Efficacy of computer-aided detection as a second reader for 6-9-mm lesions at CT colonography: multicenter prospective trial.

Brunella Barbaro, Roberto Maria Massara, Daniele Regge, Patrizia Della Monica, Giovanni Galatola, Cristiana Laudi, Antonella Zambon, Roberto Asnaghi, Loredana Correale, Claudia Borghi, Delia Campanella, Maria Carla Cassinis, Riccardo Ferrari, Andrea Ferraris, Rita Golfieri, Cesare Hassan, Franco Iafrate, Gabriella Iussich, Andrea Laghi, Emanuele NeriLapo Sali, Silvia Venturini, Giovanni Gandini

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

32 Citazioni (Scopus)

Abstract

PURPOSE: To assess the effect of computer-aided detection (CAD) as a second reader on the sensitivity and specificity of computed tomographic (CT) colonography in detecting 6-9-mm colorectal cancer (CRC) lesions. MATERIALS AND METHODS: Individuals with clinical indications for colonoscopy--either for symptoms or as part of participating in a surveillance program or CRC screening--were prospectively enrolled at one of 10 academic centers between July 2007 and May 2009. Institutional review board approval was obtained at each clinical site, and all participants provided written informed consent. All participants underwent CT colonography and colonoscopy on the same day. Experienced readers interpreted the CT colonography images unassisted and then reviewed all colorectal lesion-like structures pinpointed by the CAD algorithm. Segmental unblinding of CT colonoscopy findings at colonoscopy was utilized. The sensitivity and specificity of unassisted and CAD-assisted reading in identifying individuals with 6-9-mm lesions were calculated and compared by means of pairwise analysis. RESULTS: A total of 618 participants (mean age, 57.9 years; 54.5% male) were included in the final analysis. Of these participants, 464 (75.1%) had no lesions 6 mm or larger, and 52 (8.4%) had 6-9-mm lesions. The sensitivity of CT colonography with unassisted reading and that with CAD-assisted reading in identifying individuals with 6-9-mm lesions was 65.4% (95% confidence interval [CI]: 50.9%, 78.0%) and 76.9% (95% CI: 63.2%, 87.5%; P = .016), respectively. No significant change in specificity was observed: The specificity of CT colonography with unassisted and that with CAD-assisted reading was 91.8% (95% CI: 88.9%, 94.1%) and 90.9% (95% CI: 88.0%, 93.4%; P = .063), respectively. Evaluation of CAD candidates required an additional 1.6 minutes (25th-75th percentile: 1.0 minute to 3.4 minutes). CONCLUSION: The addition of CAD to reading performed by experienced readers resulted in a significant benefit in the detection of 6-9-mm polyps at CT colonography in this cohort.
Lingua originaleEnglish
pagine (da-a)168-176
Numero di pagine9
RivistaRadiology
Volume2013
DOI
Stato di pubblicazionePubblicato - 2013

Keywords

  • CT colonography
  • computer-aided detection

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