Literature DB >> 20663973

Colorectal polyps: stand-alone performance of computer-aided detection in a large asymptomatic screening population.

Edward M Lawrence1, Perry J Pickhardt, David H Kim, Jessica B Robbins.   

Abstract

PURPOSE: To evaluate stand-alone performance of computer-aided detection (CAD) for colorectal polyps of 6 mm or larger at computed tomographic (CT) colonography in a large asymptomatic screening cohort.
MATERIALS AND METHODS: In this retrospective, institutional review board-approved, HIPAA-compliant study, a CAD software system was applied to screening CT colonography in 1638 women and 1408 men (mean age, 56.9 years) evaluated at a single medical center between March 2006 and December 2008. All participants underwent cathartic preparation with stool tagging; electronic cleansing was not used. The reference standard consisted of interpretation by experienced radiologists in all cases. This interpretation was further refined for the subset of cases with positive findings by using subsequent colonoscopic or CT colonographic confirmation, as well as retrospective expert localization of polyps with CT colonography. This test set was not involved in training the CAD system. The Fisher exact test was used to evaluate significance; 95% confidence intervals (CIs) were obtained by using the exact method.
RESULTS: Per-patient CAD sensitivities were 93.8% (350 of 373; 95% CI: 90.9%, 96.1%) and 96.5% (137 of 142; 95% CI: 92.0%, 98.8%) at 6- and 10-mm threshold sizes, respectively. Per-polyp CAD sensitivities for all polyps, regardless of histologic features, were 90.1% (547 of 607; 95% CI: 88.0%, 92.8%) and 96.0% (168 of 175; 95% CI: 91.9%, 98.4%) at 6- and 10-mm threshold sizes, respectively; CAD sensitivities for advanced neoplasia and cancer were 97.0% (128 of 132; 95% CI: 92.4%, 99.2%) and 100% (13 of 13; 95% CI: 79.4%, 100%), respectively. The mean and median false-positive rates were 4.7 and 3 per series, respectively (9.4 and 6 per patient). Among 373 patients with a positive finding at CT colonography, CAD marked an additional 15 polyps of 6 mm or larger, including four large polyps, that were missed at the prospective three-dimensional reading by an expert but were found at subsequent colonoscopy.
CONCLUSION: Stand-alone CAD demonstrated excellent performance for polyp detection in a large screening population, with high sensitivity and an acceptable number of false-positive results. (c) RSNA, 2010.

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Year:  2010        PMID: 20663973     DOI: 10.1148/radiol.10092292

Source DB:  PubMed          Journal:  Radiology        ISSN: 0033-8419            Impact factor:   11.105


  11 in total

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4.  CT colonography: effect of computer-aided detection of colonic polyps as a second and concurrent reader for general radiologists with moderate experience in CT colonography.

Authors:  Thomas Mang; Luca Bogoni; Vikram X Anand; Dass Chandra; Andrew J Curtin; Anna S Lev-Toaff; Gerardo Hermosillo; Ralph Noah; Vikas Raykar; Marcos Salganicoff; Robert Shaw; Susan Summerton; Rafel F R Tappouni; Helmut Ringel; Michael Weber; Matthias Wolf; Nancy A Obuchowski
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6.  Time-efficient CT colonography interpretation using an advanced image-gallery-based, computer-aided "first-reader" workflow for the detection of colorectal adenomas.

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Review 7.  Computed tomography colonography: emerging evidence to further support clinical effectiveness.

Authors:  Perry J Pickhardt
Journal:  Curr Opin Gastroenterol       Date:  2013-01       Impact factor: 3.287

8.  Computed tomography colonography for colorectal cancer screening.

Authors:  Virendra Tewari; Deepali Tewari; Frank G Gress
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9.  The effect of computer-aided detection markers on visual search and reader performance during concurrent reading of CT colonography.

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Journal:  Eur Radiol       Date:  2015-01-12       Impact factor: 5.315

10.  Quantifying tumour heterogeneity with CT.

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