospital, Jilin University, Changchun, Jilin 130000, China.
Chin Med J (Engl). 2011 Feb;124(3):380-4.
Colonic polyps are frequently encountered in clinics. Computed tomographic colonography (CTC), as a painless and quick detection, has high values in clinics. In this study, we evaluated the application value of computer-aided detection (CAD) in CTC detection of colonic polyps in the Chinese population.
CTC was performed with a GE 64-row multidetector computed tomography (MDCT) scanner. Data of 50 CTC patients (39 patients positive for at least one polyp of ≥ 0.5 cm in size and the other 11 patients negative by endoscopic detection) were retrospectively reviewed first without computer-aided detection (CAD) and then with CAD by four radiologists (two were experienced and another two inexperienced) blinded to colonoscopy findings. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of detected colonic polyps, as well as the areas under the ROC curves (Az value) with and without CAD were calculated.
CAD increased the overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the colonic polyps detected by experienced and inexperienced readers. The sensitivity in detecting small polyps (5 - 9 mm) with CAD in experienced and inexperienced readers increased from 82% and 44% to 93% and 82%, respectively (P > 0.05 and P < 0.001). With the use of CAD, the overall false positive rate and false negative rate for the detection of polyps by experienced and inexperienced readers decreased in different degrees. Among 13 sessile polyps not detected by CAD, two were ≥ 1.0 cm, eleven were 5 - 9 mm in diameter, and nine were flat-shaped lesions.
The application of CAD in combination with CTC can increase the ability to detect colonic polyps, particularly for inexperienced readers. However, CAD is of limited value for the detection of flat polyps.
结肠息肉在临床上经常遇到。计算机断层结肠成像（CTC）作为一种无痛、快速的检测方法，在临床上具有很高的价值。在这项研究中，我们评估了计算机辅助检测（CAD）在中国人CTC 检测结肠息肉中的应用价值。
使用 GE 64 排多层螺旋 CT（MDCT）扫描仪进行 CTC。回顾性分析了 50 例 CTC 患者（39 例至少有一个≥0.5cm 大小的息肉阳性，11 例内镜检查阴性）的数据。首先，在没有 CAD 的情况下，然后由 4 名放射科医生（2 名有经验，2 名无经验）对结肠镜检查结果进行盲法分析。计算有和没有 CAD 时检测到的结肠息肉的敏感性、特异性、阳性预测值、阴性预测值和准确性，以及 ROC 曲线下面积（Az 值）。
CAD 提高了有经验和无经验读者检测结肠息肉的整体敏感性、特异性、阳性预测值、阴性预测值和准确性。有和无经验读者检测小息肉（5-9mm）的敏感性分别从 82%和 44%增加到 93%和 82%（P＞0.05 和 P＜0.001）。使用 CAD 后，有经验和无经验读者检测息肉的总体假阳性率和假阴性率均有不同程度的降低。在 13 个未被 CAD 检测到的息肉中，有 2 个≥1.0cm，11 个直径为 5-9mm，9 个为扁平状病变。
CAD 与 CTC 联合应用可提高结肠息肉的检测能力，特别是对无经验的读者。然而，CAD 对扁平息肉的检测价值有限。
