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Improved Classifications of Planar Whole-Body Bone Scans Using a Computer-Assisted Diagnosis System: A Multicenter, Multiple-Reader, Multiple-Case Study

Sadik, May; Suurkula, Madis; Höglund, Peter LU ; Jarund, Andreas and Edenbrandtl, Lars (2009) In Journal of Nuclear Medicine 50(3). p.368-375
Abstract
The aim of this multicenter study was to investigate whether a computer-assisted diagnosis (CAD) system could improve performance and reduce interobserver variation in bone-scan interpretations of the presence or absence of bone metastases. Methods: The whole-body bone scans (anterior and posterior views) of 59 patients with breast or prostate cancer who had undergone scintigraphy for suspected bone metastatic disease were studied. The patients were selected to reflect the spectrum of pathology found in everyday clinical work. Thirty-five physicians working at 18 of the 30 nuclear medicine departments In Sweden agreed to participate. The physicians were asked to classify each case for the presence or absence of bone metastasis, without... (More)
The aim of this multicenter study was to investigate whether a computer-assisted diagnosis (CAD) system could improve performance and reduce interobserver variation in bone-scan interpretations of the presence or absence of bone metastases. Methods: The whole-body bone scans (anterior and posterior views) of 59 patients with breast or prostate cancer who had undergone scintigraphy for suspected bone metastatic disease were studied. The patients were selected to reflect the spectrum of pathology found in everyday clinical work. Thirty-five physicians working at 18 of the 30 nuclear medicine departments In Sweden agreed to participate. The physicians were asked to classify each case for the presence or absence of bone metastasis, without (baseline) and with the aid of the CAD system (1 y later), using a 4-point scale. The final clinical assessments, based on follow-up scans and other clinical data including the results of laboratory tests and available diagnostic images (such as MRI, CT, and radiographs from a mean follow-up period of 4.8 y), were used as the gold standard. Each physician's classification was pairwise compared with the classifications made by all the other physicians, resulting in 595 pairs of comparisons, both at baseline and after using the CAD system. Results: The physicians increased their sensitivity from 78% without to 88% with the aid of the CAD system (P < 0.001). The specificity did not change significantly with CAD. Percentage agreement and K-values between paired physicians on average increased from 64% to 70% and from 0.48 to 0.55, respectively, with the CAD system. Conclusion: A CAD system improved physicians' sensitivity in detecting metastases and reduced interobserver variation in planar whole-body bone scans. The CAD system appears to have significant potential in assisting physicians in their clinical routine. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cancer, breast, bone metastases, diagnostic accuracy, radionuclide imaging, prostate cancer
in
Journal of Nuclear Medicine
volume
50
issue
3
pages
368 - 375
publisher
Society of Nuclear Medicine
external identifiers
  • wos:000264084500014
  • scopus:62449243949
ISSN
0161-5505
DOI
10.2967/jnumed.108.058883
language
English
LU publication?
yes
id
db29827e-b664-4fd4-9d13-f9429de71834 (old id 1404678)
date added to LUP
2009-06-15 09:45:58
date last changed
2017-07-23 04:00:26
@article{db29827e-b664-4fd4-9d13-f9429de71834,
  abstract     = {The aim of this multicenter study was to investigate whether a computer-assisted diagnosis (CAD) system could improve performance and reduce interobserver variation in bone-scan interpretations of the presence or absence of bone metastases. Methods: The whole-body bone scans (anterior and posterior views) of 59 patients with breast or prostate cancer who had undergone scintigraphy for suspected bone metastatic disease were studied. The patients were selected to reflect the spectrum of pathology found in everyday clinical work. Thirty-five physicians working at 18 of the 30 nuclear medicine departments In Sweden agreed to participate. The physicians were asked to classify each case for the presence or absence of bone metastasis, without (baseline) and with the aid of the CAD system (1 y later), using a 4-point scale. The final clinical assessments, based on follow-up scans and other clinical data including the results of laboratory tests and available diagnostic images (such as MRI, CT, and radiographs from a mean follow-up period of 4.8 y), were used as the gold standard. Each physician's classification was pairwise compared with the classifications made by all the other physicians, resulting in 595 pairs of comparisons, both at baseline and after using the CAD system. Results: The physicians increased their sensitivity from 78% without to 88% with the aid of the CAD system (P &lt; 0.001). The specificity did not change significantly with CAD. Percentage agreement and K-values between paired physicians on average increased from 64% to 70% and from 0.48 to 0.55, respectively, with the CAD system. Conclusion: A CAD system improved physicians' sensitivity in detecting metastases and reduced interobserver variation in planar whole-body bone scans. The CAD system appears to have significant potential in assisting physicians in their clinical routine.},
  author       = {Sadik, May and Suurkula, Madis and Höglund, Peter and Jarund, Andreas and Edenbrandtl, Lars},
  issn         = {0161-5505},
  keyword      = {cancer,breast,bone metastases,diagnostic accuracy,radionuclide imaging,prostate cancer},
  language     = {eng},
  number       = {3},
  pages        = {368--375},
  publisher    = {Society of Nuclear Medicine},
  series       = {Journal of Nuclear Medicine},
  title        = {Improved Classifications of Planar Whole-Body Bone Scans Using a Computer-Assisted Diagnosis System: A Multicenter, Multiple-Reader, Multiple-Case Study},
  url          = {http://dx.doi.org/10.2967/jnumed.108.058883},
  volume       = {50},
  year         = {2009},
}