Comparison of radiologist and CAD performance in the detection of CT-confirmed subtle pulmonary nodules on digital chest radiographs
Comparison of radiologist and CAD performance in the detection of CT-confirmed subtle pulmonary nodules on digital chest radiographs
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DOI：
10.1097/rli.0b013e318168f705
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发表时间：
2008-06-01
影响因子：
6.7
通讯作者：
Kotter, Elmar
中科院分区：
文献类型：
--
作者：
Bley, Thorsten Alexander;Baumann, Tobias;Kotter, Elmar
目的：在数字X线摄影中检测肺部微小结节是放射科医生的一项具有挑战性的任务。本研究的目的是评估一个新批准的计算机辅助检测（CAD）system.Materials和方法的性能：3放射科医生和CAD系统的灵敏度为5至15毫米的肺结节的大小，对117例患者的数字胸部X线摄影检测进行了比较。由2名经验丰富的放射科医师通过计算机断层扫描的共识阅读确定参比标准品。在4周内进行计算机断层扫描和胸部X线片。42例患者的66个肺结节被纳入统计分析，结节平均直径为7.5 mm（标准差：2.2 mm）。117例患者中有75例没有5 ~ 15 mm大小的结节。结果：CAD系统有288例假阳性检测，平均每幅图像有2.5个假阳性。CAD系统的灵敏度为39.4%（95%置信区间：11.8%），而3名放射科医师的灵敏度为18.2%至30.3%（95%置信区间：9.3%至11.1%）。3名放射科医师对结节的检测结果基本一致（[kappa]N：0.64-0.73），而3名放射科医师对CAD性能的检测结果只有中等程度的一致（[kappa]N：0.45-0.52）。结论：CAD系统对5 ~ 15 mm大小的肺结节的诊断灵敏度上级优于1名放射科医师。CAD系统可以用于辅助放射科医师在数字胸部射线照片上检测肺结节。
Objectives: Detection of subtle pulmonary nodules on digital radiography is a challenging task for radiologists. The aim of this study was to evaluate the performance of a newly approved computer aided detection (CAD) system.Materials and Methods: The sensitivity of 3 radiologists and of a CAD system for the detection of pulmonary nodules from 5 to 15 mm in size on digital chest radiography of 117 patients was compared. The reference standard was established by consensus reading of computed tomography scans by 2 experienced radiologists. Computed tomography scans and chest radiographs were performed within 4 weeks. Sixty-six pulmonary nodules from 42 patients, With a mean nodule diameter of 7.5 mm (standard deviation: 2.2 mm), were included in the statistical analysis. Seventy-five of the 117 patients did not have nodules from 5 to 15mm of size.Results: Two hundred and eighty-eight false-positive detections of the CAD system were found with an average of 2.5 false-positives per image. Sensitivity of the CAD system was 39.4% (95% confidence interval: 11.8%), when compared with 18.2% to 30.3% (95% confidence interval 9.3% to 11.1%) of the 3 radiologists. Substantial agreement for nodule detection ([kappa]N: 0.64-0.73) was found among the 3 radiologists, whereas only moderate agreement was found between the radiologists and the CAD performance ([kappa]N: 0.45-0.52).Conclusions: The CAD system's diagnostic sensitivity in detecting pulmonary nodules of 5 to 15 mm of size was superior to the 1 of radiologists. The CAD system may be used for assisting the radiologist in the detection of lung nodules on digital chest radiographs.