Purpose: To compare visual detection and computer aided diagnosis (CAD) for detection of non-solid nodules (NSN) and part-solid nodules (PSN), in a lung cancer screening trial. Methods and Materials: Baseline low-dose computed tomography (LDCT) of 2303 subjects were assessed by 2 independent operators: a) visual detection (VD); b) CAD software (CIRRUS Lung Screening). CAD was run also on first and second incidence round. Rate of agreement was calculated by weighted k test. Sensitivity and negative predictive value (NPV) were calculated according to cumulative number of subjects with detected nodules (VD and CAD). LDCT features were compared between CAD-only and VD-only detected nodules. Results: Nodules were detected in 215/2303 subjects (dominant nodule: 171/215 NSN and 44/215 PSN), notably 149 were CAD-only detected (113 NSN and 36 PSN), 27 were VD-only detected (25 NSN and 2 PSN), and 39 were CAD and VD detected (33 NSN and 6 PSN). The agreement was fair (weighted k=0.276). Sensitivity and NPV for CAD 87.4\% and 98.7\%, and for VD 30.7\% and 93.3\%. Automatic and manual caliper were similar for the assessment of maximum diameter (p=0.111). CAD-only and VD-only detected nodules showed similar nodule diameter (p=0.727) and proportion of PSN (p=0.073). Volume of CAD-only detected nodules was significantly smaller (p=0.019). Among the 27 VD-only detected nodules, 11 NSN were subsequently detected by CAD at the incidence rounds. Conclusion: Detection of NSN and PSN showed only fair agreement between VD and CAD. Combined assessment of LDCT by both VD and CAD is needed to achieve optimal sensitivity.
Subsolid and part-solid nodules in lung cancer screening: comparison between visual and computer-aided detection
M. Silva, G. Capretti, N. Sverzellati, C. Jacobs, F. Ciompi, B. van Ginneken, C. Schaefer-Prokop, A. Marchianò and U. Pastorino
European Congress of Radiology 2017.