title: Enhanced characterization of solid solitary pulmonary nodules with Bayesian analysis-based computer-aided diagnosis.
abstract: The aim of this study was to prospectively assess the accuracy gain of Bayesian analysis-based computer-aided diagnosis (CAD) vs human judgment alone in characterizing solitary pulmonary nodules (SPNs) at computed tomography (CT). The study included 100 randomly selected SPNs with a definitive diagnosis. Nodule features at first and follow-up CT scans as well as clinical data were evaluated individually on a 1 to 5 points risk chart by 7 radiologists, firstly blinded then aware of Bayesian Inference Malignancy Calculator (BIMC) model predictions. Raters' predictions were evaluated by means of receiver operating characteristic (ROC) curve analysis and decision analysis. Overall ROC area under the curve was 0.758 before and 0.803 after the disclosure of CAD predictions (P = 0.003). A net gain in diagnostic accuracy was found in 6 out of 7 readers. Mean risk class of benign nodules dropped from 2.48 to 2.29, while mean risk class of malignancies rose from 3.66 to 3.92. Awareness of CAD predictions also determined a significant drop on mean indeterminate SPNs (15 vs 23.86 SPNs) and raised the mean number of correct and confident diagnoses (mean 39.57 vs 25.71 SPNs). This study provides evidence supporting the integration of the Bayesian analysis-based BIMC model in SPN characterization.
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Perandini
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Gian Alberto
authors.initials: GA
authors.lastname: Soardi
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Motton
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Augelli
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Dallaserra
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Puntel
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Rossi
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sala
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Manuel
authors.initials: M
authors.lastname: Signorini
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Spezia
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Zamboni
authors.affiliation: Simone Perandini, Gian Alberto Soardi, Massimiliano Motton, Raffaele Augelli, Chiara Dallaserra, Gino Puntel, Arianna Rossi, Giuseppe Sala, Manuel Signorini, Laura Spezia, Federico Zamboni, Stefania Montemezzi, Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, 37100 Verona, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Montemezzi
keywords: Bayesian prediction; Computer-aided diagnosis; Lung neoplasms; Multidetector computed tomography; Solitary pulmonary nodule