Monnier-Cholley L, MacMahon H, Katsuragawa S, Morishita J, Ishida T, Doi K
Department of Radiology, Kurt Rossmann Laboratories for Radiologic Image Research, The University of Chicago, IL 60637, USA.
AJR Am J Roentgenol. 1998 Dec;171(6):1651-6. doi: 10.2214/ajr.171.6.9843307.
Our objective was to evaluate the impact of a computer-aided diagnostic scheme on radiologists' interpretations of chest radiographs with interstitial opacities by performing an observer test using receiver operating characteristic (ROC) analysis.
Twenty chest radiographs with normal findings and 20 chest radiographs with abnormal findings were used. Each radiograph was divided into four quadrants. One hundred twenty-nine quadrants (80 normal and 49 abnormal quadrants) were used for testing because we excluded 31 equivocal quadrants. Sixteen independent observers (10 residents and six attending radiologists) participated in this study. The radiologists' performance without and with computer assistance, which indicated cases with normal and abnormal findings by various markers, was evaluated by ROC analysis.
The diagnostic accuracy of the observers improved by a statistically significant magnitude when computer-aided diagnosis was used. Thus, the values for the area under the ROC curve obtained with and without the computer-aided diagnostic output were .970 and .948 (p = .0002), respectively, for all observers; .969 and .943 (p = .0006), respectively, for the residents' subgroup; and .972 and .960 (p = .162), respectively, for the attending radiologists' subgroup. The value for the area under the ROC curve for the computerized scheme by itself was .943.
Our computer-aided diagnostic scheme can assist radiologists in the diagnosis or exclusion of interstitial disease on chest radiographs.
我们的目的是通过使用接受者操作特征（ROC）分析进行观察者测试，评估计算机辅助诊断方案对放射科医生解读伴有间质模糊影的胸部X光片的影响。
使用了20张结果正常的胸部X光片和20张结果异常的胸部X光片。每张X光片被分成四个象限。由于我们排除了31个可疑象限，因此使用了129个象限（80个正常象限和49个异常象限）进行测试。16名独立观察者（10名住院医师和6名放射科主治医师）参与了本研究。通过ROC分析评估了放射科医生在无计算机辅助和有计算机辅助情况下的表现，这两种情况通过各种标记物表明了正常和异常结果的病例。
使用计算机辅助诊断时，观察者的诊断准确性有统计学意义的提高。因此，对于所有观察者，有计算机辅助诊断输出和无计算机辅助诊断输出时获得的ROC曲线下面积值分别为0.970和0.948（p = 0.0002）；住院医师亚组分别为0.969和0.943（p = 0.0006）；放射科主治医师亚组分别为0.972和0.960（p = 0.162）。计算机化方案本身的ROC曲线下面积值为0.943。
我们的计算机辅助诊断方案可协助放射科医生在胸部X光片上诊断或排除间质性疾病。
