Abstract
Objective
We aimed to identify the effect of computer-aided detection (CAD) on visual search and performance in CT Colonography (CTC) of inexperienced and experienced readers.
Methods
Fifteen endoluminal CTC examinations were recorded, each with one polyp, and two videos were generated, one with and one without a CAD mark. Forty-two readers (17 experienced, 25 inexperienced) interpreted the videos during infrared visual search recording. CAD markers and polyps were treated as regions of interest in data processing. This multi-reader, multi-case study was analysed using multilevel modelling.
Results
CAD drew readers’ attention to polyps faster, accelerating identification times: median ‘time to first pursuit’ was 0.48 s (IQR 0.27 to 0.87 s) with CAD, versus 0.58 s (IQR 0.35 to 1.06 s) without. For inexperienced readers, CAD also held visual attention for longer. All visual search metrics used to assess visual gaze behaviour demonstrated statistically significant differences when “with” and “without” CAD were compared. A significant increase in the number of correct polyp identifications across all readers was seen with CAD (74 % without CAD, 87 % with CAD; p < 0.001).
Conclusions
CAD significantly alters visual search and polyp identification in readers viewing three-dimensional endoluminal CTC. For polyp and CAD marker pursuit times, CAD generally exerted a larger effect on inexperienced readers.
Key Points
• Visual gaze is attracted by computer-assisted detection (CAD) marks on polyps
• Inexperienced readers’ gaze is affected more by CAD than experienced readers.
• CAD marks could mean that the unannotated endoluminal surface is relatively neglected.
• Correct polyp identification is increased significantly by CAD.
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Acknowledgments
The scientific guarantor of this publication is Prof. Steve Halligan. The authors of this manuscript declare relationships with the following companies: Vital Images (Vital Images Inc., Minnetonka, Minnesota, USA) and iCAD (iCAD Inc., Fairborn, Ohio, USA) provided a medical image workstation used for this research. This study was funded by the National Institute for Health (NIHR) Research under its Programme Grants for Applied Research funding scheme (RP-PG-0407-10338). Three of the authors are statisticians. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (observers) in this study. No study subjects or cohorts have been previously reported. Methodology: prospective, experimental, multicenter study.
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Helbren, E., Fanshawe, T.R., Phillips, P. et al. The effect of computer-aided detection markers on visual search and reader performance during concurrent reading of CT colonography. Eur Radiol 25, 1570–1578 (2015). https://doi.org/10.1007/s00330-014-3569-z
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DOI: https://doi.org/10.1007/s00330-014-3569-z