Computer-aided diagnosis improves detection of small intracranial aneurysms on MRA in a clinical setting

I. L. Štepán-Buksakowska, J. M. Accurso, F. E. Diehn, J. Huston, T. J. Kaufmann, P. H. Luetmer, C. P. Wood, X. Yang, D. J. Blezek, R. Carter, C. Hagen, D. Hořínek, A. Hejčl, M. Rǒcek, B. J. Erickson

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


BACKGROUND AND PURPOSE: MRA is widely accepted as a noninvasive diagnostic tool for the detection of intracranial aneurysms, but detection is still a challenging task with rather low detection rates. Our aim was to examine the performance of a computer-aided diagnosis algorithm for detecting intracranial aneurysms on MRA in a clinical setting.

MATERIALS AND METHODS: Aneurysm detectability was evaluated retrospectively in 48 subjects with and without computer-aided diagnosis by 6 readers using a clinical 3D viewing system. Aneurysms ranged from 1.1 to 6.0 mm (mean=3.12 mm, median=2.50 mm). We conducted a multireader, multicase, double-crossover design, free-response, observer-performance study on sets of images from different MRA scanners by using DSA as the reference standard. Jackknife alternative free-response operating characteristic curve analysis with the figure of merit was used.

RESULTS: For all readers combined, the mean figure of merit improved from 0.655 to 0.759, indicating a change in the figure of merit attributable to computer-aided diagnosis of 0.10 (95% CI, 0.03-0.18), which was statistically significant (F1,47 = 7.00, P = .011). Five of the 6 radiologists had improved performance with computer-aided diagnosis, primarily due to increased sensitivity.

CONCLUSIONS: In conditions similar to clinical practice, using computer-aided diagnosis significantly improved radiologists' detection of intracranial DSA-confirmed aneurysms of ≤6 mm.

Original languageEnglish (US)
Pages (from-to)1897-1902
Number of pages6
JournalAmerican Journal of Neuroradiology
Issue number10
StatePublished - Oct 1 2014

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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