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Computer-Aided Detection in Screening CT for Pulmonary Nodules

Ren Yuan1, Patrick M. Vos2 and Peter L. Cooperberg2

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.


Figure 1
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  		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).

 

Figure 2
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  		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.

 

Figure 3
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  		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.

 

Figure 4
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  		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.

 

Figure 5
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  		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).

 

Figure 6
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  		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).

 

Figure 7
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  		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).

 

Figure 8
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  		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).

 

Figure 9
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  		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).

 

Figure 10
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  		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).

 

Figure 11
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  		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).

 

Figure 12
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  		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.

 

Figure 13
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  		Fig. 6 —Detection sensitivity between computer-aided detection (CAD) and radiologist in nodules at different locations.

 

Figure 14
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  		Fig. 7A —Transverse CT section shows computer-aided detection false-positive detections (in circle), which were vessels (A) or the pleura (B).

 

Figure 15
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  		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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