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2156-751472017Journal of clinical imaging scienceJ Clin Imaging SciComputer-aided Detection Fidelity of Pulmonary Nodules in Chest Radiograph.88810.4103/jcis.JCIS_75_16The most ubiquitous chest diagnostic method is the chest radiograph. A common radiographic finding, quite often incidental, is the nodular pulmonary lesion. The detection of small lesions out of complex parenchymal structure is a daily clinical challenge. In this study, we investigate the efficacy of the computer-aided detection (CAD) software package SoftView™ 2.4A for bone suppression and OnGuard™ 5.2 (Riverain Technologies, Miamisburg, OH, USA) for automated detection of pulmonary nodules in chest radiographs.We retrospectively evaluated a dataset of 100 posteroanterior chest radiographs with pulmonary nodular lesions ranging from 5 to 85 mm. All nodules were confirmed with a consecutive computed tomography scan and histologically classified as 75% malignant. The number of detected lesions by observation in unprocessed images was compared to the number and dignity of CAD-detected lesions in bone-suppressed images (BSIs).SoftView™ BSI does not affect the objective lesion-to-background contrast. OnGuard™ has a stand-alone sensitivity of 62% and specificity of 58% for nodular lesion detection in chest radiographs. The false positive rate is 0.88/image and the false negative (FN) rate is 0.35/image. From the true positive lesions, 20% were proven benign and 80% were malignant. FN lesions were 47% benign and 53% malignant.We conclude that CAD does not qualify for a stand-alone standard of diagnosis. The use of CAD accompanied with a critical radiological assessment of the software suggested pattern appears more realistic. Accordingly, it is essential to focus on studies assessing the quality-time-cost profile of real-time (as opposed to retrospective) CAD implementation in clinical diagnostics.DelliosNikolaosNDepartment of Experimental Radiology, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller University, Jena, Germany; Institute of Radiology, Suedharz Hospital Nordhausen gGmbH, Nordhausen, Germany.TeichgraeberUlfUDepartment of Experimental Radiology, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich-Schiller University, Jena, Germany.ChelaruRobertRInstitute of Radiology, Suedharz Hospital Nordhausen gGmbH, Nordhausen, Germany.MalichAnsgarAInstitute of Radiology, Suedharz Hospital Nordhausen gGmbH, Nordhausen, Germany.PapageorgiouIsmini EIEInstitute of Radiology, Suedharz Hospital Nordhausen gGmbH, Nordhausen, Germany.engJournal Article20170220
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