Incidence Lung Cancer after a Negative CT Screening in the National Lung Screening Trial: Deep Learning-Based Detection of Missed Lung Cancers
Open Access
- 1 December 2020
- journal article
- research article
- Published by MDPI AG in Journal of Clinical Medicine
- Vol. 9 (12), 3908
- https://doi.org/10.3390/jcm9123908
Abstract
We aimed to analyse the CT examinations of the previous screening round (CTprev) in NLST participants with incidence lung cancer and evaluate the value of DL-CAD in detection of missed lung cancers. Thoracic radiologists reviewed CTprev in participants with incidence lung cancer, and a DL-CAD analysed CTprev according to NLST criteria and the lung CT screening reporting & data system (Lung-RADS) classification. We calculated patient-wise and lesion-wise sensitivities of the DL-CAD in detection of missed lung cancers. As per the NLST criteria, 88% (100/113) of CTprev were positive and 74 of them had missed lung cancers. The DL-CAD reported 98% (98/100) of the positive screens as positive and detected 95% (70/74) of the missed lung cancers. As per the Lung-RADS classification, 82% (93/113) of CTprev were positive and 60 of them had missed lung cancers. The DL-CAD reported 97% (90/93) of the positive screens as positive and detected 98% (59/60) of the missed lung cancers. The DL-CAD made false positive calls in 10.3% (27/263) of controls, with 0.16 false positive nodules per scan (41/263). In conclusion, the majority of CTprev in participants with incidence lung cancers had missed lung cancers, and the DL-CAD detected them with high sensitivity and a limited false positive rate.This publication has 22 references indexed in Scilit:
- National Lung Screening Trial: Variability in Nodule Detection Rates in Chest CT StudiesRadiology, 2013
- Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic ScreeningThe New England Journal of Medicine, 2011
- Evaluation of Reader Variability in the Interpretation of Follow-up CT Scans at Lung Cancer ScreeningRadiology, 2011
- The National Lung Screening Trial: Overview and Study DesignRadiology, 2011
- Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)Epidemiology, 2007
- Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and ElaborationPLoS Medicine, 2007
- Survival of Patients with Stage I Lung Cancer Detected on CT ScreeningThe New England Journal of Medicine, 2006
- Computerized scheme for automated detection of lung nodules in low-dose computed tomography images for lung cancer screening1Academic Radiology, 2004
- Lung Cancer: Performance of Automated Lung Nodule Detection Applied to Cancers Missed in a CT Screening ProgramRadiology, 2002
- Lung Cancers Missed at Low-Dose Helical CT Screening in a General Population: Comparison of Clinical, Histopathologic, and Imaging FindingsRadiology, 2002