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Reader Performance as a Function of Patient Size for the Detection of Hepatic Metastases

Objective To investigate reader performance as a function of patient size for the detection of hepatic metastases when an automatic exposure control (AEC) system is used, which varies image noise as a function of patient size. Methods Abdominal computed tomograhy examinations across 100, 120, 160, and 200 quality reference tube current-time product were collected, involving a cohort of 83 patients. Three radiologists identified hepatic metastases across all dose levels. Partial Spearman rank correlation and multivariate logistic regression were used to evaluate correlations between reader performance and patient size and lesion size/contrast while accounting for potential confounding effects. Analyses were repeated on an emulated less-variable noise AEC. Results No statistically significant correlation was observed between patient size and radiologist performance (for variable-noise AEC: range of partial Spearman ρ, −0.157 to −0.035]; range of adjusted odds ratios, 0.987, 1.006). Conclusions Reader performance was independent of patient size, suggesting that variable-noise AEC provides better modulation for larger patients than constant-noise AEC.