title: Application of Computer-Aided Diagnosis to the Sonographic Evaluation of Cervical Lymph Nodes.
abstract: We initiated an observer study to evaluate a computerized system developed in our previous study for automatic extraction of 10 features and estimation of the malignancy probability of cervical nodes in sonograms. In the present study, five expert radiologists and five resident radiologists interpreted the sonograms of 178 nodes. The malignancy rating and patient management recommendation (biopsy or follow-up) were made without and then with the computer aid. Under these two reading conditions, the performances of radiologists and agreement among a group of radiologists were evaluated by using the receiver operating characteristic (ROC) analysis and the κ statistic, respectively. With the computer aid, the performances of radiologists improved significantly, as indicated by the increase in the area under the ROC curve (Az) from 0.843 to 0.896 (p = 0.031) and from 0.705 to 0.822 (p < 0.001), for the expert and resident groups, respectively. Agreement among all 10 radiologists improved from slight to moderate as indicated by an increase in the κ value from 0.195 to 0.421 (p < 0.001). The average performance of residents with aid (Az = 0.822) was close to that of experts without aid (Az = 0.843). Results indicate that computer-aided diagnosis is useful to improve radiologist performance (especially that of inexperienced radiologists) in the ultrasonographic evaluation of cervical nodes and to reduce variability among radiologists.
authors.affiliation: Department of Electronic Engineering, Yunnan University, Kunming, People's Republic of China jhzhang_2006@163.com.
authors.forename: Junhua
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Electronic Engineering, Fudan University, Shanghai, People's Republic of China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Ultrasound Diagnostics, First People's Hospital of Yunnan Province, Kunming, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.affiliation: Department of Electronic Engineering, Yunnan University, Kunming, People's Republic of China.
authors.forename: Xinling
authors.initials: X
authors.lastname: Shi
authors.affiliation: Department of Electronic Engineering, Yunnan University, Kunming, People's Republic of China.
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D001706:Biopsy; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D009333:Neck; D015588:Observer Variation; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014463:Ultrasonography
keywords: cervical lymph node; computer-aided diagnosis (CAD); observer study; sonography