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Computer-Assisted Detection of Cerebral Aneurysms in MR Angiography in a Routine Image-Reading Environment: Effects

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Computer-assisted detection (CAD) for cerebral aneurysms in MR angiography is feasible. Radiologists using CAD detected 9.3% more aneurysms, improving sensitivity without significantly reducing specificity.

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Area of Science:

  • Neuroradiology
  • Medical Imaging Analysis
  • Artificial Intelligence in Medicine

Background:

  • Limited data exists on computer-assisted detection (CAD) for cerebral aneurysms in clinical practice.
  • Radiologist experiences with CAD in real-world settings for aneurysm diagnosis are unreported.

Purpose of the Study:

  • To evaluate the clinical utility of CAD for cerebral aneurysms during routine MR angiography interpretation.
  • To assess the impact of CAD on radiologist diagnostic performance in a real-life clinical environment.

Main Methods:

  • 2701 MR angiograms were reviewed by two radiologists over 39 months using a CAD system.
  • Radiologists performed initial interpretations independently, then reviewed CAD output to potentially alter diagnoses.
  • Sensitivity and specificity were evaluated using aneurysm- and patient-based analyses against a consensus reference standard.

Main Results:

  • The CAD system increased aneurysm detection by 9.3% (258 to 282).
  • Radiologist sensitivity improved from 64% to 69% with CAD use.
  • The CAD system identified 82% of aneurysms and was generally beneficial, not detrimental.

Conclusions:

  • Routine integration of CAD with MR angiography for cerebral aneurysms is feasible.
  • CAD enables radiologists to detect additional aneurysms without a significant decrease in specificity.
  • Radiologist confidence in the CAD system may influence its overall usefulness.