Computer-aided Detection of Pulmonary Embolism at CT Pulmonary Angiography: Can It Improve Performance of Inexperienced Readers?

Overview

Journal Eur Radiol

Specialty Radiology

Date 2011 Jan 13

PMID 21225269

Citations 10

Authors

Kevin N Blackmon

Charles Florin

Luca Bogoni

Joshua W McCain

James D Koonce

Heon Lee

Gorka Bastarrika

Christian Thilo

Philip Costello

Marcos Salganicoff

U Joseph Schoepf

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the effect of a computer-aided detection (CAD) algorithm on the performance of novice readers for detection of pulmonary embolism (PE) at CT pulmonary angiography (CTPA).

Materials And Methods: We included CTPA examinations of 79 patients (50 female, 52 ± 18 years). Studies were evaluated by two independent inexperienced readers who marked all vessels containing PE. After 3 months all studies were reevaluated by the same two readers, this time aided by CAD prototype. A consensus read by three expert radiologists served as the reference standard. Statistical analysis used χ(2) and McNemar testing.

Results: Expert consensus revealed 119 PEs in 32 studies. For PE detection, the sensitivity of CAD alone was 78%. Inexperienced readers' initial interpretations had an average per-PE sensitivity of 50%, which improved to 71% (p < 0.001) with CAD as a second reader. False positives increased from 0.18 to 0.25 per study (p = 0.03). Per-study, the readers initially detected 27/32 positive studies (84%); with CAD this number increased to 29.5 studies (92%; p = 0.125).

Conclusion: Our results suggest that CAD significantly improves the sensitivity of PE detection for inexperienced readers with a small but appreciable increase in the rate of false positives.

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