Computer-aided nodule detection and volumetry to reduce variability between radiologists in the interpretation of lung nodules at low-dose screening computed tomography.
OBJECTIVE
The aim of this study was to evaluate whether a computer-aided diagnosis (CAD) system improves interobserver agreement in the interpretation of lung nodules at low-dose computed tomography (CT) screening for lung cancer.


METHODS
Baseline low-dose screening CT examinations from 134 participants enrolled in the National Lung Screening Trial were reviewed by 7 chest radiologists. All participants consented to the use of their deidentified images for research purposes. Screening results were classified as positive when noncalcified nodules larger than 4 mm in diameter were present. Follow-up evaluation was recommended according to the nodule diameter: 4 mm or smaller, more than 4 to 8 mm, and larger than 8 mm. When multiple nodules were present, recommendations were based on the largest nodule. Readers initially assessed the nodule presence visually and measured the average nodule diameter manually. Revision of their decisions after reviewing the CAD marks and size measurement was allowed. Interobserver agreement evaluated using multirater κ statistics was compared between initial assessment and that with CAD.


RESULTS
Multirater κ values for the positivity of the screening results and follow-up recommendations were improved from moderate (κ = 0.53-0.54) at initial assessment to good (κ = 0.66-0.67) after reviewing CAD results. The average percentage of agreement between reader pairs on the positivity of screening results and follow-up recommendations per case was also increased from 77% and 72% at initial assessment to 84% and 80% with CAD, respectively.


CONCLUSIONS
Computer-aided diagnosis may improve the reader agreement on the positivity of screening results and follow-up recommendations in the assessment of low-dose screening CT.
Department of Radiology, College of Medicine, Gyeongsang National University, Jinju, Korea.
Kyung Nyeo
KN
Jeon
Jin Mo
JM
Goo
Chang Hyun
CH
Lee
Youkyung
Y
Lee
Ji Yung
JY
Choo
Nyoung Keun
NK
Lee
Mi-Suk
MS
Shim
In Sun
IS
Lee
Kwang Gi
KG
Kim
David S
DS
Gierada
Kyongtae T
KT
Bae
D054893:Cone-Beam Computed Tomography / Q000295:instrumentation* / Q000379:methods; D016001:Confidence Intervals; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008403:Mass Screening / Q000295:instrumentation* / Q000379:methods; D011871:Radiology / Q000706:statistics & numerical data*; D013997:Time Factors