Computer-Assisted Detection of Cerebral Aneurysms in MR Angiography in a Routine Image-Reading Environment: Effects on Diagnosis by Radiologists

• Published in: American journal of neuroradiology : AJNR Vol. 37; no. 6; pp. 1038 - 1043
• Main Authors: Miki, S, Hayashi, N, Masutani, Y, Nomura, Y, Yoshikawa, T, Hanaoka, S, Nemoto, M, Ohtomo, K
• Format: Journal Article
• Language: English
• Published: United States American Society of Neuroradiology 01-06-2016
• Subjects: Adult Brain; Humans; Image Interpretation, Computer-Assisted - methods; Intracranial Aneurysm - diagnostic imaging; Magnetic Resonance Angiography - methods; Radiologists; Sensitivity and Specificity
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.a4671

Experiences with computer-assisted detection of cerebral aneurysms in diagnosis by radiologists in real-life clinical environments have not been reported. The purpose of this study was to evaluate the usefulness of computer-assisted detection in a routine reading environment.
During 39 months in a routine clinical practice environment, 2701 MR angiograms were each read by 2 radiologists by using a computer-assisted detection system. Initial interpretation was independently made without using the detection system, followed by a possible alteration of diagnosis after referring to the lesion candidate output from the system. We used the final consensus of the 2 radiologists as the reference standard. The sensitivity and specificity of radiologists before and after seeing the lesion candidates were evaluated by aneurysm- and patient-based analyses.
The use of the computer-assisted detection system increased the number of detected aneurysms by 9.3% (from 258 to 282). Aneurysm-based analysis revealed that the apparent sensitivity of the radiologists' diagnoses made without and with the detection system was 64% and 69%, respectively. The detection system presented 82% of the aneurysms. The detection system more frequently benefited radiologists than being detrimental.
Routine integration of computer-assisted detection with MR angiography for cerebral aneurysms is feasible, and radiologists can detect a number of additional cerebral aneurysms by using the detection system without a substantial decrease in their specificity. The low confidence of radiologists in the system may limit its usefulness.