Kobayashi T, Xu X W, MacMahon H, Metz C E, Doi K
Kurt Rossmann Laboratories for Radiologic Image Research, Department of Radiology, University of Chicago, IL 60637, USA.
Radiology. 1996 Jun;199(3):843-8. doi: 10.1148/radiology.199.3.8638015.
To evaluate the effect of a computer-aided diagnosis (CAD) scheme on radiologists' performance in the detection of lung nodules, and to examine a new method of receiver operating characteristic (ROC) analysis.
One hundred twenty radiographs (60 normal and 60 abnormal with lung nodules of varying subtlety) were used. Sixteen radiologists (two thoracic, six general, and eight residents) participated in an observer study in which they read both conventional radiographs and digitized radiographs. The radiologists' performance was evaluated with ROC analysis with two different methods (independent testing and sequential testing) and a continuous rating scale.
Az (area under the best fit binormal ROC curve when it is plotted in the unit square) values obtained from ROC analysis with and without CAD output were 0.940 and 0.894, respectively, in the independent test and 0.948 and 0.906, respectively, in the sequential test. Findings with both methods indicated that the CAD scheme statistically significantly improved diagnostic accuracy, particularly for radiologists with less experience (P < .001). Reading time was not increased when CAD was used.
The CAD scheme can assist radiologists in the detection of lung nodules on chest radiographs.
评估计算机辅助诊断（CAD）方案对放射科医生检测肺结节性能的影响，并研究一种新的受试者操作特征（ROC）分析方法。
使用了120张X光片（60张正常，60张异常，伴有不同程度的肺结节）。16名放射科医生（2名胸科医生、6名普通医生和8名住院医生）参与了一项观察者研究，他们阅读了传统X光片和数字化X光片。采用两种不同方法（独立测试和序贯测试）和连续评分量表的ROC分析对放射科医生的表现进行评估。
在独立测试中，使用和不使用CAD输出的ROC分析获得的Az（最佳拟合双正态ROC曲线在单位正方形中绘制时的曲线下面积）值分别为0.940和0.894，在序贯测试中分别为0.948和0.906。两种方法的结果均表明，CAD方案在统计学上显著提高了诊断准确性，尤其是对于经验较少的放射科医生（P <.001）。使用CAD时阅读时间并未增加。
CAD方案可协助放射科医生在胸部X光片上检测肺结节。
