scholarly journals Automated detection of lung nodules and coronary artery calcium using artificial intelligence on low-dose CT scans for lung cancer screening: accuracy and prognostic value

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jordan Chamberlin ◽  
Madison R. Kocher ◽  
Jeffrey Waltz ◽  
Madalyn Snoddy ◽  
Natalie F. C. Stringer ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Lung Cancer ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Low Dose ◽  
Chest Ct ◽  
Lung Nodules ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Cardiopulmonary Outcomes

Abstract Background Artificial intelligence (AI) in diagnostic radiology is undergoing rapid development. Its potential utility to improve diagnostic performance for cardiopulmonary events is widely recognized, but the accuracy and precision have yet to be demonstrated in the context of current screening modalities. Here, we present findings on the performance of an AI convolutional neural network (CNN) prototype (AI-RAD Companion, Siemens Healthineers) that automatically detects pulmonary nodules and quantifies coronary artery calcium volume (CACV) on low-dose chest CT (LDCT), and compare results to expert radiologists. We also correlate AI findings with adverse cardiopulmonary outcomes in a retrospective cohort of 117 patients who underwent LDCT. Methods A total of 117 patients were enrolled in this study. Two CNNs were used to identify lung nodules and CACV on LDCT scans. All subjects were used for lung nodule analysis, and 96 subjects met the criteria for coronary artery calcium volume analysis. Interobserver concordance was measured using ICC and Cohen’s kappa. Multivariate logistic regression and partial least squares regression were used for outcomes analysis. Results Agreement of the AI findings with experts was excellent (CACV ICC = 0.904, lung nodules Cohen’s kappa = 0.846) with high sensitivity and specificity (CACV: sensitivity = .929, specificity = .960; lung nodules: sensitivity = 1, specificity = 0.708). The AI findings improved the prediction of major cardiopulmonary outcomes at 1-year follow-up including major adverse cardiac events and lung cancer (AUCMACE = 0.911, AUCLung Cancer = 0.942). Conclusion We conclude the AI prototype rapidly and accurately identifies significant risk factors for cardiopulmonary disease on standard screening low-dose chest CT. This information can be used to improve diagnostic ability, facilitate intervention, improve morbidity and mortality, and decrease healthcare costs. There is also potential application in countries with limited numbers of cardiothoracic radiologists.

Coronary Artery Calcium Can Predict All-Cause Mortality and Cardiovascular Events on Low-Dose CT Screening for Lung Cancer

2012 ◽  
Vol 198 (3) ◽  
pp. 505-511 ◽  
Author(s):  
Peter C. Jacobs ◽  
Martijn J. A. Gondrie ◽  
Yolanda van der Graaf ◽  
Harry J. de Koning ◽  
Ivana Isgum ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cardiovascular Events ◽  
Low Dose ◽  
Ct Screening ◽  
Low Dose Ct ◽  
All Cause Mortality

Lung Nodule Detectability of Artificial Intelligence-assisted CT Image Reading in Lung Cancer Screening

2021 ◽  
Vol 17 ◽  
Author(s):  
Yaping Zhang ◽  
Beibei Jiang ◽  
Lu Zhang ◽  
Marcel J.W. Greuter ◽  
Geertruida H. de Bock ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Lung Cancer ◽  
Detection Rate ◽  
Lung Nodule ◽  
Chest Ct ◽  
Lung Nodules ◽  
Lung Nodule Detection ◽  
Radiology Reports ◽  
Nodule Detection ◽  
Assisted Reading

Background: Artificial intelligence (AI)-based automatic lung nodule detection system improves the detection rate of nodules. It is important to evaluate the clinical value of AI system by comparing AI-assisted nodule detection with actu-al radiology reports. Objective: To compare the detection rate of lung nodules between the actual radiology reports and AI-assisted reading in lung cancer CT screening. Methods: Participants in chest CT screening from November to December 2019 were retrospectively included. In the real-world radiologist observation, 14 residents and 15 radiologists participated to finalize radiology reports. In AI-assisted reading, one resident and one radiologist reevaluated all subjects with the assistance of an AI system to lo-cate and measure the detected lung nodules. A reading panel determined the type and number of detected lung nodules between these two methods. Results: In 860 participants (57±7 years), the reading panel confirmed 250 patients with >1 solid nodule, while radiolo-gists observed 131, lower than 247 by AI-assisted reading (p<0.001). The panel confirmed 111 patients with >1 non-solid nodule, whereas radiologist observation identified 28, lower than 110 by AI-assisted reading (p<0.001). The accuracy and sensitivity of radiologist observation for solid nodules were 86.2% and 52.4%, lower than 99.1% and 98.8% by AI-assisted reading, respectively. These metrics were 90.4% and 25.2% for non-solid nodules, lower than 98.8% and 99.1% by AI-assisted reading, respectively. Conclusion: Comparing with the actual radiology reports, AI-assisted reading greatly improves the accuracy and sensi-tivity of nodule detection in chest CT, which benefits lung nodule detection, especially for non-solid nodules.

scholarly journals Evaluation of an AI-based, automatic coronary artery calcium scoring software

2019 ◽  
Vol 30 (3) ◽  
pp. 1671-1678 ◽  
Author(s):  
Mårten Sandstedt ◽  
Lilian Henriksson ◽  
Magnus Janzon ◽  
Gusten Nyberg ◽  
Jan Engvall ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Rank Test ◽  
Agatston Score ◽  
Risk Category ◽  
Automatic Method ◽  
Calcium Scoring ◽  
Excellent Correlation ◽  
Automatic Software

Abstract Objectives To evaluate an artificial intelligence (AI)–based, automatic coronary artery calcium (CAC) scoring software, using a semi-automatic software as a reference. Methods This observational study included 315 consecutive, non-contrast-enhanced calcium scoring computed tomography (CSCT) scans. A semi-automatic and an automatic software obtained the Agatston score (AS), the volume score (VS), the mass score (MS), and the number of calcified coronary lesions. Semi-automatic and automatic analysis time were registered, including a manual double-check of the automatic results. Statistical analyses were Spearman’s rank correlation coefficient (⍴), intra-class correlation (ICC), Bland Altman plots, weighted kappa analysis (κ), and Wilcoxon signed-rank test. Results The correlation and agreement for the AS, VS, and MS were ⍴ = 0.935, 0.932, 0.934 (p < 0.001), and ICC = 0.996, 0.996, 0.991, respectively (p < 0.001). The correlation and agreement for the number of calcified lesions were ⍴ = 0.903 and ICC = 0.977 (p < 0.001), respectively. The Bland Altman mean difference and 1.96 SD upper and lower limits of agreements for the AS, VS, and MS were − 8.2 (− 115.1 to 98.2), − 7.4 (− 93.9 to 79.1), and − 3.8 (− 33.6 to 25.9), respectively. Agreement in risk category assignment was 89.5% and κ = 0.919 (p < 0.001). The median time for the semi-automatic and automatic method was 59 s (IQR 35–100) and 36 s (IQR 29–49), respectively (p < 0.001). Conclusions There was an excellent correlation and agreement between the automatic software and the semi-automatic software for three CAC scores and the number of calcified lesions. Risk category classification was accurate but showing an overestimation bias tendency. Also, the automatic method was less time-demanding. Key Points • Coronary artery calcium (CAC) scoring is an excellent candidate for artificial intelligence (AI) development in a clinical setting. • An AI-based, automatic software obtained CAC scores with excellent correlation and agreement compared with a conventional method but was less time-consuming.

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