Maximum-Intensity-Projection and Computer-Aided-Detection Algorithms as Stand-Alone Reader Devices in Lung Cancer Screening Using Different Dose Levels and Reconstruction Kernels.

Ebner, Lukas; Roos, Justus E; Christensen, Jared D; Dobrocky, Thomas; Leidolt, Lars; Brela, Barbara; Obmann, Verena Carola; Joy-Bendzmierowski, Sonya; Huber, Adrian Thomas; Christe, Andreas (2016). Maximum-Intensity-Projection and Computer-Aided-Detection Algorithms as Stand-Alone Reader Devices in Lung Cancer Screening Using Different Dose Levels and Reconstruction Kernels. American Journal of Roentgenology, 207(2), pp. 282-288. American Roentgen Ray Society 10.2214/AJR.15.15588

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OBJECTIVE The objective of our study was to evaluate lung nodule detection rates on standard and microdose chest CT with two different computer-aided detection systems (SyngoCT-CAD, VA 20, Siemens Healthcare [CAD1]; Lung CAD, IntelliSpace Portal DX Server, Philips Healthcare [CAD2]) as well as maximum-intensity-projection (MIP) images. We also assessed the impact of different reconstruction kernels. MATERIALS AND METHODS Standard and microdose CT using three reconstruction kernels (i30, i50, i70) was performed with an anthropomorphic chest phantom. We placed 133 ground-glass and 133 solid nodules (diameters of 5 mm, 8 mm, 10 mm, and 12 mm) in 55 phantoms. Four blinded readers evaluated the MIP images; one recorded the results of CAD1 and CAD2. Sensitivities for CAD and MIP nodule detection on standard dose and microdose CT were calculated for each reconstruction kernel. RESULTS Dose for microdose CT was significantly less than that for standard-dose CT (0.1323 mSv vs 1.65 mSv; p < 0.0001). CAD1 delivered superior results compared with CAD2 for standard-dose and microdose CT (p < 0.0001). At microdose level, the best stand-alone sensitivity (97.6%) was comparable with CAD1 sensitivity (96.0%; p = 0.36; both with i30 reconstruction kernel). Pooled sensitivities for all nodules, doses, and reconstruction kernels on CAD1 ranged from 88.9% to 97.3% versus 49.6% to 73.9% for CAD2. The best sensitivity was achieved with standard-dose CT, i50 kernel, and CAD1 (97.3%) versus 96% with microdose CT, i30 or i50 kernel, and CAD1. MIP images and CAD1 had similar performance at both dose levels (p = 0.1313 and p = 0.48). CONCLUSION Submillisievert CT is feasible for detecting solid and ground-glass nodules that require soft-tissue kernels for MIP and CAD systems to achieve acceptable sensitivities. MIP reconstructions remain a valuable adjunct to the interpretation of chest CT for increasing sensitivity and have the advantage of significantly lower false-positive rates.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Other Institutions > Office of the Dean, Faculty of Medicine

UniBE Contributor:

Ebner, Lukas; Brela, Barbara; Obmann, Verena Carola; Joy-Bendzmierowski, Sonya; Huber, Adrian Thomas and Christe, Andreas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1546-3141

Publisher:

American Roentgen Ray Society

Language:

English

Submitter:

Karin Hofmann

Date Deposited:

19 Apr 2017 11:52

Last Modified:

19 Apr 2017 11:52

Publisher DOI:

10.2214/AJR.15.15588

PubMed ID:

27249174

Uncontrolled Keywords:

CT; computer-aided detection; maximum intensity projection; radiation dose

BORIS DOI:

10.7892/boris.94053

URI:

https://boris.unibe.ch/id/eprint/94053

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