Computer-aided detection for the identification of pulmonary nodules in pediatric oncology patients: initial experience

Background Computer-aided detection (CAD) has been shown to increase the sensitivity for detection of pulmonary nodules in adults. This study reports initial findings utilizing a CAD system for the detection of pediatric pulmonary nodules. Objective To assess the performance of CAD and pediatric radiologists in the detection of pediatric pulmonary nodules. Materials and methods CT scans from a series of pediatric patients with known primary tumors and lung nodules were analyzed by four radiologists and a commercially available CAD system. IRB approval was obtained. Sensitivities were calculated for detection according to nodule size and location. Results In 24 children (age 3–18 years) 173 nodules were identified. Overall the sensitivity of CAD was 34%, but the sensitivity of CAD for detection of nodules 4.0 mm or larger was 80%. Overall radiologist sensitivity ranged from 68% to 79%. There were 0.9 CAD false-positives and 0.3–2.4 radiologist false-positives per study. Conclusion CAD in our pediatric oncology patients had good sensitivity for detection of lung nodules 4 mm and larger with a low number of false-positives. However, the sensitivity was considerably less for nodules smaller than 4 mm.