title: Improved detection of lung nodules on chest radiographs using a commercial computer-aided diagnosis system.
abstract: OBJECTIVE
  The aim of this study was to evaluate the usefulness of a new commercially available computer-aided diagnosis (CAD) system with an automated method of detecting nodules due to lung cancers on chest radiograph.
  
  
  METHODS
  For patients with cancer, 45 cases with solitary lung nodules up to 25 mm in diameter (nodule size range, 8-25 mm in diameter; mean, 18 mm; median, 20 mm) were used. For healthy patients, 45 cases were selected on the basis of confirmation on chest CT. All chest radiographs were obtained with a computed radiography system. The CAD output images were produced with a newly developed CAD system, which consisted of an image server including CAD software called EpiSight/XR. Eight radiologists (four board-certified radiologists and four radiology residents) participated in observer performance studies and interpreted both the original radiographs and CAD output images using a sequential testing method. The observers' performance was evaluated with receiver operating characteristic analysis.
  
  
  RESULTS
  The average area under the curve value increased significantly from 0.924 without to 0.986 with CAD output images. Individually, the use of CAD output images was more beneficial to radiology residents than to board-certified radiologists.
  
  
  CONCLUSIONS
  This CAD system for digital chest radiographs can assist radiologists and has the potential to improve the detection of lung nodules due to lung cancer.
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health School of Medicine, Iseigaoka 1-1, Yahatanisi-ku, Kitakyushu-shi 807-8555, Japan. kakeda@med.uoeh-u.ac.jp
authors.forename: Shingo
authors.initials: S
authors.lastname: Kakeda
authors.forename: Junji
authors.initials: J
authors.lastname: Moriya
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sato
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Aoki
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakata
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Oda
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Katsuragawa
authors.forename: Keiji
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Kunio
authors.initials: K
authors.lastname: Doi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation*; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000295:instrumentation*; D013902:Radiography, Thoracic / Q000295:instrumentation / Q000379:methods; D015203:Reproducibility of Results; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*