Receiver operating characteristic curves and their use in radiology

Sensitivity and specificity are the basic measures of accuracy of a diagnostic test; however, they depend on the cut point used to define "positive" and "negative" test results. As the cut point shifts, sensitivity and specificity shift. The receiver operating characteristic (ROC) curve is a plot of the sensitivity of a test versus its false-positive rate for all possible cut points. The advantages of the ROC curve as a means of defining the accuracy of a test, construction of the ROC, and identification of the optimal cut point on the ROC curve are discussed. Several summary measures of the accuracy of a test, including the commonly used percentage of correct diagnoses and area under the ROC curve, are described and compared. Two examples of ROC curve application in radiologic research are presented. (C) RSNA, 2003.