Computer-Aided Detection of Colorectal Polyps at CT Colonography: Prospective Clinical Performance and Third-Party Reimbursement.
AJR Am J Roentgenol
; 208(6): 1244-1248, 2017 Jun.
Article
em En
| MEDLINE
| ID: mdl-28753031
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. MATERIALS ANDMETHODS:
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.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.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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
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Pólipos Intestinais
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Colonografia Tomográfica Computadorizada
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Reembolso de Seguro de Saúde
Tipo de estudo:
Diagnostic_studies
/
Risk_factors_studies
Limite:
Female
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Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
AJR Am J Roentgenol
Ano de publicação:
2017
Tipo de documento:
Article