Psychophysical Evaluation of Visual vs. Computer‐Aided Detection of Brain Lesions on Magnetic Resonance Images

Background Magnetic resonance imaging (MRI) diagnosis is usually performed by analyzing contrast‐weighted images, where pathology is detected once it reached a certain visual threshold. Computer‐aided diagnosis (CAD) has been proposed as a way for achieving higher sensitivity to early pathology. Purpose To compare conventional (i.e., visual) MRI assessment of artificially generated multiple sclerosis (MS) lesions in the brain's white matter to CAD based on a deep neural network. Study Type Prospective. Population A total of 25 neuroradiologists (15 males, age 39 ± 9, 9 ± 9.8 years of experience) independently assessed all synthetic lesions. Field Strength/Sequence A 3.0 T, T2‐weighted multi‐echo spin‐echo (MESE) sequence. Assessment MS lesions of varying severity levels were artificially generated in healthy volunteer MRI scans by manipulating T2 values. Radiologists and a neural network were tasked with detecting these lesions in a series of 48 MR images. Sixteen images presented healthy anatomy and the rest contained a single lesion at eight increasing severity levels (6%, 9%, 12%, 15%, 18%, 21%, 25%, and 30% elevation in T2). True positive (TP) rates, false positive (FP) rates, and odds ratios (ORs) were compared between radiological diagnosis and CAD across the range lesion severity levels. Statistical Tests Diagnostic performance of the two approaches was compared using z‐tests on TP rates, FP rates, and the logarithm of ORs across severity levels. A P‐value