Chest
Clinical InvestigationsComputer-Aided Diagnosis as a Second Reader: Spectrum of Findings in CT Studies of the Chest Interpreted as Normal
Section snippets
Materials and Methods
One hundred patients (68 women and 32 men; mean age, 52.9 years; range, 22 to 82 years) who had undergone a CT study of the chest in one of two large academic centers were included. In all cases, the CT study had been interpreted as normal, without suspicious focal lung lesions (inclusion criterion), at routine clinical reading. Three different patient subgroups were evaluated. The first group consisted of 33 consecutive patients (26 women and 7 men; mean age, 44.4 years; range, 22 to 79 years)
Results
Within all patients, 285 image features were marked by CAD and were evaluated by the study reading panel. In 33 of the 100 patients (33%), a total of 53 lesions were found that were deemed significant by reader consensus. None of these lesions had been reported at the routine clinical reading. Five of the CAD detected lesions (9.4%) were classified as high significance, 21 lesions (39.6%) were of intermediate significance, and 27 lesions (50.9%) were of low significance. A total of 19 patients
Discussion
Two types of error can occur during the interpretation of imaging studies: perception error and classification error.2, 3, 27, 28, 29 Due to a perception error, a reader simply “does not see” an abnormality that may often be readily visible in retrospect. This can occur, for example, because of a distraction during readout, or because of a particular location of the lesion (eg, a lung nodule adjacent to a vessel of similar size). In a classification error, the observer fails to report a
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Cited by (0)
Drs. Peldschus, Costello, and Schoepf had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Dr. Peldschus is supported by the Biomedical Sciences Exchange Program, Hannover, Germany. Dr. Wood is an employee of R2 Technology Inc., Sunnyvale, CA. Dr. Costello is the recipient of a research grant provided by R2 Technology Inc., Sunnyvale, CA. Dr. Schoepf is the recipient of an unrestricted research grant provided by Siemens Corporate Research, Princeton, NJ. The sponsors had no part in the design and conduct of the study or the collection, management, analysis, and interpretation of the data.