Computer-aided Detection of Masses at Mammography: Interactive Decision Support versus Prompts
Computer-aided Detection of Masses at Mammography: Interactive Decision Support versus Prompts
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DOI：
10.1148/radiol.12120218
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发表时间：
2013-01-01
期刊：
影响因子：
19.7
通讯作者：
Karssemeijer, Nico
中科院分区：
文献类型：
--
作者：
Hupse, Rianne;Samulski, Maurice;Karssemeijer, Nico
目的：为了比较交互式计算机辅助检测（CAD）系统的有效性，其中CAD标记及其相关的可疑评分保持隐藏，除非其位置被读者查询，与当前临床实践中使用的传统CAD提示在全视野数字乳腺X线照片上检测恶性肿块的效果。材料和方法：本回顾性观察者研究无需机构审查委员会批准。9名经过认证的筛查放射科医生和3名接受过乳腺成像培训的住院医师阅读了200项研究（63项研究包含至少一个屏幕检测到的肿块，17项假阴性研究，20项假阳性研究和100项正常研究）两次，一次使用CAD提示，一次使用交互式CAD。由阅片师报告局部发现并评分。在提示模式下，记录CAD激活前后的结果。计算每个读片员和每个模式的位置受试者工作特征（ROC）曲线下的部分面积，该曲线为筛选典型的低假阳性分数区间，从0到0.2。结果：无辅助阅读的平均局部ROC曲线下面积为0.57，交互式CAD的平均局部ROC曲线下面积增加到0.62，提示对局部ROC曲线下面积无影响。无辅助阅读与交互式CAD的读者表现的差异有统计学意义（P = .009）。结论：当用作决策支持时，交互式使用CAD对乳腺X线片上的恶性肿块可能比目前使用CAD更有效，这是为了防止知觉疏忽。(C)RSNA，2012年
Purpose: To compare effectiveness of an interactive computer-aided detection (CAD) system, in which CAD marks and their associated suspiciousness scores remain hidden unless their location is queried by the reader, with the effect of traditional CAD prompts used in current clinical practice for the detection of malignant masses on full-field digital mammograms.Materials and Methods: The requirement for institutional review board approval was waived for this retrospective observer study. Nine certified screening radiologists and three residents who were trained in breast imaging read 200 studies (63 studies containing at least one screen-detected mass, 17 false-negative studies, 20 false-positive studies, and 100 normal studies) twice, once with CAD prompts and once with interactive CAD. Localized findings were reported and scored by the readers. In the prompted mode, findings were recorded before and after activation of CAD. The partial area under the location receiver operating characteristic (ROC) curve for an interval of low false-positive fractions typical for screening, from 0 to 0.2, was computed for each reader and each mode. Differences in reader performance were analyzed by using software.Results: The average partial area under the location ROC curve with unaided reading was 0.57, and it increased to 0.62 with interactive CAD, while it remained unaffected by prompts. The difference in reader performance for unaided reading versus interactive CAD was statistically significant (P = .009).Conclusion: When used as decision support, interactive use of CAD for malignant masses on mammograms may be more effective than the current use of CAD, which is aimed at the prevention of perceptual oversights. (C) RSNA, 2012