Computed tomography colonography: feasibility of computer-aided polyp detection in a "first reader" paradigm.
OBJECTIVE
: To determine the feasibility of a computer-aided detection (CAD) algorithm as the "first reader" in computed tomography colonography (CTC).


METHODS
: In phase 1 of a 2-part blind trial, we measured the performance of 3 radiologists reading 41 CTC studies without CAD. In phase 2, readers interpreted the same cases using a CAD list of 30 potential polyps.


RESULTS
: Unassisted readers detected, on average, 63% of polyps > or =10 mm in diameter. Using CAD, the sensitivity was 74% (not statistically different). Per-patient analysis showed a trend toward increased sensitivity for polyps > or =10 mm in diameter, from 73% to 90% with CAD (not significant) without decreasing specificity. Computer-aided detection significantly decreased interobserver variability (P = 0.017). Average time to detection of the first polyp decreased significantly with CAD, whereas total reading case reading time was unchanged.


CONCLUSIONS
: Computer-aided detection as a first reader in CTC was associated with similar per-polyp and per-patient detection sensitivity to unassisted reading. Computer-aided detection decreased interobserver variability and reduced the time required to detect the first polyp.
Mani
Aravind
A
Department of Radiology, Stanford University Medical Center, and Stanford Medical School, CA 94305, USA.
Napel
Sandy
S
Paik
David S
DS
Jeffrey
R Brooke
RB
Yee
Judy
J
Olcott
Eric W
EW
Prokesch
Rupert
R
Davila
Marta
M
Schraedley-Desmond
Pamela
P
Beaulieu
Christopher F
CF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000000981:diagnostic imaging*; D023881:Colonography, Computed Tomographic / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013997:Time Factors