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Updated: Feb 11, 2026

An Automated Culture System for Use in Preclinical Testing of Host-Directed Therapies for Tuberculosis
Published on: August 16, 2021
Accuracy of an automated system for tuberculosis detection on chest radiographs in high-risk screening
J Melendez1, L Hogeweg2, C I Sánchez2
1Diagnostic Image Analysis Group, Radboud University Medical Center, Nijmegen, Thirona, Nijmegen, The Netherlands.
Setting:
Tuberculosis (TB) screening programmes can be optimised by reducing the number of chest radiographs (CXRs) requiring interpretation by human experts.
Objective:
To evaluate the performance of computerised detection software in triaging CXRs in a high-throughput digital mobile TB screening programme.
Design:
A retrospective evaluation of the software was performed on a database of 38 961 postero-anterior CXRs from unique individuals seen between 2005 and 2010, 87 of whom were diagnosed with TB. The software generated a TB likelihood score for each CXR. This score was compared with a reference standard for notified active pulmonary TB using receiver operating characteristic (ROC) curve and localisation ROC (LROC) curve analyses.
Results:
On ROC curve analysis, software specificity was 55.71% (95%CI 55.21-56.20) and negative predictive value was 99.98% (95%CI 99.95-99.99), at a sensitivity of 95%. The area under the ROC curve was 0.90 (95%CI 0.86-0.93). Results of the LROC curve analysis were similar.
Conclusion:
The software could identify more than half of the normal images in a TB screening setting while maintaining high sensitivity, and may therefore be used for triage.
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