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dc.contributor.authorGreer, Matthew Den
dc.contributor.authorLay, Nathanen
dc.contributor.authorShih, Joanna Hen
dc.contributor.authorBarrett, Tristanen
dc.contributor.authorBittencourt, Leonardo Kayaten
dc.contributor.authorBorofsky, Samuelen
dc.contributor.authorKabakus, Ismailen
dc.contributor.authorLaw, Yan Meeen
dc.contributor.authorMarko, Jamieen
dc.contributor.authorShebel, Haythamen
dc.contributor.authorMertan, Francesca Ven
dc.contributor.authorMerino, Maria Jen
dc.contributor.authorWood, Bradford Jen
dc.contributor.authorPinto, Peter Aen
dc.contributor.authorSummers, Ronald Men
dc.contributor.authorChoyke, Peter Len
dc.contributor.authorTurkbey, Barisen
dc.date.accessioned2018-11-05T10:26:33Z
dc.date.available2018-11-05T10:26:33Z
dc.date.issued2018-10en
dc.identifier.issn0938-7994
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/284626
dc.description.abstract© 2018 This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection 2018 Objectives: To evaluate if computer-aided diagnosis (CAD) prior to prostate multi-parametric MRI (mpMRI) can improve sensitivity and agreement between radiologists. Methods: Nine radiologists (three each high, intermediate, low experience) from eight institutions participated. A total of 163 patients with 3-T mpMRI from 4/2012 to 6/2015 were included: 110 cancer patients with prostatectomy after mpMRI, 53 patients with no lesions on mpMRI and negative TRUS-guided biopsy. Readers were blinded to all outcomes and detected lesions per PI-RADSv2 on mpMRI. After 5 weeks, readers re-evaluated patients using CAD to detect lesions. Prostatectomy specimens registered to MRI were ground truth with index lesions defined on pathology. Sensitivity, specificity and agreement were calculated per patient, lesion level and zone—peripheral (PZ) and transition (TZ). Results: Index lesion sensitivity was 78.2% for mpMRI alone and 86.3% for CAD-assisted mpMRI (p = 0.013). Sensitivity was comparable for TZ lesions (78.7% vs 78.1%; p = 0.929); CAD improved PZ lesion sensitivity (84% vs 94%; p = 0.003). Improved sensitivity came from lesions scored PI-RADS < 3 as index lesion sensitivity was comparable at PI-RADS ≥ 3 (77.6% vs 78.1%; p = 0.859). Per patient specificity was 57.1% for CAD and 70.4% for mpMRI (p = 0.003). CAD improved agreement between all readers (56.9% vs 71.8%; p < 0.001). Conclusions: CAD-assisted mpMRI improved sensitivity and agreement, but decreased specificity, between radiologists of varying experience. Key Points: • Computer-aided diagnosis (CAD) assists clinicians in detecting prostate cancer on MRI.• CAD assistance improves agreement between radiologists in detecting prostate cancer lesions.• However, this CAD system induces more false positives, particularly for less-experienced clinicians and in the transition zone.• CAD assists radiologists in detecting cancer missed on MRI, suggesting a path for improved diagnostic confidence.
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.subjectHumansen
dc.subjectProstatic Neoplasmsen
dc.subjectImage Interpretation, Computer-Assisteden
dc.subjectMagnetic Resonance Imagingen
dc.subjectProstatectomyen
dc.subjectSensitivity and Specificityen
dc.subjectRetrospective Studiesen
dc.subjectAgeden
dc.subjectMiddle Ageden
dc.subjectMaleen
dc.titleComputer-aided diagnosis prior to conventional interpretation of prostate mpMRI: an international multi-reader study.en
dc.typeArticle
prism.endingPage4417
prism.issueIdentifier10en
prism.publicationDate2018en
prism.publicationNameEuropean radiologyen
prism.startingPage4407
prism.volume28en
dc.identifier.doi10.17863/CAM.32000
dcterms.dateAccepted2018-02-06en
rioxxterms.versionofrecord10.1007/s00330-018-5374-6en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2018-10en
dc.contributor.orcidBarrett, Tristan [0000-0002-1180-1474]
dc.contributor.orcidWood, Bradford J [0000-0002-4297-0051]
dc.identifier.eissn1432-1084
rioxxterms.typeJournal Article/Reviewen
rioxxterms.freetoread.startdate2019-10-01


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