Plus disease in retinopathy of prematurity: Pilot study of computer-based and expert diagnosis
Plus disease in retinopathy of prematurity: Pilot study of computer-based and expert diagnosis
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DOI：
10.1016/j.jaapos.2007.09.005
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发表时间：
2007-12-01
期刊：
影响因子：
1.6
通讯作者：
Chiang, Michael F.
中科院分区：
文献类型：
--
作者：
Gelman, Rony;Jiang, Lei;Chiang, Michael F.
目的：测量公认专家对早产儿视网膜病变（ROP）附加疾病诊断的准确性，并开展一项检查基于计算机的图像分析系统视网膜图像多尺度分析（RISA）性能的试点研究。方法22位ROP专家独立解读了一组34张广角视网膜图像，以确定是否存在正性疾病。根据专家共识为每个图像定义一个参考标准诊断。通过基于计算机的系统分析图像，使用小动脉和小静脉系统参数的单独和线性组合：综合曲率（IC）、直径和弯曲度指数（TI）。与参考标准相比，确定每位专家以及基于计算机的系统对阳性疾病诊断的敏感性、特异性和受试者操作特征曲线下面积（AUC）。结果专家灵敏度范围为0.308 ~ 1.000，特异性范围为0.571 ~ 1.000，AUC范围为0.784 ~ 1.000。各计算机系统参数中，静脉IC的AUC最高，为0.853。在所有计算机系统参数中，小动脉IC、小动脉TI、小静脉IC、小静脉直径和小静脉TI的线性组合的AUC最高（0.967），大于22位专家中的18位（81.8%）。结论ROP专家对正性疾病的诊断准确性不高。以计算机为基础的图像分析系统具有较高的诊断准确率。需要进一步研究涉及本研究的RISA系统参数截止值，以充分验证该计算机系统与人类专家的性能比较。
PURPOSE To measure accuracy of plus disease diagnosis by recognized experts in retinopathy of prematurity (ROP), and to conduct a pilot study examining performance of a computer-based image analysis system, Retinal Image multiScale Analysis (RISA).METHODS Twenty-two ROP experts independently interpreted a set of 34 wide-angle retinal images for presence of plus disease. A reference standard diagnosis based on expert consensus was defined for each image. Images were analyzed by the computer-based system using individual and linear combinations of system parameters for arterioles and venules: integrated curvature (IC), diameter, and tortuosity index (TI). Sensitivity, specificity, and receiver operating characteristic areas under the curve (AUC) for plus disease diagnosis compared with the reference standard were determined for each expert, as well as for the computer-based system.RESULTS Expert sensitivity ranged from 0.308 to 1.000, specificity ranged from 0.571 to 1.000, and AUC ranged from 0.784 to 1.000. Among individual computer system parameters, venular IC had highest AUC (0.853). Among all computer system parameters, the linear combination of arteriolar IC, arteriolar TI, venular IC, venular diameter, and venular TI had highest AUC (0.967), which was greater than that of 18 (81.8%) of 22 experts.CONCLUSIONS Accuracy of ROP experts for plus disease diagnosis is imperfect. A computer-based image analysis system has potential to diagnose plus disease with high accuracy. Further research involving RISA system parameter cut-off values from this study are required to fully validate performance of this computer-based system compared with that of human experts.