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Improved Detection of Lung Nodules on Chest Radiographs Using a Commercial Computer-Aided Diagnosis System

Shingo Kakeda1, Junji Moriya1, Hiromi Sato1, Takatoshi Aoki1, Hideyuki Watanabe1, Hajime Nakata1, Nobuhiro Oda1, Shigehiko Katsuragawa2, Keiji Yamamoto3 and Kunio Doi4

1 Department of Radiology, University of Occupational and Environmental Health School of Medicine, Iseigaoka 1-1, Yahatanisi-ku, Kitakyushu-shi 807-8555, Japan.
2 Department of Information Media Technology, Nippon Bunri University, Ichigi 1727, Oita-shi 870-0397, Japan.
3 Mitsubishi Space Software Co., Ltd., Hyogo, Japan.
4 Kurt Rossmann Laboratories for Radiologic Image Research, Department of Radiology, The University of Chicago, 5841 S Maryland Ave., Chicago, IL 60637.



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  		Fig. 1. —Diagram shows computerized scheme of nodule detection method. CR = computed radiography, CAD = computer-aided diagnosis.

 


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  		Fig. 2. —Graph shows receiver operating characteristic curves for detection of lung nodules with (area under receiver operator characteristic curve [Az] = 0.986) and without (Az = 0.924) computer-aided diagnosis (CAD) output images.

 


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  		Fig. 3. —Bar graph shows number of cases (> 30%) affected by computer-aided diagnosis output images in confidence levels with regard to cancer cases.

 


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  		Fig. 4. —Bar graph shows number of cases (> 30%) affected by computer-aided diagnosis output images in confidence levels with regard to healthy cases.

 


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  		Fig. 5A. —50-year-old man with lung cancer. Original chest radiograph shows subtle nodule in right apex.

 


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  		Fig. 5B. —50-year-old man with lung cancer. Computer-aided diagnosis output image indicates four suspected areas (arrowheads). One area (right apex) contains actual nodule overlapping clavicle, and others contain typical false-positive findings due to normal anatomic structures, which are easily recognized as pulmonary vessels.

 


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  		Fig. 5C. —50-year-old man with lung cancer. CT scan confirms presence of nodule shown in A and B.

 

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