Abstract

Background and ObjectiveTo investigate the effect of the slab thickness in maximum intensity projections (MIPs) on the candidate detection performance of a deep learning-based computer-aided detection (DL-CAD) system for pulmonary nodule detection in CT scans. MethodsThe public LUNA16 dataset includes 888 CT scans with 1186 nodules annotated by four radiologists. From those scans, MIP images were reconstructed with slab thicknesses of 5 to 50 mm (at 5 mm intervals) and 3 to 13 mm (at 2 mm intervals). The architecture in the nodule candidate detection part of the DL-CAD system was trained separately using MIP images with various slab thicknesses. Based on ten-fold cross-validation, the sensitivity and the F2 score were determined to evaluate the performance of using each slab thickness at the nodule candidate detection stage. The free-response receiver operating characteristic (FROC) curve was used to assess the performance of the whole DL-CAD system that took the results combined from 16 MIP slab thickness settings. ResultsAt the nodule candidate detection stage, the combination of results from 16 MIP slab thickness settings showed a high sensitivity of 98.0% with 46 false positives (FPs) per scan. Regarding a single MIP slab thickness of 10 mm, the highest sensitivity of 90.0% with 8 FPs/scan was reached before false positive reduction. The sensitivity increased (82.8% to 90.0%) for slab thickness of 1 to 10 mm and decreased (88.7% to 76.6%) for slab thickness of 15–50 mm. The number of FPs was decreasing with increasing slab thickness, but was stable at 5 FPs/scan at a slab thickness of 30 mm or more. After false positive reduction, the DL-CAD system, utilizing 16 MIP slab thickness settings, had the sensitivity of 94.4% with 1 FP/scan. ConclusionsThe utilization of multi-MIP images could improve the performance at the nodule candidate detection stage, even for the whole DL-CAD system. For a single slab thickness of 10 mm, the highest sensitivity for pulmonary nodule detection was reached at the nodule candidate detection stage, similar to the slab thickness usually applied by radiologists.

Highlights

  • After false positive reduction for the results combined from all maximum intensity projection (MIP) slab thickness settings, the Competition Performance Metric (CPM) was used to evaluate the performance of the Deep learning (DL)-computer-aided detection (CAD) system [24]

  • The sensitivity first went up from 82.8% to 90.0% with increasing slab thickness from 1 to 10 mm and gradually decreased to 76.6% with slab thicknesses from 15 to 50 mm. It had the highest sensitivity for the detection of nodules regardless of size or nodules > 10 mm at a MIP slab thickness of 10 mm

  • The program again showed a sensitivity of 90.0% with 9 mm MIP slab thickness images, which is close to the 10 mm MIP images, but more false positives were found with 9 mm MIP images compared to those of 10 mm

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Summary

Introduction

Vonder et al / Computer Methods and Programs in Biomedicine 196 (2020) 105620 stage [5,6]. Clinical research has demonstrated that the maximum intensity projection (MIP) technique is an effective method for radiologists to detect nodules on CT images [7,8,9]. With the implementation of lung cancer screening all over the world, the use of a computer-aided detection (CAD) system could be essential to reduce the fast-increasing workload of radiologists. To investigate the effect of the slab thickness in maximum intensity projections (MIPs) on the candidate detection performance of a deep learning-based computer-aided detection (DLCAD) system for pulmonary nodule detection in CT scans

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