数字化胸片计算机辅助检测在肺结节早期检出中的应用

Application of Computer Aided Diagnosis (CAD) with Digital Chest Radiograph to the Early Detection for Pulmonary Nodules

[目的]评价计算机辅助检测系统(CAD)对肺结节早期检出的临床价值和局限性。[方法]从影像传输与存储系统(PACS)数据库中抽取30例直径7mm～30mm大小肺部结节的病例作为受检组。另抽取30例年龄、性别构成与受检组相仿的正常胸片作为对照组,两组病例均经螺旋CT肺部扫描检查,并由放射诊断专家诊断证实,所有胸片均为直接数字化影像(direct digital radiograph,DR)。由高年资和低年资放射诊断医生各3位分别对不用和用CAD输出分析结果的数字化胸片进行诊断,诊断结论用受试者操作特性曲线(ROC curve)分析来评价。[结果]平均ROC曲线下面积(Az)从不用CAD输出的0.872增加到用CAD输出的0.933(P<0.05)。在使用CAD时,低年资放射诊断医生比高年资放射诊断医生的平均曲线下面积增加得更多。[结论]在直接数字化胸片诊断中应用CAD系统能提高肺小结节的检出率。

[Purpose ] To estimate the clinical value and limit of computer aided diagnosis （CAD） system on the detection of pulmonary nodules. [Methods] Thirty cases with pulmonary nodules up to 9-30mm in diameter were selected from the database of picture archive and communication system （PACS） as ex- amination group, and 30 cases without pulmonary nodule cohered with examination group in age, sex composition as control group. All chest radiographs were obtained with direct digital radiograph （DR） system and confirmed by experienced chest radiologists on the chest spiral CT. Three experienced chest radiologists and three radiology residents detected the chest radiographs with/without CAD output. The result of diagnosis was evaluated with receiver operating characteristic curve （ROC curve）. [Results ] The average area under the ROC curve value （Az） increased from 0.872 without to 0.933 with CAD output（P〈 0.05）. Especially, the Az from CAD system increased more to radiology residents than to experienced radiologist. [Conclusion] Utilizing the CAD system on diagnosis of the direct digital chest radiograph can improve the detection of pulmonary nodules.