Document Detail


A comparison of follow-up recommendations by chest radiologists, general radiologists, and pulmonologists using computer-aided detection to assess radiographs for actionable pulmonary nodules.
MedLine Citation:
PMID:  21512043     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: The primary objective of our study was to compare the effect of a chest radiography computer-aided detection (CAD) system on the follow-up recommendations of chest radiologists, general radiologists, and pulmonologists.
MATERIALS AND METHODS: A chest radiography CAD system (RapidScreen 1.1) that has been approved by the U.S. Food and Drug Administration (FDA) and a second-generation version of the system (OnGuard 3.0) not yet approved by the FDA were applied to single frontal radiographs of 200 patients at high risk for lung cancer. One hundred patients had actionable nodules (mean size, 16.9 mm) and 100 patients did not. Six chest radiologists, six general radiologists, and six pulmonologists independently interpreted each image first without CAD and then with CAD during blinded reading sessions. The frequency with which readers correctly referred patients for follow-up tests was measured. Differential effects based on nodule size, shape, location, density, and subtlety were tested with multiplevariable logistic regression.
RESULTS: For patients without actionable lesions, pulmonologists showed an increase in their recommendations for follow-up from 0.46 unaided to 0.52 with CAD (p = 0.001), whereas chest and general radiologists had much lower average rates and were not affected by CAD's false marks (0.26 without CAD vs 0.25 with RapidScreen 1.1 and 0.26 with OnGuard 3.0, p ≥ 0.734). CAD improved all readers' detection of moderately subtle lesions (p = 0.013) but did not significantly increase follow-up rates overall for patients with actionable nodules (0.63 unaided vs 0.63 with RapidScreen 1.1, p = 0.795; and 0.63 unaided vs 0.64 with OnGuard 3.0, p = 0.187).
CONCLUSION: The effect of CAD on readers' clinical decisions varies depending on the training of the reader. CAD did not improve the performance of chest or general radiologists. Nonradiologists are particularly vulnerable to CAD's false-positive marks.
Authors:
Moulay Meziane; Nancy A Obuchowski; Omar Lababede; Michael L Lieber; Michael Philips; Peter Mazzone
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  196     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  W542-9     Citation Subset:  AIM; IM    
Affiliation:
Imaging Institute, Cleveland Clinic Foundation, Cleveland, OH.
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