title: Automatic detection of pulmonary nodules at spiral CT: clinical application of a computer-aided diagnosis system.
abstract: The aim of this study was to evaluate a computer-aided diagnosis (CAD) workstation with automatic detection of pulmonary nodules at low-dose spiral CT in a clinical setting for early detection of lung cancer. Eighty-eight consecutive spiral-CT examinations were reported by two radiologists in consensus. All examinations were reviewed using a CAD workstation with a self-developed algorithm for automatic detection of pulmonary nodules. The algorithm is designed to detect nodules with diameters of at least 5 mm. A total of 153 nodules were detected with at least one modality (radiologists in consensus, CAD, 85 nodules with diameter < 5 mm, 68 with diameter > or = 5 mm). The results of automatic nodule detection were compared to nodules detected with any modality as gold standard. Computer-aided diagnosis correctly identified 26 of 59 (38%) nodules with diameters > or = 5 mm detected by visual assessment by the radiologists; of these, CAD detected 44% (24 of 54) nodules without pleural contact. In addition, 12 nodules > or = 5 mm were detected which were not mentioned in the radiologist's report but represented real nodules. Sensitivity for detection of nodules > or = 5 mm was 85% (58 of 68) for radiologists and 38% (26 of 68) for CAD. There were 5.8+/-3.6 false-positive results of CAD per CT study. Computer-aided diagnosis improves detection of pulmonary nodules at spiral CT and is a valuable second opinion in a clinical setting for lung cancer screening despite of its still limited sensitivity.
authors.affiliation: Department of Clinical Radiology, University of Muenster, 48129 Muenster, Germany. dag.wormanns@uni-muenster.de
authors.forename: Dag
authors.initials: D
authors.lastname: Wormanns
authors.forename: Martin
authors.initials: M
authors.lastname: Fiebich
authors.forename: Mustafa
authors.initials: M
authors.lastname: Saidi
authors.forename: Stefan
authors.initials: S
authors.lastname: Diederich
authors.forename: Walter
authors.initials: W
authors.lastname: Heindel
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D003936:Diagnosis, Computer-Assisted; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*