Improved detection of lung nodules on chest radiographs using a commercial computer-aided diagnosis system

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.

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.

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.

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.