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This paper describes a system for detecting pulmonary nodules in CT images. It aims to label individual image voxels in accordance to one of a number of anatomical (pulmonary vessels or junctions), pathological (nodules), or spurious (noise) events. The approach is orthodoxly Bayesian, with particular care taken in the objective establishment of prior probabilities and the incorporation of relevant medical knowledge. We provide, under explicit modeling assumptions, closed-form expressions for all the probability distributions involved. The technique is applied to real data, and we present a discussion of its performance.

Thin-slice computer tomography provides high-resolution images that facilitate the diagnosis of early-stage lung cancer. However, the sheer size of the CT volumes introduces variability in radiological readings, driving the need for automated detection systems. The main contribution of this paper is a technique for combining geometric and intensity models with the analysis of local curvature for detecting pulmonary lesions in CT. The local shape at each voxel is represented via the principal curvatures of its associated isosurface without explicitly extracting the isosurface. The comparison of these curvatures to values derived from analytical shape models is then used to label the voxel as belonging to particular anatomical structures, e.g., nodules or vessels. The algorithm was evaluated on 242 CT exams with expert-determined ground truth. The performance of the algorithm is quantified by free-response receiver-operator characteristic curves, as well as by its potential for improvement in radiologist sensitivity.

Rationale and Objectives: In this study, we developed a prototype model-based computer aided detection (CAD) system designed to automatically detect both solid and subsolid pulmonary nodules in computed tomography (CT) images. By using this CAD algorithm, along with the radiologist's initial interpretation, we aim to improve the sensitivity of radiologic readings of CT lung exams., Materials and Methods: We have developed a model-based CAD algorithm through the use of precise mathematic models that capture scanner physics and anatomic information. Our model-based CAD algorithm uses multiple segmentation algorithms to extract noteworthy structures in the lungs and a Bayesian statistical model selection framework to determine the probability of various anatomical events throughout the lung. We tested this algorithm on 50 low-dose CT lung cancer screening cases in which ground truth was produced through readings by three expert chest radiologists., Results: Using this model-based CAD algorithm on 50 low-dose CT cases, we measured potential sensitivity improvements of 7% and 5% in two radiologists with respect to all noncalcified nodules, solid and subsolid, greater than 5 mm in diameter. The third radiologist did not miss any nodules in the ground truth set. The CAD algorithm produced 8.3 false positives per case., Conclusion: Our prototype CAD system demonstrates promising results as a tool to improve the quality of radiologic readings by increasing radiologist sensitivity. A significant advantage of this model-based approach is that it can be easily extended to support additional anatomic models as clinical understanding and scanning practices improve.