title: Automatic detection of lytic and blastic thoracolumbar spine metastases on computed tomography.
abstract: OBJECTIVE
  To evaluate a computer-aided detection (CADe) system for lytic and blastic spinal metastases on computed tomography (CT).
  
  
  METHODS
  We retrospectively evaluated the CADe system on 20 consecutive patients with 42 lytic and on 30 consecutive patients with 172 blastic metastases. The CADe system was trained using CT images of 114 subjects with 102 lytic and 308 blastic spinal metastases. Lesions were annotated by experienced radiologists. Detected benign lesions were considered false-positive findings. Detector sensitivity and the number of false-positive findings were calculated as the criteria for detector performance, and free-response receiver operating characteristic (FROC) analysis was conducted. Detailed analysis of false-positive and false-negative findings was performed.
  
  
  RESULTS
  Algorithm runtime is 3 ± 0.5 min per patient. The system achieves a sensitivity of 83 % at 3.5 false positives per patient on average for blastic metastases and a sensitivity of 88 % at 3.7 false positives for lytic metastases. False positives appeared predominantly in the area of degenerative changes in the case of the blastic metastasis detector and in osteoporotic areas in the case of the lytic metastasis detector.
  
  
  CONCLUSIONS
  The CADe system reliably detects thoracolumbar spine metastases in real time. An additional study is planned to evaluate how the bone lesion CADe system improves radiologists' accuracy and efficiency in a clinical setting.
  
  
  CONCLUSIONS
  • Computer-aided detection (CADe) of bone metastases has been developed for spinal CT. • The CADe system exhibits high sensitivity with a tolerable false-positive rate. • Analysis of false-positive detection may further improve the system. • CADe may reduce the number of missed spinal metastases at CT interpretation.
authors: Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, 91054 Erlangen, Germany. matthias.hammon@uk-erlangen.de
authors: Matthias
authors: M
authors: Hammon
authors: Peter
authors: P
authors: Dankerl
authors: Alexey
authors: A
authors: Tsymbal
authors: Michael
authors: M
authors: Wels
authors: Michael
authors: M
authors: Kelm
authors: Matthias
authors: M
authors: May
authors: Michael
authors: M
authors: Suehling
authors: Michael
authors: M
authors: Uder
authors: Alexander
authors: A
authors: Cavallaro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001331:Automation; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology*; D010024:Osteoporosis / Q000175:diagnosis / Q000000981:diagnostic imaging; D012372:ROC Curve; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D012984:Software; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*
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