CAD techniques, challenges, and controversies in computed tomographic colonography

Computer-aided diagnosis (CAD) for computed tomographic colonography (CTC) automatically detects the locations of suspicious polyps and masses on CTC and provides radiologists with a second opinion. CAD has the potential to increase radiologists' diagnostic performance in the detection of polyps and masses and to decrease variability of the diagnostic accuracy among readers without significantly increasing the reading time. Technical developments have advanced CAD substantially during the past several years, and a fundamental scheme for the detection of polyps has been established. The most recent CAD systems based on this scheme produce a clinically acceptable high sensitivity and a low false-positive rate. However, CAD for CTC is still under active development, and the technology needs to be improved further. This report describes the expected benefits, the current fundamental scheme, the key techniques used for detection of polyps and masses on CTC, the current detection performance, as well as the pitfalls, challenges, controversies, and the future of CAD.