Computer-Aided Detection of Small Bowel Strictures for Emergency Radiology in CT Enterography

Computer-aided detection (CAD) of small bowel strictures can have significant impact in improving the workflow of CT enterography in an emergency setting where even non-expert radiologists could use it to rapidly detect sites of obstruction. A CAD scheme was developed to detect strictures from abdominal CT enterography data by use of multi-scale template matching and a blob detector. A pilot study was performed on 15 patients with 22 surgically confirmed strictures to study the effect of the CAD scheme on observer performance. The 77% sensitivity of an inexperienced radiologist assisted by the CAD scheme was comparable with the 81% sensitivity of an unaided expert radiologist (p=0.07). The use of CAD significantly reduced the reading time to identify strictures (p<0.0001). Most of the false-positive CAD detections were caused by collapsed bowel loops, approximated bowel wall, muscles or vessels, and they were easy to dismiss. The results indicate that CAD can provide radiologists with rapid and accurate interpretations of strictures to improve workflow in an emergency setting.