Computer-aided detection of cerebral aneurysms with magnetic resonance angiography: usefulness of volume rendering to display lesion candidates

Purpose The clinical usefulness of computer-aided detection of cerebral aneurysms has been investigated using different methods to present lesion candidates, but suboptimal methods may have limited its usefulness. We compared three presentation methods to determine which can benefit radiologists the most by enabling them to detect more aneurysms. Materials and methods We conducted a multireader multicase observer performance study involving six radiologists and using 470 lesion candidates output by a computer-aided detection program, and compared the following three different presentation methods using the receiver operating characteristic analysis: (1) a lesion candidate is encircled on axial slices, (2) a lesion candidate is overlaid on a volume-rendered image, and (3) combination of (1) and (2). The response time was also compared. Results As compared with axial slices, radiologists showed significantly better detection performance when presented with volume-rendered images. There was no significant difference in response time between the two methods. The combined method was associated with a significantly longer response time, but had no added merit in terms of diagnostic accuracy. Conclusion Even with the aid of computer-aided detection, radiologists overlook many aneurysms if the presentation method is not optimal. Overlaying colored lesion candidates on volume-rendered images can help them detect more aneurysms.