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Computer-Aided Detection of Colorectal Polyps at CT Colonography: Prospective Clinical Performance and Third-Party Reimbursement.
- Source :
-
AJR. American journal of roentgenology [AJR Am J Roentgenol] 2017 Jun; Vol. 208 (6), pp. 1244-1248. - Publication Year :
- 2017
-
Abstract
- Objective: We assessed the initial clinical performance and third-party reimbursement rates of supplementary computer-aided detection (CAD) at CT colonography (CTC) for detecting colorectal polyps 6 mm or larger in routine clinical practice.<br />Materials and Methods: We retrospectively assessed the prospective clinical performance of a U.S. Food and Drug Administration-approved CAD system in second-reader mode in 347 consecutive adults (mean age, 57.6 years; 205 women, 142 men) undergoing CTC evaluation over a 5-month period. The reference standard consisted of the prospective interpretation by experienced CTC radiologists combined with subsequent optical colonoscopy (OC), if performed. We also assessed third-party reimbursement for CAD for studies performed over an 18-month period.<br />Results: In all, 69 patients (mean [± SD] age, 59.0 ± 7.7 years; 32 men, 37 women) had 129 polyps ≥ 6 mm. Per-patient CAD sensitivity was 91.3% (63 of 69). Per-polyp CAD-alone sensitivity was 88.4% (114 of 129), including 88.3% (83 of 94) for 6- to 9-mm polyps and 88.6% (31 of 35) for polyps 10 mm or larger. On retrospective review, three additional polyps 6 mm or larger were seen at OC and marked by CAD but dismissed as CAD false-positives at CTC. The mean number of false-positive CAD marks was 4.4 ± 3.1 per series. Of 1225 CTC cases reviewed for reimbursement, 31.0% of the total charges for CAD interpretation had been recovered from a variety of third-party payers.<br />Conclusion: In our routine clinical practice, CAD showed good sensitivity for detecting colorectal polyps 6 mm or larger, with an acceptable number of false-positive marks. Importantly, CAD is already being reimbursed by some third-party payers in our clinical CTC practice.
- Subjects :
- Colonography, Computed Tomographic statistics & numerical data
Female
Humans
Insurance, Health, Reimbursement statistics & numerical data
Machine Learning economics
Machine Learning statistics & numerical data
Male
Radiographic Image Interpretation, Computer-Assisted statistics & numerical data
Reproducibility of Results
Sensitivity and Specificity
United States epidemiology
Colonography, Computed Tomographic economics
Colorectal Neoplasms diagnostic imaging
Colorectal Neoplasms economics
Insurance, Health, Reimbursement economics
Intestinal Polyps diagnostic imaging
Intestinal Polyps economics
Subjects
Details
- Language :
- English
- ISSN :
- 1546-3141
- Volume :
- 208
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- AJR. American journal of roentgenology
- Publication Type :
- Academic Journal
- Accession number :
- 28753031
- Full Text :
- https://doi.org/10.2214/AJR.16.17499