• Daniele Regge, Patrizia Della Monica, Giovanni Galatola, Cristiana Laudi, Antonella Zambon, Loredana Correale, Roberto Asnaghi, Brunella Barbaro, Claudia Borghi, Delia Campanella, Maria Carla Cassinis, Riccardo Ferrari, Andrea Ferraris, Cesare Hassan, Rita Golfieri, Franco Iafrate, Gabriella Iussich, Andrea Laghi, Roberto Massara, Emanuele Neri, Lapo Sali, Silvia Venturini, and Giovanni Gandini.
• Radiology Unit, Institute for Cancer Research and Treatment, Candiolo, Italy.
• Radiology. 2013 Jan 1; 266 (1): 168-76.

PurposeTo assess the effect of computer-aided detection (CAD) as a second reader on the sensitivity and specificity of computed tomographic (CT) colonography in detecting 6-9-mm colorectal cancer (CRC) lesions.Materials And MethodsIndividuals with clinical indications for colonoscopy--either for symptoms or as part of participating in a surveillance program or CRC screening--were prospectively enrolled at one of 10 academic centers between July 2007 and May 2009. Institutional review board approval was obtained at each clinical site, and all participants provided written informed consent. All participants underwent CT colonography and colonoscopy on the same day. Experienced readers interpreted the CT colonography images unassisted and then reviewed all colorectal lesion-like structures pinpointed by the CAD algorithm. Segmental unblinding of CT colonoscopy findings at colonoscopy was utilized. The sensitivity and specificity of unassisted and CAD-assisted reading in identifying individuals with 6-9-mm lesions were calculated and compared by means of pairwise analysis.ResultsA total of 618 participants (mean age, 57.9 years; 54.5% male) were included in the final analysis. Of these participants, 464 (75.1%) had no lesions 6 mm or larger, and 52 (8.4%) had 6-9-mm lesions. The sensitivity of CT colonography with unassisted reading and that with CAD-assisted reading in identifying individuals with 6-9-mm lesions was 65.4% (95% confidence interval [CI]: 50.9%, 78.0%) and 76.9% (95% CI: 63.2%, 87.5%; P = .016), respectively. No significant change in specificity was observed: The specificity of CT colonography with unassisted and that with CAD-assisted reading was 91.8% (95% CI: 88.9%, 94.1%) and 90.9% (95% CI: 88.0%, 93.4%; P = .063), respectively. Evaluation of CAD candidates required an additional 1.6 minutes (25th-75th percentile: 1.0 minute to 3.4 minutes).ConclusionThe addition of CAD to reading performed by experienced readers resulted in a significant benefit in the detection of 6-9-mm polyps at CT colonography in this cohort.Supplemental Materialhttp://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120376/-/DC1.RSNA, 2012

22 keywords...

hide…