Rationale and objectives: Computer-aided diagnosis (CAD) schemes for chest radiography are being developed with which to alert radiologists to possible lesions, and thus potentially improve diagnostic accuracy. However, CAD schemes have not been tested on a large number of clinical cases. The authors identify design parameters that would be required for development of an intelligent workstation.
Methods: Computer-aided diagnosis programs were applied for the automated detection of lung nodules, cardiomegaly, and interstitial infiltrates to 310 consecutive chest radiographs, and were analyzed for potential usefulness and limitations. Computer-aided diagnosis output was evaluated by radiologists and physicists for accuracy and technical problems, respectively.
Results: Approximately 70% of the results were judged to be potentially acceptable; however, the number of false-positive findings was relatively high. Technical problems included failure to detect subtle abnormalities and the occurrence of false-positive detections caused by normal anatomical structures.
Conclusion: Computer-aided diagnosis has the potential to be a valuable aid to radiologists in clinical practice, if certain technical problems can be overcome and if optimal operating points can be defined for clinical use.