Health Imaging & IT - November 2008 - (Page 86)

imagiNg tools By Sarah Lamberti a second reader that makes sense Lung CAD software was developed primarily for the detection of pulmonary nodules, which can be overlooked by radiologists reading chest x-rays and lung CTs. The software has been refined over the last few years, overcoming initial speculation regarding its efficacy with recent clinical studies that have validated its performance. “Chest x-ray CAD makes sense—it helps to find nodules in the lungs on an x-ray that has superimposed soft tissues, skeletal structures, mediastinal structures—the problem is that it seems to be oversensitive in areas of overlapping bones such as the anterior rib and posterior rib crossings,” says Judith K. Amorosa, MD, clinical professor, radiology at Robert Wood Johnson School of Medicine in Piscataway, N.J., who uses the IQQA-Chest CAD enterprise solution from EDDA Technologies. Lung CT CAD finds nodules which need to be distinguished from blood vessels and pleural reflections. It also can be useful for less experienced readers for confirmation of a possible finding. Used by less-experienced readers, CAD for chest x-rays (CXRs) will likely lead to more chest CTs, however, it is less expensive than a second reader, Amorosa notes. Achieving a high level of sensitivity and specificity with the actual software, at a level where radiologists find it helpful in their day-to-day work, has been a challenge, adds Heber MacMahon, MB, BCh, professor of radiology at the University of Chicago and director, section of thoracic imaging. Using the OnGuard lung CAD system from Riverain Technologies, MacMahon and colleagues sought to determine the sensitivity and number of false-positive marks for identifying lung cancers that were detected but misinterpreted on chest radiographs by radiologists. The OnGuard system marked 35 percent of lung cancers that had been previously overlooked, according to the study results that appeared in Radiology (January 2008). Despite its sensitivity, the software tends to have a relatively high number of false HealthImaging.com Defining Lung CAD’s Role Computer-assisted detection (CAD) software to analyze lung imaging studies is steadily gaining ground, improving in sensitivity and specificity as a increasingly reliable second pair of trained eyes to aid radiologists in the detection of pulmonary nodules. While more radiologists are championing the technology, the lack of PACS integration is a stumbling block for widespread adoption. At the same time, what first emerged as a tool for detection is transforming into a tool for characterization and possible diagnosis, while expanding its utilization beyond pulmonary diseases and lung cancer. [ The right and left images are from the same patient but acquired at different dates. In assessing pulmonary nodule evolution by automatic computation of volume and diameter changes, Median Technologies’ LMSLung CAD automatically retrieves the lesion in the new dataset, measures it, providing variation of volume and diameters. ] 86 Health Imaging & IT | November 2008 http://www.HealthImaging.com

Table of Contents Feed for the Digital Edition of Health Imaging & IT - November 2008

Health Imaging & IT - November 2008 Table of Contents On the Web The Enterprise News Update RIS/PACS Speech PACS Peripherals Advanced Visualization CT DR & CR CAD Molecular Imaging MRI Ultrasound Healthcare IT Furniture reading Services Cardiac Imaging Data Storage & Archiving Displays Oncology Imaging 3T MRI Flexing its Muscle Breast Imaging Workflow: Optimum Efficiency & Beyond Enterprise Long-term Storage: Plan for the Worst, Hope for the Best LCD Monitors Sharpen Soft-copy Mammography Defining Lung CAD’s Role Digital Endoscopy: Challenges for Enterprise Imaging Reader's Resource On the Frontline: CT in the ED

Health Imaging & IT - November 2008

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