Computer-assisted detection of pulmonary embolism: performance evaluation in consensus with experienced and inexperienced chest radiologists.
The value of a computer-aided detection tool (CAD) as second reader in combination with experienced and inexperienced radiologists for the diagnosis of acute pulmonary embolism (PE) was assessed prospectively. Computed tomographic angiography (CTA) scans (64 x 0.6 mm collimation; 61.4 mm/rot table f...
| Publicado en: | European Radiology Vol. 18; no. 2; pp. 298 - 308 |
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| Autores principales: | , , , , , , , , , |
| Formato: | clinical trial research Journal Article |
| Publicado: |
Springer Nature
Feb2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105753409&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105753409 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Feb2008 vid: 18 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 105753409 NLM17901958 2009813999 10.1007/s00330-007-0770-3 NLM17901958 105753409 ppf: 298 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Computer-assisted detection of pulmonary embolism: performance evaluation in consensus with experienced and inexperienced chest radiologists. aug: au: Engelke C Schmidt S Bakai A Auer F Marten K Engelke, Christoph Schmidt, Stephan Bakai, Annemarie Auer, Florian Marten, Katharina affil: Department of Radiology, University of Wuerzburg, 97080 Wuerzburg, Germany sug: subj: Clinical Competence Statistics and Numerical Data Diagnosis, Computer Assisted Methods Pulmonary Embolism Diagnosis Specialties, Medical Methods Acute Disease Adult Aged Aged, 80 and Over Clinical Trials Diagnosis, Computer Assisted Statistics and Numerical Data Female Male Middle Age Observer Bias Prospective Studies Pulmonary Artery Radiography Reference Values ROC Curve Sensitivity and Specificity Specialties, Medical Statistics and Numerical Data Tomography, X-Ray Computed Human Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: The value of a computer-aided detection tool (CAD) as second reader in combination with experienced and inexperienced radiologists for the diagnosis of acute pulmonary embolism (PE) was assessed prospectively. Computed tomographic angiography (CTA) scans (64 x 0.6 mm collimation; 61.4 mm/rot table feed) of 56 patients (31 women, 34-89 years, mean = 66 years) with suspected PE were analysed by two experienced (R1, R2) and two inexperienced (R3, R4) radiologists for the presence and distribution of emboli using a five-point confidence rating, and by CAD. Informed consent was obtained from all patients. Results were compared with an independent reference standard. Inter-observer agreement was calculated by kappa, confidence assessed by ROC analysis. A total of 1,116 emboli [within mediastinal (n = 72), lobar (n = 133), segmental (n = 465) and subsegmental arteries (n = 455)] were included. CAD detected 343 emboli (sensitivity = 30.74%, correct-positive rate = 6.13/patient; false-positive rate = 4.1/patient). Inter-observer agreement was good (R1, R2: kappa = 0.84, 95% CI = 0.81-0.87; R3, R4: kappa = 0.79, 95% CI = 0.76-0.81). Extended inter-observer agreement was higher in mediastinal and lobar than in segmental and subsegmental arteries (kappa = 0.84-0.86 and kappa = 0.51-0.58 for mediastinal/lobar and segmental/subsegmental arteries, respectively P < 0.05). Agreement between experienced and inexperienced readers was improved by CAD (kappa = 0.60-0.62 and kappa = 0.69-0.72 before and after CAD consensus, respectively P < 0.05). The experienced outperformed the inexperienced readers (Az = 0.95, 0.93, 0.89 and 0.86 for R1-4, respectively, P < 0.05). CAD significantly improved overall performances of readers 3 and 4 (Az = 0.86 for R3, R4 and Az = 0.89 for R3, R4 with CAD, P < 0.05), by enhancing sensitivities in segmental/subsegmental arteries. CAD improved experienced readers' sensitivities in segmental/subsegmental arteries (sens. = 0.93 and 0.90 for R1, R2 before and 0.97 and 0.94 for R1, R2 after CAD consensus, P < 0.05), without significant improvement of their overall performances (P > 0.05). Particularly inexperienced readers benefit from consensus with CAD data, greatly improving detection of segmental and subsegmental emboli. This system is advocated as a second reader. pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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