Computer-aided simple triage

Goldenberg, Roman; Peled, Nathan

doi:10.1007/s11548-011-0552-x

Cited by 15 publications

(14 citation statements)

References 18 publications

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“…Instead, in the presented study, inexperienced readers apply the advanced cardiac software package as semi-automatic coronary artery visualization and segmentation tool, with the final decision up to the human interpreter. Our work stands in consistency with Goldenberg et al [19] who propose a CADx as an initial analyzer (rather than a second reader), but leaves the final decision to the physician. As displayed by the excellent sensitivity and NPV, as well as the acceptable specificity and PPV, the presented method fulfills demands of a screening test [20].…”

Section: Discussionsupporting

confidence: 87%

Evaluation of novice reader diagnostic performance in coronary CT angiography using an advanced cardiac software package

et al. 2013

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PurposeThe purpose of this research was to evaluate whether a commercially available advanced cardiac software package for coronary CT angiography (CTA) interpretation may reliably assist inexperienced readers to screen for significant coronary artery stenoses.MethodsCoronary CTA data sets of 61 consecutive patients with suspected coronary artery disease were evaluated by three novice readers with no experience in cardiac CT interpretation. In the first 15 patients, the novice readers were trained to use the advanced cardiac software package (includes automatic detection of coronary vessels, curved MPR and VRT reconstructions and a measurement too) knowing the results of an expert read. In the next 46 patients, the novice readers had to state whether there is a significant coronary artery stenosis (50 %) and if they are confident with their diagnosis. The results of the novice readers were compared to the expert read.ResultsThe 46 coronary CTA data sets contained 184 vessels with 15 stenoses in 9 patients. On a per-vessel analysis, novice reader 1/2/3 demonstrated 60 %/100 %/ 93% sensitivity, and 98 %/90 %/86 % specificity. Per patient, the readers diagnosed 36/28/29 cases correctly as free of stenoses, 6/9/8 correctly as having at least one stenosis, missed 3/0/1 cases with a stenosis and overdiagnosed 1/9/8 patients. Cohen’s kappa values for the three readers versus the expert were 0.60, 0.61 and 0.54. The three novice readers felt confident in the diagnosis of 36/33/30 patients. In these patients, they missed one significant stenosis, showed a sensitivity of 100 %/100 %/75 % and a specificity of 100 %/92 %/88 %.ConclusionsThe evaluated advanced cardiac software package successfully assists novice readers in interpreting coronary CTA data sets especially in ruling out significant coronary artery stenosis.

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Section: Discussionsupporting

confidence: 87%

Evaluation of novice reader diagnostic performance in coronary CT angiography using an advanced cardiac software package

et al. 2013

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“…To the best of our knowledge, the only commercially available system that automatically detects significant coronary artery stenosis in CTA is the COR Analyzer (Rcadia Medical Imaging Ltd., Haifa, Israel). The summary of 14 clinical trials evaluating the system is available in Goldenberg and Peled (2011). The system reports location and type (calcified, soft, mixed) of significant coronary lesions (≥ 50% stenosis).…”

Section: Previous Workmentioning

confidence: 99%

Standardized evaluation framework for evaluating coronary artery stenosis detection, stenosis quantification and lumen segmentation algorithms in computed tomography angiography

Kirişli¹,

Schaap²,

Metz³

et al. 2013

Medical Image Analysis

185

148

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Though conventional coronary angiography (CCA) has been the standard of reference for diagnosing coronary artery disease in the past decades, computed tomography angiography (CTA) has rapidly emerged, and is nowadays widely used in clinical practice. Here, we introduce a standardized evaluation framework to reliably evaluate and compare the performance of the algorithms devised to detect and quantify the coronary artery stenoses, and to segment the coronary artery lumen in CTA data. The objective of this evaluation framework is to demonstrate the feasibility of dedicated algorithms to: (1) (semi-)automatically detect and quantify stenosis on CTA, in comparison with quantitative coronary angiography (QCA) and CTA consensus reading, and (2) (semi-)automatically segment the coronary lumen on CTA, in comparison with expert's manual annotation. A database consisting of 48 multicenter multivendor cardiac CTA datasets with corresponding reference standards are described and made available. The algorithms from 11 research groups were quantitatively evaluated and compared. The results show that (1) some of the current stenosis detection/quantification algorithms may be used for triage or as a second-reader in clinical practice, and that (2) automatic lumen segmentation is possible with a precision similar to that obtained by experts. The framework is open for new submissions through the website, at http://coronary.bigr.nl/stenoses/.

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“…The system reported in this study, yielding a 64% specificity for a low-risk population, falls into a different category of computer-aided analysis tools: the Computer-Aided Simple Triage (CAST) recently introduced by Goldenberg and Peled 13 . As a CAST tool, it can be used for chest pain patient triage in the emergency department or for reading sequence prioritization in high-volume practices with low-risk populations.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, 3 studies were published which evaluated the COR Analyzer performance and reported promising system sensitivity and negative predictive values 10-12 . Furthermore, the 3 studies proved to have specificities of over 60%, which is significant when considering the potential for the software to be used as a Computer-Aided Simple Triage (CAST) tool 13 . A successful CAST tool can be employed in the emergency department as an initial rapid read to allow for triage of patients.…”

Section: Introductionmentioning

confidence: 99%

Computer-Aided Analysis of 64-Slice Coronary Computed Tomography Angiography: A Comparison with Manual Interpretation

Abramowicz

Daubert

Malhotra

et al. 2013

Heart International

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Coronary computed tomography angiography (CCTA) is increasingly used for the assessment of coronary heart disease (CHD) in symptomatic patients. Software applications have recently been developed to facilitate efficient and accurate analysis of CCTA. This study aims to evaluate the clinical application of computer-aided diagnosis (CAD) software for the detection of significant coronary stenosis on CCTA in populations with low (8%), moderate (13%), and high (27%) CHD prevalence. A total of 341 consecutive patients underwent 64-slice CCTA at 3 clinical sites in the United States. CAD software performed automatic detection of significant coronary lesions (>50% stenosis). CAD results were then compared to the consensus manual interpretation of 2 imaging experts. Data analysis was conducted for each patient and segment. The CAD had 100% sensitivity per patient across all 3 clinical sites. Specificity in the low, moderate, and high CHD prevalence populations was 64%, 41%, and 38%, respectively. The negative predictive value at the 3 clinical sites was 100%. The positive predictive value was 22%, 21%, and 38% for the low, moderate, and high CHD prevalence populations, respectively. This study demonstrates the utility of CAD software in 3 distinct clinical settings. In a low-prevalence population, such as seen in the emergency department, CAD can be used as a Computer-Aided Simple Triage tool to assist in diagnostic delineation of acute chest pain. In a higher prevalence population, CAD software is useful as an adjunct for both the experienced and inexperienced reader.

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Computer-aided simple triage

Abstract: CAST systems have a potential to become an "enabling technology" allowing introduction of advanced imaging techniques into the emergency workflow protocols by addressing the reader unavailability and reading prioritization problems.

Cited by 15 publications

References 18 publications

Evaluation of novice reader diagnostic performance in coronary CT angiography using an advanced cardiac software package

Evaluation of novice reader diagnostic performance in coronary CT angiography using an advanced cardiac software package

Standardized evaluation framework for evaluating coronary artery stenosis detection, stenosis quantification and lumen segmentation algorithms in computed tomography angiography

Computer-Aided Analysis of 64-Slice Coronary Computed Tomography Angiography: A Comparison with Manual Interpretation

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