Efficacy of Computer-aided Detection as a Second Reader for 6-9-mm Lesions at CT Colonography: Multicenter Prospective Trial

被引：36

作者：

Regge, Daniele ^{[1
]}

Della Monica, Patrizia ^{[1
]}

Galatola, Giovanni ^{[2
]}

Laudi, Cristiana ^{[2
]}

Zambon, Antonella ^{[3
]}

Correale, Loredana ^{[4
]}

Asnaghi, Roberto ^{[5
]}

Barbaro, Brunella ^{[6
]}

Borghi, Claudia ^{[7
]}

Campanella, Delia ^{[1
]}

Cassinis, Maria Carla ^{[8
]}

Ferrari, Riccardo ^{[9
]}

Ferraris, Andrea ^{[8
]}

Golfieri, Rita ^{[10
]}

Hassan, Cesare ^{[11
]}

Iafrate, Franco ^{[12
]}

Iussich, Gabriella ^{[1
]}

Laghi, Andrea ^{[9
]}

Massara, Roberto ^{[6
]}

Neri, Emanuele ^{[13
]}

Sali, Lapo ^{[14
]}

Venturini, Silvia ^{[15
]}

Gandini, Giovanni ^{[8
]}

机构：

[1] Inst Canc Res & Treatment, Radiol Unit, Candiolo, Italy

[2] Inst Canc Res & Treatment, Gastroenterol Unit, Candiolo, Italy

[3] Bicocca Univ Milano, Dept Stat, Unit Biostat, Milan, Italy

[4] im3D, Turin, Italy

[5] Salvatore Maugeri IRCCS Fdn, Radiol Unit, Novara, Italy

[6] Univ Cattolica Sacro Cuore, A Gemelli Hosp, Dept Bioimaging & Radiol Sci, Rome, Italy

[7] Valduce Hosp, Radiol Unit, Como, Italy

[8] Univ Turin, AOU S Giovanni Battista, Dept Med & Surg Disciplines, Diagnost Imaging Div, Turin, Italy

[9] Sapienza Univ Rome Polo Pontino, Dept Radiol Oncol & Pathol Sci, Rome, Italy

[10] St Orsola Marcello Malpighi Hosp, Dept Digest Dis & Internal Med, Radiol Unit, Bologna, Italy

[11] Osped Nuovo Regina Margherita, Gastroenterol Unit, I-00153 Rome, Italy

[12] Univ Roma La Sapienza, Dept Radiol Sci, Rome, Italy

[13] Univ Pisa, Dept Oncol Transplants & Adv Technol Med, Pisa, Italy

[14] Univ Florence, Dept Clin Physiopathol, Radiodiagnost Sect, Florence, Italy

[15] Natl Canc Inst, Radiol Unit, Aviano, Italy

来源：

RADIOLOGY | 2013年 / 266卷 / 01期

关键词：

COLORECTAL-CANCER; TOMOGRAPHIC COLONOGRAPHY; ADVANCED NEOPLASIA; TASK-FORCE; COLONOSCOPY; ADENOMAS; RISK; SURVEILLANCE; MAMMOGRAPHY; PERFORMANCE;

D O I：

10.1148/radiol.12120376

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Purpose: To assess the effect of computer-aided detection (CAD) as a second reader on the sensitivity and specificity of computed tomographic (CT) colonography in detecting 6-9-mm colorectal cancer (CRC) lesions. Materials and Methods: Individuals with clinical indications for colonoscopy-either for symptoms or as part of participating in a surveillance program or CRC screening-were prospectively enrolled at one of 10 academic centers between July 2007 and May 2009. Institutional review board approval was obtained at each clinical site, and all participants provided written informed consent. All participants underwent CT colonography and colonoscopy on the same day. Experienced readers interpreted the CT colonography images unassisted and then reviewed all colorectal lesion-like structures pinpointed by the CAD algorithm. Segmental unblinding of CT colonoscopy findings at colonoscopy was utilized. The sensitivity and specificity of unassisted and CAD-assisted reading in identifying individuals with 6-9-mm lesions were calculated and compared by means of pairwise analysis. Results: A total of 618 participants (mean age, 57.9 years; 54.5% male) were included in the final analysis. Of these participants, 464 (75.1%) had no lesions 6 mm or larger, and 52 (8.4%) had 6-9-mm lesions. The sensitivity of CT colonography with unassisted reading and that with CAD-assisted reading in identifying individuals with 6-9-mm lesions was 65.4% (95% confidence interval [CI]: 50.9%, 78.0%) and 76.9% (95% CI: 63.2%, 87.5%; P = .016), respectively. No significant change in specificity was observed: The specificity of CT colonography with unassisted and that with CAD-assisted reading was 91.8% (95% CI: 88.9%, 94.1%) and 90.9% (95% CI: 88.0%, 93.4%; P = .063), respectively. Evaluation of CAD candidates required an additional 1.6 minutes (25th-75th percentile: 1.0 minute to 3.4 minutes). Conclusion: The addition of CAD to reading performed by experienced readers resulted in a significant benefit in the detection of 6-9-mm polyps at CT colonography in this cohort. (C) RSNA, 2012

引用

页码：168 / 176

页数：9

共 29 条

[1]

Agliozzo S, 2009, INT J COMPUT ASSI S1, V4

[2] Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial [J].

