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True Detection Versus “Accidental” Detection of Small Lung Cancer by a Computer-Aided Detection (CAD) Program on Chest Radiographs

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Abstract

To evaluate the number of actual detections versus “accidental” detections by a computer-aided detection (CAD) system for small nodular lung cancers (≤30 mm) on chest radiographs, using two different criteria for measuring performance. A Food-and-Drug-Administration-approved CAD program (version 1.0; Riverain Medical) was applied to 34 chest radiographs with a “radiologist-missed” nodular cancer and 36 radiographs with a radiologist-mentioned nodule (a newer version 3.0 was also applied to the 36-case database). The marks applied by this CAD system consisted of 5-cm-diameter circles. A strict “nodule-in-center” criterion and a generous “nodule-in-circle” criterion were compared as methods for the calculation of CAD sensitivity. The increased sensitivities by the nodule-in-circle criterion were considered as nodules detected by chance. The number of false-positive (FP) marks was also analyzed. For the 34 radiologist-missed cancers, the nodule-in-circle criterion caused eight more cancers (24%) to be detected by chance, as compared to the nodule-in-center criterion, when using the version 1.0 results. For the 36 radiologist-mentioned nodules, the nodule-in-circle criterion caused seven more lesions (19%) to be detected by chance, as compared to the nodule-in-center criterion, when using the version 1.0 results, and three more lesions (8%) to be detected by chance when using the version 3.0 results. Version 1.0 yielded a mean of six FP marks per image, while version 3.0 yielded only three FP marks per image. The specific criteria used to define true- and false-positive CAD detections can substantially influence the apparent accuracy of a CAD system.

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Authors and Affiliations

  1. Kurt Rossmann Laboratories for Radiologic Image Research, Department of Radiology, MC2026, The University of Chicago, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA

    Feng Li, Roger Engelmann, Kunio Doi & Heber MacMahon

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  1. Feng Li
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  2. Roger Engelmann
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  3. Kunio Doi
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  4. Heber MacMahon
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Correspondence to Feng Li.

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Li, F., Engelmann, R., Doi, K. et al. True Detection Versus “Accidental” Detection of Small Lung Cancer by a Computer-Aided Detection (CAD) Program on Chest Radiographs. J Digit Imaging 23, 66–72 (2010). https://doi.org/10.1007/s10278-009-9201-0

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  • DOI: https://doi.org/10.1007/s10278-009-9201-0

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