Computer-Aided Diagnosis Improves Detection of Small Intracranial Aneurysms on MRA in a Clinical Setting
Abstract
BACKGROUND AND PURPOSE: MRA is widely accepted as a noninvasive diagnostic tool for the detection of intracranial aneurysms, but detection is still a challenging task with rather low detection rates. Our aim was to examine the performance of a computer-aided diagnosis algorithm for detecting intracranial aneurysms on MRA in a clinical setting.
MATERIALS AND METHODS: Aneurysm detectability was evaluated retrospectively in 48 subjects with and without computer-aided diagnosis by 6 readers using a clinical 3D viewing system. Aneurysms ranged from 1.1 to 6.0 mm (mean = 3.12 mm, median = 2.50 mm).
We conducted a multireader, multicase, double-crossover design, free-response, observer-performance study on sets of images from different MRA scanners by using DSA as the reference standard. Jackknife alternative free-response operating characteristic curve analysis with the figure of merit was used.
RESULTS: For all readers combined, the mean figure of merit improved from 0.655 to 0.759, indicating a change in the figure of merit attributable to computer-aided diagnosis of 0.10 (95% Cl, 0.03-0.18), which was statistically significant (F-1,F-47 = 7.00, P = .011). Five of the 6 radiologists had improved performance with computer-aided diagnosis, primarily due to increased sensitivity.
CONCLUSIONS: In conditions similar to clinical practice, using computer-aided diagnosis significantly improved radiologists' detection of intracraniat DSA-confirmed aneurysms of {= 6 mm.