Computer-assisted detection of acute pulmonary embolism at CT pulmonary angiography in children and young adults: a diagnostic performance analysis

• Published in: Acta radiologica (1987) 2019-08, Vol.60 (8), p.1011-1019
• Main Authors: Tang, Chun Xiang, Zhou, Chang Sheng, Schoepf, Uwe Joseph, Mastrodicasa, Domenico, Duguay, Taylor, Cline, Anna, Zhao, Yan E, Lu, Li, Li, Xie, Tao, Shu Min, Lu, Meng Jie, Lu, Guang Ming, Zhang, Long Jiang
• Format: Article
• Language: English
• Subjects: Acute Disease; Adolescent; Adult; Child; Computed Tomography Angiography - methods; Female; Humans; Image Interpretation, Computer-Assisted - methods; Lung - diagnostic imaging; Male; Pulmonary Embolism - diagnostic imaging; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Young Adult
• ISSN: 0284-1851; 1600-0455
• DOI: 10.1177/0284185118808547

Background To diagnose pulmonary embolism (PE) in children and adults since evaluating tiny pulmonary vasculature beyond segmental level is a challenging and demanding task with thousands of images. Purpose To evaluate the effect of computer-assisted detection (CAD) on acute PE on CTPA in children and young adults by readers with varying experience levels. Material and Methods Six radiologists were retrospectively divided into three groups according to experience levels and assessed the CTPA studies on a per-emboli basis. All readers identified independently the PE presence, and ranked diagnostic confidence on a 5-point scale with and without CAD. Reading time, sensitivities, specificities, accuracies, positive predictive values (PPVs), and negative predictive values (NPVs) were calculated for each reading. Results The sensitivities and NPVs differed significantly in most readers (P = 0.004, 0.001, 0.010, 0.010, and 0.012 for sensitivities and P = 0.011, 0.003, 0.016, 0.017, and 0.019 for NPVs) except for reader 6 (P = 0.148 and 0.165, respectively), and the accuracies of all readers differed significantly (all P