title: Does a computer-aided detection algorithm in a second read paradigm enhance the performance of experienced computed tomography colonography readers in a population of increased risk?
abstract: We prospectively determined whether computer-aided detection (CAD) could improve the performance characteristics of computed tomography colonography (CTC) in a population of increased risk for colorectal cancer. Therefore, we included 170 consecutive patients that underwent both CTC and colonoscopy. All findings >or=6 mm were evaluated at colonoscopy by segmental unblinding. We determined per-patient sensitivity and specificity for polyps >or=6 mm and >or=10 mm without and with computer-aided detection (CAD). The McNemar test was used for comparison the results without and with CAD. Unblinded colonoscopy detected 50 patients with lesions >or=6 mm and 25 patients with lesions >or=10 mm. Sensitivity of CTC without CAD for these size categories was 80% (40/50, 95% CI: 69-81%) and 64% (16/25, 95% CI: 45-83%), respectively. CTC with CAD detected one additional patient with a lesion >or=6 mm and two with a lesion >or=10 mm, resulting in a sensitivity of 82% (41/50, 95% CI: 71-93%) (p = 0.50) and 72% (18/25, 95% CI: 54-90%) (p = 1.0), respectively. Specificity without CAD for polyps >or=6 mm and >or=10 mm was 84% (101/120, 95% CI: 78-91%) and 94% (136/145, 95% CI: 90-98%), respectively. With CAD, the specificity remained (nearly) unchanged: 83% (99/120, 95% CI: 76-89%) and 94% (136/145, 95% CI: 90-98%), respectively. Thus, although CTC with CAD detected a few more patients than CTC without CAD, it had no statistically significant positive influence on CTC performance.
authors.affiliation: Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Ayso.devries@amc.uva.nl
authors.forename: Ayso H
authors.initials: AH
authors.lastname: de Vries
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Jensch
authors.forename: Marjolein H
authors.initials: MH
authors.lastname: Liedenbaum
authors.forename: Jasper
authors.initials: J
authors.lastname: Florie
authors.forename: Chung Y
authors.initials: CY
authors.lastname: Nio
authors.forename: Roel
authors.initials: R
authors.lastname: Truyen
authors.forename: Shandra
authors.initials: S
authors.lastname: Bipat
authors.forename: Evelien
authors.initials: E
authors.lastname: Dekker
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
authors.forename: Lubbertus C
authors.initials: LC
authors.lastname: Baak
authors.forename: Jaap
authors.initials: J
authors.lastname: Stoker
mesh_terms: D000368:Aged; D000465:Algorithms; D003111:Colonic Polyps / Q000000981:diagnostic imaging; D023881:Colonography, Computed Tomographic / Q000379:methods*; D003936:Diagnosis, Computer-Assisted; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012306:Risk; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*