title: Sensitivity of CT colonography for nonpolypoid colorectal lesions interpreted by human readers and with computer-aided detection.
abstract: OBJECTIVE
  The purpose of our study was to determine the sensitivity of CT colonography (CTC) interpreted by human readers and with computer-aided detection (CAD) for genuinely nonpolypoid colorectal lesions, defined as 2 mm or less in lesion height at colonoscopy.
  
  
  METHODS
  A computerized database search for a 33-month period found 21 patients who had undergone both colonoscopy and CTC and who had a total of 23 genuinely nonpolypoid colorectal lesions: eight adenomas (9-30 mm in width), 10 stage Tis or T1 adenocarcinomas (10-25 mm), and five nonadenomatous lesions (8-20 mm). CTC was performed using a cathartic preparation and fecal tagging and was interpreted by experienced readers in a blinded manner using a primary 3D method and with CAD.
  
  
  RESULTS
  The sensitivities of human readers for nonpolypoid adenomatous lesions (i.e., both adenomas and adenocarcinomas), adenocarcinomas, and nonadenomatous lesions were 66.7% (12/18), 90% (9/10), and 0% (0/5), respectively. Sensitivities were 55.6% (10/18), 90% (9/10), and 0% (0/5) for CAD. A 10-mm stage T1 adenocarcinoma was missed by a human reader on blinded review but was detected with CAD. Both human readers and CAD yielded significantly higher sensitivity for adenomatous lesions than for nonadenomatous lesions (p = 0.014 and 0.046, respectively) and for adenocarcinomas than for noncancerous lesions (p = 0.003 and 0.0001, respectively).
  
  
  CONCLUSIONS
  CTC showed a high sensitivity for nonpolypoid stage Tis and T1 adenocarcinomas 10 mm or greater in width despite the limited overall sensitivity for nonpolypoid adenomatous lesions, when performed using cathartic preparation and fecal tagging.
authors: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea. seongho@amc.seoul.kr
authors: Seong Ho
authors: SH
authors: Park
authors: So Yeon
authors: SY
authors: Kim
authors: Seung Soo
authors: SS
authors: Lee
authors: Luca
authors: L
authors: Bogoni
authors: Ah Young
authors: AY
authors: Kim
authors: Suk-Kyun
authors: SK
authors: Yang
authors: Seung-Jae
authors: SJ
authors: Myung
authors: Jeong-Sik
authors: JS
authors: Byeon
authors: Byong Duk
authors: BD
authors: Ye
authors: Hyun Kwon
authors: HK
authors: Ha
mesh_terms: D001185:Artificial Intelligence; D003111:Colonic Polyps / Q000000981:diagnostic imaging; D023881:Colonography, Computed Tomographic / Q000379:methods*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity