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Proceedings Paper

Computer-aided detection as a decision assistant in chest radiography
Author(s): Maurice R. M. Samulski; Peter R. Snoeren; Bram Platel; Bram van Ginneken; Laurens Hogeweg; Cornelia Schaefer-Prokop; Nico Karssemeijer
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Paper Abstract

Background. Contrary to what may be expected, finding abnormalities in complex images like pulmonary nodules in chest radiographs is not dominated by time-consuming search strategies but by an almost immediate global interpretation. This was already known in the nineteen-seventies from experiments with briefly flashed chest radiographs. Later on, experiments with eye-trackers showed that abnormalities attracted the attention quite fast but often without further reader actions. Prolonging one's search seldom leads to newly found abnormalities and may even increase the chance of errors. The problem of reading chest radiographs is therefore not dominated by finding the abnormalities, but by interpreting them. Hypothesis. This suggests that readers could benefit from computer-aided detection (CAD) systems not so much by their ability to prompt potential abnormalities, but more from their ability to 'interpret' the potential abnormalities. In this paper, this hypothesis was investigated by an observer experiment. Experiment. In one condition, the traditional CAD condition, the most suspicious CAD locations were shown to the subjects, without telling them the levels of suspiciousness according to CAD. In the other condition, interactive CAD condition, levels of suspiciousness were given, but only when readers requested them at specified locations. These two conditions focus on decreasing search errors and decision errors, respectively. Results of reading without CAD were also recorded. Six subjects, all non-radiologists, read 223 chest radiographs in both conditions. CAD results were obtained from the OnGuard 5.0 system developed by Riverain Medical (Miamisburg, Ohio). Results. The observer data were analyzed by Location Response Operating Characteristic analysis (LROC). It was found that: 1) With the aid of CAD, the performance is significantly better than without CAD; 2) The performance with interactive CAD is significantly better than with traditional CAD at low false positive rates.

Paper Details

Date Published: 3 March 2011
PDF: 6 pages
Proc. SPIE 7966, Medical Imaging 2011: Image Perception, Observer Performance, and Technology Assessment, 796614 (3 March 2011); doi: 10.1117/12.877968
Show Author Affiliations
Maurice R. M. Samulski, Radboud Univ. Nijmegen Medical Ctr. (Netherlands)
Peter R. Snoeren, Radboud Univ. Nijmegen Medical Ctr. (Netherlands)
Bram Platel, Fraunhofer MeVis (Germany)
Bram van Ginneken, Radboud Univ. Nijmegen Medical Ctr. (Netherlands)
Laurens Hogeweg, Radboud Univ. Nijmegen Medical Ctr. (Netherlands)
Cornelia Schaefer-Prokop, Meander Medical Ctr. Amersfoort (Netherlands)
Nico Karssemeijer, Radboud Univ. Nijmegen Medical Ctr. (Netherlands)

Published in SPIE Proceedings Vol. 7966:
Medical Imaging 2011: Image Perception, Observer Performance, and Technology Assessment
David J. Manning; Craig K. Abbey, Editor(s)

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