Computed tomography pulmonary angiography in acute pulmonary embolism: the effect of a computer-assisted detection prototype used as a concurrent reader.

Abstract:

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' sensitivity (P<0.001) without loss of specificity (P=0.855) with the effects being reader dependent (P<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<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' confidence scores using CAD as a concurrent reader (P<0.001). CONCLUSIONS:CAD as a concurrent reader has the potential to increase readers' 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.

journal_name

J Thorac Imaging

authors

Wittenberg R,Peters JF,van den Berk IA,Freling NJ,Lely R,de Hoop B,Horsthuis K,Ravesloot CJ,Weber M,Prokop WM,Schaefer-Prokop CM

doi

10.1097/RTI.0b013e3182870b97

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

315-21

issue

5

eissn

0883-5993

issn

1536-0237

journal_volume

28

pub_type

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