Effect of computer-aided detection as a second reader in multidetector-row CT colonography
Our purpose was to assess the effect of computer-aided detection (CAD) on lesion detection as a second reader in computed tomographic colonography, and to compare the influence of CAD on the performance of readers with different levels of expertise. Fifty-two CT colonography patient data-sets (37 patients: 55 endoscopically confirmed polyps ≥0.5 cm, seven cancers; 15 patients: no abnormalities) were retrospectively reviewed by four radiologists (two expert, two nonexpert). After primary data evaluation, a second reading augmented with findings of CAD (polyp-enhanced view, Siemens) was performed. Sensitivities and reading time were calculated for each reader without CAD and supported by CAD findings. The sensitivity of expert readers was 91% each, and of nonexpert readers, 76% and 75%, respectively, for polyp detection. CAD increased the sensitivity of expert readers to 96% (P = 0.25) and 93% (P = 1), and that of nonexpert readers to 91% (P = 0.008) and 95% (P = 0.001), respectively. All four readers diagnosed 100% of cancers, but CAD alone only 43%. CAD increased reading time by 2.1 min (mean). CAD as a second reader significantly improves sensitivity for polyp detection in a high disease prevalence population for nonexpert readers. CAD causes a modest increase in reading time. CAD is of limited value in the detection of cancer.
KeywordsCT colonography Computer-aided detection Virtual endoscopy Polyp Colon cancer
- 3.Cotton PB, Durkalski VL, Pineau BC, Palesch YY, Mauldin PD, Hoffman B, Vining DJ, Small WC, Affronti J, Rex D, Kopecky KK, Ackerman S, Burdick JS, Brewington C, Turner MA, Zfass A, Wright AR, Iyer RB, Lynch P, Sivak MV, Butler H (2004) Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. JAMA 291:1713–1719PubMedCrossRefGoogle Scholar
- 6.Rockey DC, Paulson E, Niedzwiecki D, Davis W, Bosworth HB, Sanders L, Yee J, Henderson J, Hatten P, Burdick S, Sanyal A, Rubin DT, Sterling M, Akerkar G, Bhutani MS, Binmoeller K, Garvie J, Bini EJ, McQuaid K, Foster WL, Thompson WM, Dachman A, Halvorsen R (2005) Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet 365:305–311PubMedGoogle Scholar
- 26.Taylor SA, Halligan S, Slater A, Goh V, Burling DN, Roddie ME, Honeyfield L, McQuillan J, Amin H, Dehmeshki J (2006) Polyp detection with CT colonography: primary 3D endoluminal analysis versus primary 2D transverse analysis with computer-assisted reader software. Radiology 239:759–767PubMedCrossRefGoogle Scholar
- 29.Burling D, Halligan S, Altman DG, Atkin W, Bartram C, Fenlon H, Laghi A, Stoker J, Taylor S, Frost R, Dessey G, De Villiers M, Florie J, Foley S, Honeyfield L, Iannaccone R, Gallo T, Kay C, Lefere P, Lowe A, Mangiapane F, Marrannes J, Neri E, Nieddu G, Nicholson D, O’Hare A, Ori S, Politi B, Poulus M, Regge D, Renaut L, Rudralingham V, Signoretta S, Vagli P, Van der Hulst V, Williams-Butt J (2006) CT colonography interpretation times: effect of reader experience, fatigue, and scan findings in a multi-centre setting. Eur Radiol 16:1745–1749PubMedCrossRefGoogle Scholar