Observer training for computer-aided detection of pulmonary nodules in chest radiography

Abstract

ObjectivesTo assess whether short-term feedback helps readers to increase their performance using computer-aided detection (CAD) for nodule detection in chest radiography.MethodsThe 140 CXRs (56 with a solitary CT-proven nodules and 84 negative controls) were divided into four subsets of 35; each were read in a different order by six readers. Lesion presence, location and diagnostic confidence were scored without and with CAD (IQQA-Chest, EDDA Technology) as second reader. Readers received individual feedback after each subset. Sensitivity, specificity and area under the receiver-operating characteristics curve (AUC) were calculated for readings with and without CAD with respect to change over time and impact of CAD.ResultsCAD stand-alone sensitivity was 59 % with 1.9 false-positives per image. Mean AUC slightly increased over time with and without CAD (0.78 vs. 0.84 with and 0.76 vs. 0.82 without CAD) but differences did not reach significance. The sensitivity increased (65 % vs. 70 % and 66 % vs. 70 %) and specificity decreased over time (79 % vs. 74 % and 80 % vs. 77 %) but no significant impact of CAD was found.ConclusionShort-term feedback does not increase the ability of readers to differentiate true- from false-positive candidate lesions and to use CAD more effectively.Key Points• Computer-aided detection (CAD) is increasingly used as an adjunct for many radiological techniques.• Short-term feedback does not improve reader performance with CAD in chest radiography.• Differentiation between true- and false-positive CAD for low conspicious possible lesions proves difficult.• CAD can potentially increase reader performance for nodule detection in chest radiography.

Computer-aided Detection Fidelity of Pulmonary Nodules in Chest Radiograph

“…In previous studies, CAD stand-alone sensitivity was 59% with FPR 1.9 FP/image. [ 5 ] The study of Schalekamp et al, not only showed a higher sensitivity of 74% but also in turn a higher FPR of 1/image. [ 2 ] In another study comparing different versions of CAD systems, the sensitivity of the newest tested version OnGuard 5 was 64.4% and the FPR was 2/image.…”

The diagnostic value of grey-scale inversion technique in chest radiography

“…Over the last decades, digital chest radiography has iteratively and incrementally improved, with numerous processing tools being developed to support radiologists in the detection of pathological findings [ 2 , 4 , 5 ]. Most of these tools have been implemented to improve nodule detection, including digital tomosynthesis [ 6 – 8 ], dual energy and temporal subtraction techniques [ 9 – 11 ], computer-aided detection systems [ 12 , 13 ] and dark-field CXR. More recently, dark-field CXR has been demonstrated to be a valuable complementary tool for the assessment of pulmonary infiltrates, cardiomegaly and hemopericardium [ 14 , 15 ].…”