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This would, however, compromise quality of service to users located in the cusp region and therefore highlights a design trade-off For simplicity, cusping loss is assumed ideal (Lcusp 0) in this analysis, thus further analysis is required to fully model = the impact of cusping loss Once the beamwidth becomes smaller than the largest angular spread, this latter effect dominates, causing energy to spread out of the main beam with the possibility of increasing interference levels to co-channel users This residue beamwidth (RB) is illustrated in figure 620 and can be defined as the angular spread ( A S ) observed when an infinitely narrow beam excites the channel Figure 620 shows that the beamwidth is limited by the angular spread This is reflected in table 67 where beam efficiency rapidly reduces for beamwidths of less than the angular spread.



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A large-scale retrospective study is being performed of 300 cases with matched normals from the Emergency Department (ED) at the Los Angeles County +, University of Southern California Hospital (LAC+USC) comprising patients who had been previously diagnosed with AIH Compared to the hospital in Hong Kong where the validation and evaluation data were collected, LAC+USC is an entirely different clinical environment, serves different patient populations, and utilizes CT scanners from various manufacturers with different clinical protocols For the questions raised above, the interim results are very promising, with 85% sensitivity and a little bit lower in speci city Further improvement is expected 2562 Next Steps for Deployment of the CAD System for AIH in Clinical Environment After the evaluation described in Section 256.





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1 is completed, the next logical step in the evolution of the system is actual integration of the CAD into a normal radiology infrastructure and work ow It is important to implement the system such that future enhancements can readily be tested within a true clinical environment rather than in the isolation of a development or test environment This next step will allow netuning aspects of the system design that must be optimized before a CAD system can be truly effective The CAD system must be integrated into the existing systems architecture to automatically run in real time, intercepting new studies and running prior to or in parallel with other existing work ow processes Furthermore the results of the CAD system must be stored as distinct les, preserving the original studies but remaining immediately accessible within the existing client software.

Throughout this investigation an angular spread of 10" is considered representative of an urban environment and falls within the range reported in [99] LAS is computed by equation (617) where BW is the azimuth beamwidth and AS the angular spread..

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Integration must therefore occur ahead of PACS or integrated with the PACS system Existing radiology and emergency department work ow must be altered to take advantage of the presence of the CAD system However, acceptance testing of the CAD system within a clinical environment requires stringent con rmatory steps to ensure that no treatment decisions are made wholly based on the CAD system until such time that the CAD system has been validated within the clinical environment This speci cally applies to clinicians who must be instructed to consult with a radiologist despite the presence of CAD output during this next phase of development Radiologists must also be recruited to facilitate validation in the clinical environment by modifying their existing work ow to reference CAD output and by assisting in documenting the successes and failures of both the algorithm and the system.

Most important, the system enhancements based on user input, from both clinicians and radiologists, is an essential next step in the evolution of the CAD system Factors like processing time, output visualization, accessibility, reporting, and logging, which.

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