Artificial intelligence-supported lung cancer detection by multi-institutional readers with multi-vendor chest radiographs: a retrospective clinical validation study.

We investigated the performance improvement of physicians with varying levels of chest radiology experience when using a commercially available artificial intelligence (AI)-based computer-assisted detection (CAD) software to detect lung cancer nodules on chest radiographs from multiple vendors. Chest radiographs and their corresponding chest CT were retrospectively collected from one institution between July 2017 and June 2018. Two author radiologists annotated pathologically proven lung cancer nodules on the chest radiographs while referencing CT. Eighteen readers (nine general physicians and nine radiologists) from nine institutions interpreted the chest radiographs. The readers interpreted the radiographs alone and then reinterpreted them referencing the CAD output. Suspected nodules were enclosed with a bounding box. These bounding boxes were judged correct if there was significant overlap with the ground truth, specifically, if the intersection over union was 0.3 or higher. The sensitivity, specificity, accuracy, PPV, and NPV of the readers' assessments were calculated. In total, 312 chest radiographs were collected as a test dataset, including 59 malignant images (59 nodules of lung cancer) and 253 normal images. The model provided a modest boost to the reader's sensitivity, particularly helping general physicians. The performance of general physicians was improved from 0.47 to 0.60 for sensitivity, from 0.96 to 0.97 for specificity, from 0.87 to 0.90 for accuracy, from 0.75 to 0.82 for PPV, and from 0.89 to 0.91 for NPV while the performance of radiologists was improved from 0.51 to 0.60 for sensitivity, from 0.96 to 0.96 for specificity, from 0.87 to 0.90 for accuracy, from 0.76 to 0.80 for PPV, and from 0.89 to 0.91 for NPV. The overall increase in the ratios of sensitivity, specificity, accuracy, PPV, and NPV were 1.22 (1.14-1.30), 1.00 (1.00-1.01), 1.03 (1.02-1.04), 1.07 (1.03-1.11), and 1.02 (1.01-1.03) by using the CAD, respectively. The AI-based CAD was able to improve the ability of physicians to detect nodules of lung cancer in chest radiographs. The use of a CAD model can indicate regions physicians may have overlooked during their initial assessment.

Ueda D ，Yamamoto A ，Shimazaki A ，Walston SL ，Matsumoto T ，Izumi N ，Tsukioka T ，Komatsu H ，Inoue H ，Kabata D ，Nishiyama N ，Miki Y ... -  《BMC CANCER》

Deep Convolutional Neural Network-based Software Improves Radiologist Detection of Malignant Lung Nodules on Chest Radiographs.

Sim Y ，Chung MJ ，Kotter E ，Yune S ，Kim M ，Do S ，Han K ，Kim H ，Yang S ，Lee DJ ，Choi BW ... -  《-》

Validation of a Deep Learning Algorithm for the Detection of Malignant Pulmonary Nodules in Chest Radiographs.

Yoo H ，Kim KH ，Singh R ，Digumarthy SR ，Kalra MK ... -  《JAMA Network Open》

Improved detection of pulmonary nodules on energy-subtracted chest radiographs with a commercial computer-aided diagnosis software: comparison with human observers.

Szucs-Farkas Z ，Patak MA ，Yuksel-Hatz S ，Ruder T ，Vock P ... -  《-》

An Artificial Intelligence-Based Chest X-ray Model on Human Nodule Detection Accuracy From a Multicenter Study.

Homayounieh F ，Digumarthy S ，Ebrahimian S ，Rueckel J ，Hoppe BF ，Sabel BO ，Conjeti S ，Ridder K ，Sistermanns M ，Wang L ，Preuhs A ，Ghesu F ，Mansoor A ，Moghbel M ，Botwin A ，Singh R ，Cartmell S ，Patti J ，Huemmer C ，Fieselmann A ，Joerger C ，Mirshahzadeh N ，Muse V ，Kalra M ... -  《JAMA Network Open》