本研究旨在研究基于特征金字塔网络（FPN）的脑转移瘤（BM）计算机辅助检测（CAD）在非手术治疗前后的价值，并评估其在对比增强（CE）磁共振成像（MRI）监测BM治疗反应中的性能。本研究回顾性纳入了遥城人民医院进行初次和随访三维CE MRI的85例新诊断BM的癌症患者。由评价者1进行手动检测（MD）。由评价者2使用uAI Discover-BMs软件进行计算机辅助检测（CAD）。对每位患者的治疗反应由两个评价者分别进行评估。使用配对卡方检验比较MD和CAD在BM检测中的差异。使用kappa检验评估MD和CAD在监测BM治疗反应方面的一致性。 MD和CAD在初次3D CE MRI上的敏感性分别为78.65%和99.13%。MD和CAD在随访3D CE MRI上的敏感性分别为76.32%和98.24%。评价者1和评价者2在评估BM治疗反应方面达到了很好的一致性。 与MD相比，基于FPN的CAD在BM检测中具有接近100%的更高灵敏度和更低的假阴性（FN）。尽管CAD在反映治疗后BM的变化方面存在一些缺点，但在CE MRI监测BM治疗反应方面表现出较高的性能。 版权所有 © 2023. Elsevier Ltd. 发表。

To investigate the value of feature pyramid network (FPN)-based computer-aided detection (CAD) of brain metastases (BMs) before and after non-surgical treatment, and to evaluate its performance in monitoring treatment response of BM on contrast-enhanced (CE) magnetic resonance imaging (MRI).Eighty-five cancer patients newly diagnosed with BM who had undergone initial and follow-up three-dimensional (3D) CE MRI at Liaocheng People's Hospital were included retrospectively in this study. Manual detection (MD) was performed by reviewer 1. Computer-aided detection (CAD) was performed by reviewer 2 using uAI Discover-BMs software. The treatment response was assessed by the two reviewers for each patient separately. A paired chi-square test was used to compare the differences in the detection of BM between MD and CAD. Agreement between MD and CAD in monitoring treatment response was assessed by kappa test.The sensitivities of MD and CAD on initial 3D CE MRI were 78.65% and 99.13%, respectively. The sensitivities of MD and CAD on follow-up 3D CE MRI were 76.32% and 98.24%, respectively. There was a very good agreement between Reviewer 1 and Reviewer 2 in evaluating the treatment response of BM.FPN-based CAD has a higher sensitivity of close to 100% and lower false negatives (FNs) for BM detection, compared to MD. Although CAD had a few shortcomings in reflecting changes of BMs after treatment, it had high performance in monitoring treatment response of BM on CE MRI.Copyright © 2023. Published by Elsevier Ltd.