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Proceedings Paper

Potential effect of CAD systems on the detection of actionable nodules in chest CT scans during routine reporting
Author(s): Dag Wormanns; Florian Beyer; Arnauld Butzbach; Livia Zierott; Walter Heindel
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Paper Abstract

The purpose of the presented study was to determine the impact of two different CAD systems used as concur-rent reader for detection of actionable nodules (>4 mm) on the interpretation of chest CT scans during routine reporting. Fifty consecutive MDCT scans (1 mm or 1.25 mm slice thickness, 0.8 mm reconstruction increment) were se-lected from clinical routine. All cases were read by a resident and a staff radiologist, and a written report was available in the radiology information system (RIS). The RIS report mentioned at least one actionable pulmonary nodule in 18 cases (50%) and did not report any pulmonary nodule in the remaining 32 cases. Two different recent CAD systems were independently applied to the 50 CT scans as concurrent reader with two radiologists: Siemens LungCare NEV and MEDIAN CAD-Lung. Two radiologists independently reviewed the CAD results and determined if a CAD result was a true positive or a false positive finding. Patients were classified into two groups: in group A if at least one actionable nodule was detected and in group B if no actionable nodules were found. The effect of CAD on routine reporting was simulated as set union of the findings of routine reporting and CAD thus applying CAD as concurrent reader. According to the RIS report group A (patients with at least one actionable nodule) contained 18 cases (36% of all 50 cases), and group B contained 32 cases. Application of a CAD system as concurrent reader resulted in detec-tion of additional CT scans with actionable nodules and reclassification into group A in 16 resp. 18 cases (radi-ologist 1 resp. radiologist 2) with Siemens NEV and in 19 resp. 18 cases with MEDIAN CAD-Lung. In seven cases MEDIAN CAD-Lung and in four cases Siemens NEV reclassified a case into group A while the other CAD system missed the relevant finding. Sensitivity on a nodule (>4 mm) base was .45 for Siemens NEV and .55 for MEDIAN CAD-Lung; the difference was not yet significant (p=.077). In our study use of CAD as second reader in routine reporting doubled the percentage of patients with actionable nodules larger than 4 mm.

Paper Details

Date Published: 17 March 2006
PDF: 6 pages
Proc. SPIE 6146, Medical Imaging 2006: Image Perception, Observer Performance, and Technology Assessment, 614618 (17 March 2006); doi: 10.1117/12.652346
Show Author Affiliations
Dag Wormanns, Univ. Hospital Münster (Germany)
Florian Beyer, Univ. Hospital Münster (Germany)
Arnauld Butzbach, MEDIAN Technologies (France)
Livia Zierott, Univ. Hospital Münster (Germany)
Walter Heindel, Univ. Hospital Münster (Germany)

Published in SPIE Proceedings Vol. 6146:
Medical Imaging 2006: Image Perception, Observer Performance, and Technology Assessment
Yulei Jiang; Miguel P. Eckstein, Editor(s)

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