Application value of a computer-aided diagnosis and management system for the detection of lung nodules

Abstract

Background Computer-aided diagnosis (CAD) systems can help reduce radiologists’ workload. This study assessed the value of a CAD system for the detection of lung nodules on chest computed tomography (CT) images. Methods The study retrospectively analyzed the CT images of patients who underwent routine health checkups between August 2019 and November 2019 at 3 hospitals in China. All images were first assessed by 2 radiologists manually in a blinded manner, which was followed by assessment with the CAD system. The location and classification of the lung nodules were determined. The final diagnosis was made by a panel of experts, including 2 associate chief radiologists and 1 chief radiologist at the radiology department. The sensitivity for nodule detection and false-positive nodules per case were calculated. Results A total of 1,002 CT images were included in the study, and the process was completed for 999 images. The sensitivity of the CAD system and manual detection was 90.19% and 49.88% (P<0.001), respectively. Similar sensitivity was observed between manual detection and the CAD system in lung nodules >15 mm (P=0.08). The false-positive nodules per case for the CAD system were 0.30±0.84 and those for manual detection were 0.24±0.68 (P=0.12). The sensitivity of the CAD system was higher than that of the radiologists, but the increase in the false-positive rate was only slight. Conclusions In addition to reducing the workload for medical professionals, a CAD system developed using a deep-learning model was highly effective and accurate in detecting lung nodules and did not demonstrate a meaningfully higher the false-positive rate.