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Computer-Aided Detection in Screening CT for Pulmonary Nodules

¹ Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, V5Z 1M9 Canada.
² Department of Radiology, St. Paul's Hospital, 1081 Burrard St., Vancouver, British Columbia, V6Z 1Y6 Canada.

View larger version (82K): [in a new window]   Fig. 1 —Computer-aided detection workstation user interface. Transaxial section at middle lung zone level contains lesion highlighted by green circle (right image panel). Yellow line indicates anatomic level of displayed section in coronal maximum intensity projection of pulmonary vascular tree (left upper image panel). 3D volume rendering (left lower image panel) of lesion displays anatomic location of lesion and relationship between lesion and surrounding structures (e.g., vessels and pleura).

View larger version (84K): [in a new window]   Fig. 2A —Transverse CT images with target field of view show solid nodules (green circles) only detected by computer-aided detection (CAD) system. Small (< 4 mm) central nodule (A), moderate (4 mm diameter 10 mm) peripheral nodule (B), and moderate (4 mm diameter 10 mm) nodule at hilum (C) were surrounded by similar-sized vessels, which make them difficult for radiologist to distinguish on 2D image.

View larger version (155K): [in a new window]   Fig. 2B —Transverse CT images with target field of view show solid nodules (green circles) only detected by computer-aided detection (CAD) system. Small (< 4 mm) central nodule (A), moderate (4 mm diameter 10 mm) peripheral nodule (B), and moderate (4 mm diameter 10 mm) nodule at hilum (C) were surrounded by similar-sized vessels, which make them difficult for radiologist to distinguish on 2D image.

View larger version (155K): [in a new window]   Fig. 2C —Transverse CT images with target field of view show solid nodules (green circles) only detected by computer-aided detection (CAD) system. Small (< 4 mm) central nodule (A), moderate (4 mm diameter 10 mm) peripheral nodule (B), and moderate (4 mm diameter 10 mm) nodule at hilum (C) were surrounded by similar-sized vessels, which make them difficult for radiologist to distinguish on 2D image.

View larger version (130K): [in a new window]   Fig. 3A —Small solid nodules (< 4 mm; CTpeak > -100 H) were missed by computer-aided detection because of size algorithm. Some were in contact with the pleura (A) or vessels (B).

View larger version (137K): [in a new window]   Fig. 3B —Small solid nodules (< 4 mm; CTpeak > -100 H) were missed by computer-aided detection because of size algorithm. Some were in contact with the pleura (A) or vessels (B).

View larger version (187K): [in a new window]   Fig. 4A —Computer-aided detection missed moderate (4 mm diameter 10 mm) nodules (surrounded by green hexagons) that resulted from contact with pleura (A), lower density (CTpeak < -100 H) (B), or contact with normal intrapulmonary structures (e.g., major fissure [C] and vessel [D]). Some were missed inexplicably (E).

View larger version (100K): [in a new window]   Fig. 4B —Computer-aided detection missed moderate (4 mm diameter 10 mm) nodules (surrounded by green hexagons) that resulted from contact with pleura (A), lower density (CTpeak < -100 H) (B), or contact with normal intrapulmonary structures (e.g., major fissure [C] and vessel [D]). Some were missed inexplicably (E).

View larger version (174K): [in a new window]   Fig. 4C —Computer-aided detection missed moderate (4 mm diameter 10 mm) nodules (surrounded by green hexagons) that resulted from contact with pleura (A), lower density (CTpeak < -100 H) (B), or contact with normal intrapulmonary structures (e.g., major fissure [C] and vessel [D]). Some were missed inexplicably (E).

View larger version (153K): [in a new window]   Fig. 4D —Computer-aided detection missed moderate (4 mm diameter 10 mm) nodules (surrounded by green hexagons) that resulted from contact with pleura (A), lower density (CTpeak < -100 H) (B), or contact with normal intrapulmonary structures (e.g., major fissure [C] and vessel [D]). Some were missed inexplicably (E).

View larger version (163K): [in a new window]   Fig. 4E —Computer-aided detection missed moderate (4 mm diameter 10 mm) nodules (surrounded by green hexagons) that resulted from contact with pleura (A), lower density (CTpeak < -100 H) (B), or contact with normal intrapulmonary structures (e.g., major fissure [C] and vessel [D]). Some were missed inexplicably (E).

View larger version (177K): [in a new window]   Fig. 5 —Computer-aided detection (CAD) failed to detect large nodules (> 10 mm), presumably due to segmentation algorithm. Nodules contacted pleura (in circle) and normal intrapulmonary structures and therefore were extracted by CAD segmentation algorithm.

View larger version (29K): [in a new window]   Fig. 6 —Detection sensitivity between computer-aided detection (CAD) and radiologist in nodules at different locations.

View larger version (141K): [in a new window]   Fig. 7A —Transverse CT section shows computer-aided detection false-positive detections (in circle), which were vessels (A) or the pleura (B).

View larger version (144K): [in a new window]   Fig. 7B —Transverse CT section shows computer-aided detection false-positive detections (in circle), which were vessels (A) or the pleura (B).

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