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Computer-Aided Detection for Computed Tomographic Colonography Screening

2014; Lippincott Williams & Wilkins; Volume: 49; Issue: 3 Linguagem: Inglês

10.1097/rli.0000000000000009

1536-0210

Gabriella Iussich, Loredana Correale, Carlo Senore, Cesare Hassan, Nereo Segnan, Delia Campanella, Alberto Bert, G. Galatola, C. Laudi, Daniele Regge,

AI in cancer detection

The objective of this study was to prospectively compare diagnostic performance and time efficiency of a double-reading paradigm in which a first-reader computer-aided detection (CAD) is followed by a fast 2-dimensional review (DR FR-CAD) with those of a double reading with second-reader CAD (SR CAD).The local ethical committee approved this study. Consecutive immunological patients who have positive results for fecal immunological test who were scheduled for colonoscopy were enrolled for a 10-month period. Computed tomographic colonography studies were read with CAD (CAD COLON-1.20; im3D, Turin, Italy) by using both SR CAD (applied after unassisted interpretation primary 2-dimensional) and DR FR-CAD (CAD-prompts evaluation followed by a fast 2-dimensional review) in randomized order with the radiologist for each reading paradigm masked to the other reader's results.Per-patient sensitivity and specificity of unassisted and CAD-assisted readings for detecting 6-mm adenomas or larger were calculated by using unblinding colonoscopy as reference standard. Reporting times were also calculated. Pairwise comparisons were performed.A total of 182 participants (median age, 65 years; range, 58-76) were included in the final analysis. Of these, 93 (51%) had at least 1 cancer or a 6-mm adenoma or larger. At the 6-mm threshold, sensitivity of unassisted reading (79.6%; 95% confidence interval [CI], 69.9-87.2) increased significantly with the use of both SR CAD (86.0%; 95% CI, 77.3%-92.3%) and DR FR-CAD (89.2%; 95% CI, 81.1%-94.7%), without differences between CAD readings (P = 0.500). No significant differences in specificity among the 3 paradigms were observed. Double reading with first-reader CAD required less reading time than that for SR CAD (378 vs 496; Δ118 seconds; P < 0.001) and was 59 seconds longer than the unassisted reading (P = 0.058).When compared with unassisted reading, a double-reading paradigm in which first-reader CAD is followed by a fast 2-dimensional review improves the adenoma detection rate to the same level achieved by a second-reader CAD while decreasing reporting times.