Abstract

We present a computer-aided diagnosis system (CADx) for the automatic categorization of solid, part-solid and non-solid nodules in pulmonary computerized tomography images using a Convolutional Neural Network (CNN). Provided with only a two-dimensional region of interest (ROI) surrounding each nodule, our CNN automatically reasons from image context to discover informative computational features. As a result, no image segmentation processing is needed for further analysis of nodule attenuation, allowing our system to avoid potential errors caused by inaccurate image processing. We implemented two computerized texture analysis schemes, classification and regression, to automatically categorize solid, part-solid and non-solid nodules in CT scans, with hierarchical features in each case learned directly by the CNN model. To show the effectiveness of our CNN-based CADx, an established method based on histogram analysis (HIST) was implemented for comparison. The experimental results show significant performance improvement by the CNN model over HIST in both classification and regression tasks, yielding nodule classification and rating performance concordant with those of practicing radiologists. Adoption of CNN-based CADx systems may reduce the inter-observer variation among screening radiologists and provide a quantitative reference for further nodule analysis.

Highlights

  • Consistent identification of nodule malignancy in CT images[7,8,9]

  • The accuracy of the convolutional neural network (CNN) trained with slice strategy ALL (CNN-ALL) was 2% higher than the CNN with strategy SINGLE (CNN-SINGLE), and at least 18% higher than histogram analysis (HIST) with respect to the ALL and SINGLE strategies

  • For precision and recall metrics, the CNN-ALL outperformed the schemes of CNN-SINGLE, HIST-ALL and HIST-SINGLE

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Summary

Introduction

Consistent identification of nodule malignancy in CT images[7,8,9]. When successfully implemented, CADx systems are expected to improve diagnostic outcomes[6] and reduce unnecessary biopsy, thoracotomy and surgery[10]. Recent clinical studies have suggested that non-solid and especially part-solid nodules may be more likely than solid nodules to be confirmed as pulmonary adenocarcinoma[11,12,13,14,15]. In the context of conventional CADx schemes[12, 20], the process of image segmentation commonly requires user intervention (e.g., manual refinement[22, 23], candidate selection[24], etc.) to obtain accurate contours. We develop a new CADx method to automatically categorize solid, part-solid and non-solid nodules in CT images, without depending on image segmentation. Our work serves as a new, segmentation-free, computerized reference for nodule attenuation

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