title: Automated detection of small pulmonary nodules in whole lung CT scans.
abstract: OBJECTIVE
  The objective of this work was to develop and evaluate a robust algorithm that automatically detects small solid pulmonary nodules in whole lung helical CT scans from a lung cancer screening study.
  
  
  METHODS
  We developed a three-stage detection algorithm for both isolated and attached nodules. The algorithm consisted of nodule search space demarcation, nodule candidates' generation, and a sequential elimination of false positives. Isolated nodules are nodules that are surrounded by lung parenchyma, whereas attached nodules are connected to large, dense structures such as pleural and/or mediastinal surface. Two large well-documented whole lung CT scan databases (Databases A and B) were created to train and test the detection algorithm. Database A contains 250 sequentially selected scans with 2.5-mm slice thickness that were obtained at Weill Medical College of Cornell University. With equipment upgrade at this college, a second database, Database B, was created containing 250 scans with a 1.25-mm slice thickness. A total of 395 and 482 nodules were identified in Databases A and B, respectively. In both databases, the majority of the nodules were isolated, comprising 72.1% and 82.3% of nodules in Databases A and B, respectively.
  
  
  RESULTS
  The detection algorithm was trained and tested on both Databases A and B. For isolated nodules with sizes 4 mm or larger, the algorithm achieved 94.0% sensitivity and 7.1 false positives per case (FPPC) for Database A (2.5 mm). Similarly, the algorithm achieved 91% sensitivity and 6.9 FPPC for Database B (1.25 mm). The algorithm achieved 92% sensitivity with 17.4 FPPC and 89% sensitivity with 5.5 FFPC for attached nodules with sizes 3 mm or larger in the Database A (2.5 mm) and Database B (1.25 mm), respectively.
  
  
  CONCLUSIONS
  The developed algorithm achieved practical performance for automated detection of both isolated and the more challenging attached nodules. The automated system will be a useful tool to assist radiologists in identifying nodules from whole lung CT scans in a clinical setting.
authors: School of Electrical and Computer Engineering, Rhodes Hall, Cornell University, Ithaca, NY 14850, USA. andy@ece.cornell.edu
authors: Andinet A
authors: AA
authors: Enquobahrie
authors: Anthony P
authors: AP
authors: Reeves
authors: David F
authors: DF
authors: Yankelevitz
authors: Claudia I
authors: CI
authors: Henschke
mesh_terms: D000465:Algorithms; D005189:False Positive Reactions; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D036542:Tomography, Spiral Computed / Q000379:methods*