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CT Colonography with Computer-aided Detection as a Second Reader: Observer Performance Study¹

¹ From the Diagnostic Radiology Department, Clinical Center, National Institutes of Health, Bldg 10, Room 1C351, Bethesda, MD 20892-1182 (M.H., R.M.S., S.C.Y., L.B., A.L.); National Institute of Biomedical Imaging and Bioengineering (NIBIB)/Center for Devices and Radiological Health Joint Laboratory for the Assessment of Medical Imaging Systems, U.S. Food and Drug Administration (FDA), Rockville, Md (N.P.); Department of Radiology, Georgetown University School of Medicine, Washington, DC (E.M.I.); Department of Radiology, Walter Reed Army Medical Center, Washington, DC (J.R.C.); and Department of Radiology, University of Wisconsin Medical School, Madison, Wis (P.J.P.). From the 2005 RSNA Annual Meeting. Received December 19, 2006; revision requested February 16, 2007; revision received April 4; final version accepted May 4. Supported in part by the intramural research program of the National Institutes of Health Clinical Center (NIBIB). No FDA endorsement of any product or company mentioned in this manuscript should be inferred. Address correspondence to R.M.S. (e-mail: rms{at}nih.gov).

View larger version (35K): [in this window] [in a new window] [Download PPT slide]   Figure 1: Flowchart shows initial case selection and final distribution of study cases TN = true-negative, TP = true-positive.

View larger version (77K): [in this window] [in a new window] [Download PPT slide]   Figure 2a: CT colonographic image of 10-mm tubulovillous adenoma (white arrow) in ascending colon of 59-year-old man; found by reader 2 with CAD and readers 1, 3, and 4 without. (a) Transverse CT and (b) 3D endoluminal virtual colonoscopic views of polyp. CAD prompts (a, white rectangle; b, pink indicator) shown to readers when CAD prompts were turned on. Polyp is submerged in opacified colonic fluid. Navigation aid (a, blue arrow) provided by software.

View larger version (106K): [in this window] [in a new window] [Download PPT slide]   Figure 2b: CT colonographic image of 10-mm tubulovillous adenoma (white arrow) in ascending colon of 59-year-old man; found by reader 2 with CAD and readers 1, 3, and 4 without. (a) Transverse CT and (b) 3D endoluminal virtual colonoscopic views of polyp. CAD prompts (a, white rectangle; b, pink indicator) shown to readers when CAD prompts were turned on. Polyp is submerged in opacified colonic fluid. Navigation aid (a, blue arrow) provided by software.

View larger version (77K): [in this window] [in a new window] [Download PPT slide]   Figure 3a: CT colonographic image of 7-mm tubular adenoma (short white arrows) in rectum of 62-year-old man. Polyp abuts rectal tube (long white arrows); readers 1, 2, and 3 identified the polyp with CAD; none did so without. (a) Transverse CT and (b) 3D endoluminal virtual colonoscopic views of polyp. CAD prompts (a, white rectangle; b, pink indicator) shown to readers when CAD prompts were turned on. Navigation aid (a, blue arrow) provided by software.

View larger version (90K): [in this window] [in a new window] [Download PPT slide]   Figure 3b: CT colonographic image of 7-mm tubular adenoma (short white arrows) in rectum of 62-year-old man. Polyp abuts rectal tube (long white arrows); readers 1, 2, and 3 identified the polyp with CAD; none did so without. (a) Transverse CT and (b) 3D endoluminal virtual colonoscopic views of polyp. CAD prompts (a, white rectangle; b, pink indicator) shown to readers when CAD prompts were turned on. Navigation aid (a, blue arrow) provided by software.