Is Contrast Enhanced Ultrasonography a useful tool in a beginner's hand? How much can a Computer Assisted Diagnosis prototype help in characterizing the malignancy of focal liver lesions?

Aim: Contrast enhanced ultrasound (CEUS) improved the characterization of focal liver lesions (FLLs), but is an operatordependent method. The goal of this paper was to test a computer assisted diagnosis (CAD) prototype and to see its benefit in assisting a beginner in the evaluation of FLLs.Material...

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Published in:Medical Ultrasonography Vol. 19; no. 3; pp. 252 - 259
Main Authors: Moga, Tudor Voicu, Popescu, Alina, Sporea, Ioan, Danila, Mirela, David, Ciprian, Guia, Vasile, Iacob, Nicoleta, Miclaus, Gratian, Sirli, Roxana, Gui, Vasile
Format: Journal Article
Published: Romanian Society of Ultrasonography in Medicine & Biology Sep2017
Online Access:View this record in EBSCOhost
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      pub: Romanian Society of Ultrasonography in Medicine & Biology
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        atl: Is Contrast Enhanced Ultrasonography a useful tool in a beginner's hand? How much can a Computer Assisted Diagnosis prototype help in characterizing the malignancy of focal liver lesions?
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          Moga, Tudor Voicu
          Popescu, Alina
          Sporea, Ioan
          Danila, Mirela
          David, Ciprian
          Guia, Vasile
          Iacob, Nicoleta
          Miclaus, Gratian
          Sirli, Roxana
          Gui, Vasile
        affil: Department of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy, Timișoara, Romania
      sug:
        subj:
          Clinical Competence Statistics and Numerical Data
          Carcinoma, Hepatocellular
          Ultrasonography Methods
          Diagnosis, Computer Assisted Methods
          Liver Neoplasms
          Contrast Media
          Image Enhancement Methods
          Liver
          Reproducibility of Results
          Ferrans and Powers Quality of Life Index
          Scales
      ab: Aim: Contrast enhanced ultrasound (CEUS) improved the characterization of focal liver lesions (FLLs), but is an operatordependent method. The goal of this paper was to test a computer assisted diagnosis (CAD) prototype and to see its benefit in assisting a beginner in the evaluation of FLLs.Material and Method: Our cohort included 97 good quality CEUS videos[34% hepatocellular carcinomas (HCC), 12.3% hypervascular metastases (HiperM), 11.3% hypovascular metastases (HipoM), 24.7% hemangiomas (HMG), 17.5% focal nodular hyperplasia (FNH)] that were used to develop a CAD prototype based on an algorithm that tested a binary decision based classifier. Two young medical doctors (1 year CEUS experience), two experts and the CAD prototype, reevaluated 50 FLLs CEUS videos (diagnosis of benign vs. malignant) first blinded to clinical data, in order to evaluate the diagnostic gap beginner vs. expert.Results: The CAD classifier managed a 75.2% overall (benign vs. malignant) correct classification rate. The overall classification rates for the evaluators, before and after clinical data were: first beginner-78%; 94%; second beginner-82%; 96%; first expert-94%; 100%; second expert-96%; 98%. For both beginners, the malignant vs. benign diagnosis significantly improved after knowing the clinical data (p=0.005; p=0,008). The expert was better than the beginner (p=0.04) and better than the CAD (p=0.001). CAD in addition to the beginner can reach the expert diagnosis.Conclusions: The most frequent lesions misdiagnosed at CEUS were FNH and HCC. The CAD prototype is a good comparing tool for a beginner operator that can be developed to assist the diagnosis. In order to increase the classification rate, the CAD system for FLL in CEUS must integrate the clinical data.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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