Effect of CAD on radiologists' detection of lung nodules on thoracic CT scans: analysis of an observer performance study by nodule size.
Effect of CAD on radiologists' detection of lung nodules on thoracic CT scans: analysis of an observer performance study by nodule size.
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CAD对放射科医生对肺结节的检测对胸腔CT扫描的影响：通过结节大小对观察者性能研究的分析。
DOI：
10.1016/j.acra.2009.08.006
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发表时间：
2009-12
影响因子：
4.8
通讯作者：
Attili, Anil
中科院分区：
文献类型：
--
作者：
Sahiner, Berkman;Chan, Heang-Ping;Hadjiiski, Lubomir M.;Cascade, Philip N.;Kazerooni, Ella A.;Chughtai, Aamer R.;Poopat, Chad;Song, Thomas;Frank, Luba;Stojanovska, Jadranka;Attili, Anil
回顾性研究计算机辅助检测（CAD）系统对放射科医生在CT检查中检测肺小结节的性能的影响，以放射科专家小组作为参考标准。获得了机构审查委员会的批准。我们的数据集包含52个由肺部图像数据库联盟收集的CT检查，33个来自我们的机构。所有CT均由多位胸放射科专家读取，以确定检测的参考标准。其他六名胸部放射科医生首先阅读了无CAD的CT检查，然后阅读了CAD。对于不同直径阈值以上的结节，使用自由响应受试者工作特征（FROC）和折刀FROC分析方法（JAFROC）评估性能。241个结节，大小从3.0到18.6 mm（平均5.3 mm），被确定为参考标准。在直径阈值为3、4、5和6 mm时，CAD系统的灵敏度分别为54%、64%、68%和76%，每次扫描平均有5.6个假阳性（FP）。在没有CAD的情况下，对于相同的结节直径阈值，从JAFROC分析中获得的6名放射科医生的平均优值（FOM）分别为0.661、0.729、0.793和0.838。CAD组相应的平均FOM分别提高到0.705、0.763、0.810和0.862。在3 mm和4 mm阈值下，结节的改善达到统计学显著性（分别为p=0.002和0.020），在5 mm和6 mm阈值下未达到显著性（分别为p=0.18和0.13）。在结节直径阈值为3 mm时，放射科医师的平均灵敏度和FP率分别为0.56和0.67（无CAD），0.67和0.78（有CAD）。CAD提高了胸部放射科医生在CT检查中检测5 mm以下肺结节的性能，这些结节通常被单独的目视检查所忽视。
To retrospectively investigate the effect of a computer aided detection (CAD) system on radiologists’ performance for detecting small pulmonary nodules in CT examinations, with a panel of expert radiologists serving as the reference standard. Institutional review board approval was obtained. Our data set contained 52 CT examinations collected by the Lung Image Database Consortium, and 33 from our institution. All CTs were read by multiple expert thoracic radiologists to identify the reference standard for detection. Six other thoracic radiologists read the CT examinations first without, and then with CAD. Performance was evaluated using free-response receiver operating characteristics (FROC) and the jackknife FROC analysis methods (JAFROC) for nodules above different diameter thresholds. 241 nodules, ranging in size from 3.0 to 18.6 mm (mean 5.3 mm) were identified as the reference standard. At diameter thresholds of 3, 4, 5, and 6 mm, the CAD system had a sensitivity of 54%, 64%, 68%, and 76%, respectively, with an average of 5.6 false-positives (FPs) per scan. Without CAD, the average figures-of-merit (FOMs) for the six radiologists, obtained from JAFROC analysis, were 0.661, 0.729, 0.793 and 0.838 for the same nodule diameter thresholds, respectively. With CAD, the corresponding average FOMs improved to 0.705, 0.763, 0.810 and 0.862, respectively. The improvement achieved statistical significance for nodules at the 3 and 4 mm thresholds (p=0.002 and 0.020, respectively), and did not achieve significance at 5 and 6 mm (p=0.18 and 0.13, respectively). At a nodule diameter threshold of 3 mm, the radiologists’ average sensitivity and FP rate were 0.56 and 0.67, respectively, without CAD, and 0.67 and 0.78 with CAD. CAD improves thoracic radiologists’ performance for detecting pulmonary nodules under 5 mm on CT examinations, which are often overlooked by visual inspection alone.
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