Accuracy of automated software-guided detection of significant coronary artery stenosis by CT angiography: comparison with invasive catheterisation

作者：Anders Katharina^*; Achenbach Stephan; Petit Isabel; Daniel Werner G; Uder Michael; Pflederer Tobias

来源：European Radiology, 2013, 23(5): 1218-1225.

DOI：10.1007/s00330-012-2717-6

• Coronary artery disease
• Coronary stenosis
• Multidetector computed tomography
• Coronary angiography
• Computer assisted diagnosis

True automated detection of coronary artery stenoses might be useful whenever expert evaluation is not available, or as a %26quot;second reader%26quot; to enhance diagnostic confidence. We evaluated the accuracy of a PC-based stenosis detection tool alone and combined with expert interpretation. %26lt;br%26gt;One hundred coronary CT angiography datasets were evaluated with the automated software alone, by manual interpretation (axial images, multiplanar reformations and maximum intensity projections in free double-oblique planes), and by expert interpretation aware of the automated findings. Stenoses a parts per thousand yenaEuro parts per thousand 50 % were noted per-vessel and per-patient, and compared with invasive angiography. %26lt;br%26gt;Automated post-processing was successful in 90 % of patients (88 % of vessels). When excluding uninterpretable datasets, per-patient sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 89 %, 79 %, 74 % and 92 % (per-vessel: 82 %, 85 %, 48 % and 96 %). All 100 datasets were evaluable by expert interpretation. Per-patient sensitivity, specificity, PPV and NPV were 95 %, 95 %, 93 % and 97 % (per-vessel: 89 %,98 %, 88 % and 98 %). Knowing the results of automated interpretation did not improve the performance of expert readers. %26lt;br%26gt;Automated off-line post-processing of coronary CT angiography shows adequate sensitivity, but relatively low specificity in coronary stenosis detection. It does not increase accuracy of expert interpretation. Failure of post-processing in 10 % of all patients necessitates additional manual image work-up. %26lt;br%26gt;aEuro cent Coronary CT angiography is increasingly used for detection of coronary artery stenosis %26lt;br%26gt;aEuro cent Computer assisted diagnosis might facilitate and speed up interpretation %26lt;br%26gt;aEuro cent Performance in properly segmented cases compared favourably with manual image interpretation %26lt;br%26gt;aEuro cent However, automated segmentation failed in about 10 % of cases %26lt;br%26gt;aEuro cent Manual reading is still mandatory; computer assisted diagnosis can provide a useful second read.

• 出版日期2013-5