Computed Tomography Pulmonary Angiography in Acute Pulmonary Embolism: The Effect of a Computer-assisted Detection Prototype Used as a Concurrent Reader

作者：Wittenberg Rianne^*; Peters Joost F; van den Berk Inge A H; Freling Nicole J M; Lely Rutger; de Hoop Bartjan; Horsthuis Karin; Ravesloot Cecile J; Weber Michael; Prokop W Mathias; Schaefer Prokop Cornelia M

来源：Journal of Thoracic Imaging, 2013, 28(5): 315-321.

DOI：10.1097/RTI.0b013e3182870b97

• pulmonary embolism
• computer-assisted detection
• computed tomography angiography

Purpose: To assess the effect of computer-assisted detection (CAD) on diagnostic accuracy, reader confidence, and reading time when used as a concurrent reader for the detection of acute pulmonary embolism in computed tomography pulmonary angiography.Materials and Methods: In this institutional review board-approved retrospective study, 6 observers with varying experience evaluated 158 negative and 38 positive consecutive computed tomography pulmonary angiographies (mean patient age 60 y; 115 women) without and with CAD as a concurrent reader. Readers were asked to determine the presence of pulmonary embolism, assess their diagnostic confidence using a 5-point scale, and document their reading time. Results were compared with an independent standard established by 2 readers, and a third chest radiologist was consulted in case of discordant findings.Results: Using logistic regression for repeated measurements, we found a significant increase in readers%26apos; sensitivity (P%26lt;0.001) without loss of specificity (P=0.855) with the effects being reader dependent (P%26lt;0.001). Sensitivities varied from 68% to 100% without CAD and from 76% to 100% with CAD. A 2-way analysis of variance showed a small but significant decrease in reading time (P%26lt;0.001), with the duration varying between 24 and 208 seconds without CAD and between 17 and 196 seconds with CAD, and a significant increase in readers%26apos; confidence scores using CAD as a concurrent reader (P%26lt;0.001).Conclusions: CAD as a concurrent reader has the potential to increase readers%26apos; sensitivity and confidence with a decrease in reading time without loss of specificity. The differences between readers, however, require further evaluation of CAD as a concurrent reader in a larger trial before stronger conclusions can be drawn.

• 出版日期2013-9