Assessing the use of digital radiography and a real-time interactive pulmonary nodule analysis system for large population lung cancer screening

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• 作者：Yan Xu¹ ; ^{xuyan0827@yahoo.com.cn} ; Daqing Ma ; ^{madaqing@263.net} ; ^{madaqing2010@gmail.com} ; Wen He
• 关键词：Pulmonary nodules ; Digital radiography ; Computer aided detection ; Lung cancer screening ; Receiver operating characteristic curve (ROC)
• 刊名：European Journal of Radiology
• 出版年：2012
• 期刊代码：93_0720048x
• 类别：med
• 出版时间：April, 2012
• 卷：81
• 期：4
• 页码：e451-e456
• 文件大小：981 K

摘要

Rationale and objectives

To assess the use of chest digital radiograph (DR) assisted with a real-time interactive pulmonary nodule analysis system in large population lung cancer screening.

Materials and methods

346 DR/CR patient studies with corresponding CT images were selected from 12,500 patients screened for lung cancer from year 2007 to 2009. Two expert chest radiologists established CT-confirmed Gold Standard of nodules on DR/CR images with consensus. These cases were read by eight other chest radiologists (participating radiologists) first without using a real-time interactive pulmonary nodule analysis system and then re-read using the system. Performances of participating radiologists and the computer system were analyzed.

Results

The computer system achieved similar performance on DR and CR images, with a detection rate of 76%and an average FPs of 2.0 per image. Before and after using the computer-aided detection system, the nodule detection sensitivities of the participating radiologists were 62.3%and 77.3%respectively, and the A_z values increased from 0.794 to 0.831. Statistical analysis demonstrated statically significant improvement for the participating radiologists after using the computer analysis system with a P-value 0.05.

Conclusion

The computer system could help radiologists identify more lesions, especially small ones that are more likely to be overlooked on chest DR/CR images, and could help reduce inter-observer diagnostic variations, while its FPs were easy to recognize and dismiss. It is suggested that DR/CR assisted by the real-time interactive pulmonary nodule analysis system may be an effective means to screen large populations for lung cancer.