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Keywords:
Neuroradiology brain, Computer applications, MR, Computer Applications-Detection, diagnosis, Comparative studies
Authors:
K. Schwerdtner1, M. Domin1, H.-J. Huppertz2, M. Grothe1, E. Rathmann1, S. Langner1; 1Greifswald/DE, 2Zurich/CH
DOI:
10.1594/ecr2017/C-3044
Conclusion
Discussion - Main Findings
Visual Assessment (sensitivity of 81.1% for racT2ll) is time consuming and error-prone.
Therefore,
computer aided lesion detection is desirable.
Disregarding the quantitatively correct assessment of changes:
- sensitivity sadcT2ll vs racT2ll 84.9% vs 92.7%
- specificity sadcT2ll vs racT2ll 99.7% vs 97.6%
Regarding the correct assessment of cT2ll:
- sadcT2ll lacks of accuracy (i.e.
sensitivity of 69.6% vs 81.1% of racT2ll)
- sadcT2ll with high specificity (i.e.
99.4% vs 95.7% of racT2ll)
The findings demonstrate,
that the diagnostic performance of the method for sadcT2ll presented here is inferior to radiological assessment of cT2ll.
Discussion - Limitations
With the presented algorithm,
semi-automatic detected changes in T2ll still have to be evaluated by visual inspection making this approach prone to user bias.
- No threshold is defined to differentiate between a new lesion,
new lesions with just subtle changes in T2-SI,
changes within a previously existing lesion or artefacts.
- New lesions with inconsistent signals hinder fully automated assessment.
Detected and assessed changes of T2-SI within lesions (“change within lesion”) are not part of the current clinical classification for the diagnostics of Multiple Sclerosis – and they are not included in radiological reports.
Conclusion
The method of sadcT2ll presented is this study is inferior to standard visual assessment by a radiologist.
Especially in assessing quantitatively correct lesion changes sadcT2ll lacks accuracy and does not improve diagnostic yield.
Nevertheless it is a fast and robust technique and could serve as complementary tool in daily clinical routine.
It may be beneficial in patients with high T2ll or with subtle lesion changes.