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Eur Radiol (2013) 23:18621870 DOI 10.1007/s00330-013-2774-5
COMPUTER APPLICATIONS
Automatic detection of lytic and blastic thoracolumbar spine metastases on computed tomography
Matthias Hammon & Peter Dankerl & Alexey Tsymbal &
Michael Wels & Michael Kelm & Matthias May &
Michael Suehling & Michael Uder & Alexander Cavallaro
Received: 12 October 2012 /Revised: 6 December 2012 /Accepted: 19 December 2012 /Published online: 9 February 2013 # The Author(s) 2013. This article is published with open access at Springerlink.com
AbstractObjective To evaluate a computer-aided detection (CADe) system for lytic and blastic spinal metastases on computed tomography (CT).
Methods We retrospectively evaluated the CADe system on 20 consecutive patients with 42 lytic and on 30 consecutive patients with 172 blastic metastases. The CADe system was trained using CT images of 114 subjects with 102 lytic and 308 blastic spinal metastases. Lesions were annotated by experienced radiologists. Detected benign lesions were considered false-positive findings. Detector sensitivity and the number of false-positive findings were calculated as the criteria for detector performance, and free-response receiver operating characteristic (FROC) analysis was conducted. Detailed analysis of false-positive and false-negative findings was performed.
Results Algorithm runtime is 30.5 min per patient. The system achieves a sensitivity of 83 % at 3.5 false positives per patient on average for blastic metastases and a sensitivity of 88 % at 3.7 false positives for lytic metastases. False positives appeared predominantly in the area of degenerative changes in the case of the blastic metastasis detector and in osteoporotic areas in the case of the lytic metastasis detector.
Conclusion The CADe system reliably detects thoracolumbar spine metastases in real time. An additional study is planned to evaluate how the bone lesion CADe system
improves radiologists accuracy and efficiency in a clinical setting.
Key Points Computer-aided detection (CADe) of bone metastases has been developed for spinal CT.
The CADe system exhibits high sensitivity with a tolerable false-positive rate.
Analysis of false-positive detection may further improve the system.
CADe may reduce the number of missed spinal metastases at CT interpretation.
Keywords Computer-aided detection (CADe) . Bone metastases . Computed tomography (CT) . Spine . Clinical decision support
AbbreviationsCADe computer-aided detectionCT computed tomographyFDG fluorodeoxyglucoseFN false negativeFP false positiveFROC free-response receiver operating characteristic MRI magnetic resonance imagingPET-CT positron emission tomographycomputed tomographyTN true negativeTP true...