Computer-aided detection (CAD) of lung nodules in CT scans: radiologist performance and reading time with incremental CAD assistance.

Published

Journal Article

OBJECTIVE: The diagnostic performance of radiologists using incremental CAD assistance for lung nodule detection on CT and their temporal variation in performance during CAD evaluation was assessed. METHODS: CAD was applied to 20 chest multidetector-row computed tomography (MDCT) scans containing 190 non-calcified > or =3-mm nodules. After free search, three radiologists independently evaluated a maximum of up to 50 CAD detections/patient. Multiple free-response ROC curves were generated for free search and successive CAD evaluation, by incrementally adding CAD detections one at a time to the radiologists' performance. RESULTS: The sensitivity for free search was 53% (range, 44%-59%) at 1.15 false positives (FP)/patient and increased with CAD to 69% (range, 59-82%) at 1.45 FP/patient. CAD evaluation initially resulted in a sharp rise in sensitivity of 14% with a minimal increase in FP over a time period of 100 s, followed by flattening of the sensitivity increase to only 2%. This transition resulted from a greater prevalence of true positive (TP) versus FP detections at early CAD evaluation and not by a temporal change in readers' performance. The time spent for TP (9.5 s +/- 4.5 s) and false negative (FN) (8.4 s +/- 6.7 s) detections was similar; FP decisions took two- to three-times longer (14.4 s +/- 8.7 s) than true negative (TN) decisions (4.7 s +/- 1.3 s). CONCLUSIONS: When CAD output is ordered by CAD score, an initial period of rapid performance improvement slows significantly over time because of non-uniformity in the distribution of TP CAD output and not to a changing reader performance over time.

Full Text

Duke Authors

Cited Authors

  • Roos, JE; Paik, D; Olsen, D; Liu, EG; Chow, LC; Leung, AN; Mindelzun, R; Choudhury, KR; Naidich, DP; Napel, S; Rubin, GD

Published Date

  • March 2010

Published In

Volume / Issue

  • 20 / 3

Start / End Page

  • 549 - 557

PubMed ID

  • 19760237

Pubmed Central ID

  • 19760237

Electronic International Standard Serial Number (EISSN)

  • 1432-1084

Digital Object Identifier (DOI)

  • 10.1007/s00330-009-1596-y

Language

  • eng

Conference Location

  • Germany