Does computer-assisted detection of pulmonary emboli enhance severity assessment and risk stratification in acute pulmonary embolism?

Clinical Radiology
Christoph EngelkeKatharina Marten

Abstract

To prospectively assess the value of computer-aided detection (CAD) for the computed tomography (CT) severity assessment of acute pulmonary embolism (PE). CT angiographic scans of 58 PE-positive patients (34-89 years, mean 66 years) were analysed by four observers for PE severity using the Mastora index, and by CAD. Patients were stratified to three PE risk groups and results compared to an independent reference standard. Interobserver agreement was tested by Bland and Altman and extended kappa (Ke) statistics. Mastora index changes after CAD data review were tested by Wilcoxon signed ranks. CAD detected 343 out of 1118 emboli within given arterial segments and a total of 155 out of 218 polysegmental emboli (segmental vessel-based sensitivity = 30.7%, embolus-based sensitivity = 71.2% false-positive rate = 4.1/scan). Interobserver agreement on PE severity [95% limits of agreement (LOA) = -19.7-7.5% and-5.5-3% for reader pairs 1 versus 2 and 3 versus 4, respectively was enhanced by consensus with CAD data (LOA = -6.5-5.4% and-3.7-2% for reader pairs 1 versus 2 and 3 versus 4, respectively). Simultaneously, the percentual scoring errors (PSE) were significantly decreased (PSE = 35.4+/-31.8% and 5.1+/-8.9% for readers 1/2 and 2/3,...Continue Reading

References

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Feb 18, 2003·IEEE Transactions on Medical Imaging·Yoshitaka MasutaniKunio Doi
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Apr 26, 2006·Journal of Thrombosis and Haemostasis : JTH·G Le GalF Couturaud
Oct 19, 2006·European Radiology·Katharina Marten, Christoph Engelke
Nov 29, 2007·Journal of Thoracic Imaging·U Joseph SchoepfPhilip Costello
Nov 29, 2007·Journal of Thoracic Imaging·Zeev V MaizlinPeter L Cooperberg

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Citations

Dec 24, 2010·AJR. American Journal of Roentgenology·Rianne WittenbergCornelia M Schaefer-Prokop
Dec 29, 2013·AJR. American Journal of Roentgenology·Seth J KligermanCharles S White
Oct 27, 2012·Insights Into Imaging·Pauline J Abrahams-van Doorn, Ieneke J C Hartmann
Sep 16, 2011·Academic Radiology·Nancy A Obuchowski

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