Computer-aided detection is gradually gaining acceptance in radiology and has become a major research focus in the past few years. The development of CAD with multislice CT has reached the point where, together, they have the potential to offer new capabilities in the interpretation of emergency room scans.
Various versions of the CAD acronym have been suggested, including computer-aided detection, computer-aided diagnosis, and computer-assisted detection. Today, it is universally accepted that any CAD applications will assist a radiologist rather than serve as independent diagnostic tools, and therefore the term "detection" is more appropriate.1 The recognition of virtual colonoscopy for the screening of precancerous colonic polyps and of CAD for generating automated segmentations of liver and kidney has encouraged further work to auto-mate advanced postprocessing applications.2-4 Although the potential of computer-aided techniques for use with MRI data sets has been explored for a few clinical needs, there is more acceptance of CAD algorithms with MSCT.5,6
Novel methodologies and techniques, like CAD, should always be directed to look for solutions to common and routine problems. Emergency radiology accounts for 30% to 40% of all CT scans and is important to patient care because of the frequency of life-threatening presentations in the emergency room. Given the importance of emergency radiology and its potentially crucial impact on standards of patient care, it would be wise to encourage the development of MSCT-CAD applications geared to solving the common problems in diagnosis of acute, life-threatening clinical conditions.
Certain advantages of MSCT are unique to an emergency radiology setting. Generally, a seriously ill or injured patient is likely to be imaged on a modality that ensures good accuracy and reinforces diagnostic confidence of radiologists and clinicians. MSCT has performed the best so far in maintaining the delicate balance between accuracy, readers' confidence, and time savings in the emergency room. MSCT also offers the best diagnostic accuracy for most clinical conditions that present in emergency situations and is preferred over MRI because of its faster scan speed and better image resolution. These qualities also lower the probability of encountering motion artifacts in the images, which is a common problem in an emergency radiology setting.
Research and development that explore the utility of computer-aided techniques has been uneven across the various dimensions of clinical practice. Practitioners in a clinical setting put up with a high rate of false-positives because of the better accuracy and specificity of CAD results. But concerns over false-positive results have delayed exploration of CAD's potential in an emergency radiology setting, where the instant and accurate detection of life-threatening conditions is of paramount importance.
