Correlation between a 2D channelized Hotelling observer and human observers in a low-contrast detection task with multislice reading in CT

Purpose: Model observers have been successfully developed and used to assess the quality of static 2D CT images. However, radiologists typically read images by paging through multiple 2D slices (i.e., multislice reading). The purpose of this study was to correlate human and model observer performance in a low-contrast detection task performed using both 2D and multislice reading, and to determine if the 2D model observer still correlate well with human observer performance in multislice reading. Methods: A phantom containing 18 low-contrast spheres (6 sizes x 3 contrast levels) was scanned on a 192-slice CT scanner at five dose levels (CTDIvol = 27, 13.5, 6.8, 3.4, and 1.7 mGy), each repeated 100 times. Images were reconstructed using both filtered-backprojection (FBP) and an iterative reconstruction (IR) method (ADMIRE, Siemens). A 3D volume of interest (VOI) around each sphere was extracted and placed side-by-side with a signal-absent VOI to create a 2-alternative forced choice (2AFC) trial. Sixteen 2AFC studies were generated, each with 100 trials, to evaluate the impact of radiation dose, lesion size and contrast, and reconstruction methods on object detection. In total, 1600 trials were presented to both model and human observers. Three medical physicists acted as human observers and were allowed to page through the 3D volumes to make a decision for each 2AFC trial. The human observer performance was compared with the performance of a multislice channelized Hotelling observer (CHO_MS), which integrates multislice image data, and with the performance of previously validated CHO, which operates on static 2D images (CHO_2D). For comparison, the same 16 2AFC studies were also performed in a 2D viewing mode by the human observers and compared with the multislice viewing performance and the two CHO models. Results: Human observer performance was well correlated with the CHO_2D performance in the 2D viewing mode [Pearson product-moment correlation coefficient R = 0.972, 95% confidence interval (CI): 0.919 to 0.990] and with the CHO_MS performance in the multislice viewing mode (R = 0.952, 95% CI: 0.865 to 0.984). The CHO_2D performance, calculated from the 2D viewing mode, also had a strong correlation with human observer performance in the multislice viewing mode (R = 0.957, 95% CI: 879 to 0.985). Human observer performance varied between the multislice and 2D modes. One reader performed better in the multislice mode (P = 0.013); whereas the other two readers showed no significant difference between the two viewing modes (P = 0.057 and P = 0.38). Conclusions: A 2D CHO model is highly correlated with human observer performance in detecting spherical low contrast objects in multislice viewing of CT images. This finding provides some evidence for the use of a simpler, 2D CHO to assess image quality in clinically relevant CT tasks where multislice viewing is used. (C) 2017 American Association of Physicists in Medicine