Computer-aided detection of colorectal polyps: can it improve sensitivity of less-experienced readers? Preliminary findings.
OBJECTIVE
To determine whether computer-aided detection (CAD) applied to computed tomographic (CT) colonography can help improve sensitivity of polyp detection by less-experienced radiologist readers, with colonoscopy or consensus used as the reference standard.


METHODS
The release of the CT colonographic studies was approved by the individual institutional review boards of each institution. Institutions from the United States were HIPAA compliant. Written informed consent was waived at all institutions. The CT colonographic studies in 30 patients from six institutions were collected; 24 images depicted at least one confirmed polyp 6 mm or larger (39 total polyps) and six depicted no polyps. By using an investigational software package, seven less-experienced readers from two institutions evaluated the CT colonographic images and marked or scored polyps by using a five-point scale before and after CAD. The time needed to interpret the CT colonographic findings without CAD and then to re-evaluate them with CAD was recorded. For each reader, the McNemar test, adjusted for clustered data, was used to compare sensitivities for readers without and with CAD; a Wilcoxon signed-rank test was used to analyze the number of false-positive results per patient.


RESULTS
The average sensitivity of the seven readers for polyp detection was significantly improved with CAD-from 0.810 to 0.908 (P=.0152). The number of false-positive results per patient without and with CAD increased from 0.70 to 0.96 (95% confidence interval for the increase: -0.39, 0.91). The mean total time for the readings was 17 minutes 54 seconds; for interpretation of CT colonographic findings alone, the mean time was 14 minutes 16 seconds; and for review of CAD findings, the mean time was 3 minutes 38 seconds.


CONCLUSIONS
Results of this feasibility study suggest that CAD for CT colonography significantly improves per-polyp detection for less-experienced readers.
Baker
Mark E
ME
Department of Radiology, the Cleveland Clinic Foundation, 9500 Euclid Ave, Hb6, Cleveland, OH 44195, USA. bakerm@ccf.org
Bogoni
Luca
L
Obuchowski
Nancy A
NA
Dass
Chandra
C
Kendzierski
Renee M
RM
Remer
Erick M
EM
Einstein
David M
DM
Cathier
Pascal
P
Jerebko
Anna
A
Lakare
Sarang
S
Blum
Andrew
A
Caroline
Dina F
DF
Macari
Michael
M
D002983:Clinical Competence; D003111:Colonic Polyps / Q000000981:diagnostic imaging*; D023881:Colonography, Computed Tomographic / Q000379:methods*; D003936:Diagnosis, Computer-Assisted; D005189:False Positive Reactions; D005240:Feasibility Studies; D006801:Humans; D007417:Intestinal Polyps / Q000000981:diagnostic imaging*; D012002:Rectal Diseases / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity