Effect of computer-aided diagnosis system on reading time and diagnostic accuracy in detection of intracranial aneurysms on MR angiography

目标。确定使用计算机辅助诊断（CAD）系统是否可以缩短读取时间，同时保持放射科医生在mri血管造影上检测颅内动脉瘤的诊断性能。材料和方法。采用50例患者（颅内动脉瘤16例，阴性34例）的50张最大强度投影MR血管造影作为观察者表现研究。16名放射科医生（8名神经放射科医生和8名经验不足的放射科医生）参与了观察员研究，并使用独立的测试方法对没有CAD输出图像和有CAD输出图像的MR血管造影进行了解释。在每个案例中记录每个观察者的阅读时间。采用受试者工作特征（ROC）分析对观察者的表现进行评价。对于经验不足的放射科医生，当有CAD输出图像时，动脉瘤病例的平均阅读时间显著减少了20.4秒（34.4%）（从59.3秒减少到38.9秒，p <0.01），阴性病例的平均阅读时间显著减少了38.2秒（48.7%）（从78.4秒减少到40.2秒，p <0.01）。有CAD输出图像的观察者的表现（平均Az = 0.911）明显优于没有CAD输出图像的观察者（平均Az = 0.787） （p = 0.022）。然而，对于神经放射科医生来说，平均阅读时间和观察者的表现并没有随着CAD输出而改善。使用CAD系统可以缩短阅读时间，同时提高经验不足的放射科医生的诊断性能。

OBJECTIVE. To determine whether the use of a computer-aided diagnosis (CAD) system can shorten the reading time while maintaining a diagnostic performance of radiologists in the detection of intracranial aneurysms on MR angiograms.MATERIALS AND METHODS. Fifty maximum intensity projection MR angiograms in 50 patients (16 cases with intracranial aneurysms and 34 negative cases) were used for observer performance study. Sixteen radiologists (8 neuroradiologists and 8 less experienced radiologists) participated in observer studies and interpreted the MR angiograms without and with the CAD output images by using an independent test method. The reading time for each observer was recorded in each case. The observers' performance was evaluated by use of receiver operating characteristic (ROC) analysis.RESULTS. For the less experienced radiologists, the mean reading time per case was reduced significantly by 20.4 sec (34.4%) for the aneurysm cases (from 59.3 sec to 38.9 sec, p < 0.01) and 38.2 sec (48.7%) for the negative cases (from 78.4 sec to 40.2 sec, p <0.01), when CAD output images were available. The observer performance with CAD output images (mean Az = 0.911) was significantly better than that without CAD (mean Az = 0.787) (p = 0.022). For the neuroradiologists, however, both the mean reading time and observer performance was not improved with CAD output.CONCLUSION. The use of the CAD system can shorten the reading time while improving diagnostic performance for less experienced radiologists.