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British Journal of Radiology (2008) 81, 841-847
© 2008 British Institute of Radiology
doi: 10.1259/bjr/50635688
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British Journal of Radiology 81 (2008),841-847 ©2008 The British Institute of Radiology

Full paper

Performance evaluation of a computer-aided detection algorithm for solid pulmonary nodules in low-dose and standard-dose MDCT chest examinations and its influence on radiologists

M DAS, MD 1 G MÜHLENBRUCH, MD 1 S HEINEN, MD 1 A H MAHNKEN, MD, MBA 1 M SALGANICOFF 2 S STANZEL, MSc 3 R W GÜNTHER, MD 1 and J E WILDBERGER, MD 1

1 Department of Diagnostic Radiology, RWTH Aachen University Hospital, Aachen, Germany, 2 Siemens Medical Solutions, CAD Applications, Malvern, PA, USA and 3 Institute of Medical Statistics, RWTH Aachen University, Aachen, Germany

Correspondence: Marco Das, Department of Diagnostic Radiology, RWTH Aachen University Hospital, Pauwelsstrasse 30, D–52074 Aachen, Germany. E-mail: das{at}rad.rwth-aachen.de

The aim of the study was to evaluate the performance of a computer-aided detection (CAD) algorithm in low-dose and full-dose multidetector-row CT (MDCT) of the thorax and its impact on radiologists' performance. Chest CT examinations of 77 patients were evaluated retrospectively for pulmonary nodules. All patients had undergone a 16-slice MDCT chest examination with a standard acquistion protocol. Artificial image noise was added to the raw data to simulate image acquisition at 10 mAseff. The data were transferred to dedicated lung analysis software (LungCareTM) with a prototype CAD algorithm (LungCADTM). CAD was applied to both dose settings. Images were read by a radiologist and a first-year resident with and without the software at both dose settings. All images were reviewed in consensus by the two radiologists to set the reference standard. Sensitivity results with respect to the reference standard were compared. No statistically significant differences in the detection rate for all pulmonary nodules could be found between low-dose and full-dose settings for the CAD software alone (p = 0.0065). Both radiologists displayed a statistically significant increase in sensitivity with the use of CAD (p<0.0001). In conclusion, CAD is beneficial in both low-dose and standard-dose settings. This may be beneficial in reducing false-negative diagnosis in lung cancer screening, standard chest examinations and the search for metastases.






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