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. 2010 Apr;20(4):801-6.
doi: 10.1007/s00330-009-1628-7. Epub 2009 Oct 28.

Computer-assisted detection of pulmonary embolism: evaluation of pulmonary CT angiograms performed in an on-call setting

Rianne Wittenberg  1 , Joost F Peters, Jeroen J Sonnemans, Mathias Prokop, Cornelia M Schaefer-Prokop
Affiliations

Computer-assisted detection of pulmonary embolism: evaluation of pulmonary CT angiograms performed in an on-call setting

Rianne Wittenberg et al. Eur Radiol. 2010 Apr.

Abstract

Purpose: The purpose of the study was to assess the stand-alone performance of computer-assisted detection (CAD) for evaluation of pulmonary CT angiograms (CTPA) performed in an on-call setting.

Methods: In this institutional review board-approved study, we retrospectively included 292 consecutive CTPA performed during night shifts and weekends over a period of 16 months. Original reports were compared with a dedicated CAD system for pulmonary emboli (PE). A reference standard for the presence of PE was established using independent evaluation by two readers and consultation of a third experienced radiologist in discordant cases.

Results: Original reports had described 225 negative studies and 67 positive studies for PE. CAD found PE in seven patients originally reported as negative but identified by independent evaluation: emboli were located in segmental (n = 2) and subsegmental arteries (n = 5). The negative predictive value (NPV) of the CAD algorithm was 92% (44/48). On average there were 4.7 false positives (FP) per examination (median 2, range 0-42). In 72% of studies <or=5 FP were found, 13% of studies had >or=10 FP.

Conclusion: CAD identified small emboli originally missed under clinical conditions and found 93% of the isolated subsegmental emboli. On average there were 4.7 FP per examination.

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Figures

Fig. 1
Fig. 1
Classis embolus found by CAD
Fig. 2
Fig. 2
Subsegmental embolus missed by primary readers
Fig. 3
Fig. 3
False-positive candidate lesion found by CAD due to motion artifacts
See this image and copyright information in PMC

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