Atkin, Wendy S. ;

Edwards, Rob ;

Kralj-Hans, Ines ;

Wooldrage, Kate ;

Hart, Andrew R. ;

Northover, John M. A. ;

Parkin, D. Max ;

Wardle, Jane ;

Duffy, Stephen W. ;

Cuzick, Jack .

LANCET, 2010, 375 (9726) :1624-1633

[3] Computer-aided detection of colorectal polyps: Can it improve sensitivity of less-experienced readers? Preliminary findings [J].

Baker, Mark E. ;

Bogoni, Luca ;

Obuchowski, Nancy A. ;

Dass, Chandra ;

Kendzierski, Renee M. ;

Remer, Erick M. ;

Einstein, David M. ;

Cathier, Pascal ;

Jerebko, Anna ;

Lakare, Sarang ;

Blum, Andrew ;

Caroline, Dina F. ;

Macari, Michael .

RADIOLOGY, 2007, 245 (01) :140-149

[4] IMAGE FEATURE ANALYSIS AND COMPUTER-AIDED DIAGNOSIS IN DIGITAL RADIOGRAPHY .1. AUTOMATED DETECTION OF MICROCALCIFICATIONS IN MAMMOGRAPHY [J].

CHAN, HP ;

DOI, K ;

GALHOTRA, S ;

VYBORNY, CJ ;

MACMAHON, H ;

JOKICH, PM .

MEDICAL PHYSICS, 1987, 14 (04) :538-548

[5] Effect of Computer-aided Detection for CT Colonography in a Multireader, Multicase Trial [J].

Dachman, Abraham H. ;

Obuchowski, Nancy A. ;

Hoffmeister, Jeffrey W. ;

Hinshaw, J. Louis ;

Frew, Michael I. ;

Winter, Thomas C. ;

Van Uitert, Robert L. ;

Periaswamy, Senthil ;

Summers, Ronald M. ;

Hillman, Bruce J. .

RADIOLOGY, 2010, 256 (03) :827-835

[6] CT colonography: False-negative interpretations [J].

Doshi, Taral ;

Rusinak, David ;

Halvorsen, Robert A. ;

Rockey, Don C. ;

Suzuki, Kenji ;

Dachman, Abraham H. .

RADIOLOGY, 2007, 244 (01) :165-173

[7] Colorectal neoplasia screening with CT colonography in average-risk asymptomatic subjects: Community-based study [J].

Edwards, JT ;

Mendelson, RM ;

Fritschi, L ;

Foster, NM ;

Wood, C ;

Murray, D ;

Forbes, GM .

RADIOLOGY, 2004, 230 (02) :459-464

[8] Single reading with computer-aided detection for screening mammography [J].

Gilbert, Fiona J. ;

Astley, Susan M. ;

Gillan, Maureen G. C. ;

Agbaje, Olorunsola F. ;

Wallis, Matthew G. ;

James, Jonathan ;

Boggis, Caroline R. M. ;

Duffy, Stephen W. .

NEW ENGLAND JOURNAL OF MEDICINE, 2008, 359 (16) :1675-1684

[9] Characterization of lesions missed on interpretation of CT colonography using a 2D search method [J].

Gluecker, TM ;

Fletcher, JG ;

Welch, TJ ;

MacCarty, RL ;

Harmsen, WS ;

Harrington, JR ;

Ilstrup, D ;

Wilson, LA ;

Corcoran, KE ;

Johnson, CD .

AMERICAN JOURNAL OF ROENTGENOLOGY, 2004, 182 (04) :881-889

[10] Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population [J].

Graser, A. ;

Stieber, P. ;

Nagel, D. ;

Schaefer, C. ;

Horst, D. ;

Becker, C. R. ;

Nikolaou, K. ;

Lottes, A. ;

Geisbuesch, S. ;

Kramer, H. ;

Wagner, A. C. ;

Diepolder, H. ;

Schirra, J. ;

Roth, H. J. ;

Seidel, D. ;

Goeke, B. ;

Reiser, M. F. ;

Kolligs, F. T. .

GUT, 2009, 58 (02) :241-248

← 1 2 3 →